Overview of the Family Assessment Service (FAS)
The Anna Freud Learning Network spoke to Katherine Mautner, Senior Clinician at the Centre's Specialist Clinical Services, Trauma and Maltreatment (STAMS) unit regarding the role of the Family Assessment Service as part of our Spotlight on Improving Systems and Decision Making.
What does the Family Assessment Service at the Anna Freud National Centre for Children and Families do?
FAS is a multi-disciplinary assessment and treatment team offering:
- Time limited multi-disciplinary assessments of families where there are concerns about serious risks to the child(ren), often where care proceedings have either been initiated in the Family Court or are being considered.
- A range of therapeutic mentalization informed treatments for families and children who have experienced trauma or maltreatment including post-adoption support and Child and Family Traumatic Stress Intervention (CFTSI).
- Support to families who have been traumatically bereaved and provide evidence-based intervention where indicated
- Training in trauma-focused CBT to Child and Adolescent Mental Health Services in the UK and around Europe
What are the different specialisms within the team?
The clinicians in the team are all specialists in working with children, parents and other family members/carers to promote the best interests of the child(ren) across the age range. They come from a range of therapeutic disciplines including: Clinical Psychology, Systemic Family Therapy, Adult Psychiatry, Child and Adolescent Psychotherapy, Play Therapy and Social Work.
Areas of specialism include working with families: where abuse or neglect has been experienced over multiple generations; who have complicated relationships and histories with services; who have experienced serious and/or chronic trauma; to promote recovery after trauma; to promote reflective parenting in order to improve the emotional care available to the child(ren).
What is the assessment model used at the Family Assessment Service?
The model of assessment used in FAS places the child at the centre of our thinking and our practice in 4 ways:
- Every assessment involves at least one clinician who ‘takes the lead’ on assessing the child(ren). This ensures that the views, perspectives and needs of the child are advocated for throughout the process and avoids the tendency for adults’ issues to become central to decision making. Every family is presented in a multi-disciplinary case discussion, which allows clinicians’ perspectives to be challenged during the assessment and brings them back to thinking about the child.
- We use a standard template of 9 questions to structure our response to the legal instructions. These 9 questions focus on the child’s broad needs and ensure that we do not just think about risk but also consider their wider developmental needs and their parents’ capacity to meet these needs into the future.
- We feedback directly to parents and where possible to children in order to best communicate our opinions and recommendations and to counter the common experience of assessments being ‘done to’ rather than ‘done with’. Clinicians write an adapted version of the report for children and young people to keep and where possible, visit them after the assessment to talk through their recommendations directly with the child.
- Where appropriate, we offer creative treatment packages after assessment that meet children and families’ needs in a way that standard services offered elsewhere might not be able to.
Observation forms a large part of our assessment of children and their relationships with their parents/family members. However, we also use standardized tools to measure things like attachment style (such as the Child Attachment Interview and Story Stem Assessments) in order to provide robust evidence of our findings that take into account the way the child presents in different setting and in response to different approaches.
What are the benefits of a multi-disciplinary model of assessment?
The main benefit of the multi-disciplinary model of assessment in the Family Assessment Service is that every child and family is thought about from several perspectives and every recommendation is tested and informed by knowledge and experience of several expert clinicians. This kind of assessment reduces the possibility that exists with individual experts, that assessments are skewed by a single clinical background and an individual relationship with a family. Our clinicians are used to challenging each other to justify the position they have taken during an assessment and either justifying or revising their opinions through discussion where appropriate. In our experience, this improves the quality of the assessment and equips the clinicians to make carefully judged, robust recommendations in the best interests of children.