Family Assessment Visit and Report Guidelines

8/2/2019 Family Assessment Visit and Report Guidelines

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Guidelines: Year Two Family Assessment Visit and Report

THE DEPARTMENT OF COMMUNITY MEDICINE

AND

THE DEPARTMENT OF PSYCHIATRY AND

BEHAVIORAL SCIENCES

UNDERSTANDING AND ASSESSING

FAMILIES IN PRIMARY CARE MEDICINE

06/10 Year Two Family Assessment Visit and Report Guide 1 of 19


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YEAR TWO FAMILY ASSESSMENT

Overview

During the Year Two Visit, the student will re-visit the families that were assessed during

the Year One Visit. The student will reassess the families, revise and update the ChronicIllness Report, and complete a Preliminary Family Systems Analysis. The connectionbetween family function and attitudes toward health and the health care system should

become more clearly focused during the Year Two Visit and articulated in the Year Two

Family Assessment Report. Further emphasis in the Year Two Visit and Report is uponchanges that have occurred in the family and how they distort or support health and

illness.

Review of criteria for family selection:

1. Year One Visit: The preceptor selects two families from his or her patientpopulation. The student will follow and study the dynamics of the families, aswell as health and illness patterns throughout his/her four years of medical school.

The preceptor should introduce the families to the student.

2. Year Two Visit: The student conducts follow-up visits with the familiesinterviewed in the Year One Visit. The purpose of the Year Two Family

Assessment Reports is to document updates and changes through the continueduse of the Genogram, Typology of the Illness, Time Phase of the Illness, Family

APGAR questionnaires, and with several new required elements that will help the

student establish a more focused picture of family system dynamics. Each of these

elements is discussed below.

3. Guidelines for the selection of the families is the same as in the Year One Visitand are as follows:

a. At least one person in either family with a chronic disease requiring longterm care (diabetes, mental retardation, etc.) or a terminal illness*

b. One indigent familyc. One family with health insurance or Medicaid benefitsd. Each of the two families should be at a different life stage

*Required

4. The student spends sufficient time with each family to establish a personal andprofessional relationship and to elicit appropriate information.5. In the event that a family is no longer available for study from one visit to the

next, the student is required to select another family with the support of thepreceptor.



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IMPORTANT NOTES:

1. If the patient is deceased or placed in care elsewhere and the family is stillavailable, do the family assessment on the same family. This will give the student

a chance to see the family effects of a significant transition to another life stage.

2. If the family itself is no longer available (e.g. they have moved, or the student isin a new site), utilize the Year One Family Assessment Report guidelines (onlineathttp://medicine.mercer.edu/Departments/Community%20Medicine/cm_familysystems)

and conduct an initial family assessment with a family assigned by the preceptor.

Use the guidelines for Family One on pages 43 and 44. Documentation should beprovided as to why the previously assessed family is no longer available. This

should be included in the first paragraph of the Report. This will also indicate

why you did not turn in copies of the first assessment.

http://medicine.mercer.edu/Departments/Community%20Medicine/cm_familysystemshttp://medicine.mercer.edu/Departments/Community%20Medicine/cm_familysystemshttp://medicine.mercer.edu/Departments/Community%20Medicine/cm_familysystemshttp://medicine.mercer.edu/Departments/Community%20Medicine/cm_familysystems


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The Year Two Family Assessment Report

Objectives and Activities:

1. Return to the families interviewed in the Year One Visit and conduct in-depth andfocused family evaluations to gather information regarding changes in the illnessand the family.

2. Complete an update of the Year One Chronic Illness Report that was writtenfollowing your Year One Visit interview ofFamily One. Details are providedbelow.

3. Complete a Preliminary Family Systems Analysis on both families. Details areprovided below.

Requirements:

1. To write an updated Chronic Illness Report on Family One interviewed during theYear One Visit.The report is to be double spaced and should be organized by theheadings provided in the following Year Two Family Assessment Report Outline.

2. To write a Preliminary Family Systems Analysis on both families. The report is to bedouble spaced and should be organized by the headings provided in the followingYear Two Family Assessment Report Outline.

3. TO INCLUDE COPIES OF THE YEAR ONE FAMILY ASSESSMENTREPORTS AS APPENDICES. YOUR YEAR TWO FAMILY ASSESSMENT

REPORTS WILL BE RETURNED TO YOU UNLESS THE YEAR ONEREPORTS ARE INCLUDED AS APPENDICES!! THERE ARE NO

EXCEPTIONS!!



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YEAR TWOFAMILY ASSESSMENT REPORT OUTLINE

Family One

1. UPDATED CHRONIC ILLNESS REPORTa. Write a 2-3 page update to the Year One Chronic Illness Report. Emphasis is to be onchanges that have occurred in the areas below. Use the following headings in this section of

your paper and address each topic:

1. History of the Presenting Illness/Problem2. Impact of the Illness on the Individual3. Impact of the Illness on the Family4. Meaning of the Illness and Family Resources5. Impact of the Illness on the Physicians Office

2. UPDATED TIMELINE OF THE ILLNESSa. Use the Timeline of the Illness form

3. UPDATED TYPOLOGY OF THE ILLNESSa. Use the Typology of the Illness form

4. NEW FAMILY APGAR QUESTIONNAIRESa. Use the Family APGAR form included in this document.b. Have at least two family members complete the APGAR, preferably the patient and a

primary caregiver. Other family members/caregivers may also complete the APGAR.c. Write a brief summary of changes in family members responses to the Family APGAR

Questionnaire from Year One to Year Two.

5.

UPDATED SCREEMa. Review, Eliciting Information About Family Resources: How to use the SCREEM. Usingthese and other questions, gather information about the familys resources and how theyimpact the familys health and the illness.

b. Write a summary of the information gathered in each area of the SCREEM, specificallynoting how CHANGE in the resources or lack of resources has affected the patient, the

family, and the treatment of the illness since your last visit.



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Family Two

1. NEW FAMILY APGAR QUESTIONNAIRESa. Use the Family APGAR form included in this document.b.

Have at least two family members complete the APGAR, preferably the patientand a primary caregiver. Other family members/caregivers may also complete the

APGAR.

c. Write a brief summary of changes in family members responses to the FamilyAPGAR Questionnaire from Year One to Year Two.

2. UPDATED SCREEMa. Review, Eliciting Information About Family Resources: How to use the

SCREEM. Using these and other questions, gather information about the

familys resources and how they impact the familys health and the illness.

b. Write a summary of the information gathered in each area of the SCREEM,specifically noting how CHANGE in the resources or lack of resources hasaffected the patient, the family, and the treatment of the illness since your last

visit.



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IMPORTANT NOTE:

If interviewing Family One for the first time, follow the instructions for the Year One Family AssessmentReport. BE SURE TO DOCUMENT IN THE FIRST PARAGRAPH THAT THIS IS A DIFFERENT

FAMILY THAN ASSESSED IN THE YEAR ONE FAMILY ASSESSMENT REPORT, AND WHY

THE FIRST FAMILY WAS NOT AVAILABLE FOR INTERVIEW.

Both Families

1. PRELIMINARY FAMILY SYSTEMS ANALYSISa. Demographic Data

1) Determine name (first name and last initial only), age, occupation, education, ethnicbackground (if culturally significant), and socioeconomic level of each person living inthe household and any other significant person who directly influences the family

system.

2) Determine appearance of each family member, including dress, affect, and voice level(think mini mental status in developing this section of the report). What impact might

your observations have on the process of treating the family members illness?3) Determine the sources and extent of community/social involvement closed or open

system.b. Updated Genogram (use the following section as a guide to new additional information to

include in the Genogram, particularly item 2 below in the Stresses on Family section).

c. Stresses on Family1) Indicate Family Life Cycle Stage and Tasks. Write a narrative describing the life stage of

the family citing evidence for your assessment. Describe the tasks and changes that this

family must address in order to proceed developmentally. What challenges do they faceas they address the tasks and changes necessary to proceed developmentally? What

difficulties are they having with this life stage? What factors contribute to this difficulty?

In short, consider how the family is adapting to this life cycle stage and/or transition?How does this process intersect with the illness(es)? How has the family changed interms of life cycle stage and tasks since last year?

2) Identify critical events and/or dynamic changes since your previous visit. Report recent(last 2-3 years) family changes including geographic moves, deaths, job changes, brokenrelationships, significant life style changes, and chronic illnesses.

3) Describe marital relationships, including number, to whom, and the quality of therelationship(s). How do you characterize the relationships in terms of being supportiveand nurturing or negative, critical, and blaming? How might this affect the family

members illness and family response to it?

4) Describe executive functioning of parenting. Include both the previous generation andthe present generation (rules of each parent in parenting). How would you characterizethe parents executive functioning and parenting style in terms of the following domains?

What is the degree of nurturance or connection, e.g. the degree of warmth, support, &

acceptance? What is the degree of control exerted by parents in the family, e.g.behavioral and psychological methods used to protect children from harm and socialize

them to act in socially appropriate ways (monitoring, reasoning, clear and consistent

rules and consequences, harsh punishment or arbitrary rules)? It may be helpful toconsider Diana Baumrinds conceptualization of parenting styles as you think about this.



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Diana Baumrinds

Parenting Styles

Nurturance

HIGH LOW

ControlHIGH Authoritative Authoritarian

LOW Indulgent Neglectful

Authoritative:high nurturance &high control,o The mostnurturing and effective parenting styleo Focus onpositive reinforcement VS punishmento Highly responsive to child, but notover indulgento Clear and consistent discipline strategies

Authoritarian: low nurturance &high controlo Fixed set of standards no negotiations/explanations o Value childrensobedience to authorityo Punitive, forcefuldisciplinary methods

Permissive indulgent:high nurturance & low controlo Respond in nonpunishing, accepting, & affirming mannero Exert little direct control rely on logic & reasono Consult with children aboutrule and rationale

Permissive neglectful: low support & low controlo No clearly definedrules for behavioro Children receive little or no attention

IMPORTANT NOTE 2:

If interviewing Family One for the first time, follow the instructions for the Year One Family Assessment

Report. BE SURE TO DOCUMENT IN THE FIRST PARAGRAPH THAT THIS IS A DIFFERENT

FAMILY THAN ASSESSED IN THE YEAR ONE FAMILY ASSESSMENT REPORT, AND WHYTHE FIRST FAMILY WAS NOT AVAILABLE FOR INTERVIEW.



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INSTRUCTIONS FOR ASSESSING A FAMILY

WITH CHRONIC ILLNESS OR DISABILITY

1. Conduct an interview with a family that has at least one member with chronic illness or disability.This assessment interfaces with one of your two family interviews for Community Medicine.

2. Use the form, Eliciting the Patients and Familys Story, as a guide to interview the family. Write atwo to three page summary based on the information provided. Divide the paper into five sections, tocover each of the five areas included in the guide. Use headings to separate the five sections of the

report. Use only the patients first name and last initial to preserve confidentiality.

3. Use the form, The Time Line of the Illness. Put the patients first name and last initial on the form.Mark an X on the Time Line in one of the five periods. This X will indicate where the family is in

dealing with the illness or disability. Date the X for future reference, as the same form will be datedin your Year 4 reports to show the progression of the illness or disability.

4. Use the form, The Typology of the Illness. Put the patients first name and last initial in the top left-hand corner, along with the date. Read the four illness questions at the bottom of the page, and circlethe word in each of the four questions that applies to the family you have interviewed. Then, go to the

chart and either circle the illness or write it in the appropriate place representing the typology of the

illness.

5. Use the form, Family APGAR Questionnaire. Put the patients first name and last initial in the topleft hand corner, along with the date.

6. Use the form, Eliciting Information About Family Resources: How to use the SCREEM. Using theseand other questions, gather information about the familys resources and how they impact the familys

health and the illness.



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ELICITING THE PATIENTS AND FAMILYS STORY

These questions may be asked of the patient individually or of the patient and familytogether.

H ISTORY OF TH E ILLNESS/PROBLEM How long have you had this problem?

How did you first notice it?

How did family and friends react to changes you were going through?

Who first suggested that you seek medical help?

How many physicians and other health care providers have been involved in yourcare? How have they been helpful? Not helpful?

What tests or procedures were needed to diagnose this problem? Have you beenhospitalized? What medications are you taking?

What is your understanding of the current status of your health?

IMPACT OF TH E ILLNESS ON T H E INDIVIDUAL How has your daily functioning changed?

What do you miss most from before you were ill?

What have you learned from this illness that has been useful to you?

What do you think will happen with the illness in the future?

I MPACT O F T H E I LLNE SS O N T H E FA MI LY What changes have occurred in the family since the illness began?

How are family members coping with this difficulty?

Do you talk about the illness as a family?

Who has been most affected? Least affected? Who has the greatest responsibility for caring for the ill family member? How does

the primary caregiver get support?

In general, how do you support one another? How do you express emotions?

Does this experience remind you or your family of other difficulties the family hasfaced?

How well is the family coping? Is there anything the family wishes they could dodifferently?

ME ANING OF TH E ILLN ESS AND FAMILY RESOURCES Why do you think this illness has occurred?

How long do you think it will last?

Are there times when the illness seems stronger than you or the family? Are theretimes when you or the family seems stronger than the illness?

Does you or your family have religious or spiritual beliefs about this illness? If so,what are they?

What are the strengths of your family? What keeps you going?



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ELICITING THE PATIENTS AND FAMILYS STORY(CONTINUED)

IMPACT OF PATIENT WITH CH RONIC ILLNESS ON TH E PH YSICIANAND HIS OFFICE

Is the office physically accessible to the disabled? Have you trained office personnel how to deal with the dying patient?

Have you dealt with your own issues around illness and mortality?

Can you use the biopsychosocial model for understanding pain and suffering fromall three levels? Does your staff also understand it?

Have you established referral sources for community referrals, i.e. financialcounselors, social service agencies, support groups?

Do you understand how certain illnesses and their treatments affect thought andbehavior well enough to explain them to the patient and family?

Do you understand the local cultural/ethnic context of the patient populationtoward illness?

Have you looked at how chronic illness affects sensitive issues, such as sexuality,gender, religion, alternative family structures (e.g. the single-parent family, gayrelationships, etc.)?

Do you have a support person (i.e. another health care professional) who can serveas a confidant/consultant for you when you are exhausted with treating thispopulation?



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THE TIMELINE OF THE ILLNESS

PATIENT FIRST NAME AND LAST INITIAL:________________________________________________

PHASES CRISIS CHRONIC TERMINAL

TIMELINE

DIAGNOSIS DEATH

PREDIAGNOSISwith symptoms

Initial adjustmentperiod

Chroniclong haul

Pre-terminal Mourning andresolution of

loss

Time Line and Phases of IllnessNote: From Toward a Psychosocial Typology of Chronic and Life Threatening Illness. By J. Rolland, 1984,Family Systems Medicine, 2, 245-62. Copyright by Family Process, Inc. Reprinted with permission.

Figure 12.3 Rollands Time Line

MARK AN X ON THE TIME LINE TO REPRESENT THE TIMEPHASE OF THE CHRONIC ILLNESS. DATE THE X SO THAT

WHEN YEAR 2 AND YEAR 4 VISITS ARE CONDUCTED THEPROGRESSION OF THE ILLNESS CAN BE TRACED.



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Note: Students should both circle the appropriate categorization characteristics in the lowerbox, AND circle or place the name of the illness in the typology.

THE TYPOLOGY OF THE ILLNESS

PATIENT FIRST NAME AND LAST INITIAL: ______________________________

DATE:____________

Incapacitating Non-incapacitating

Acute Gradual Acute Gradual

FATAL

Progressive Lung cancer with CNS metastasesAIDS

Acute leukemiaPancreatic cancer

Cystic fibrosis*

Bone Marrow failure Metastatic breast cancerAmyotrophic lateral sclerosis Malignant melanoma

Lung cancerLiver cancerIncurable cancers in remission

Relapsing

POSSIBLY FATAL SHORTENED LIFE SPAN

Progressive Emphysema Juvenile diabetes*Alzheimers disease MalignantMulti-infarct dementia HypertensionMultiple sclerosis (late) Insulin-dependentChronic alcoholism Adult-onset diabetesHuntingtons choreaScleroderma

Relapsing Angina Early multiple sclerosis Sickle cell disease* Systemic lupusEpisodic alcoholism Hemophilia* Erythematosis*

Constant StrokeModerate/severe myocardialinfarction

P.K.U. and other congenital errorsof metabolism

Mild myocardial infarctionCardiac arrhythmia

Hemodialysis treatedRenal failure

Hodgkins disease

NONFATAL

Progressive Parkinsons disease Noninsulin-dependentRheumatoid arthritis Adult-onset diabetesOsteoarthritis

Relapsing Lumbosacral disc disorder Kidney stones Peptic ulcerGout Ulcerative colitisMigraine Chronic bronchitisSeasonal allergy Irritable bowel syndrome

Asthma PsoriasisEpilepsy Malabsorption syndromes

Constant Congenital malformations Nonprogressive mentalretardation

Benign arrhythmia Hyper/hypothyroidism

Spinal cord injury Cerebral palsy Congenital heart disease Pernicious anemiaAcute blindness Controlled hypertensionAcute deafness Controlled glaucomaPosthypoxic syndrome

*=Early

Source: Reprinted from Rolland, J.S. (1984). Toward a psychosocial typology of chronic and life threatening illness. Family Systems Medicine, 2, 245-62. Reprinted withpermission of Family Process Inc.

Figure 12.2 Rollands TypologyCategorization of Chronic Illness by Psychosocial Type

1. IS THE ILLNESS FATAL, NONFATAL, OR POSSIBLYFATAL?

3. IS THE ILLNESS ACUTE OR GRADUAL?

2. IS THE ILLNESS INCAPACITATING ORNONINCAPACITATING?

4. IS THE ILLNESS PROGRESSIVE, RELAPSING, ORCONSTANT?



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SAMPLE GENOGRAMGenogram-Maker Millennium

McGoldrick, Shellenberger & Gerson, 2005



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FAMILY APGAR QUESTIONNAIRE*

FAMILY MEMBER FIRST NAME AND LAST INITIAL_________________________The following questions have been designed to help us better understand you and yourfamily. You should feel free to ask questions about any item in the questionnaire. The space

for comments should be used when you wish to give additional information or if you wish todiscuss how the question is applied to your family. Please try to answer all questions. Familyis defined as the individual(s) with whom you usually live. If you live alone, your familyconsists of persons with whom you now have the strongest emotional ties. For eachquestion, check only one box.

Almostalways

Some ofthe time

Hardlyever

I am satisfied that I can turn to my family for help whensomething is troubling me. Comments

I am satisfied with the way my family talks over things with meand shares problems with me. Comments

I am satisfied that my family accepts and supports my wishes totake on new activities or directions Comments

I am satisfied with the way my family expresses affection andresponds to my emotions, such as anger, sorrow, and love. Comments

I am satisfied with the way my family and I share time together.

Comments

*By at Least 1 Family Member Preferably Each Family MemberFrom: G. Smilkstein. The Family APGAR: A proposal for a Family Function Test and Its Use by Physicians. Journalof Family Practice, 1978, 6, 1231-1239.



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ELICITING INFORMATION ABOUT THE PATIENTS ANDFAMILYS RESOURCES:

HOW TO USE THE SCREEM

Use these and other questions to assess resources in the family.

1. SocialA.Does this family get together with other families often?B. How do the children get along with peers at school?C.What social contracts does this family have? Are they involved in church,

sports, civic organizations?2. Cultural

A.What is the ethnic background of this family?B. Do they have extended family close by? Do they interact often?C.What other cultural influences (special music, art, hobbies, etc.) have an

impact on this family and how their health and illness?

3. ReligionA.What kinds of religious support does this family have?B. Is their religious community available to help with problems the may have?C. Does their religion instill hope in their future?

4. EducationalA.What is the educational level of this family?B.What value is placed on the education of children in this family?C.To what extent do they support the educational efforts of all family

members?5. Economic

A.What is (are) the breadwinner(s)?B. Is the income sufficient to provide for the needs of the family?

C. Does making a living demand so much energy from the caretakers thatthere is little time left for the emotional needs of the family?

6. MedicalA.What is the level of physical health of this family?B.Are people getting proper care?C.What emphasis is placed on proper diet, exercise and preventive health

measures?

As you assess the familys resources, consider how they contribute to thefamilys health and illness.



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SCREEM (SAMPLE) *

The SOCIAL network of the Anderson family is varied. They are active in community lifethrough their participation in social and civic groups, church life, and school organizations.These social outlets provide a strong sense of community to whom the Anderson family can

turn in times of stress. They have a wide range of friends from many different settings withwhom they socialize frequently.

CULT URA LLY, the family is upper middle class with typical upper middle class values onparenting. They tend to live through the accomplishments of their children and to keep onbeing involved with their children during time to separate. They are involved with onegrandparent and a number of aunts, uncles, and cousins on a monthly basis. The familyusually congregates at someones house for holidays. Extended family seems not to be sopersonally powerful, but to reinforce the upwardly mobile values of the family.

The RELIGIOUS orientation of this family is pronounced. They are actively involved inthe Methodist church in their town. Both parents serve on the Board of Stewards andattend most meetings. The oldest daughter and her family are also regular church attendees,but Jack and June express concern over the irregular attendance of Judy and Allen. Theparents are open in their religious views and not against a lot of activities. Theirreligious orientation seems to be a support to them personally and to give them the basicfelling that life is good and people are to be loved and trusted.

ECONOMICALLY, the family is comfortable. Both spouses work outside the home,employ part-time help with yard and housework, and seem to keep their house andautomobiles in good repair. The do not live luxuriously, but have a nice home. They spendtheir money on their priorities, education, church, and home. They have adequate medicalinsurance to cover check-ups and illnesses.

The EDUCATIONAL level of the Anderson family is high. Jack has a college degree inengineering, June a Masters degree in design, and Susan a B.S. in Elementary Education.Judy is working on a Masters degree in counseling, and Allen is attending a college in town.The family values books, seminars, conferences, and information in general.

The MEDICAL resources of this family are excellent. They value health and watch diet anddaily exercise. Jack has high blood pressure and a weight problem, so June is making anextra effort to cook low calorie food and he is responsible for getting them to an afternoonwalk. His weight and blood pressure are coming down. Both Jack and June say they feelwell and have plenty of energy for daily activities.

Note: This is only a sample for teaching purposes. Your actual SCREEMwill easily be two or more pages long, depending on the detailed natureof your interview.



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The Stages of the Family Life Cycle

Family Life Cycle StagesEmotional Process of

Transition Key PrinciplesSecond Order Changes in Family StatusRequired to Proceed Developmentally

1. Between Families:The Unattached Adult Accepting parent offspring separation a. Differentiation of self in relation tofamily of origin

b. Development of intimate peerrelationships

c. Establishment of self in work

2. The Joining of Families Commitment to the new system a. Formation of marital systemb. Realignment of relationships with

extended families and friends to includespouse

3. The Family with Young Children Accepting new members into the family a. Adjusting marital systems to make spacefor child(ren)

b. Taking on parenting roles

c. Realignment of relationships withextended family to include parenting andgrandparenting

4. The Family with Adolescents Increasing flexibility of family boundariesto include childrens independence

a. Shifting of parent-child relationships topermit adolescent to move in and out ofsystem

b. Refocus on mid-life marital and careerissues

c. Beginning shift toward concerns for oldergeneration

5. Launching Children and Parents Accepting a multitude of exits from andentries into the family

a. Renegotiations of marital system as adyad

b. Development of adult to adultrelationships

c. Realignment of relationships to includein-laws and grandchildren

d. Dealing with disabilities and death ofparents (grandparents)

6. The Family in Later Life Accepting the shifting of generation roles a. Maintaining own and/or couplefunctioning and interests in face ofphysiological decline; exploration of newfamilial and social role options

b. Support for a more central role formiddle generation

c. Making room in the system for thewisdom and experiences of the elderly,supporting the older generation withoutoverfunctioning for them

d. Dealing with loss of spouse, siblings, andother peers and preparation for owndeath. Life review and integration.

From: Carter, E. & McGoldrick, M. (Eds.): The Family Life Cycle: A Framework for Family Therapy; 1980, Gardner Press, New York



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SCORING CRITERIA

Year Two Family Assessment Report

The reports will be scored on a scale from zero to 100 points. Point breakdown is as follows.

Criteria Point Value

FAMILY ONE

CHRONIC ILLNESS UPDATE

Updated Chronic Illness Report (15 points total)

History of the Illness or Presenting Problem 3

Impact of the Illness on the Individual 3

Impact of the Illness on the Family 3

Meaning of the Illness and Family Resources 3

Impact of the Illness on the Physicians Office 3

Updated Timeline of Illness 4Updated Typology of Illness 4

Updated APGAR (At least two) 4

Updated SCREEM 4

PRELIMINARY FAMILY SYSTEMS ANALYSIS

Demographic Data 4

Updated Genogram 4

Stresses on the Family (20 points total)

Life Cycle Stage and Tasks listed and addressed 4

Critical Events and Dynamic Changes in Family Life 4

Marital Relationships 4

Parenting 4

FAMILY TWO

PRELIMINARY FAMILY SYSTEMS ANALYSIS

Updated APGAR (At least two) 5

Updated SCREEM 5

Demographic Data 5

Updated Genogram 5

Stresses on the Family (20 points total)

Life Cycle Stage and Tasks listed and addressed 5

Critical Events and Dynamic Changes in Family Life 5

Marital Relationships 5

Parenting 5

Year 1 Reports Appended (Required; your paper will be returned ungraded if you

fail to submit your Year One Reports)

Professional Presentation 5

Total 100 points

If interviewing one of the families for the first time, be sure to include the form ScoringCriteria: Year One Family Assessment Report with your Year Two Report.


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