In the family, when a member, usually a child or adolescent, has a (psychiatric) disorder, this influence is magnified. And for diagnostic purposes, the effect of the family on the child and the child's effect on the family must be assessed to prepare for optimal treatment, according to Allan M. Josephson, M.D.
A comprehensive family assessment is the process of identifying, gathering, and weighing information to understand the significant factors affecting a child's safety, permanency and well-being, parental protective capacity, and the family's ability to assure the safety of their children (Johnson et al, 2006, p.1). There are several sequential functions included in family assessment, which are (1) screening and general disposition, which usually takes place during intake; (2) definition of the problem, which may include diagnostic assessments (or quantification of problem severity) that takes place during intake and investigation procedures; (3) planning, selecting, and matching services with identified problems; and (4) monitoring progress and evaluating service outcomes (Hawkins, 1979). In short, the family plays a major role in this context, and the role it will play in the treatment process should be based on a balanced case formulation which can be realized through a complete, systematic, and detailed family assessment.
A good family assessment doesn't only gather information to be able to formulate a well-made treatment plan for the patient, rather it is also relationship building. It involves everyone in the family to take part, exploring goals, values, and strengths to help build mutual trust and respect among them. This relationship can be built when problems arise -- a slice of truth in the saying that problems do create opportunities for a brighter tomorrow. In short, the family assessment identifies areas for intervention and engages the family in a collaborative manner (Josephson, 2007).
Evelyn came to see the therapist with her daughter Alicia. Alicia is the eldest of Evelyn and Dan's two daughters. The presenting problem is that Alicia has been noticeably quiet and extremely introverted these days. She has been quite indifferent in school, especially towards school work and school activities and her teachers have noticed the sudden change in her personality. Her indifference has also caused her grades to suffer, although she has no problem interacting with her old set of friends, she spends most of her time usually with only her best friend Marianne. Alicia has no apprehensions of going to school, so Evelyn suspects it might have been something at home that influenced her daughter's behavior change. At home, Alicia is usually cooped up in her room listening to music, watching TV, or reading a book. Her relationship with her younger sister is very harmonious - no problems at all. However, as compared to before, she interacts less with her parents, especially her mother, and she likes retreating in her own world when at home. In short, Alicia has suddenly gone from lively and cheerful to introverted, quiet, and indifferent. Evelyn suspects that perhaps due to their current financial situation, she might have said a thing or two about budgeting their expenses tightly, as well as sometimes vocalizing how she, a bank employee, seems to be the only one earning for the family as their father's business seem to have