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Effective Interventions Unit - Young people with, or at risk of developing, problematic substance misuse: A guide to assessment
Appendix 3: Feedback From the Young People Assessment Consultation Seminars, September - November 2003
This document provides information and evidence to support the work being undertaken to develop a guide about assessment for young people with, or at risk of developing, problematic substance misuse. These consultation seminars drew on experience from those working with young people to help them address their substance use and a range of other issues. The purpose of the consultation was to:
identify the key issues and stages of assessment for young people
identify those who need to be involved in the assessment process
suggest ways of engaging with young people in the design and delivery of the assessment process
consider ways of eliminating multiple assessment
discuss some of the assessment tools currently in use and the need for a national tool.
The seminars also provided an opportunity for those involved to share experience and good practice. We undertook to let all participants have a summary of the main points raised in the workshops. In this brief feedback sheet, we give particular emphasis to points that were raised and were common to all the discussions. We have grouped the views expressed by participants under the following headings:
Keys to effective assessment.
Multiple Assessment - how can it be eliminated?
Assessment Tools - what are the key elements.
Keys to effective assessment
The relationship between the assessor and the young person is key to a realistic assessment. Without a feeling of trust and openness on both parts, an assessment will be less effective.
Strong listening skills and the ability to speak in the young person's language.
The process must be young person friendly - this includes using media that is commonly used by young people and creating an informal atmosphere in which to meet.
There is need for services to focus on the individual and to avoid fitting the individual into the service.
Identify the young person's aspirations and support them.
Consider where there may be support for the young person i.e. parents, family or carers.
All who participated emphasised the importance of building a good trusting relationship with the young person and the need to invest time in building that relationship. There is a strongly held view that only once time has been invested in the relationship can an effective assessment process start.
There are a number of other issues which were highlighted as important within the assessment process. Child protection issues were a vital part of the overall consideration. Child protection protocols and confidentiality issues need to be openly addressed at the beginning of the assessment process. Many young people coming to services have multiple needs and there must be a close and trusting relationship between services in order to ensure that relevant information is properly and timeously shared. There needs to be a risk assessment of the young person at an early stage. This is for the protection and benefit of the client as well as a crucial safeguard for staff.
Multiple Assessment - How can this be eliminated?
The consultation seminars confirmed that multiple assessment is a problem for both young people and for agencies. This is undesirable for the young person who because of multiple needs may have been through a number of assessment processes, many of which seek like information:
Services need to understand each other's roles and recognise the professional integrity of other agencies.
Workers, and young people, need to know the full range of services that exist.
Reduce the 'culture' gap between statutory and voluntary sector organisations.
Agree what information can/needs to be shared and establish protocols.
Discuss with the client at an initial stage what information needs to be
shared, why and with whom.
Increased co-operation between agencies and services built on joint working and joint training builds relationships, trust and understanding which encourages better information sharing.
There is a general perception that the sharing of information and the joint assessment was less of a problem for an individual than it was for agencies and services. Clients were more concerned about seeking help than they were concerned about basic data being shared with other agencies. Often clients have repeated their situation on a number of occasions and would welcome not having to retell their story.
Assessment Tools - what are the key elements?
There were a number of tools in use, some recognised and validated for use with clients who have particular issues. A number of these were discussed in more depth. Many agencies have created their own tool or have adapted a tool to fit the particular circumstances of their client group. Many people do not use tools.
Of all of the discussions this was the least conclusive. There was, however, a general consensus that whilst a single national tool might bring advantages in reporting data and inter-agency working, it would not be flexible enough to meet the needs of individuals. A common assessment framework (guidelines that allowed for some flexibility) would be helpful.
There was thought to be a need for a screening process to allow young people to access services which were appropriate for their needs or could form a route to get to a more appropriate service. A substance misuse element within wider tools was to be encouraged which could help route the client to an appropriate drug service.
A 'Tool Shed' was thought to be a way forward. This would allow a range of needs to be met.
The way that young people use tools is important - filling in a form was thought to be least favourable. CD - ROMs, interactive computer based, tick boxes and smiley faces were all reported.
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