Purpose

Explaining the purpose of an assessment of a young person with complex needs, and the main components: what to ask about, and how to ask.

Why assess?

Assessment is key to delivering the most appropriate interventions for this particular young person's needs.

Many of the target youth that AMBIT is directed at are functioning poorly, or demonstrating symptoms in multiple domains, and this co-morbidity is often a major reason for the failure of interventions. A common problem is that practitioners tend to deliver those interventions (from psychoanalysis to kicking a football around!) that they are most confident with, or enjoy delivering most, rather than the interventions that this particular array of problems most calls for at this particular time; as a result the young person and their family may not experience any meaningful change, so at best expensive professional time may have been wasted, and at worst they may be more likely to dis-engage, or have suffered unnecessary harm from the delay or inappropriate treatments.

What to do:

To avoid overfocus on any one area, to the detriment of understanding in other areas, the assessment involves four parts.

Ideally the KeyWorker starts from a "wide-angled lens" view, and then homes in on the most important KeyProblems to target:

Timescale

This should be completed by the end of the second week of working, but preferably within a week of first contact. ASSESSMENT IS A CONTINUOUS ACTIVITY and needs to be continuously updated as facts change and new information emerges.

1. NARRATIVE ACCOUNT

The details of the story - who, when, how, where...

See Narrative History for suggestions on what to cover. You might find Topics covered by the AIM - a checklist helpful to ensure that you cover all the key areas that the AIM (see below) requires you to provide information about. The resulting history and background details can be added to as additional information comes to light. In addition there are various self-rated evaluative questionnaires that can help a young person to describe their current state of mind - for instance the Warwick-Edinburgh Self-rated Wellbeing Scale. Once you have covered the Narrative History you should have the information to complete the next stage of the assessment:

2. AIM QUESTIONNAIRE

A structured set of scored questions

The questions we suggest using are found at AIM Form, a questionnaire using validated questions that link directly to material in the manual (see AIM for more explanation); this is completed by the KeyWorker during or after one or more interviews, preferably within a week of first contact, but definitely within 2 weeks. This questionnaire covers all the major domains, ensuring that the worker does not focus too narrowly, too quickly. It is where KeyProblems are first identified. It also acts as one of the key Outcomes measures, as well as interacting with manualized material to generate lists of suggestions for appropriate interventions (AIM suggested interventions) to consider given this particular problem set.

3. RISK ASSESSMENT

A structured set of questions about risk

There is an example of a Risk Assessment at Risk Assessment - paper form, but a team's local Governance structures for Managing Risk may require alternatives to be used in its place - what is important is that some explicit consideration of Risk is made. (If you are using the ICR version, then Make or View Client Notes also contains the AIM Risk Assessment that should be completed, or you can go direct to this via Make or View notes on RISK ASSESSMENT.)

4. DIS-INTEGRATION GRID

A structured way of Addressing Dis-integration in networks

A specific tool, the Dis-integration grid, which highlights potential areas across the multiple domains (individual, family, team, inter-agency, etc) where a lack of integration across the various systems may influence outcomes, should be completed.

AFTER the assessment?:

Putting together the information to plan the most helpful interventions.

Follow Starting a NEW CASE - CheckLists to ensure that you translate your findings into clinically useful information and plans. This is where Active Planning is at its most active - in developing your Formulation and Treatment Aims.