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The right place for assessments

Jack Phelan

Assessments seem to be an essential part of our CYC experience, but I do not think they should be. Dictionaries remind us that the main point of assessing something is to determine its monetary value, particularly for insurance or taxation purposes. Actually there is a very important role for psychosocial assessments in our field; to determine the value or price of services to be rendered, based on the problematic history of the youth we are living with or creating services for. Insurance providers and public funders want to determine the potential cost of care, so assessments, labels, problem diagnoses, and other existing toxic conditions are measured to estimate the monetary reimbursement needed for each “client”. So this can and should be done, but it must be quite separate from the actual treatment planning for each human being (youth or family) that we serve.

The people who use their skills to create connections and trustworthy relationships do not need to have anything to do with this part of the business, and actually the youth and families already know that the funding labels do not help them at all. When we sit together and solemnly discuss the “value assessment” which pigeon holes people into funding grid categories, we are getting in our own way (see shooting oneself in the foot).

CYC practitioners need language and terminology that allow them to describe people in useful ways. When you work in the life space and share connections, you can talk about the person very clearly, but if your goal is to focus on how difficult or problematic he is (or was) particularly by referring to past behaviour, then you will have a difficult time accurately talking about doing competent CYC work. The treatment planning should not be concerned with estimating monetary value by building a problem profile.

So what should we be describing? Phone answering machines say it best; “Who are you and what do you want?” Helpful plans clearly describe who the youth is, what is happening for him right now, and what does he want for himself. Then it can go on to discuss developmental capacity and how this may be creating roadblocks to achieving what the youth desires for himself. Attachment capability (not attachment disorder) and how to increase this vital ingredient, social and emotional awareness, as well as empathy can be a focus, with ideas about how to use relationships and experiential messages to build strength and skill here. Working in the life space creates unique opportunities for the CYC practitioner to know things about the youth that can be helpful, as well as to have ways to prepare the youth for being able to get what he needs, even though the pathway may be complex and even paradoxical at times.

There are many more pieces to a competent practitioner’s treatment plan process, which I will not belabour here. My point is that we need to see assessment as it is presently used as a tool to create monetary value for our efforts, not as a helpful way to create or describe good CYC practice. Problematic histories and diagnostic labels actually limit us much more than they support us to do our job well.

So we should continue to write assessments about the problem dynamics and disordered conditions found in our youths, but only for the eyes of the insurance and other funding groups that need this information to value our services accurately.