INTEGRATED FAMILY ASSESSMENT AND
INTERVENTION MODEL
(IFAIM):
An integrative, collaborative, systemic approach at the
crossroad of clinical, educational, community and forensic
practices
Ana Teixeira de Melo
Faculty of Psychology and Education Sciences of the University of Coimbra, Portugal
Scholar of the Portuguese Foundation for Science and Technology, Portugal
(SFRH/BD/39912/2007)
E-mail: anamelopsi@gmail.com
Madalena Alarcão
Faculty of Psychology and Education Sciences of the University of Coimbra, Portugal
Efta congress, Paris, October 30, 2010
DEFINITION, AIMS AND POPULATION
WHAT IS IFAIM?




An integrative, multi-systemic, family-focused assessment and
intervention model
A model with a collaborative (with narrative and solution-focused
therapies influences) and strength-based orientation
A community-based and in-home approach
A model designed to support the Child Protection and Welfare
system :

In regard to the production of meaningful information to inform
decision-making (assessment)

In regard to the provision of family support to guarantee child’s safety
and well-being (intervention)
POPULATION

Multi-challenged families with at-psychocial risk,
maltreated or neglected children

Multi-challenged families (Melo & Alarcão, 2010):

a) have been or are currently developing in harsh living
conditions (e.g., living in poverty, experiencing social exclusion,
oppression or violence, etc.) with a prolonged exposition to
stressful environments or circumstances;
OR have been or are experiencing harsh living conditions
during short periods of time but with acute stress;
b) are or have been facing multiple concurrent challenges, often
simultaneously with major normative transitions and crises.
WHY IFAM?


Traditional approaches focused on only one dimension
of the families’ life may be inadequate or insufficient
to meet the needs of multi-challenged families
Therapy with poor families must take into account how
the social and economical conditions constrain family’s
relations and difficult family adjustment (Frankel &
Frankel, 2006; Minuchin, Colapinto & Minuchin,
2007;Rojano, 2004)
WHY IFAM?

Multi-challenged families face the risk of multiple
assistance and associated consequences . Integrative,
systemic approaches may avoid or minimize the
negative aspects of multiple assistance including
family dilution (Colapinto, 1995; Coleti & Linares,
1997; Minuchin, Colapinto & Minuchin, 2007)
WHY IFAM IN PORTUGAL?


Most social, child welfare , child protection and family services, in
Portugal, are still orientated by expert-driven, problem and
individually focused perspectives
There is a paucity in Portugal of assessment frameworks and
models specifically designed to both conduct assessment in cases
of child maltreatment and neglect and support the families, in an
integrated way, in performing the necessary changes to ensure
children’s safety and well-being. Current approaches to
assessment in cases of child maltreatment and neglect are mainly
expert-driven and not collaborative
AIMS


To promote family strengthening
To protect and potentiate the physical,
psychological and social well-being of family
members
OBJECTIVES

Specific objectives are divided in two categories:

Objectives related to assessment purposes (e.g.
assessment of risk and protection dynamics; assessment
of potential for change)

Objectives related to the facilitation of change and
strengthening of processes which may foster family’s
growth and adaptation.

Changes in factors related to the family’s social and
environmental living conditions, the entire family, the parents
and the children, which may contribute to achieve IFAIM’s
broader aims.
IN PRACTICE
CONTEXT OF CURRENT IMPLEMENTATION
Centers for Family Support and Parental
Counseling in Portugal
(Recent family support services)

IN PRACTICE

5 STAGES OF IMPLEMENTATION:
 Referral
 Reception
 Assessment
(1 to 3 months)
 Support for change (3 to 12 months)
 Follow-up and closure (3 to 12 months)
 Longer
cases are often associated with the
prevention of child removal and/or the promotion
of the family’s reunification
THE CORE TEAM

Inter/trans disciplinary team
 Standard minimum composition of 3 practitioners:
 Psychologist
 Social worker
 Social educator
(2 practitioners assigned for each case in the initial
stage)
Other extended family, community members or
professionals may be involved. IFAIM’s team
mediates relationships with other systems.
The referral professional are asked to assume social
control functions in cases of child protection.
DISTINTICE FEATURES OF IFAIM
The integrative character: a model
emerged from a crossroad of perspectives
of perspectives
The integrative character:
INTER/TRANSDISCIPLINARITY
THEORETICAL INTEGRATION


Integrative case conceptualization build upon a
Multiple Challenges Comprehensive Framework (Melo
& Alarcão, 2010)- integrative theoretical framework
designed to facilitate an understanding of the risks and
opportunities associated with the developmental
pathways of multi-challenges families
Integrative case conceptualization hypothesis as a
fundamental tool during assessment and support for
change
THEORETICAL INTEGRATION
Prefered outcomes in
IFAIM:
MULTIPLE CHALLENGES
COMPREHENSIVE FRAMEWORK
Symptoms/
problems/
child
maltreatment
and neglect
-Children safety and wellbring;
-Family’s preferred views
and directions in life;
- Exercise of the right to
freedom
Time
Constraining and facilitating dimensions related to individual,
family, environmental, social and cultural factors
Melo & Alarcão, 2010
THREE PREFERRED OUTCOMES IN IFAIM



Children’s protection and well-being- provides a direction for
change and indicators of the results to be achieved
Families living according to their preferred visions and
directions in life (Madsen, 2007;White, 2007)- provides the
strength to change
Families exercise their right to freedom (families exercise their
ability to learn know how they change and to create
meaningful information about themselves, the world and their
relation with it; exercise the ability to create, seek and
experimenting alternatives and to make deliberated and
authored choices which are integrated in their preferred
views)– provides the context for change
INTEGRATION OF PERSPECTIVES
DURING ASSESSMENT

Assessment stage includes:
 Risk assessment (in regard to child maltreatment
and neglect)
 Comprehensive
assessment
(parental
capacity/competencies; family functioning and
other factors which affect parental capacity; social
and environmental factors assessment; child focused
assessment)
 Assessment of the potential for change assessment
to inform child protection decision-making
INTEGRATION OF PERSPECTIVES
DURING ASSESSMENT


Combination of actuarial and clinical-consensual
methods in risk assessment
Combination of traditional concerns (e.g. rigour and
utility of information) and assessment practices (e.g
use of standardized instruments) (Munro, 2008) with a
collaborative,
strength
and
solution-focused
assessment perspective to facilitate change during
assessment (Berg & Kelly, 2001; Turnell & Essex,
2006; Turnell & Edwards, 1999)
INTEGRATION IN THE SUPPORT FOR CHANGE STAGE



A narrative perspective (Sluzki, 1992, 1998; White 2007)
informs the view of change as ultimately supported by the
family’s narratives and the ones constructed in relation with
other meaningful systems. Behavioral, emotional and cognitive
changes are seen as ultimately supported by the family’s
narratives.
Support for change sessions as change rehearsal sessions.
Change rehearsals sessions prepared using knowledge from
different disciplines and targeting different factors from the
individual to the social contexts.
INTEGRATION IN THE SUPPORT FOR CHANGE STAGE

Narrative practices are combined with different intervention
strategies, from different disciplines, approaches and models to
facilitate the rehearsal of alternative behaviors, emotions,
cognitions and discourses.
INTEGRATION IN THE CONCEPTUALIZATION AND SUPPORT
FOR CHANGE

Regular integrative family sessions ,are a common feature to all
cases
 Aim to help the family recruit and expand abilities and the
preferred outcomes of the change rehearsal sessions to
elaborate more useful meanings and to develop reflexive
abilities which may help them adapt, grow and strengthen.


Resilience processes are specially targeted (Walsh, 2006)
Narrative approaches are particularly influential (Sluzki, 1992;
Madsen, 2007 White, 2007; )
TRAINING
TRAINING



Inter/transdisciplinary training common to all
professionals
Common set of skills reflecting the integration of
contributions from different models of family
therapy
Outcome orientated training process focused on
the acquisition and/or development of:
 Integrative
theoretical case conceptualization skills
 Practical skills divided in 5 categories
TRAINING
5
categories of practical skills targeted and
periodically assessed with corresponding rating scales:
 Basis
session management skills
 Skills specific to the referral and assessment stages
 Skills to support change
 Skills to conduct in-home sessions
 Skills to conduct sessions with other professionals or
significant elements
 IFAIM
and its training program are manualized
CURRENT AND FUTURE RESEARCH
RESEARCH FOCUS
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Multiple case studies of the process and outcome of
implementation of IFAIM in local communities
Case studies of the process of training and exploratory evaluation
of its efficacy in promoting practitioners’ skills acquisition and
development
Preliminary feasibility study of the efficacy of IFAIM in achieving
its aims and objectives
Instrument development and evaluation (e.g. Rating scales to assess
practitioner’s skills to implement IFAIM)
... Future research is expected and welcomed
THANK YOU FOR YOUR
ATTENTION
E-MAIL : anamelopsi@gmail.com