Assessment form and Narrative

Family dynamics

1. Family membership, including roles for each member:

2. Identify conflicts within the family members:

3. Family’s value system, rituals, and traditions:

4. Power structure within the family unit:

5. Current family life stage, and how the family is handling the tasks for that stage:

6. Identify the existence of any internal or external stressors:

7. Communication patterns of the members:

8. Coping patterns of the members to change/stress:

9. Identify any personality factors of any of the members that impacted the family dynamics:

10. Any extended family member issues/impact on the family unit?

b. Environmental/Community Dynamics:

1. Description of the neighborhood/community they live in:

2. Access to community resources/networks for the family:

3. Economics of the family: poverty access to jobs/education:

4. Discuss the different ways the families are linked to the community:

5. Identify any particular issues/problems faced by the community, how the problem/issue impacts the family:

6. Identify the environmental stressors for the family:

7. Were there any political factors involved with the family good or bad?

8. Any other observations made for this area of assessment?

c. Cultural/Racial Dynamics:

1. Identify and describe the cultural and racial traits of the families:

2. Diversity in family composition:

3. Describe the impact of the culture/race on the family dynamics:

4. Discuss the impact of the cultural/racial traits on the local community:

5. Does the cultural/racial traits impact the family’s social status? If so, how?

6. Identify the struggles/limits the family has due to their cultural/racial identity:

7. Any other observations on this area of assessment?