Mana Ake Assessment A Guideline for Mana Ake Workers

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Contents 1. WELL-BEING ASSESSMENT: ................................................................................................... 2

1.1 BACKGROUND: ....................................................................................................................... 2

1.2 CONTEXT: ................................................................................................................................. 2

1.3 STRUCTURE: .............................................................................................................................. 3

1.4 CHOICE AND PARTNERSHIP: THE CHOICE ASSESSMENT ..................................................... 3

2 THE ‘CHOICE’ MEETING/CONVERSATION ........................................................................ 3

2.1 THE ‘CHOICE’ PROCESS: ......................................................................................................... 5

2.2 SETTING THE SCENE/ENGAGEMENT: ....................................................................................... 6

2.3 EXPLORING THE CURRENT SITUATION: STRENGTHS AND CONCERNS: ................................ 8

2.4 COVERING RISKS AND SCREENS: ........................................................................................... 9

2.5 EXPLORING FAMILY AND WHĀNAU: .................................................................................... 10

2.6 SCHOOL AND LEARNING: ..................................................................................................... 12

2.7 SOCIAL: ................................................................................................................................... 13

2.8 PHYSICAL AND MENTAL HEALTH: .......................................................................................... 14

2.9 EXPLORE WISHES, HOPES, STRENGTHS AND SOLUTIONS - BE CURIOUS ........................... 15

2.10 SHARE YOUR HONEST OPINION AND DEVELOP A SHARED

UNDERSTANDING/FORMULATION .............................................................................................. 16

2.11 DEVELOPING A MENU OF OPTIONS: .................................................................................. 17

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1. WELL-BEING ASSESSMENT:

MANA AKE - STRONGER FOR TOMORROW

1.1 BACKGROUND:

The Mana Ake approach in Canterbury aims to address the ongoing impacts of the earthquakes on

mental health and wellbeing for school children in years 1-8. This approach focuses on the need for

support identified by schools and will be sensitive to the social environment in which these learners

and their families/whānau are embedded.

Mana Ake implementation has commenced in a phased process, being delivered in clusters of schools

across Greater Christchurch (including the Waimakariri and Selwyn districts), Hurunui and Kaikoura.

The full approach is planned to be operational by July 2019.

Whilst the broader initiative will be operationalised through system-wide elements, the functioning

of the teams working with the clusters will be guided by a values-based Practice Framework, which

underpins this Assessment Framework to achieve the goals of the approach.

1.2 CONTEXT:

Values embedded in the Practice Framework and underpinning assessment include:

CHILD AND WHĀNAU

FOCUSED ACCESSIBLE CULTURALLY ABLE

SYSTEM FOCUSED RELATIONSHIP-BASED -

PARTNERSHIP FOCUSED

RESILIENCE / WELLBEING-

FOCUSED/TRAUMA

INFORMED

RESPONSIVE AND VISIBLE TRUST STRENGTHS-BASED, HOPE-

FOCUSED

FLEXIBLE EMPOWERING EVIDENCE INFORMED

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1.3 STRUCTURE:

The Assessment Framework is described at the following levels:

COMMUNITY

It is an expectation that the Mana Ake teams will have completed an inventory of the broad range of services which are a part of the local communities surrounding the clusters of schools they are partnered with. Additionally, these teams will keep abreast of the status of the local community/ies with regards to specific social issues impacting on residents including employment and housing and other determinants likely to affect community well-being. This information will inform an assessment of family and whānau well-being.

SCHOOL

It is an expectation that Mana Ake teams will have an in-depth knowledge of the capability of the school community including pastoral care teams, school leadership teams and teachers to support student well-being. This information will inform an assessment of the ‘well-being’ including positive culture of the school and provide opportunities to enhance school well-being through increasing the capability of the elements of the school directly impacting on school well-being.

CHILD AND WHĀNAU

It is an expectation that Mana Ake workers will be able to directly work with children and whānau and utilise a strengths-based process to partner with, identify concerns and suggest options to enhance child and whānau well-being. The ‘Choice’ assessment (www.capauk.net) provides the basis for the assessment.

1.4 CHOICE AND PARTNERSHIP: THE CHOICE ASSESSMENT

The Choice and Partnership Approach (CAPA) is a collaborative service improvement model

offering choices to children, young people and their families/whānau in their contact with services,

and partnerships with service personnel. The CAPA model provides a strengths based framework for

service delivery where the child and family/whānau are at the heart of the process. The CAPA

approach describes specific components, promoting seamless service delivery offered at the right

time, at the right place with people with the right skills and knowledge.

The ‘front-end’ of CAPA is a process described as ‘The Choice Appointment’. The ‘Choice

Appointment’ requires the worker to have a high level of skill with regards to engagement and

assessment from a well-being perspective.

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The ‘Choice Appointment’ provides an opportunity for an exploration of the concerns experienced by

the child and family/whānau, a discussion regarding options to address the concerns; an exploration

of resiliency and risk: risk to self, risk to others and risk from others. Where risks are identified, action

is taken as required.

The ‘Choice Appointment’ concludes with the development of a plan identifying the discussion and

chosen options. Options will include suggestions regarding positive activity the child and

family/whānau can engage in immediately, and outline ‘next-steps’. Next steps may include continued

engagement with the child and their family/whānau, assessment and intervention delivered by the

worker and the Mana Ake Team; collaboration and support to the school environment; collaboration

and support to the local community.

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2. THE ‘CHOICE’ MEETING/CONVERSATION

2.1 THE ‘CHOICE’ PROCESS:

A Choice appointment will involve meeting with the child and caregivers to have an extended

conversation exploring concerns that have been identified and discussed with the pastoral care team

at the school. The meeting will follow a strengths based approach that is designed to identify and

enhance the child and family/whānau’s resiliencies and suggest support options where these might

be indicated. A process guiding the conversation is described here. It needs to be acknowledged that

the conversation does not necessarily evolve in a linear format, the focus is on having a conversation

in plain language that is accessible for child (developmentally appropriate) and their family/whānau,

and covers a number of key areas as follows:

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Assuming some key demographic information has been collected

(e.g. name, age, ethnicity, caregiver contacts, custody status, and

address), the conversation can proceed to include the following

areas:

2.2 SETTING THE SCENE/ENGAGEMENT:

The conversation begins with introductions, attending to cultural considerations or needs as

appropriate (e.g. offering karakia or inviting the family/whānau to do so), explaining confidentiality

and limits, the process and the time required, and what will be offered at the end of the conversation.

This process allows significant opportunity for the child and family/whānau to ask questions and raise

any concerns. Opportunities are offered during this meeting for the family/whanau to have time alone

with the worker. This part of the conversation leads to a transitional question on exploring ‘likes and

best-things’ for the child, and what is really important and what that ‘looks’ like for the parent.

WORKER - CHILD:

Hi there Jo, my name is XXX and I am part of XXXX

I am really keen to spend some time with you, to hear how things

are for you, what is going well for you, and if there are things that

we can suggest to help you with at school…

It is important to let you know that what we talk about… We also

plan to catch up with your … (Caregivers)

If it’s ok with you, we will… and I will…

Now let’s start with hearing about the favourite things you like to

do with your time?

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WORKER - FAMILY/WHĀNAU:

Hello there XXX I am XXX. Thanks so much for agreeing to meet today-

You are aware that… and if it is OK with you, I would like to spend some

time today hearing from you what is going well with Jo and your

family/whānau and if there are some things that are not going quite so

well. There may be some helpful suggestions that we can think about

together- If there are any ideas that you feel would be good to try, I will

write these down and give you a plan to take away. Would that be ok?

Is there any way that you would like to open our time together today?

Some family /whānau we meet like to begin with karakia- would that be

helpful to begin or can I offer…

If it is Ok with you I would like to start off our conversation with finding

out what’s really important for you and your whānau, what that looks

like?

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2.3 EXPLORING THE CURRENT SITUATION: STRENGTHS AND

CONCERNS

In this part of the conversation the worker asks what is going well, what is not going so well, how long

it has been going on for and how it is affecting their lives? Questions might include what the child or

caregiver thinks other family/whānau members, friends or teachers would say about what is

happening for the child, what has been helpful and not so helpful.

WORKER - CHILD:

So Jo one of the things that I understand has been getting in

your way at school is… I’m not sure if you think that as well?

Can you tell me some more about this? What is that like for

you? What kind of things do you find helpful? What are

things that aren’t so helpful? What do you think your Mum

knows about what is happening for you? Dad? Your sister…

WORKER- FAMILY/WHĀNAU:

I’m wondering if we can now move on to talking about

your view of what might be happening for Jo at the

moment, if you think there is anything going on?...

Can you tell me some more about that? What is that

like for you? Are there things that seem to help? Are

there things that aren’t so helpful? What does… know

about this?...

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2.4 COVERING RISKS AND SCREENS:

The exploration of the concerns provides an opportunity to also explore any areas of risk for the child.

This will include suicidality, self-harm, harm from others, and harm to others. As the conversation

proceeds and further information is made available, other opportunities to explore any concerns that

compromise safety need to be taken and addressed. These include family/whānau violence/home

safety, alcohol and other substance use, and gambling harm.

If there are significant safety issues, STOP at this point to attend to these. Explain to the

child/family/whānau what you are doing. The following example explores suicidality. Other safety

concerns would also need to be explored using the graduated questioning process as follows:

WORKER-CHILD:

Thanks Jo, I’m thinking that those things may have been really hard

on you. Sometimes when things like this happen, children can feel…

Is that something that you have thought about? Can you tell me more

about that? Can you tell me what your thoughts were? Did you do

anything about these thoughts? What did you do? Did you tell

anyone? Have you had these thoughts before? Have you had these

thoughts again? …

WORKER - FAMILY/WHĀNAU:

Thanks for being able to explain things so well- I am

thinking that this situation might have raised some

thoughts around your/Jo’s safety. I’m wondering if

you can tell me about any concerns that you may have

or have had with regards to safety for…

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2.5 EXPLORING FAMILY AND WHĀNAU:

This part of the conversation enables a discussion on the family/whānau structure and developmental

history for the child as required. For the child, this is about their perspective of their family/ whānau

and the family/whānau relationships. For the caregivers, the focus will be on their perspective(s) of

the family/whānau, providing information on strengths and potential areas for support.

WORKER-CHILD:

Thanks so much for giving me such a good picture of what has been

happening for you Jo. I’d like to spend some time now finding out a bit

more about your home and your family/whānau and other things that are

important for you. This will really help me to be able to think about what

things might be helpful for you… Would that be ok?

Can you tell me who lives in your house? Who are you closest to in your

family/ whānau?

What kinds of things do you like to do with your family/whānau? Are there any other adults that you are close to?

Do you have your own room?

Do you eat meals together?

How does your family/whānau get around? (Car, public transport…?)

What are there things that you really like about your family/whānau?

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WORKER- FAMILY/WHĀNAU:

Thanks for that really helpful information. I’m wondering now if we

can move on talking about your family/whānau and home. This will

help me to get a really clear picture of how things are for Jo and for

you and your family/whānau. Would that be OK?

Can you tell me about your family/whanau? Who lives at home, how

things are for each person in your family/whānau, what are the

things that you are proud of about your family/whānau?

Are there things that aren’t going so well?

Do you have worries that affect many families/ whānau such as

financial worries, long work hours, worries about heating, meeting

the basic needs for families…

Do you have time for yourself? Time with friends? Time alone with …

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2.6 SCHOOL AND LEARNING:

WORKER-CHILD:

What is school like for you? What subjects do you like? Like less…

What do you do at playtime and

lunchtime? Do you have friends in class to

work with? Who are your friends? Do you

enjoy coming to school? Why? Why not? If

you had a problem at school who would you

tell (child? adult?)

What other activities are you involved in at

school? (choir, librarian, road patrol, Kapa

haka, sport etc). Which adult at school knows

you best?

WORKER- FAMILY/WHĀNAU:

Can you please tell me about Jo and school? Does he like school? What are the ‘top’ things

for Jo about school? Does he head off to school in the mornings without too many prompts?

Does he talk about school when he gets home? Does he bring friends home? Does he have a

special teacher? What reports do you get from the Teachers about Jo at your meetings with the school? Have you any concerns about Jo and school? Have you ever had any concerns

about Jo and school?

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2.7 SOCIAL:

WORKER-CHILD:

Who is your favourite friend? How long have they been

your friend for? What do you do together? Are you and

your friend part of a group? Do you play any sports after

school?

Other activities?

Do you have a cell-phone? Do you use social media?

Facebook, Instagram etc?

Gaming?

WORKER - FAMILY/WHĀNAU:

Can you tell me about Jo and how he gets on with other children? Friends?

How does he spend his time?

Sport? Devices? Social media?

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2.8 PHYSICAL AND MENTAL HEALTH:

WORKER-CHILD:

What time do you get to sleep-wake-up? What did you have

for breakfast today? What foods do you like?

What games/sports do you play? Do you get sick very often?

Do you go to the Doctor very often? Been in hospital? Have

you been to other places (services) for help? Do you get really

sad sometimes? Do you worry about your parents?

WORKER - FAMILY/WHĀNAU:

Can you tell me how your family/whānau keeps healthy? Are

there any health issues in your family/whānau? Are there any

other well-being concerns? Mental health concerns? Concerns

with alcohol or other substances?

Do you have a GP? Have you visited them lately?

Have you or Jo had contact with any other health services?

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2.9 EXPLORING SOLUTIONS-

BE CURIOUS

This part of the conversation builds on the ‘transitional’ questions explored at the engagement stage

of the conversation and involves further exploration of what the child, family/whānau have described

as their hopes and wishes for the future, and the strengths and solutions they bring to get through

their current situation. Continue with this conversation until you reach a point of agreement with

what the child, family/whānau most want to work towards. Ask what they have already tried, what

worked even a little, and what were/are the barriers to working on it or continuing with it. Ask what

the family/whānau might see as other solutions and what supports may be helpful based on their

experience and expertise. Ask what it would take to move towards those goals, what would be

required and from whom.

WORKER-CHILD:

You have been so helpful in letting me know what has been

happening for you and your family/whānau. It’s time now to hear

about the thing that would make things better for you. Let’s think

about the things we have talked about today. Out of all of those

things, what would you most like to be different? What have you

tried already to makes things better, what worked, and what would

we leave off trying again?

WORKER- FAMILY/WHĀNAU:

Thank you for being so open and helpful in our discussion today. Of all of the things that we have talked about today, I’d like to hear from you which

thing you would most like to be different? What would that look like? What’s worked already? Any other ideas about what could be tried to make that thing

better?

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2.10 SHARE YOUR HONEST OPINION AND DEVELOP A

SHARED UNDERSTANDING/FORMULATION

Use accessible language and provide your honest opinion on everything discussed- Ask the child/family/

whānau what they think of this. Provide examples of what has been helpful for other children and

families/whānau using an evidence base. This part of the conversation will lead toward a shared

understanding/formulation with the child/family/whānau and potential options that meet their

agreement, providing information on each option.

WORKER-CHILD:

We are coming to the end of our time together today; you have been so

helpful in explaining how things are for you. Because I have worked with

lots of children and families quite similar to yourself, I have some ideas

about what might be happening for you and what might be helpful.

As I mentioned earlier, it will be important for me to meet with your

family/whānau to hear more about how they see things, and offer my

thoughts from today. From there we can all work together to make sure

things get better for you by considering what you have tried already to

makes things better, what worked, and what would we leave off trying

again.

WORKER- FAMILY/WHĀNAU:

It has been great to catch up with you and to hear about Jo and your family/whānau. Because of the work that I do,

hearing how you see things at the moment, what you would like to be better, and what you know you could do to make this happen, is really helpful. I have some ideas about what

you have shared, and some options that I could suggest. Would that be OK?...

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2.11 DEVELOPING A MENU OF OPTIONS:

This final part of the Choice process involves offering numerous options for the child/family/whānau to

consider. This part of the process will include:

Identifying what they are already doing and listing these items as things to continue with

The worker offering some ideas/strategies about what the child/family/whānau can do to work

towards their goal

Suggesting resources such as web-sites, E-Therapies

Suggesting specific interventions that are known to be evidence based for issues identified by the

child/family/ whānau

Suggesting who could offer the interventions discussed. This may include the worker, and/or

other services

These options are then offered as part of either the ‘Choice template or Choice letter’. The Choice template

is developed with the child/ family/ whānau during the Choice appointment; the original is retained by the

child/family/whānau and copies are made for service records. The alternative is the Choice letter which is

developed as soon as is practicable, if not at the end of the Choice appointment; copies are then sent to

the child/family/whanau. The Choice template and letter act as a ‘plan’ including brief information on the

issues discussed, the identified goal, options and next steps. Consent is requested to share this Choice

documentation (plan) with all key people/agencies who are a part of the system of care of support involved

with the child/family/ whānau.

ACKNOWLEDGEMENT- REFERENCE:

This resource has been developed from:

York, A., Kingsbury, S. (2013). The Choice and Partnership Approach, A Service Transformation Model. UK:

CAPA Systems Ltd.

In 2017, in collaboration with a team from Werry Workforce Whāraurau and Ann York, a national working

group of clinicians from child and adolescent services across New Zealand used information from the above

publication combined with their clinical knowledge of service delivery to develop a resource for services:

‘The Choice and Partnership Approach: Guidelines for Choice’ (www.werryworkforce.org)

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The information for this resource for Mana Ake workers draws from the above publications, and has been

prepared in collaboration with the Werry Workforce Whāraurau CAPA team.

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