Family Assessment of Needs and Strengths – Trauma Exposure and Adaptation (FANS-TEA) Laurel Kiser Vickie Beck Kay Connors & John Lyons Sarah Gardner Fred Strieder
Acknowledgements • Substance Abuse and Mental Health Services Administration (NCTSI Category II) • In developing the FANS-TEA, we build off of several existing versions of the CANS: • the CANS-TEA (Kisiel, Lyons, Saxe, Blaustein & Ellis, 2002) • Several of the trauma items were developed or adapted based collaborations with Cassandra Kisiel, Ph.D., Glenn Saxe, M.D., Margaret Blaustein, Ph.D., and Heidi Ellis, Ph.D., with the SAMHSA-funded National Child Traumatic Stress Network. • the Family Advocacy and Support Tool (FAST) • Additionally, we want to acknowledge the work of all those individuals who made contributions to development of the CANS family of instruments.
Families with Complex Adaptations to Trauma • Too many families are exposed to accumulated traumatic circumstances. • Complex adaptations to trauma in families are defined by the intensity, duration, chronicity, or “toxicity” of the accumulated trauma, and by the nature of the family’s response. • Those families whose strengths have been overwhelmed by their accumulated traumatic stressors exhibit distress and disrupted family functioning.
Families with Complex Adaptations to Trauma • Exposure to multiple traumas within a traumatic context • Systemic response • Multiple family members experiencing trauma-related distress • Multiple family subsystems negatively impacted • Family resources are insufficient to support needs • Family unit trauma-related distress • Family maladaptation with risk of becoming a trauma-organized system
Child Response Traumatic Context Sibling Relations Family Unit Individual and Family Outcomes Parent-Child Relations Adult/ Parental Response Parenting Practices & Quality Intergenerational Response Adult Intimate Relations Time Acute and longer-term effects Individual development Family life cycle Adapted from Kiser & Black, 2005
Purposes • To document the range of strengths and needs exhibited by families affected by trauma, • To describe the contextual factors and systems that can support a family’s adaptation to trauma, and • To assist in the management and planning of services for families with exposure and adaptation to traumatic experiences.
Administration • Completed by a trained clinician • Information is typically gathered during 1-3 sessions with the family. • Clinician may use the Family Trauma Treatment Interview (FTTI) for structuring the conversation with the family. • Clinician completes the FANS-TEA using the information collected.
I. THE FAMILY TRAUMATIC CONTEXT In this section, we would like you to think about the experiences that your family has had regarding trauma and stressors. These traumas and stressors could have occurred to any member of the family or to the whole family together. For FamilyTraumatic Context, use the following categories/action levels: 0 indicates a dimension where there is no evidence of any trauma/stress of this type. 1 indicates a dimension where a single incident of trauma occurred or suspicion exists of trauma experiences; or mild stressor 2 indicates a dimension on which the family has experienced multiple traumas or a moderate degree of trauma/stressor. 3 indicates a dimension which describes repeated and severe incidents of trauma with medical and physical consequences; or major stressors.
I. THE FAMILY TRAUMATIC CONTEXT • Items 1-10 cover different trauma types. • sexual abuse physical abuse • emotional abuse neglect • medical trauma family violence • community violence natural/manmade disaster • political violence cultural violence
I. THE FAMILY TRAUMATIC CONTEXT 11. IMMEDIATE RISK - This item refers to the family’s current risk of exposure to any of the previously rated traumas.
I. THE FAMILY TRAUMATIC CONTEXT • Items 12-17 cover potential contextual stressors/strengths: • family life cycle stressors • neighborhood safety • community resources • financial resources • residential stability • military transitions
FANS-TEA Scoring Needs Strengths '0' indicates centerpiece strength '1' indicates a strength that you can use in planning '2' indicates an identified strength that must be built '3' indicates the no strength identified • '0' indicates no need for action • '1' indicates a need for watchful waiting • '2' indicates a need for action/moderate degree • '3' indicates the need for either immediate or intensive action
II. THE FAMILY as a Whole 22. EFFICACY- This rating should be based on the family’s belief that it is effective in achieving its goals and able to successfully manage daily family life and handle stressors.
VI. Adult Intimate Partners 61. Partnership AFFECT management- This item refers to the extent to which adult partners modulate or express emotions and manage their reactions in the context of their relationship.
I. Caregiving 65. SATISFACTION/MEANING OF CAREGIVING- This item refers to the importance placed on the role of caregiving and to the sense of accomplishment or pride that the caregiver feels related to carrying out her/his caregiving role and responsibilities.
FANS-TEA Triggers and Links • Triggers - indicate actions that should be considered based on the section or item rating: • Additional assessments recommended • Plans to be developed/implemented • Reports that need to be made • Referrals that need to be facilitated • Links - indicate additional materials or resources that may be valuable in assisting the clinician in treatment planning or service delivery.
FANS-TEA Triggers and Links • Links for items 8 & 9 - Disaster/Political Violence • Psychological First Aid was developed by the NCTSN and National Center for PTSD. • It is an evidence-informed approach for assisting children, adolescents, adults, and families in the aftermath of disaster and terrorism: www.nctsnet.org/nccts/nav.do?pid=typ_terr_resources_pfa
FANS-TEA Triggers and Links Section VII: CAREGIVING Needs [items = 5; range = 0-15]; Strengths [items = 4; range = 0-12] High Needs & Low Strengths Triggers - The following table identifies programs that effectively impact on parenting:
Looking forward to your input: Please visit the FITT Website to learn more about the FITT Center and FITT Model http://fittcenter.umaryland.edu For more information on the FANS TEA or to review it, provide feedback, participate in beta testing e-mail Dr. Kiser at email@example.com