Comprehensive Assessment and Training Services Program

The Comprehensive Assessment and Training Services (CATS) project provides timely, multidimensional, comprehensive assessments of families and children identified by the Department for Community Based Services (DCBS) that meet specific eligibility criteria. This assessment provides an evaluation of the child and family strengths and vulnerabilities within five major domains:

        1) family/social;

        2) emotional/behavioral/psychological/physiological;

        3) attachment; 

        4) life history/traumatic events;

        5) developmental/cognitive/academic.

For each of these domains, quantitative and qualitative data are gathered using overlapping methodologies; structured observations, structured interviews, psychometric testing and a content analysis of the medical, legal and DCBS record. A multidisciplinary team of psychiatrists, pediatricians, social workers, psychologists, and psychiatric nurses then synthesizes the data into findings, conclusions and recommendations. The final evaluation is distributed to the DCBS worker and the judge who has jurisdiction of the case prior to the dispositional hearing.

Once the report is completed, CATS and others identified by the service region administrators oversee the initial implementation of the recommendations, direct the initial treatment, and assist in the development of the case plan. The CATS Clinic operates as a “living laboratory” where the latest assessment and treatment technology is tested and refined. The new technology is then transferred into the field to many different consumers. This may require significant training of the family members (biological, kinship care, or adoptive) in addition to training the DCBS staff in how to continue to intervene in ways most likely to lead to stabilization and improvement of family. Training to meet the child and family needs is provided by CATS, DCBS, and other regionally identified staff and partners. Individual and group therapy is provided to adoptive families and children that have been identified in the assessment process as having significant issues related to attachment and unresolved trauma.

The mission of the CATS project is to provide evidence-informed, comprehensive and multidimensional assessment and training services to assist the Cabinet for Health and Family Services in case planning and decision-making that will enhance child and family safety and well-being.

Procedure for Receiving, Evaluating, and Accepting Referrals

The CATS Program has specific requirements for referrals to the clinic. These include:

• Child is referred by a DCBS worker,
• Child has an open case with DCBS at time of referral,
• Case has completed the investigation phase and is in the case-planning phase of DCBS service delivery at time of referral.

The procedure for referral and intake is as follows:

• The DCBS worker contacts the CATS clinic by phone or e-mail. That CATS program provides the DCBS worker with the CATS Referral Form (also available here, see bottom of page).
• Upon receipt of the completed CATS Referral Form, the CATS staff reviews for completeness. If incomplete, the DCBS worker is contacted for clarification.

Referrals may be assigned to the following service options:

1. CATS Full Evaluation Services,

2. CATS Consultation Services,

3. Referral to another program.

   

The case is scheduled for the specific service. Letters confirming appointment date and times are sent to the DCBS worker and the parties are scheduled for evaluation. In most cases, a pre-assessment conference with the worker is arranged.

Training and education is an important dimension of the CATS Program. As the program was designed, one charge given the CATS Team was to find effective ways of sharing knowledge with the Cabinet for Health and Family Services. This charge also reflects the overall land-grant institutional mission of the University of Kentucky. Through a variety of approaches, the CATS Program shares and transfers information, techniques, approaches, and technologies to the Cabinet for Health and Family Services leadership, DCBS workers, foster parents and other caregivers, and to other professionals who work with CHFS to advance the best interests of children. Based on mandates set forth by the CHFS, the “state of the art” in contemporary child welfare, as well as the cumulative experience of consulting with DCBS workers, the CATS Program has identified and prioritized specific training targets:

• Trauma and traumatic stress concerns in child welfare;
• Secondary traumatic stress;
• Typical and atypical infant, toddler, and child development;
• The role child-caregiver attachment plays in the development and maintenance of adaptive family functioning;
• Family systems models, approaches to problem-solving with families, and developing positive family relationships;
• Clinical decision-making approaches and strategies;
• Introduction to effective approaches to assessment strategies, procedures, and instrumentation;
• Teaming and collaboration approaches with mental health service delivery agents and systems;
• The impact of violence or neglect on brain development.

The CATS treatment initiative is designed to 1) address the needs of foster/adoptive children and their families who had been assessed in the CATS program and 2) to respond to concerns raised by the Cabinet for Health and Family Services about the growing number of adoptions that were being disrupted in Kentucky. Several evidence-based treatment protocols are used to address the unique challenges of adoptive families. The selection of all intervention protocols is guided by the following philosophy.



Philosophy

 

• A child’s biopsychosocial development is greatly impacted by experiences across the childhood and adolescence.
• Events such as trauma, neglect, and child maltreatment can have a deleterious effect on the course of development and the child’s overall well-being. 
• Intervention approaches must consider the child in context of their social environment and primary attachment relationships.

With this in mind, the intervention protocols utilized by CATS are guided by the following principles. Treatment should:

 

• Emphasize the importance of the relationship rather than behavior.
• Empower the parent(s) to nurture the child even when the child resists.
• Recognize that parents are doing the best they can and need help and encouragement rather than criticism.
• Assist by modeling appropriate behavior. Parents need to experience support and encouragement in the relationship with the therapist in order to do the same with the child.
• Teach parents to identify their own biases that may interfere with effective parenting.
• Help parents feel supported and recognize their struggles are not unique.
• Provide opportunities for experiential learning rather than relying on purely didactic presentations. Experience is the best way to learn and change behavior.
• Help the parent understand that the child’s behavior results from frustration with caregivers not being nurturing and dependable in the past.
• Stress the importance of allowing children to affect their world through their relationship with the parent.

Eligibility



Families with children who have been identified by DCBS as a concurrent planning or adoptive home.

CATS Research Agenda



The research agenda established by the CATS project involves generating questions and hypotheses about relationships among the identified variables of study. This allows the project to contribute to the knowledge base of the field of child maltreatment, and make generalizations that indirectly benefit clients.

The domains of variables identified for study include:

Maltreatment Factors

• Frequency
• Duration
• Relationship between child and perpetrator
• Severity of Maltreatment
• Use of force 
• Co-occurrence of other forms of maltreatment

Child Factors

• Child's age and stage of development
• Gender
• Temperament
• Medical/biological/physical conditions
• Pre-maltreatment adjustment
• Intelligence and cognitive skills
• Internal vs. external locus of control
• Coping strategies (active vs. passive)
• Self esteem
• Child's perception of and attribution re: maltreatment
• Nature and quality of attachment to caregiver
• Academic performance

Family Factors

• Family Support of the child post-maltreatment
• Acknowledgement of the maltreatment
• Belief in the child feelings and attitudes toward the child
• Provision of adequate parenting post-maltreatment
• Ability to protect the child from further maltreatment
• Presence or absence of an intact family unit
• Family functioning and parenting pre-maltreatment
• Adequacy and health of parents relationship (violence)
• Individual functioning of parents (e.g. mental or SA disorder)
• Poverty: stability of residence
• Discipline/parenting effectiveness and appropriateness
• Accurate perception of child's needs and capacity to respond
• Impulse control
• Nature and quality of attachment to child
• Utilization of appropriate child and family support services
• Nature and quality of interactions with academic institution

Environmental Factors

• Cultural-societal toleration of maltreatment
• Community's reaction to the child and family
• Supportive social relationship for child and family
• Availability of appropriate and accessible resources
• Provision of appropriate services for child and family
• Criminal justice involvement
• Quality and availability of academic resources

Researchers and/or faculty members who are interested in conducting collaborative studies with the CTAC team should submit a proposal outlining the proposed project to:

Ginny Sprang, Ph.D.  

University of Kentucky

Center on Trauma and Children

3470 Blazer Parkway Suite 100

Lexington, Kentucky 40509