Assessment tools for stresses on the care-giving relationship
by Robin Balbernie

This page is an edited extract from a paper written by Robin Balbernie on assessment and evaluation measures / tools that can be used in early intervention services. See the full paper here. Robin divides all the tools he describes into nine areas of which stresses on the care-giving relationship is the third, each of the nine areas has a separate page on this wiki, links to all nine areas are available on an overview page.)

1. These can be noted using a simple check list (available from PIP UK or me; and see appendix 2c of ‘Conception to age 2’) which then gives a
quick profile of the difficulties a family faces, enables intervention to be put in on the basis of risk (before maltreatment may have occurred),
makes clear other targets for intervention besides direct clinical work and provides both an anonymous description for comparison and data
for commissioners and partner agencies. These are risks in the ecology of parents’ lives that will have a deleterious impact on the
caregiving relationship. It cannot be assumed that such a list will invariably identify all children at risk; also, there is a socio-economic
bias and, of course, a child might be maltreated with no obvious family risks being visible. This can be integral to a ‘request for service’ form,
ensuring that referrals carry a range of appropriate information. It also can be used to demonstrate how early intervention work is usually
highly complex, needing to deal with a wide range of factors where families are struggling with multiple adverse circumstances. It makes
clear that there are no quick fixes.

2. In the Zero to Three DC:0-3 there is another index of risk, their Psychosocial & Environmental Stressor Checklist’, that has sections
covering: challenges to a child’s primary support group; changes in the social environment; education/child care challenges; housing
challenges; economic challenges; occupational challenges; health-care access challenges; health of a child; legal/criminal justice challenges;
and other (which includes abduction!). Copy available on

3. Perhaps the Parenting Daily Hassle Scale would come into this section. This is also a measure that, with a bit of imagination, can be used to
evaluate the effects of intervention for both group and individual work. It aims to assess the frequency and intensity and impact of twenty
everyday experiences with children that can be stressful to parents. Copy from DoH and