Domain 8 - Engagement and motivation (Contextual Domain)

Overview

This domain considers the parent/caregiver’s motivation to engage in or accept assistance. Children do not have the agency or resources required to seek services and support independently. Therefore, the parent/caregiver’s engagement and motivation are the focus of this domain for children.

Whilst this domain rates the engagement and motivation of the parent/caregivers, the child should be included in discussions, using language they understand, and supported to express their choices, preferences, fears, and goals about referral next steps. Assessment is unlikely to be valid unless rapport is established with the child and the child participates in the assessment process.

PRACTICE POINT - checking in when engagement or motivation is low

A follow-up check-in helps determine if the recommended information, resources, or services are being utilised and perceived as helpful. Proactively “checking in” or encouraging the parent/caregiver to “check back” is essential when engagement or motivation is low. A plan for check-in should be made at the point of referral and documented.

The check-in could explore the following questions:

  1. Is the parent/caregiver engaging with the recommended information, resources, or services? If the parent/caregiver is not engaging, it is essential to re-examine motivation and explore reasons for the lack of engagement.

  2. Is the child engaging with the recommended information, resources, or services? If the child is not engaging, it is essential to re-examine motivation and explore reasons for the lack of engagement.

  3. Does the child and their parent/caregiver think that the recommended information, resources, or services are/were helpful?

  4. Is there evidence of deterioration or changing risk of suicide or harm to self or others?

  5. Is the child or family experiencing new or worsening social and environmental stressors?

  6. Discuss and document the next steps in collaboration with the parent/caregiver and child. The next steps might:

  • Continue existing service arrangements,

  • Build in additional supports,

  • Initiate a referral to a different level of care.

Scoring

0 = Optimal

  1. The parent/caregiver is motivated and capable of participating fully in the recommended services and supports.

  2. The parent/caregiver is capable of taking an active role in supporting the child to manage the condition.

1 = Positive

  1. The parent/caregiver is mostly willing to accept and participate in the recommended services and support.

  2. The parent/caregiver can mostly take an active role in supporting the child to manage the condition.

2 = Limited or mixed

  1. The parent/caregiver is unsure whether they will accept or participate in the recommended services and supports or has limited capacity to do so.

  2. There is significant divergence between the parents/caregivers in the level of engagement, motivation, or ability to participate in the recommended services and supports.

3 = Minimal

  1. The parent/caregiver cannot participate in the recommended services and support without considerable practical or emotional assistance.

  2. Despite the child requiring them, the parent/caregiver has not facilitated access to services and support in the past due to low engagement or motivation.

4 = Disengaged

  1. The parent/caregiver cannot support participation in services and supports or avoids potentially useful and available supports.