Research project in LIVSVÆRK: Assessment methods for interventions in the zone of proximate development for mentally vulnerable children, parents, young persons and adults

The aim of the research project is to train professionals in four newly developed assessment methods in selected institutions under the auspices of LIVSVÆRK with a view to improving the selection of realistic intervention plans in efforts related to mentally vulnerable children, parents, young people and adults. Additionally, the aim is to be able to validate the methods to ensure ethically sound and appropriate as-sessments in a broader context as well as ensure a high level of quality in the use of the assessment methods. The project entails an investigation of the professionals’ experiences with using the assessment tools in practice.

Background knowledge
Unfortunately, considerable resources are used to support people with mental health challenges without research-based knowledge on whether the initiative or intervention will have the desired effect, especially in terms of personal, emotional and social competences. Many professionals have reported a desire to be able to ‘tailor’ interventions and also to be able to measure the impact of interventions. Most evaluations and assessments often only concern the child’s, young person’s or adult’s level of cognitive or motor functioning and occasionally, they undergo psychiatric evaluation which results in one or several psychi-atric diagnoses. These evaluations are rarely followed up with intervention plans for how best to support the individual’s personality, emotional or social development. Therefore, we frequently see in the clinical environment that the development efforts often depends on the individual professional’s subjective as-sessment of what might prove helpful.

Fortunately, studies and assessments of children, parents, young persons and adults’ emotional develop-ment, which theoretically integrate attachment theory, developmental psychology, trauma theory and neu-roscience, are increasingly being adopted in both day treatment and 24-hour treatment environments. The intention is to develop relevant intervention plans to meet the emotional, personality or social development needs of children, parents, young persons and adults regardless of their inherent competences or difficul-ties. It has been found that while no single intervention method works for everyone, nearly everyone can benefit from one of the numerous methods that exist. As with cognitive learning, emotional learning is only possible in the zone of proximate development, which is why it is insufficient to merely know what a person needs to learn to develop their personality. One also needs to know what the person is currently capable of learning. A specific and targeted intervention therefore requires well-developed assessment methods to identify the most appropriate intervention. Accordingly, there is a need to help professionals identify the emotional, personality and social level of functioning in children, parents, young persons and adults and, on the basis of that assessment, prepare an optimal intervention plan for pedagogical interven-tions, psychotherapy/family therapy, etc.

A literature search conducted in 2018 in connection with a PhD dissertation found a lack of any national or international assessment methods that focus on emotionality and communication and which can meas-ure developmental stages, capacities and vulnerabilities (Hart, 2018). Developing this type of assessment methods can help ensure that interventions are impactful and hold greater potential to ensure mental health development and well-being regardless of the individual’s diagnosis or vulnerability.

The research project
The aim of the project is to link assessments to interventions as well as ensure ethically sound and appro-priate assessments of people with special mental health and psychological challenges, with a view to en-suring that the resources spent to ensure health and well-being are utilised optimally. Since 2012, we in the research group have been working on developing assessment methods to identify the personality, emotional and communicative resources of children, parents, young persons and adults, as well as the interaction qualities that take place between parent and child. The assessment methods are used by profes-sionals to design realistic interventions where it is subsequently possible to measure the effect of the in-tervention, both in terms of emotional functions in children, parents, young persons and adults as well as the interactions between parent and child.

The four newly developed assessment methods are as follows:
1) The Neuroaffective Analysis (NAA), which analyses emotional competencies in children, young persons and adults.

2) The Emotional Mentalizing Scale (EMS), which analyses the mentalising skills of young persons, adults and parents.

3) The Marschak Interaction Method of Psychometrics (MIM-P), which is a structured interaction observation method that analyses parent and child/young person interactions.

4) The Assessment of Parent-Child Interaction (APCI), which is also a structured interaction obser-vation method that assesses non-verbal interaction qualities between parent and child.

Upskilling and quality assurance
The benefits and value of the research project consist of the implementation and quality assurance of as-sessment methods focused on the development of personality, emotions and social competences in vul-nerable children, parents, young persons and adults with mental health challenges in LIVSVÆRK’s insti-tutions as well as an upskilling of professionals working under the auspices of LIVSVÆRK in terms of dissemination to other relevant subject and network groups not affiliated with LIVSVÆRK.

In collaboration with LIVSVÆRK, a selection of professionals from a wide range of LIVSVÆRK insti-tutions will be trained and certified in the use of new assessment methods, while collecting data with a view to enable a quality assurance of their use. The assessment methods are used as a framework of un-derstanding for interventions and can contribute background knowledge for providing realistic interven-tions focused on the emotional zone of proximate development. The aim is to use NAA to evaluate emo-tional competences and collect data on the basis of daily practice in work involving approximately 300-400 children, parents, young persons and adults over a period of approximately 12 months. From this group, 40 parents, young persons or adults who have undergone an EMS evaluation will be selected to assess their mentalising competences. The aim is also to use two assessment methods to evaluate interac-tions between parents and children (MIM-P and APCI) and collect data on the basis of daily practice with 40 families over a period of approximately 12 months.

Data from the assessment methods will be analysed and the methods compared to examine, adjust and document reliability and validity. This will provide potential opportunities to expand the applicability of the methods in relation to their effect, which in turn provides opportunities to generate research-based evidence of the utility of the methods.

In addition to the implementation and quality assurance of the assessment methods’ utility, the profes-sionals’ experiences with using the methods will be investigated with the help of a digital questionnaire. The focus in this aspect of the project will be on their experiences with learning and how they perceive the assessment methods and their experiences with their application in terms of designing realistic interven-tion plans and targeted interventions. With a view to further developing and ensuring the quality of future interventions, follow-up research on parents, young persons and adults’ experiences with participating in EMS, MIM-P and APCI can be included as part of the project, provided that funding and resources are available for such follow-up research.

This research project aims to test assessment tools examining emotional and social challenges of people in vulnerable positions including children, adolescents, adults, and families. Practitioners need good assessment tools to explore psychological challenges and potentials in order to plan the best interventions. Unfortunately, there is a lack of evidence-based assessments looking at emotional, social and interaction skills which is why researchers from Aalborg University and a large group of professionals from LIVSVÆRK are collaborating to test and improve a number of newly developed assessment tools for the benefit of both individual citizens and citizens in vulnerable positions and society as a whole.