Assessment Concepts

1.Impact of poverty on individuals, families, groups, organizations, and communities (e.g., social determinants of health)

• Social determinants of health (WHO) are the conditions in which people are born, grow, live, work and age: income, housing, food security, education, employment, social inclusion and access to care. They drive health more than medical care does.
• Poverty in childhood produces toxic stress that can affect brain development, school readiness and lifelong health; the effects are cumulative and interact with adverse childhood experiences.
• Poverty is measured differently: the US uses the Official Poverty Measure and the Supplemental Poverty Measure; Canada’s official poverty line since 2019 is the Market Basket Measure.
• Do not confuse poverty with neglect: a family without food or heat because of low income needs resources, while neglect involves a caregiver’s failure to meet needs that could be met.
• Assess and address basic needs first (food, shelter, safety, income) before insight-oriented work, and treat poverty as structural, avoiding blame-the-victim explanations such as the discredited culture of poverty thesis.

In practice: A mother is referred because her children often miss school. The worker learns the family was evicted and is moving between relatives. The plan begins with housing, transport and school stability supports rather than a parenting class.

2.Indicators and impact of trauma, stressors, violence, and crises on individuals, families, groups, organizations, and communities (e.g., intergenerational, historical, and complex)

• The Adverse Childhood Experiences study (Felitti and Anda, 1998) found a dose-response link between childhood abuse, neglect and household dysfunction and later physical and mental illness; protective relationships buffer the effect.
• DSM-5-TR PTSD requires exposure to actual or threatened death, serious injury or sexual violence, plus intrusion, avoidance, negative changes in thinking and mood, and changes in arousal and reactivity, lasting more than one month. Acute stress disorder covers 3 days to 1 month.
• Complex trauma follows repeated, interpersonal trauma, often in childhood, and affects emotion regulation, self-concept and relationships (ICD-11 lists complex PTSD; DSM-5-TR does not).
• Historical trauma (Brave Heart) is the cumulative wound across generations from mass trauma such as colonization, slavery or genocide; intergenerational trauma passes through parenting, family stories and stress biology.
• A crisis (Caplan) is a time-limited state of disequilibrium, often resolving in four to six weeks, when usual coping fails; crises are developmental, situational or existential, and can be a turning point for growth.
• Trauma shows differently by age: regression and repetitive play in young children, school problems and risk-taking in adolescents, somatic complaints and substance use in adults; groups, organizations and communities also show collective trauma.

In practice: After a fatal shooting at a community center, a worker offers psychological first aid to staff and youth, watches for intrusive memories and avoidance over the following weeks, and refers those with persistent symptoms for trauma-focused treatment.

3.Indicators and impact of addiction and substance use and abuse on individuals, families, groups, organizations, and communities

• DSM-5-TR substance use disorder uses 11 criteria in four groups: impaired control, social impairment, risky use and pharmacological criteria (tolerance, withdrawal). Severity: mild 2 to 3, moderate 4 to 5, severe 6 or more within 12 months.
• Tolerance and withdrawal from a medication taken as prescribed do not count toward the diagnosis.
• Alcohol and benzodiazepine withdrawal can be life-threatening (seizures, delirium tremens) and need medical management; opioid withdrawal is very distressing but rarely fatal, while opioid overdose is, especially with fentanyl.
• Screening tools include AUDIT and CAGE for alcohol, DAST for drugs, and CRAFFT for adolescents; screen everyone, because use is often hidden.
• Families adapt with roles (Wegscheider-Cruse: enabler, hero, scapegoat, lost child, mascot) and codependency; children of parents with addiction face higher risk, and prenatal alcohol exposure can cause fetal alcohol spectrum disorder.
• Organizations and communities feel the impact through absenteeism, accidents, overdose deaths and strained services, as in the opioid crisis in both the US and Canada.

In practice: A client mentions shaking hands and sweating in the morning that stop after a drink. The worker recognizes possible alcohol withdrawal, screens with the AUDIT and arranges a medical assessment before any plan to stop drinking abruptly.

Clinical items expect DSM-5-TR criteria and severity; Bachelors items expect recognition of signs, screening and referral.

4.Indicators, dynamics, and impact of physical, sexual, and psychological abuse and neglect on individuals, families, groups, organizations, and communities

• Neglect is the most common form of child maltreatment; physical, sexual and psychological abuse and exposure to domestic violence are the others.
• Physical abuse indicators: bruises in protected areas (torso, ears, neck), patterned marks (hand, belt, cord), injuries at different stages of healing, explanations that do not fit the injury or the child’s development, and any bruise on a baby who is not yet mobile.
• Sexual abuse indicators include sexual knowledge or behavior beyond the child’s age, sexually transmitted infections, genital injury, and sudden fear of a person or place; many children show no physical signs.
• Intimate partner violence is a pattern of power and control (Duluth Power and Control Wheel); Walker’s cycle runs tension building, acute violence, then reconciliation. Leaving is often the most dangerous period, so safety planning comes before urging separation.
• Psychological abuse (threats, terrorizing, isolating, belittling) and neglect have effects as serious as physical abuse on development, attachment and mental health.
• Older and dependent adults experience physical, sexual, emotional and financial abuse and neglect, including self-neglect; signs include unexplained injuries, poor hygiene, missing money and an isolated, fearful person.

In practice: A 4-month-old brought in for a cold has small bruises on the cheek and ear. The worker recognizes that bruising in a non-mobile infant is a red flag and makes a child protection report while the medical team examines the baby.

5.Family dynamics and functioning and the effects on individuals, families, groups, organizations, and communities

• Family systems theory treats the family as a whole greater than its parts: a change in one member affects all, families seek homeostasis, and causality is circular rather than linear.
• Minuchin’s structural concepts: subsystems (parental, sibling), boundaries that are clear, enmeshed (too diffuse) or disengaged (too rigid), and hierarchy.
• Bowen’s concepts: differentiation of self, triangulation (pulling a third person into a two-person conflict), emotional cutoff, multigenerational transmission and the family projection process.
• The family life cycle (Carter and McGoldrick) describes stages such as forming a couple, families with young children, adolescents, launching and later life; distress often peaks at transitions.
• Parentification, scapegoating and rigid roles shape individual behavior; family patterns also spill into schools, workplaces and communities.
• Tools: the genogram maps three generations of relationships and patterns; the ecomap maps the family’s links to outside systems.

In practice: A 12-year-old’s school refusal began when his parents’ conflict escalated. The worker sees that his symptom pulls the parents together around him (triangulation) and engages the whole family rather than the boy alone.

6.Dynamics of interpersonal relationships and relationship development (e.g., family, couples, groups, polyamory)

• Adult attachment styles (secure, anxious, avoidant, fearful-avoidant) echo early attachment and shape closeness, conflict and trust in couples and friendships.
• Gottman identifies four patterns that predict relationship breakdown: criticism, contempt, defensiveness and stonewalling; contempt is the strongest predictor. Repair attempts and a positive ratio of interactions protect relationships.
• Relationships develop through stages of initiating, deepening and maintaining, and may deteriorate and end; groups move through stages of forming, storming, norming, performing and adjourning (Tuckman).
• Polyamory and other forms of consensual non-monogamy are relationship structures, not pathology; assess the same issues as for any relationship (agreements, communication, jealousy, safety, legal rights) without judgment.
• Power, communication patterns, culture and family-of-origin roles shape all relationships; abuse can occur in any relationship structure.

In practice: A client in a polyamorous triad seeks help with conflict over time-sharing. The worker explores each partner’s needs and agreements, as with any couple’s conflict, and does not treat the structure as the problem.

7.Indicators of mental and emotional illness throughout the lifespan

• About half of lifetime mental disorders begin by mid-adolescence and three quarters by the mid-20s, so early identification matters.
• Childhood: ADHD symptoms must appear before age 12 and in two or more settings; autism signs (social communication differences, restricted or repetitive behavior) appear in early development; anxiety often shows as stomach aches or school avoidance; depression in children and teens may look like irritability.
• Adolescence and young adulthood: onset of mood, anxiety and eating disorders and of psychosis; schizophrenia usually begins between the late teens and mid-30s, often after a prodrome of withdrawal and declining functioning.
• Older adults: depression often presents with physical complaints, fatigue or memory problems; delirium starts suddenly with fluctuating attention and is a medical emergency, while dementia develops gradually with intact attention early on.
• General indicators at any age: marked change in sleep, appetite, functioning or relationships, withdrawal, hopelessness, unusual thoughts or perceptions, and talk of death or suicide.
• Suicide risk varies by group and age: rates are high among older men and among middle-aged adults, and suicide is a leading cause of death for youth; in Canada, rates are much higher in some Indigenous communities, especially among Inuit youth.

In practice: An 80-year-old woman becomes confused over two days, sees insects on the walls and is drowsy, then agitated. The worker recognizes possible delirium and arranges urgent medical assessment rather than assuming dementia.

Clinical items expect DSM-5-TR differentiation (for example, delirium versus dementia, onset criteria); Bachelors items expect recognition and referral.

8.Impact of out-of-home placement (e.g., hospitalization, foster care, residential care, criminal justice system) on clients/client systems

• Children in foster care experience loss and grief, loyalty conflicts between birth and foster families, disrupted attachment and often placement instability, which predicts worse outcomes.
• Kinship care is preferred when safe because it preserves family, culture and community ties; reunification is usually the first permanency goal.
• Youth aging out of care face high risks of homelessness, unemployment and justice involvement; many US states extend foster care to 21 and Canadian provinces offer extended supports into the early or mid-20s.
• Residential care, psychiatric hospitalization and incarceration remove people from family and community; use the least restrictive setting and plan discharge from the start.
• Incarceration affects whole families: parental incarceration is an adverse childhood experience, and people returning from prison face barriers to housing and work and, in some US states, to voting.
• Older adults moving to long-term care may experience relocation stress (confusion, depression); preparation, choice and familiar belongings help.

In practice: A 10-year-old placed in foster care is angry with his foster mother and protective of his birth mother. The worker normalizes his loyalty conflict, keeps regular family visits, and helps the foster parent understand the behavior as grief.

9.Factors of out-of-home displacement (e.g., homelessness, immigration, and refugee status) on clients/client systems

• Homelessness can be chronic, episodic, transitional or hidden (couch-surfing); structural causes such as housing costs and low income interact with individual vulnerabilities such as illness, addiction and violence.
• Housing First provides permanent housing without requiring sobriety or treatment first, with support services; it improves housing stability in US programs and in Canada’s At Home/Chez Soi trial.
• Groups overrepresented among people who are homeless include Indigenous people, LGBTQ2S+ youth, people leaving care or prison, veterans and survivors of violence.
• Displacement disrupts schooling, health care, social ties and identity; in the US, the McKinney-Vento Act protects homeless children’s right to stay in their school.
• Refugees, migrants and people displaced by disasters or climate change face loss of home, community and status, and stress that continues after arrival.

In practice: A youth staying with friends asks for help finishing school. The worker identifies hidden homelessness, connects him with youth housing and the school’s liaison for homeless students, and keeps him enrolled in his current school.

10.Co-occurring disorders and conditions

• Co-occurring disorders are common: roughly half of people with a substance use disorder also have a mental disorder, and the reverse is also frequent.
• Integrated treatment, addressing both conditions at once by the same team, is the evidence-based standard, rather than sequential (one then the other) or parallel (separate providers) care.
• Distinguish substance-induced symptoms from independent disorders: symptoms that began before use or persist about a month after stopping suggest an independent disorder.
• Co-occurring conditions also include chronic medical illness with depression, intellectual or developmental disability with mental illness (often called dual diagnosis in Canada), and trauma with addiction.
• Co-occurring disorders raise risk of homelessness, incarceration, suicide and dropout; assess both conditions whenever one appears and do not exclude people from services because of the other condition.

In practice: A man with bipolar disorder drinks heavily during depressive periods. The worker refers him to a program that treats mood and alcohol use together and coordinates with his psychiatrist rather than requiring sobriety before mental health care.

Clinical items test substance-induced versus independent disorders and integrated treatment planning; other levels test recognition and referral.

11.Factors influencing self- and body-image (e.g., culture, race, religion/spirituality, age, ability, trauma, gender, sexuality, size)

• Self- and body-image are shaped by culture, media and social media, race, religion, age, ability, gender, sexuality, size and trauma; weight stigma itself harms health.
• Eating disorders: anorexia nervosa (restriction, significantly low weight, fear of weight gain, distorted body image) has one of the highest mortality rates of any mental disorder; bulimia nervosa involves binge eating and compensatory behaviors; binge-eating disorder is the most common.
• Avoidant/restrictive food intake disorder involves restriction without body-image concerns; body dysmorphic disorder is preoccupation with perceived flaws, including muscle dysmorphia, more common in men.
• Men, older adults, people in larger bodies and racialized clients are often missed; ask about eating and body image directly.
• Sexual abuse, bullying, gender dysphoria, disability and aging can all affect body image; a weight-inclusive, nonjudgmental approach supports engagement.

In practice: A 15-year-old athlete has lost weight quickly and avoids team meals. The worker asks directly about eating and body image, involves the parents as appropriate, and arranges an urgent medical evaluation because of possible medical instability.

12.Characteristics of perpetrators of abuse, neglect, and exploitation

• Most child maltreatment is committed by parents or caregivers, and most child sexual abuse by someone the child knows and trusts, not a stranger.
• Risk factors for perpetration include a history of being abused, substance use, untreated mental illness, high stress, social isolation, unrealistic expectations of children and acceptance of violence; none is a profile, and many people with these factors never abuse.
• Grooming progresses from selecting a vulnerable child, gaining trust (of child and family), filling needs, isolating, sexualizing contact and maintaining secrecy.
• Intimate partner abusers often minimize, deny or blame the victim, show jealousy and control, and may appear charming in public.
• Elder abuse perpetrators are often adult children or spouses, frequently dependent on the victim for money or housing, sometimes with substance use or caregiver stress.
• Exploiters and traffickers are often partners, relatives or acquaintances who use affection, debt or threats.

In practice: A mother says her new partner insists on bathing her 7-year-old alone and buys the child secret gifts. The worker recognizes grooming signs, explores safety and consults about a report to child protection.

13.Impact of caregiving on families

• Caregivers, most of them women, often experience caregiver burden: depression, anxiety, poor health, isolation, lost income and strained relationships; tools like the Zarit Burden Interview measure it.
• The sandwich generation cares for children and aging parents at once; young carers (children caring for a parent or sibling) are often invisible to services.
• Supports include caregiver assessment, respite, support groups, education about the illness, care coordination and financial help; Canada’s Employment Insurance caregiving benefits and the US Family and Medical Leave Act protect some leave.
• Severe caregiver stress, especially with substance use or a hostile relationship, is a risk factor for elder abuse and neglect, so support for the caregiver also protects the care recipient.
• Caregiving can also bring meaning and closeness; family conflict about who cares and how often needs a family meeting.

In practice: A daughter caring for her father with dementia admits she yelled at him and fears she will hurt him. The worker assesses safety, arranges respite and day programs, and links her to a caregiver support group.

14.Indicators, dynamics, and impact of exploitation across the lifespan (e.g., financial, immigration status, trafficking)

• Exploitation takes different forms across the lifespan: online grooming and sextortion of children, recruitment of adolescents into sex trafficking (often through a romantic partner), labor trafficking and wage theft of adults, and financial exploitation of older adults.
• Indicators: someone else controls the person’s documents, money or phone; scripted or rehearsed answers; unexplained gifts, phones or money in youth; frequent running away; injuries; working excessive hours; sudden changes in an older adult’s banking, will or power of attorney.
• Immigration status is a lever: threats of deportation, debt bondage and withheld passports keep victims silent.
• Trauma bonding, shame, fear and dependence explain why victims may defend or return to their exploiter.
• Response: safety first, a trauma-informed, nonjudgmental approach, specialized services and, for minors, child protection reporting.

In practice: An older man’s new caregiver has been added to his bank account and his savings are dropping. The worker meets him alone, assesses his capacity and wishes, explains options, and reports to adult protective services where required.

15.Biopsychosocial assessment model and related components and factors

• The biopsychosocial model (Engel, 1977) holds that problems arise from interacting biological, psychological and social factors; social work often adds the spiritual dimension.
• Biological: health, disability, medications, substance use, sleep, nutrition, family medical history and development.
• Psychological: mood, cognition, mental status, coping, personality, trauma history and strengths.
• Social: family, culture, relationships, housing, income, employment, education, legal issues, community and access to services; spiritual: beliefs, practices and meaning.
• The assessment ends in a formulation that links the factors, explains the presenting problem, and leads to goals; the person-in-environment perspective (and the PIE classification) keeps the focus on the fit between person and environment.

In practice: A man referred for anger outbursts is found to have untreated sleep apnea, recent job loss and isolation since moving. The worker’s formulation links all three, and the plan addresses medical care, employment help and social connection.

16.Effects of physical and mental ability throughout the lifespan

• Models of disability: the medical model locates disability in the person; the social model locates it in barriers in the environment; the WHO’s International Classification of Functioning (2001) combines body, activity, participation and context.
• Intellectual developmental disorder (intellectual disability) in DSM-5-TR involves deficits in intellectual and adaptive functioning with onset in the developmental period; severity is defined by adaptive functioning, not IQ alone.
• Acquired disability (injury, stroke, illness) brings grief, identity change and adjustment for the person and family.
• The independent living and disability rights movements (nothing about us without us) emphasize choice, accommodation and inclusion over protection; ableism is discrimination based on ability.
• Ability changes across the lifespan: children with disabilities need early intervention and inclusive education, adults need work and independence supports, and people aging with a disability face added health changes.

In practice: A young woman with cerebral palsy wants to move out of her parents’ home. The worker focuses on the supports and accommodations she needs and her right to choose, while helping her parents with their worries.

17.Typical and atypical physical, cognitive, emotional, and sexual development throughout the lifespan

• Erikson’s psychosocial stages: trust versus mistrust (infancy), autonomy versus shame and doubt (toddler), initiative versus guilt (preschool), industry versus inferiority (school age), identity versus role confusion (adolescence), intimacy versus isolation (young adult), generativity versus stagnation (middle adult), integrity versus despair (older adult).
• Piaget’s cognitive stages: sensorimotor (0 to 2, object permanence), preoperational (2 to 7, symbolic play, egocentrism, no conservation), concrete operational (7 to 11, logic about concrete things, conservation) and formal operational (12 and up, abstract and hypothetical thinking).
• Attachment (Bowlby, Ainsworth’s Strange Situation): secure, anxious-ambivalent, avoidant, and disorganized (Main), the last linked to frightening or maltreating care.
• Typical milestones include walking around 12 months, two-word phrases around 2 years and puberty between roughly 8 and 14; delays in speech, social engagement or motor skills call for developmental screening.
• Sexual development is part of normal development: curiosity and self-touching are typical in young children, while sexual knowledge or acts beyond the child’s age, coercion or distress are concerning.
• Kohlberg’s moral development moves from preconventional (avoid punishment) to conventional (rules and approval) to postconventional (principles); Gilligan added an ethic of care.

In practice: Parents worry that their 4-year-old insists the moon follows the car and that a tall glass holds more juice than a wide one. The worker explains this is typical preoperational thinking, not a delay.

18.Impact of aging on the individual and family systems

• Theories of aging: activity theory (staying engaged supports wellbeing), disengagement theory (mutual withdrawal, now largely criticized) and continuity theory (people keep earlier patterns).
• Some slowing of memory and processing is normal; dementia, depression and delirium are not normal aging and need assessment.
• Older adults face multiple losses (spouse, friends, health, roles), ageism, risks of falls and polypharmacy, and elder abuse; many also show high resilience and life satisfaction.
• Family systems shift: adult children may become caregivers, grandparents may raise grandchildren, and retirement changes couple roles.
• Income and health programs differ: in the US, Social Security (reduced from 62, full at 67 for those born in 1960 or later) and Medicare at 65; in Canada, Old Age Security, the Guaranteed Income Supplement, the Canada and Quebec Pension Plans and provincial health care; most older adults wish to age in place.

In practice: A 78-year-old recently widowed man stops going to his seniors’ club and sleeps much more. The worker screens for depression and suicide risk, since older men have high suicide rates, rather than attributing the change to age.

19.Racial, ethnic, cultural, and spiritual/faith development throughout the lifespan

• Children notice racial differences in preschool and absorb messages about them early; parents’ racial socialization (preparing children for bias, cultural pride) protects wellbeing.
• Phinney’s ethnic identity model moves from unexamined identity through exploration (moratorium) to achieved identity; racial identity models (Cross, Helms) are covered in Diversity and Social Justice.
• Fowler’s stages of faith run from intuitive-projective and mythic-literal faith in childhood through synthetic-conventional, individuative-reflective and conjunctive faith to universalizing faith.
• Spirituality and faith communities are often sources of meaning, coping and support; religious trauma or conflict between faith and identity can also cause distress.
• Include a spiritual assessment when relevant (tools such as FICA or HOPE ask about faith, importance, community and how to address it in care), following the client’s lead.

In practice: A Muslim teen raised in a small town begins wearing a hijab and faces comments at school. The worker supports her exploration of identity, addresses the bullying with the school, and helps her parents support her choice.

20.Defense mechanisms and their effects on behavior and relationships

• Defense mechanisms are mostly unconscious ways to manage anxiety (Anna Freud); they become a problem when rigid or when they distort reality or relationships.
• Immature defenses: denial (refusing to accept reality), projection (attributing one’s own feelings to others), splitting (all good or all bad), acting out, regression (returning to earlier behavior), passive aggression.
• Neurotic defenses: repression (pushing memories out of awareness), displacement (redirecting feelings to a safer target), reaction formation (acting the opposite of one’s feelings), rationalization (plausible excuses), intellectualization (focusing on facts to avoid feelings), undoing and isolation of affect.
• Mature defenses: sublimation (channeling impulses into acceptable activity), humor, altruism, suppression (consciously setting aside) and anticipation.
• Recognizing defenses guides how you respond: gently explore denial rather than confronting it head on, and notice splitting of staff in teams.

In practice: A man angry at his boss comes home and yells at his teenage son. The worker names the pattern as displacement and helps him find safer ways to address the work conflict.

21.The influence and impact of technology, including social media, on client/client-systems (personal and professional)

• Technology brings benefits (connection, information, telehealth, online peer support) and risks (cyberbullying, sextortion, problematic gaming or social media use, sleep loss, social comparison and misinformation).
• Technology-facilitated abuse includes stalking apps, GPS tracking, monitoring accounts and sharing intimate images; include devices in safety planning.
• The digital divide (cost, connectivity, skills, disability) limits access to services that have moved online, especially for older, rural and low-income clients.
• Ask about technology use in assessment as you would about any other part of daily life, without assuming it is harmful.
• Professionally, manage your own online presence, expect clients to search for you, and never enter identifiable client information into apps or artificial intelligence tools your agency has not approved for confidential data.

In practice: A woman leaving an abusive partner keeps finding him wherever she goes. The worker helps her check her phone and car for tracking, change passwords, and adds technology safety to her plan.

22.Impact of urbanization, globalization, environmental hazards, and climate change on individuals, families, groups, organizations, and communities

• Urbanization brings opportunity but also crowding, gentrification and displacement, segregation, food deserts and isolation.
• Globalization shifts jobs and industries, drives migration and transnational families, and spreads economic shocks to local communities.
• Environmental hazards fall hardest on poor, racialized and Indigenous communities: lead (no safe blood level in children), air pollution, contaminated water and industrial sites.
• Climate change brings disasters, extreme heat (dangerous for older, isolated and chronically ill people), displacement, loss of livelihoods and climate distress or eco-anxiety; the profession now treats a changing environment as a social work concern.
• Assessment includes environmental risks; intervention ranges from disaster response and heat-wave check-ins to community organizing for environmental justice.

In practice: Before a forecast heat wave, a worker at a seniors’ agency calls isolated clients without air conditioning, arranges cooling center transport, and checks medications that raise heat risk.

23.Client/client system competence, self-determination, and self-monitoring techniques (e.g., financial decisions, treatment decisions, emancipation, age of consent, permanency planning)

• Capacity is a clinical judgment, specific to a decision and a time; competence (incompetence) is a legal finding by a court. Presume capacity unless there is evidence otherwise.
• Substitute decision-making ranges from powers of attorney and representative payees to guardianship or conservatorship (in Quebec, since 2022, tutorship to adults, assistance measures and the protection mandate); use the least restrictive option and supported decision-making where possible.
• Minors: age of consent to treatment varies (Quebec 14, Ontario capacity-based, many US states set ages for specific services); emancipation of minors is a legal status granted by courts or by events such as marriage, depending on the jurisdiction; age of sexual consent is 16 in Canada with close-in-age exceptions and 16 to 18 in US states.
• Permanency planning gives children a stable, lasting family through reunification, kinship care, guardianship or adoption; concurrent planning works on reunification and an alternative plan at the same time.
• Self-monitoring techniques (logs, diaries, scaling, mood and craving trackers, apps) increase clients’ awareness and control and provide data for evaluating progress.

In practice: An adult son asks the worker to take over his mother’s finances because she gave money to a charity he dislikes. The worker assesses whether she understands her choices, finds she has capacity, and respects her decision while offering scam education.