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Foster/Adoptive Parent Coaching Request Form

Clarifying Terms:
"Learner" - Person being referred for coaching
"Requestor" - Person making the request

Learner's Name:
Learner's Email:
Requestor's Name
Requestor's Email:
Requestor's Phone:
Training Region:
Licensing Agency:
Primary Reason for Referral:
Purpose of Coaching Event:
(maximum of 150 characters)

Additional Comments:
(maximum of 150 characters)

Directions:
1.  Scroll directly to the topics appropriate for coaching for the Learner.
                                            2.  Click in the box next to the skill set that you would like to have a Coach work on with the Learner
3.  Once skills sets have been selected click on SUBMIT at the bottom.
  

NOTE: 
This is not a comprehensive needs assessment.
Please just select the skill sets that can reasonably be addressed in a coaching intervention.

Role On The Child Protection Team

922

01

Ability to effectively work with caseworker and other agency staff

922

02

Ability to assist with the achievement of case plan goals

922

03

Ability to effectively function as a member of the child protection team

Developmental Issues in Child Maltreatment

923

01

Ability to recognize indicators of healthy development

923

02

Ability to recognize and respond to potential developmental problems

923

03

Ability to enhance children's development

923

04

Ability to promote healthy sexual development in children

923

05

Ability to adjust parenting style to better care for a child who has been maltreated

Attachment, Separation and Placement

924

01

Ability to recognize effect of insecure attachment

924

02

Ability to help children maintain attachments formed prior to placement

924

03

Ability to help children develop healthy attachments

Constructively Managing Children's Behavior

925

01

Ability to determine the influences on children's behavior

925

02

Ability to manage children's behavior

925

03

Ability to use the appropriate form of discipline for the child and the behavior

Promoting Placement Stability

926

01

Ability to adjust to the impact of caregiving

926

02

Ability to cope with ongoing stress related to caregiving

926

03

Ability to develop and maintain supportive relationships

926

04

Ability to help children adjust to caregiver's home

926

05

Ability to prevent family crisis in the caregiving home

926

06

Ability to resolve family crisis safely in the caregiving home

Cultural Foundations

927

01

Ability to recognize the impact of culture for a child and family

927

02

Ability to interact with children and their families in a culturally supportive way

927

03

Ability to help children resolve issues related to cultural differences

Primary Families

928

01

Ability to support contacts between children and their primary famlies

928

02

Ability to work with primary families towards permanency

Permanency Options For Children In Care

929

01

Ability to assist the child welfare team in achieving the most appropriate permanency goal for the child

929

02

Ability to determine if adoption is an option for the caregiving family

Building Self Reliance, Resilience and Independence in Children

941

01

Ability to help children and adolescents develop skills and relationships needed to thrive in adulthood

941

02

Ability to provide support to adolescents/young adults as they prepare to live on their own

941

03

Ability to help the emancipating youth locate resources and networks

941

04

Ability to help the emancipating youth find suitable independent living arrangements

Caring For Adolescents Who are Pregnant or Parenting

942

01

Ability to provide care to pregnant adolescents

942

02

Ability to provide care to parenting adolescents

Caring for Children Who Have Been Maltreated

943

01

Ability to care for a child who has been physically abused

943

02

Ability to care for a child who has been neglected

943

03

Ability to care for a child who has been sexually abused

943

04

Ability to help child victims of sexual abuse resolve emotional and behavioral problems

943

05

Unique considerations for caregivers who are caring for sexually abused children

Care for Children Who Have Been Sexually Abused

944

01

Ability to provide care to children who have sexually abuse other children

944

02

Ability to provide a safe environment for all members of the caregiving family

Caregiver Training on Family Safety

945

01

Ability to maximize safety of family member in the home

945

02

Ability to recognize when personal safety may be at risk

Providing Care to Children Who Are Medically Fragile

946

01

Ability to provide care to children who have fragile medical conditions

946

02

Ability to help the child and family member cope with emotional reactions to the medically fragile condition

946

03

Ability to participate as a member of the treatment team for a child with a fragile medical condition

Caregiver Training in Managing Placement Transitions

947

01

Ability to assist in reunifying the child with this primary family or kinship family

947

02

Ability to prepare a child to leave the caregiver's home and join her adoptive family or next caregiving family

947

03

Ability to help the child re-join the family after reunification fails

Promoting Post-Adoption Family Stability

948

01

Ability to make the transition from caregiving family to adoptive family

948

02

Ability to cope with the ongoing stress related to adoptive parenting

948

03

Ability to resolve issues of infertility

Enhancing Children's Connections

949

01

Ability to work with siblings of children in care

949

02

Ability of foster and kinship caregivers to work with primary parents and extended family members to promote permanence and well-being for the child

949

03

Ability to talk with placed or adopted children about their history and birth families

949

04

Ability to manage a range of openness in caregiver and adoptive placements

949

05

Ability to help children search for birth family members

Legal and Ethical Issues for Caregivers

950

01

Ability to participate in juvenile court hearing for foster or kinship children

950

02

Ability to protect oneself from legal liability and defend against allegations of wrongdoing

Coaching and Mentoring Primary Families and Other Caregiving Families

951

01

Ability to plan and conduct coaching and mentoring to help primary families and caregivers increase their knowledge and skills

Preventing Placement Disruption

952

01

Ability to help children adjust to caregiver's home

952

02

Ability to help build relationships among all children in the home

952

03

Ability to detect early signs that a placement is breaking down, and to take action to save the placement

Caregiver Training on Written and Verbal Communication

980

01

Ability to write clear and accurate caregiver reports for the case record

980

02

Ability to communicate with the family and community members

Caregiver Training on Culture and Diversity

981

01

Ability to work toward cultural competence

981

02

Ability to understand families from diverse cultures

981

03

Ability to understand issues of refugees or immigrants

Caregiver Training on Developmental Disorders

983

01

Ability to provide care to children with developmental disorders

983

02

Ability to obtain assessments, treatment, and services for children who have developmental disorders

983

03

Ability to identify developmental disabilities in adults

983

04

Ability to support parents with developmental problems

Caregiver Training on Gangs and Cults

984

01

Ability to care for youth who are involved in gangs and cults

Caregiver Training on Human Sexuality

985

01

Ability to help children and adolescents with the development of a healthy sexual identity

Effects of Adoptive Parenting and Caregiving on Families With Diverse Structures

987

01

Ability to manage caregiving as a single parent

987

02

Ability to manage roles of parent and spouse/partner

Caregiver Training on Substance Abuse

988

01

Ability to recognize signs of alcohol and drug abuse

988

02

Ability to work with parents who abuse drugs or alcohol

988

03

Ability to provide care for children who abuse drugs or alcohol

Self-Care for Caregivers and Foster Parents

989

01

Ability to organize time to complete caregiver tasks

989

02

Ability to take care of personal stress often found with caregiving

Caregiver Training on Health Issues

990

01

Ability to recognize illnesses or conditions in children

990

02

Ability to care for children with an illness or medical condition

990

03

Ability to help children and adolescents obtain treatment for Sexually Transmitted Infections (STI's)

Caregiver Training on Domestic and Family Violence

993

01

Ability to recognize the signs and impact of domestic violence

Caregiver Training Meeting Children's Educational Needs

994

01

Ability to support children in regular school settings

994

02

Ability to advocate for child's fair treament in school

994

03

Ability to help the child cope with the stresses of school and encourage continued education

994

04

Ability to ensure children in care receive special educational programs, services, and accommodations, as needed

994

05

Ability to help teens apply to colleges or universities

Caregiver Training on Mental Health Problems

995

01

Ability to provide care to children with emotional, behavioral, or thought disorders

995

02

Ability to recognize and respond to indicators of mental health problems in children

995

03

Ability to provide a therapeutic environment for children with mental health problems

995

04

Ability to identify mental health problems in adults

995

05

Ability to provide a therapeutic environment for children with mental health disorders