For the purposes of this report, screening and assessment fall within the broad category of approaches used to identify or uncover barriers to employment. Identification efforts may include the use of case management techniques to elicit disclosure of a barrier, the use of formal or informal screening and assessment tools (discussed in Questions Four and Five), or clinical diagnosis. Because TANF agencies are not expert in diagnosing specific conditions, nor are their staff generally trained as clinicians or social workers, the level of identification undertaken by TANF agencies is likely to fall under the broad headings of screening or assessment. Below we clarify our use of these terms in this report. However, it bears noting that different organizations use these terms differently and, just as TANF agencies and their partners need to clarify how terms used to describe barriers are used, so do they need to clarify terminology used regarding identification.
What do we mean by "screening?"
The use of the term "screening" in this report refers to a process of determining if an individual is "at risk" of a certain condition or barrier. Screenings are intended to determine the likelihood that a person requires additional assessment to uncover a particular barrier. Screening as used here is not considered a definitive decision that a person faces a particular problem or condition - that would be a diagnosis6 - or even a comprehensive attempt to uncover a barrier. Screening tools are often described as inexpensive, requiring no training for staff to administer,7 and requiring little time to implement.
What do we mean by "assessment?"
The term "assessment," as used in this report, includes both specific efforts to identify barriers, as well as an on-going process of determining what barriers an individual faces. Assessment might include using a tool to identify a particular barrier, or could be a more general process of monitoring progress and analyzing (or assessing) why expected progress is not achieved. If a screening determines that an individual is likely to have a substance abuse problem, assessment will help confirm or deny the problem. Assessment for a specific barrier differs from screening in that it is more definitive and likely requires some training to implement and interpret results. However, it does not replace formal diagnosis. Conclusive determination that a problem exists, and determination of its extent, requires clinical assessment or diagnosis by a professional.
6 Diagnosis is a formal medical determination requiring professional training and is often required for insurance purposes or program participation. Given that this level of identification is not likely to occur within TANF agencies, it is not discussed in detail.
7 This does not alleviate the need for training on related issues such as awareness, handling information obtained through screening, or making appropriate referrals based on screening information, discussed further in Question Eight.