Blended Family Dynamics Assessment Form
General Information
Family Name
Date
Assessment Completed By
Family Structure
List all household members and relationship to child(ren)
Number of children
Children's names and ages
How long have the current family members been living together?
Previous Family Experiences
Brief history of previous relationships/marriages (if applicable)
Describe the current relationship between biological parents
Family Dynamics
Describe the interactions between stepparent(s) and child(ren)
Describe the interactions between all siblings/stepsiblings
How are conflicts typically managed in the household?
Describe any family routines and traditions
Challenges and Strengths
What challenges has the family encountered as a blended unit?
What strategies have been helpful for overcoming these challenges?
Identify current strengths within the family
Additional Comments/Concerns