# Evaluating the Applicability of the Self-Assessment Tool for Family Caregivers (SSA-PA) in Care Counseling According to Section 45 of the German Social Code (SGB XI): A Mixed-Methods Study

## TL;DR

This study explores how well a self-assessment tool works for caregivers in German care counseling, finding it useful but needing improvements.

## Contribution

The study provides empirical insights into the SSA-PA's applicability in statutory German care counseling settings.

## Key findings

- Care advisors found the SSA-PA useful for structuring and reflecting on caregiver burden discussions.
- Practical challenges included time constraints and emotional strain for caregivers.
- Suggestions for improvement include automated processing and longitudinal tracking.

## Abstract

Background/Objectives: Family caregivers play a central role in long-term care but are frequently exposed to considerable physical, emotional, and social strain. In Germany, care counseling pursuant to §45 SGB XI aims to identify caregiver burden at an early stage and provide preventive, resource-oriented support. Structured self-assessment tools may facilitate reflective dialogue within time-limited counseling sessions. The Self-Assessment Tool for Family Caregivers (SSA-PA) was developed to support this process; however, empirical evidence regarding its applicability in statutory counseling settings remains limited. This exploratory mixed-methods study aimed to generate empirical insights into (1) the perceived usefulness and acceptance of the SSA-PA among care advisors, (2) opportunities and challenges associated with its practical implementation, and (3) its perceived integration potential within routine counseling practice. Methods: Thirteen care advisors working under §45 SGB XI applied the SSA-PA in routine counseling and subsequently completed a structured online survey combining Likert-scale items and open-ended questions. Quantitative data were analyzed descriptively using IBM SPSS Statistics (Version 29), and qualitative responses were examined using thematic analysis. Given the moderate sample size (n = 13), analyses were primarily descriptive and exploratory in nature. Results: Care advisors reported high perceived usefulness and broad acceptance of the SSA-PA as a structuring and reflective instrument in counseling sessions. The tool was described as supportive in facilitating discussion of caregiver burden across multiple life domains and enhancing transparency of stress-related issues. At the same time, participants identified practical challenges, including time constraints, emotional strain for caregivers, technical barriers, and the need for clearer evaluation outputs. Suggestions for further development included automated result processing, individualized recommendations, and longitudinal tracking functions. Conclusions: From the perspective of participating care advisors, the SSA-PA demonstrates promising feasibility and acceptance within statutory preventive counseling under §45 SGB XI. While the findings provide practice-based evidence for its applicability, conclusions regarding effectiveness or outcome improvements cannot be drawn. Further research with larger samples and outcome-oriented designs is required to evaluate its impact on caregiver burden and counseling processes.