Threshold decisions: how social workers prioritize referrals of child concern

This paper examines local authority social workers' decision‐making when considering referrals of children, where the concerns are on the margin of child protection procedures. In doing so, it describes the findings of a qualitative research study undertaken in the policy context of attempts to ‘refocus’ social work practice in the late 1990s and early twenty‐first century. Data collection involved interviews with social workers and parents in 23 cases. Conclusions are that referrals were evaluated on the basis of five key factors, specificity, severity, risk, parental accountability and corroboration, the use of which determined whether an initial assessment or an investigation of alleged abuse took place. The analysis builds on previous work in the child protection field, but demonstrates how the application of these factors differs between cases of child concern and cases of child protection. Policy implications concern the complexity of decision‐making in the uncertain context of limited referral information and it is proposed that the simplistic notion of a continuum of abuse is now outdated. Copyright © 2006 John Wiley & Sons, Ltd.     

Comparing child protection decision-making in England and Finland: supervised or supported judgement?

ABSTRACT

Systems for the protection of children have evolved differently across nation states. Studies have identified contrasting system ‘orientations’, related to how child protection problems are framed and how organisations respond in different contexts. In this study, the influence of national and organisational factors on practice-level decision reasoning by social workers has been compared. Interviews were conducted with 30 child protection social workers in sites across England and Finland, structured around two hypothetical case vignettes. While similarities were observed in how the social workers responded to the vignettes, there were differences in the nature and extent of managerial involvement described, with the English social workers appearing to rely on managerial input for decision-making to a greater extent than the Finnish social workers. These findings suggest evidence for two distinct organisational approaches to decision-making: ‘supervised’ and ‘supported’ judgement. Here, supervised judgement describes a hierarchical, ‘top-down’ form of decision-making, while supported judgement describes a more horizontal and shared decision-making approach. The lens of comparative methodology has revealed how these organisational factors come into play in different child protection systems. The practice implications of supervised, manager-led approaches to decision-making, as contrasted with supported, team-led approaches, are discussed.     

Obstacles for child participation in care and protection cases—why Norwegian social workers find it difficult

Although some attempts are being made to increase children's participation in Norwegian child protection cases, much needs to be done in order to comply with the participation principle in the United Nations Convention on the Rights of the Child. This paper reports on a study of factors that are likely to predict if social workers will attempt to give children an effective voice in decision making processes. 53 child protection case managers and 33 social work students participated in a questionnaire survey in which they were asked to agree or disagree with 20 statements about child participation. Statistical factor analysis was used in order to identify underlying factors in the dataset. The results suggest three main reasons for children not being allowed to participate: communication difficulties (communication factor); because child participation was not deemed necessary (participation advocacy factor); or that participation was considered inappropriate because it might be harmful (protectionism factor). This research suggests that, if we are to improve participation within the child protection system, formal regulations and guidelines need to be accompanied by a greater attention to development of social work skills in working with children through participatory processes. Copyright © 2010 John Wiley & Sons, Ltd.     

GPs' and health visitors' participation in child protection case conferences

This study was conducted in two related but separate phases. Phase one compared the frequency and type of participation by general practitioners and health visitors in child protection case conferences. Two hundred consecutive case conferences involving 83 general practitioners from 33 practices were independently reviewed and scored to assess the level of general practitioner and health visitor participation, whether by written report and/or by attendance. Health visitors showed a far higher level of participation in case conferences than general practitioners and their attendance was more often rated essential by the social worker than that of the general practitioner. There was no evidence in those cases where social workers rated the general practitioner's attendance as essential that this resulted in increased general practitioner participation. General practitioners were equally unlikely to participate in initial, first review and subsequent review case conferences. Most importantly, general practitioner participation/non-participation was not related to length of notice given. In phase two, 76 general practitioners from the sample of 83 were interviewed in order to elicit factors underlying their decision on participation in child protection case conferences. Personal and practice characteristics and attitudes towards the case conference and towards social workers were examined and subsequently analysed. No significant associations were discovered apart from a link between previous training in child protection and a less negative attitude towards communication with social workers and the belief that the general practitioner's participation in the case conference helps him/her in the subsequent management of the case. Personal contact between local social workers and the primary health care team was seen as likely to be helpful in the establishment of a climate of trust which would facilitate the flow of sensitive information in both directions. Health visitors were often regarded by general practitioners as fulfilling the role of delegate to the case conference without having any formal remit to carry out this task.     

The context of decision-making in cases of child neglect

This paper explores professional decision-making in cases of child neglect within the context of child protection practice in Britain. The literature on the nature of neglect is reviewed. Difficulties associated with decision-making are then examined within a framework that addresses the social, political and organizational context of child protection practice. It is argued that the current system, which focuses on incidents of abuse rather than the context of children's lives, provides inadequate protection for many children experiencing chronic neglect. Conclusions are drawn with regard to the development of practice that supports vulnerable parents while still remaining the child's welfare as paramount. © 1998 John Wiley & Sons, Ltd.     

Child protection decision-making: social workers’ perceptions

ABSTRACT

Decision-making is located at the heart of social work as a core professional activity, because much of what social workers do concerns decisions about future courses of action. Drawing on elements of the learning together systems model and Falkov’s Systemic Family Model, this study investigated social workers’ perceptions regarding how child protection decisions are made. Evidence was drawn from a constructivist–-interpretivist qualitative research design, involving 16 semi-structured interviews with qualified and experienced social workers and 20 direct, non-participant observations of child protection meetings. Evidence from the study suggests that professionals and family members do not rely entirely on the guidance on the threshold criterion of the likelihood and significance of risk of harm when making decisions. Instead, they use discretionary intuition and analytical judgement, involving multidimensional criteria which includes consensus between professionals and with family members; individual professional’s state of mind; other agencies and professionals’ priorities as well as external factors such as the availability of resources. Conclusion can be drawn that existing guidance on decision-making is inadequate, hence the discretionary use of a combination of intuitive heuristics and analytical thinking in a complementary manner. This study, therefore, contributes to considerable conceptual clarity regarding the complex child protection decision-making process.     

Ethical challenges in conducting research with hard to reach families

This paper reflects on some of the ethical challenges encountered by the authors whilst undertaking sensitive qualitative research with parents and children who are traditionally hard to reach. The research aimed to provide more holistic and in‐depth accounts of parenting on a low income in diverse social circumstances than already exist. The nature of the sample and the subject matter that was covered inevitably raised many familiar ethical dilemmas and some that are less often encountered in practice, particularly in relation to child protection. In this article we discuss our approach to ethics, some of the ethical challenges we encountered undertaking work with families and discuss the complexity of decision‐making around risk of harm to children. We conclude that a clear framework to avoid harm should be developed at the outset and a transparent approach to child protection issues should be used. Additional time and resources need to be incorporated at the planning stage of similar projects in order to develop appropriate methods, ensure effective decision‐making and support researchers. Copyright © 2008 John Wiley & Sons, Ltd.     

The rediscovery of child neglect

The article is a discussion of the construction of child neglect in a child and family social work team in the UK, based on ethnographic research in the social work office. Two influential and contrasting professional discourses on neglect are identified, and it is suggested that the dominant construction of neglect in the team studied is maternal failure to adequately service children's bodies. This construction is discussed in relation to some relevant theoretical insights and in the context of trends in contemporary child protection work.     

Child protection: An unreflective practice

This paper highlights the need for social work education to focus on the ideological, cultural and organisational influences that shape practitioner perspectives and determine case careers, particularly in the area of child protection. Using the findings from a case study on the processing of child abuse referrals made to a social work team in Ireland's largest health board region, this paper illustrates the dissonance between the 'official' child protection discourse and the complexities and dilemmas of everyday practice. It also highlights practitioners' apparent lack of awareness of the dynamics that determine the way in which decisions and assessments are reached. The need to encourage and facilitate social workers' use of theory as a means of addressing these complex areas is endorsed, and implications for educational programmes are discussed.     

The rights of the child enabling community development to contribute to a valid social work practice with children at risk

This paper presents a way of thinking about and doing child protection work using community development (CD) principles to guide practice. It suggests that a useful addition to CD can be found within the rights of the child provisions in Human Rights conventions. Using examples from the authors' three countries to illustrate the work that practitioners do in their work with children at risk, we argue that social work practice can be enhanced by the inclusion of these principles and practices which are essentially core generic social work practice. However, much of social work with the protection of children is bound by ‘risk’ perceptions which result in investigatory approaches being used as a first action, often to the exclusion of preventive approaches. This article demonstrates that in very different situations from different environments, CD in concert with the principles of the rights of the child can assist good outcomes with children at risk. A model is presented for unifying the worldview of human/children's rights with social work's core concern, the protection of children, using generic social work skills.     

Using Q-sort methodology as an educational tool in post-qualifying education whilst simultaneously gathering research data about views on parenting

Post-qualifying courses for social workers offer unique access to large numbers of practising social workers. Therefore, they present an opportunity to gather research data about current practice concerns. Asking students on post-qualifying courses to take part in research activity can also enable reflections upon the links between research and practice. However, ideally, any research activity should also contain an educational element so that students will directly gain from taking part. This paper describes a study in which Q-sort methodology was used as a method of both gathering data and as an educational tool. The study was an exploration of the links between views about both 'good enough' parenting and decision-making in child care and protection work. Subjects were students attending post-qualifying child protection courses. The methodology was successful both in gathering meaningful data and in stimulating lively debate about the issue. This paper will describe the study, briefly set out the research findings and discuss the advantages of the methodology as an educational tool.     

Reframing child protection: A response to a constant crisis of confidence in child protection

Child protection systems appear to be in a continual crisis of confidence. They get criticised for not doing enough to protect some children, whilst at the same time being criticised for being too intrusive or not managing demand. This constant balancing act drives almost continual reforms, none of which appear to reduce further crises of confidence. The central issue facing tertiary child protection systems stems from their function as makers of sometimes highly uncertain risk screening decisions. Uncertainty leads to errors; false positives and false negatives. Two recurring issues challenging child protection agencies are concerns about these errors. Fears about doing too much are concerns about false positives and fears of doing too little are concerns about false negatives. The need to address both issues within the context of uncertain high stakes decision making, in a highly risk intolerant environment leads to poorly formed sentinel event driven policy that in turn leads to organisational fragility. A decision outcome-based performance model based on Signal Detection Theory provides indicators that explicitly outline the link between these two strategic issues facing child protection systems. This has improved dialogue, understanding and support from sponsors. It has led an informed focus on improving decision making and stabilisation of decision thresholds. It demonstrates that Child protection systems are in fact very responsive and do perform well in their decision making (risk screening) function. Social work decision makers provide value in their decision making in spite of highly uncertain decisions to make. Child protection systems do not need reform, they need to be “reframed” to better understand true performance and so avoid poorly informed reactive policy responses to the genuine challenges that they face.     

Child protection decision-making

The effects of interagency collaboration on risk assessment in child protection practice were analysed in respect of the decision-making processes in child death inquiries. Universal features in the assessment of risk as identified in psychological literature were applied; in particular, the concepts of ‘groupthink’, the ‘certainty effect’ and ‘group polarization’. It is suggested that case conference decisions are inherently more risky than those taken by professionals with individual responsibility because of the way in which cases are framed in terms of losses.     

Fit for Purpose? Post-Qualifying Social Work Education in Child Protection in Scotland

Recommendations for post-qualifying training and education in child protection social work consistently form part of the political response to child abuse scandals. The influence of child abuse politics upon the push towards post-qualifying training and education has been consistent across the United Kingdom. Within Scotland educators have been quick to respond to the market demand for programme provision and there is now a growing number of academic programmes being offered by higher education institutions. Yet despite post-qualifying training and education achieving the status of ‘panacea’ there is little in the way of a national dialogue about what post-qualifying training and education in social work child protection should look like. The parameters of this have not been subject to any kind of national debate and the Scottish academic community has not entered into a professional dialogue on these issues. More crucially, educators have not engaged in any level of identifiable evaluation of their provision and there is an absence of engagement with the scholarship of teaching child protection at the post-qualifying level. This paper connects with these issues to question whether the post-qualifying training and education delivered by Scotland's universities can be considered fit for purpose.     

The impact of expert evidence on care proceedings

There has been an increased demand for expert child psychiatric opinion in child care cases where social services have instigated care proceedings under the Children Act 1989. However, there has been little evaluation of this work in terms of whether such a referral changes the care plan of the referring social work agency or the outcome for the child. This article examines the contribution to care proceedings of assessment reports completed by a child and adolescent forensic psychiatry team in respect of 37 consecutive child care cases. All of the assessments were presented to court and the information was collated once the proceedings were completed. Our findings indicated that the court followed the recommendations of the child psychiatric report entirely in 73% of cases. In addition, in 86% of cases the social service departments reported that they had gained confirmation of their professional opinion. In only 10% of cases did they change their care plan in response to the child psychiatric assessment. In conclusion, the results suggest that in most cases social service departments are using child psychiatry expert evidence merely to validate and/or lend support to their original care plans. Copyright © 1999 John Wiley & Sons, Ltd.     

Emotional harm and neglect: the legal response

This paper reports on a study of the extent to which child protection applications brought to the Melbourne Children's Court in Victoria, Australia, were based on emotional/psychological harm or neglect of a child and what factors were presented as evidence of harm or neglect. The study examined records of 208 court‐ordered pre‐trial conferences heard in the court between February and July 2002. What was found was that, although cases involving emotional abuse have increased in terms of child protection applications, they remain cases that are difficult to decide. While in 1998/9 emotional harm was a ground in 25.7% of child protection matters completed in the Family Division of the Children's Court of Victoria, legal decision‐makers are reluctant to make a finding of child abuse in these cases because there is less accuracy in the determination of emotional harm and negligible legal criteria available to guide decision‐making. Copyright © 2006 John Wiley & Sons, Ltd.     

Family participation in child protection

The paper summarizes a Department of Health funded research study of the extent to which parents and children were involved in the child protection work of seven English social services departments. The child protection process and the social work practice with a cohort of 220 consecutive cases is described for the period before the initial conference and the 6 months following it. The authors draw on interview data from parents, young people and social workers and on social work records to assess whether the process and practice were participatory and the extent to which family members were actually involved in the decisions and the work. They concluded that there was benefit for parents and children in attempts to involve them, even thought only 3% of 378 family members were rated as partners in the protection process and a further 13% were rated as participating to a considerable extent. There was a statistically significant association between the participation of family members and the interim outcomes for the parents and children being rated by the researchers as good or moderately good.     

A therapeutic social work team in practice

In 1996, as a result of interagency collaboration between social services and health, Leeds Social Services Department brought together three groups of social workers undertaking therapeutic work into a centrally managed team. Continued inter-agency working together has ensured that the Therapeutic Social Work Team has become an established service for children and families. This paper describes the work of the team by focusing on four areas: the context of interagency collaboration, therapeutic work in the child protection process, managing different theoretical approaches in one team, and evaluating practice.     

Social work and artefacts: social workers' use of objects in client relations

Social workers' use of physical objects—i.e. artefacts such as paper, computers and plastic models—in client relations is rarely investigated. Most often, research focus is on interpersonal relations, user groups, professional skills and treatment methods in social work. In a study of decision-making tools and their impact on caseworkers' decision making, examples were found of caseworkers using artefacts in client relations. This paper presents these findings and discusses the purposes for which the caseworkers use artefacts. The empirical data consist of 30 qualitative interviews with caseworkers from a study of three different decision-making tools used in eldercare, employment services and child protection in Danish municipalities. The analysis shows that the caseworkers are concerned with the issue of how to justify the questions they ask clients and their assessment of clients. Job counsellors use artefacts to justify sensitive questions, for instance, questions concerning substance abuse. Family counsellors use artefacts as proof that they are guided by a model rather than making up the questions themselves. The caseworkers who grant homecare service use artefacts when rejecting an application.     

Social Workers’ Preparation for Child Protection: Revisiting the Question of Specialisation

Abstract

Child welfare work is a key field of practice for social work graduates and for graduates of a growing range of disciplines. In the present paper, the authors drew on a survey of 208 child welfare workers and interviews with 28 senior personnel in child and family welfare agencies to analyse perceptions of the educational preparation of social workers and other human science graduates for this field of practice. The findings indicated that child welfare workers and employers are ambivalent about the value of social work and other generic social science and human services programmes as preparation for tertiary or statutory child protection practice, which involves investigation, assessment, and intervention in child abuse and neglect. The authors argue that the social work profession must better balance generic and specialist aspects to prepare graduates for practice in specialist fields of high social work involvement, particularly in tertiary child protection work.