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.     

Parent participation in social work meetings - the case of child protection conferences

This paper is about parent participation in cases where children are involved in a child protection process in the UK. It concentrates on the child protection conference as a site at which the participation of the client and decision-making by professionals are balanced with one another. Unlike previous research, which has been concerned with asking participants their reactions and views using research interviews, the focus here will be on the verbal exchanges between participants in the conference, based on a recording of a child protection review. In this way it is proposed that attention is directed at how the client is enabled to participate and what significance is given to such participation during the event. Der Aufsatz befaßt sich mit der Partizipation von Eltern im Fall, daß Ihre Kinder von der Arbeit des Kinderschutzes erfaßt werden. Er konzentriert sich auf die Kinderschutzkonferenz als den Ort, an dem die Partizipation von Klienten und die Entscheidungen der Professionellen in ein Gleichgewicht gebracht werden. Anders als vorgängige Forschungsansätze, die im Rahmen von Interviews die Klienten nach ihren Reaktionen und Einschätzungen befragt haben, wird hier auf der Basis eines aufgezeichneten Gesprächs zur Prüfung des Falles der Fokus auf die verbalen Interaktionen zwischen den Teilnehmern der Konferenz gerichtet. Deshalb wird vorgeschlagen, die Aufmerksamkeit darauf zu richten, auf welche Weise die Klienten zur Partizipation befähigt werden und welche Bedeutung einer solchen Form der Partizipation während des Prozesses zugemessen wird. Este artículo trata de la participación de los padres en casos en los que los niños se encuentran en situación de protección infantil en el Reino Unido. Se concentra en las conferencias para la protección a la infancia como un lugar en el que se equilibran la participación de los clientes y el proceso de toma de decisiones por parte de los profesionales. A diferencia de anteriores investigaciones, donde se pedía a los participantes que expresaran sus reacciones y puntos de vista a través de entrevistas, aquí nos centramos en los intercambios verbales entre los participantes de las conferencias, a través de la gravación de un caso específico. De esta manera se propone que se dirija la atención hacia cómo se facilita la participatión del cliente y la importancia que se da a dicha participatión durante el encuentro. Cet article traite de la participation des parents d'efants bénéficiant de la protection de l'enfance en Grande-Bretagne. La conférence sur la protection de l'enfance constitue l'objet de cette étude, en tant que lieu dans lequel la participation des usagers et la prise de décision par les professionnels se contrebalancent l'une l'autre. Contrairement à une recherche précédente pour laquelle on cherchait à connaître la réaction et l'opinion des participants en utilisant des entretiens de recherche, il s'agit ici d'étudier les echanges verbaux entre les participants de la conférence, à partir de l'enregistrement d'un compte-rendu sur la protection de l'enface. Ainsi, les auteurs choisissent de se concentrer sur la façon dont l'usager est amené à participer et sur la signification donnée à cette participation pendant l'événement.     

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.     

Child protection: a survey of psychiatrists' knowledge and attitudes

The aim of the study was to examine psychiatrists' knowledge of the child protection process and their attitudes toward child protection training. An anonymous questionnaire survey was sent out to all psychiatric staff in a large psychiatric hospital. The response rate was 72 per cent. Fifty‐seven per cent of respondents had never attended child protection training and 16 per cent thought that it was of no relevance to their position. Significant differences in self‐rated knowledge were identified between those who had attended training and those who had not. Variations in the availability and quality of child protection training may result in psychiatrists not attaining the core knowledge required in order to work effectively as part of the child protection process. Hospital management should work towards prioritising and disseminating local child protection policies and procedures more effectively and consider routine child protection training as part of any new staff induction. The Royal College of Psychiatrists should consider inclusion of child protection in junior staff education programmes and as part of the MRCPsych examination curriculum. Likewise, consideration should be given to enhancing the status of child protection training in continuing professional development programmes for career‐grade psychiatric staff. Copyright © 2010 John Wiley & Sons, Ltd.     

The use of sociograms to explore collaboration in child protection conferences

The Strengthening Families child protection conference model attempts to empower parents' participation in conferences and to enhance collaboration between conference participants. This paper, which is part of a broader study looking at the implementation of the Strengthening Families model across a county council in England, UK, explored the use of ‘power’ and ‘mutual interaction’ in both traditional and Strengthening Families child protection conferences. Data was collected using sociograms which were recorded during observations of the two types of conferences. Sociograms were analysed in order to identify patterns in terms of ‘power’ and ‘communication’ together with the use of the ‘group cohesion index’ which enabled us to draw conclusions about the degree of interaction between conference participants.Findings indicated a difference between the use of power in traditional and Strengthening Families conferences. In traditional conferences the power was mostly static (held by the chair), and in the Strengthening Families conferences power was shifted from the leader of the collaboration (chair) to the people who administer the collaboration (conference participants). Also, in the Strengthening Families model more interaction between conference participants and better group coherence were evident; however, in both types of conference communication was limited between the professionals. Sociograms proved a useful method for exploring group dynamics in the context of child protection conferences. It is suggested that a broader understanding of the underpinning principles of the Strengthening Families model is needed to successfully empower parents' participation in conferences and to enhance collaboration between conference participants.     

Child death review teams: a vital component of child protection

The alarming number of children killed and seriously injured as a result of child maltreatment and neglect has led to increased calls for action. In response, interdisciplinary and multiagency child death review teams have emerged as an important component of child protection. Paradoxically, child death review teams are among the least visible and understood elements in efforts to protect children. This article examines the role and functions of child death review teams and their contributions to child welfare in practice, prevention, and policy.     

Agency policy and the participation of children and young people in the child protection process

This article explores agency policy in relation to children's participation in the child protection process. This was done by examining policy documents and conference minutes and by interviewing social workers and conference chairs working in child protection in Wales. Issues and dilemmas surrounding the participation of children and young people in the child protection process are identified and examined. The lack of children's more direct participation was noted, but many agencies were taking action to inform themselves of children's views indirectly. Advocacy was being more frequently used, and highly valued where it was available, but did raise some role dilemmas. The essentially child‐unfriendly nature of child protection processes (particularly the conferences) was identified as a significant barrier to promoting children's voices. The contradiction of trying to promote children's direct participation in a process that is inherently not geared towards their direct involvement was noted. The total lack of children's input into service planning for child protection services was seen as significant. Copyright © 2006 John Wiley & Sons, Ltd.     

General practitioners and child protection case conference participation: reasons for non‐attendance and proposals for a way forward

General practitioners' (GPs') attitudes to child protection case conferences were explored in the belief that commonly cited practical reasons, such as inconvenient timing, fail to provide a complete explanation for poor participation. Twelve GPs took part in a preliminary investigation by telephone interview and a postal questionnaire was then sent to 112 GPs in the Nottingham area. The response rate was 100% for the preliminary study and 82% for the questionnaire. The postal survey showed that nearly half the respondents agreed there were too many other tasks of higher priority than case conference attendance, confirming that previously mentioned constraints alone did not account for poor participation. Contrary to previous research, issues such as confidentiality and parental attendance do not stop the majority of GPs contributing. Suggestions that might improve participation, such as facility to stay for the first half hour of a conference and guidance on content of reports, had favourable responses. It was concluded that it may be more fruitful to concentrate on improving report submission rate and content because of GPs' priorities. Improved education of GPs and social workers with respect to each other's roles and responsibilities would facilitate communication in case conferences. Copyright © 2000 John Wiley & Sons, Ltd.     

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.     

Unconscious sequences in child protection work: case studies of professionals' experiences of child removal

At a time of increasing calls for a return to relationship‐based practice, this paper presents qualitative research findings regarding the effects of more coercive and less coercive interventions on relationships between social workers and parents. Its context is the use, in England, of investigations of alleged child abuse (more coercive) versus initial assessments (less coercive, and potentially leading to family support services). Methods were based on 23 case studies involving interviews of both parent and social worker. The paper concludes that the less coercive initial assessments, combined with child welfare concerns that were perceived as less serious, provided the context for good working relationships between parent and worker. However, it is suggested that these conditions were not a prerequisite for good relationships. Worker skill was of significant importance, and good relationships were seen to be possible in a variety of procedural contexts. Comparisons are made with accounts of the therapeutic alliance in the counselling and psychotherapy literature.     

Child abuse,child protection and disabled children: a review of recent research

This paper reports the results of a scoping study that reviewed research about child abuse, child protection and disabled children published in academic journals between 1996 and 2009. The review was conducted using a five stage method for scoping studies. Several studies have revealed a strong association between disability and child maltreatment, indicating that disabled children are significantly more likely to experience abuse than their non‐disabled peers. Those with particular impairments are at increased risk. There is evidence that the interaction of age, gender and/or socio‐cultural factors with impairment results in different patterns of abuse to those found among non‐disabled children although the reasons for this require further examination. It appears that therapeutic services and criminal justice systems often fail to take account of disabled children's needs and heightened vulnerability. In Britain, little is known about what happens to disabled children who have been abused and how well safeguarding services address their needs. Very few studies have sought disabled children's own accounts of abuse or safeguarding. Considerable development is required, at both policy and practice level, to ensure that disabled children's right to protection is upheld. The paper concludes by identifying a number of aspects of the topic requiring further investigation. Copyright © 2010 John Wiley & Sons, Ltd.     

Aboriginal child placement principle and family group conferences

Throughout the twentieth century, Aboriginal children have been removed from their family and cultural networks under a range of government policies that have professed to be ‘in their best interests’. This article outlines the historical context to the development of the Aboriginal Child Placement Principle, which is currently the operating principle for all States and Territories in Australia when child welfare services have engaged with Aboriginal families and there is likelihood that a child may be removed. Because of problems with the implementation of the Principle, the option of family group conferences is suggested as a way of ensuring the objectives of the Principle are still met. Family Group Conferences originated in New Zealand initially as a response to the over-representation of Maori children in the substitute care system, and have since been part of child welfare legislation in that country for both Maori and non-Maori families since 1989. The application of the New Zealand model to working with Indigenous Australians will be discussed, along with a recommendation for this form of empowering practice to be considered more comprehensively as a family decision-making strategy within the field of child protection.     

Child participation and positive youth development

This article explains how a child's right to participation in healthy relationships, experiences, and opportunities promotes positive youth development. The author identifies the substantive articles related to participation, identifies and explains the social anchors vital to promoting participation, highlights the importance of the 40 developmental assets for empowering children with the capacities necessary to assert their right to participation, and concludes by calling for a national family policy guided by the United Nations Convention on the Rights of the Child.     

Maintaining front-line workers in child protection: a case for refocusing supervision

This paper suggests that a refocusing of supervision be seen as one possible strategy for lowering high attrition rates among child protection workers. Research findings from a qualitative study undertaken in two rural regions in the State of Victoria, Australia illustrate that the current model of supervision gives insufficient attention to the emotional intrusiveness of the work, to building resilience in workers and the implications of adult learning theory. An argument is made for a refocusing of supervision which moves beyond task, encompassing much of what is already known from the supervision literature. The supervisor can be thought of as a messenger who must send and receive messages to and from workers. What message is sent and how supervisors respond to what they receive are critical if the objective is to retain front-line staff. Critically, the supervisor must affirm both the merit and necessity of exploring the impact of feelings and thoughts on action and perception. A key message for supervisors to deliver is the value of individual workers to the organization, leading to increased self-esteem and self-efficacy. The paper also argues for adult learning via reflective supervision. This change to supervision involves a fundamental shift in organizational priorities and an acceptance throughout of the impact of anxiety on all those working in this field. Copyright © 2001 John Wiley & Sons, Ltd.     

Defining and strengthening child well-being in child protection

Although the goals of safety and permanency for children continue as critically important mandates in child protection, the field has witnessed an increased focus on child well-being in recent years. Whereas safety and permanency have been well operationalized, child well-being appears to be a much more complex and daunting concept to define and measure. Current federal guidelines require child protective agencies to improve outcomes in the area of child well-being, and although federal regulations offer some direction on interpreting this concept, the definition and operationalization remain vague. As leaders in the field have attempted to provide language by which to talk about and measure child well-being, a number of key frameworks have emerged. In this paper, we present a conceptual map that provides a visual overlay of these existing frameworks that can help guide child protection policy-makers, administrators, and practitioners toward a fuller understanding of the complexities of child well-being. While this conversation on child well-being is not new, this paper aims to add to the national discussion and deepen the understanding and conceptualization of child wellbeing within the context of child protection.     

Child poverty and child outcomes

This article reviews the most up to date evidence on the prevalence of child poverty in Britain. It traces how child poverty has changed over the last 20 years, and how child poverty in Britain compares with that in other countries. Then there is a brief section describing the characteristics of poor children. It then reviews evidence of the impact of poverty on the well‐being of children drawing on the ESRC Children 5–16 programme project—Poverty: the Outcomes for Children (Bradshaw, 2001a). It concludes with a discussion of how the Labour Government is doing in its aspirations to abolish child poverty. Copyright © 2002 John Wiley & Sons, Ltd.