14 February 2008
Engagement, analysis and reflectiveness: Developing a Framework for the Assessment of Vulnerable Children and Their Families
Dr Helen Buckley, Trinity College Dublin, Ireland
Abstract, slides and audio of presentation
Edited transcript
The following audio presentation is brought to you by the Australian Institute of Family Studies as part of our monthly seminar series in which we showcase national and international research related to the family.
The seminars are designed to promote a forum for discussion and debate. They are open to the public and free of charge.
Seminar facilitated & speaker introduced by Dr Leah Bromfield.
Dr Helen Buckley:
Thank you very much Leah. Thanks everybody for coming. I'm very flattered that people would take time out of their busy daily work lives to come and here somebody from Ireland speak. I'm truly delighted to be here. I was in New South Wales last week and I'm in Melbourne this week, and it's now become my favourite city and I'm going to Adelaide next week so let's just see what happens.
Just to give you a little background, I know Leah introduced me so you probably don't need to hear this a second time, but I'm a lecturer in Trinity College in Dublin. I don't know if anybody here is Irish or knows Trinity, but Trinity's well on the tourist trail. When you come to Dublin you nearly always visit it, so I'm lucky enough to be working there.
My main job is that I coordinate and teach on a postgraduate diploma for people who work in the area of child protection welfare. That includes social workers, police, project workers, nurses, anybody who has an interest and experience in child protection and welfare. Like all academics I have to do research as well, and I also have some links with central government, because Ireland is a very small place and we're lucky to be able to have those links. And I can tell you in Ireland they look to Australia extensively for inspiration about how to move our system forward, and I'm under a lot of instruction when I go back, to relay everything that I've seen here. And I think you will probably attract a lot more Irish visitors here on the pretext of finding out about your child protection system. But we do recognise that you do very innovative work and that the institute here is well known. The Child Protection Clearinghouse is world famous and we all use it, and we feel very lucky to have it as a resource.
So I'm going to talk to you today about some research that I've been involved in in Ireland, principally about developing a framework for assessment. But I know that here in Australia, you have your own frameworks and you're going to have a framework issued quite soon by the Department of Human Services. So I'm not going to do it very descriptively, because I think you'd be quite bored if I did. I'm going to talk to you more about some of the issues that came up for us in actually developing the materials, and the areas that we consider to be very important to focus on.
As you know in the UK, a framework for the assessment of children in need and their families was implemented in the year 2000, and probably as a result of that we felt that we needed to pay attention to having something similar in our system. Myself and a colleague in Trinity were commissioned, and we were lucky to have as one of our partners Jan Horwath from the University of Sheffield, who has been extensively involved in producing training materials for the English framework.
So as I go through it you will I hope - I know you're familiar with these things - but you'll begin to see differences I think, which reflect probably our national attitude towards having a lot of materials and having to do things in a very precise way. We're a little bit more qualitative maybe in the way that we approach things in Ireland. It may not be necessarily a good thing, and I'd be interested in your feedback on how we've done it.
I've always been involved in two other studies since we developed the framework. One of those was children and domestic violence, and we interviewed 22 children and young people about their experiences of growing up with domestic violence. So that has actually coloured the way we present the framework now. And I've also recently been involved in an as yet unpublished study on service users' impressions of the child protection system, and you can imagine they were quite interesting and stimulating. And the findings from that study have also influenced the way that I'm presenting this, and I will refer briefly to them.
So I'll just start by saying the aims are really to talk about the development of the assessment framework in Ireland, and also to highlight how the framework incorporated process issues. These process issues we've prioritised are engagement, reflection, gender practice and analysis, and I hope as I go through the presentation you will see why we considered these issues to be so important.
I know that what I'm focusing on how is familiar territory to you, that most of you here would have read research on pretty well the same issues. And I know that you probably have read Messages From Research, which is the UK publication based on a programme of research done there in the 90's, which really highlighted the problem of an over-focus on child protection at the expense of family support. And I know this is the sort of thing that you've probably gone quite a long way in addressing here in Victoria, because I've been to see some people in the Department of Human Services and I've been very impressed with the way that you're reshaping your system.
But these are difficulties that arose for us, based on some high profile child abuse enquiries that we had, some research and some policy documents, and they would be disparities about thresholds. Thresholds you know are very moveable. It depends very much on the context in which people are working and the workforce, the availability, the management, everything, but what we found was major inconsistencies in the way that services were being delivered to people.
We also found that child neglect was being neglected. That there was lot of emphasis on sexual abuse, and we've had a fair share of scandals about sexual abuse in Ireland, particularly in the Catholic church, which is maybe not the highest incidence of sexual abuse but one of the most high profile ones. Physical abuse as well, but I think and I think you'll agree with me, that child neglect, which is a very insidious and highly damaging form of child harm, was not getting the response that it required. They were the type of cases they were being put on waiting lists essentially.
We also found that practitioners were not very good at assessing child neglect. It was much easier if there was a straightforward and rather legalistic path to follow, but child neglect didn't actually offer that. We've had our difficulties with multidisciplinary work, and again I think they're pretty ubiquitous. Some difficulties in working with the police because of different perspectives and different structural arrangements. Some difficulties between statutory and non-governmental organisations, because of responsibilities and priorities, and then within disciplines we've had our share of difficulties and these are fairly organic, I think, different rivalries, different hierarchies, that type of thing. So we want to try and address that.
We found a lack of focus on children. A study that I did in the early 90's on child protection reporting and investigation, found that in only 25 per cent of cases were children actually seen, which sounds very strange I'm sure. But it wasn't that children were ignored. The children's voices were constructed through adult voices, and they would have been teachers, parents, police, health workers and so on. But it wasn't very common for workers to engage meaningfully and directly with children.
We found a weakness in integrating information, but while workers may have been quite good at investigating and gathering data, they weren't always very expert - and we know this is very challenging - at actually integrating it into a decision, their final conclusion and a direction for intervention. While we do have a network of family support services in Ireland, they're not terribly well integrated with the statutory service and we did feel that they needed a higher profile. I know that that's something that you're addressing very well here.
Then as I said, we've done some studies since that time and I'm quoting really from other research that's been carried out in Ireland as well as our recent studies. But we felt that when we interviewed children about domestic violence, we suddenly realised that even in the assessment framework when we're talking about parenting capacity, we're asking parents how did you manage this, how did you find refuge services, were you able to leave your situation? Were you able to take action, did you go back? And we realised that our questions were very adult centred.
We weren't really asking children about how they experienced living with domestic violence. So it really highlighted for us the importance of centring the assessment in on the child, always hearing it from the child's perspective. I think we felt we'd fallen into a bit of a trap of again going to parental voices.
The other issue that came very strongly for us out of our service user study and out of an interesting and comparable study carried out in the North of Ireland, by an academic there called David Hayes in Queen's. That families really find - I know this isn't news to you, but it came very strongly out of our study - families would run a mile to avoid child protection welfare services. They see a caseworker or social worker arriving on their doorstep, as an endorsement of everything that's bad and deficient about the way they live their lives and look after their children.
It's a very depressing finding, but I suppose it needs to be faced up to if we're going to move forward in providing effective services for families. So it's really just to bear in mind how difficult families find it to engage with services, and how intimidating and frightening and powerless - how fully the services are perceived. So I suppose that's just a message in terms of actually engaging with families.
Because this is a very important institute and it's world famous for its integrity and its evidence based research, I thought it was important to refer to other research before I presented ours.So I'm just giving you some brief references to international research that's been carried out on assessments. One is a study that was carried out by an academic in Central Lancashire in England, called Brian Corby. I don't know if that name is familiar to you. He's a terrific researcher and writer on child protection. He's some written some of the best basic texts on child protection that I've ever read, and very sadly he died last year. But he was an active researcher all his life with Malcolm Millar, and they've done a lot of service user research.
So they looked at the English framework, the triangle, to see if - they wanted to ask the question of whether actually carrying an assessment with families in itself makes the difference, more than just the results of the assessment. And they found that their hypothesis was proved, that the act of paying attention to a family, of giving them the opportunity to participate in something that's going to - have identified their difficulties and hopefully resolve their difficulties, when it's carried out in an [insistent] fashion did have a therapeutic effect. And families felt affirmed, they felt included and they felt important. So that had a positive outcome.
Millar and Corby were not blind to the difficulties in implementing an assessment framework and the resource demands, and sometimes the possibly mechanistic way in which the work can be done. But they felt that overall that you could easily believe that carrying out an assessment in using good practice, was actually going to have a positive benefit for families, in the action as well as in the results.
I'm sorry there's a mistake that I should have corrected in the next reference. That should be Beth Crisp, I think, and Pam Lister Green, who are two researchers. They published a recent article in the British Journal of Social Work, where they looked at assessment frameworks for different types of time populations, elderly people, just people with disabilities and people with child protection needs.
And similar to Millar and Corby they came up with the finding that supervision and training are essential, and we certainly hold that very much in mind in designing the material that we produced. That a very strong message from us is that no matter how good your framework is, it's the way that it's used and the way that it's supported that's actually going to make the difference.
Another academic called Dendy Platt, who is currently in Bristol University, carried out a study in the early 90's not so much on the English framework, because it hadn't been fully implemented then, but on how re-focusing services towards family support, was actually being perceived by service users. And he found that one of the main elements that produced a positive attitude from service users, was the very act of being included, being invited to identify their problems, being invited to actually produce written contributions to the assessments. So he found that very positive.
And then our colleague Jan Horwath had a look at some evaluations done on the English framework, and she came up with an important message, which is really that assessment is a head and a heart activity. And that's really the essence of the presentation that I'm giving you today, is that yes, assessment frameworks are very important in order to point out the important domains of a child's life that need to be addressed. And they're important in pointing out precisely what sort of information you should attain, how long it should take you to do it, and the important principles involved, and all of the other procedural aspects.
But she very much made the point that unless the qualitative aspects of reflectiveness, engagement, collaboration, inclusiveness, supervision, looking at the influences that affect your decision making, the context, your own mood, the mood in the office, the style of management, the resource availability, the self-esteem in the organisation. All of those things seriously impact on our ability to hear and see what we're doing properly, and to, I suppose, in a clearheaded way reach an effective conclusion with our colleagues and families. So it's an important message, I think, that assessment is a head and a heart activity.
Marie Connolly is a name that's very familiar to you, has developed a conceptual framework for practice, which she has used the image of a basket or kete is the Kiwi word for it. And it's a very useful representation, where she sees a framework and it's not just a framework for assessment, but a framework for practice and for intervention, which I think is what you're producing here in Victoria. She sees that as establishing the foundation stones for practice, and I think that's a very good way of looking at it. And her framework encapsulates both the activities, the phases of assessment, but also the principles that you need to employ at each stage. So it weaves together like a basket, so it's actually a very, very good sort of symbol or image to keep in your head when you're carrying out an assessment.
Hedy Cleaver and Steven Walker are two researchers in England who were heavily involved in both the early research that forms the basis of the English assessment framework and in the development of the English framework and they carried out an early evaluation. Now they would say we were involved in actually developing these materials so we're not really the right people to evaluate it, but having stated their limitations they produced a very useful piece of work, which indicated some of the factors that we've already referred to.
But principally that in the areas where they observed the implementation of the English framework they found huge discrepancies, which made it an interesting study. And they found that in areas where the framework had been taken very seriously, had been implemented at an official senior level, where there was strong leadership involved, where all staff were given a clear message about this is not an add on to your work, this is actually a fundamental part of your work. They found that in both areas the use of the assessment framework was higher, and the use of core assessment after initial assessment was higher. And as far as they could see, staff and service users were much happier with it.
Where they found that in areas where the framework was just simply handed out to staff as an add on to their existing workload, that it was less effectively used, the number of full assessments was lower, the gate keeping was higher and I suppose there are a lot of other contextual factors involved. But the message was if you're introducing a new policy measure or a new tool for work, you need to take it very, very seriously.
Now there's an Irish academic called Paul Michael Garrett who writes a lot in journals. He worked in England for quite a long time and he's back now working in the University in Galway in Ireland, and he's extremely provocative, quite amusing really I suppose. It's not that he's not serious, he is serious, but he takes a poke at - I think assumptions about the next best thing and how great it is, and how we've all gone to - we're all making a new start and everything should be discarded that we worked with before.
He takes a very ironic view of some of the new materials, and he's written several articles about it. But one of his arguments is that assessment tools are produced by middle class people who have certain ideas about parenting, can have a very normative and prescriptive view of the world. Now he's pokes fun at some of the materials - luckily he hasn't had a chance to do anything to us yet - but he pokes fun at some of the materials in the English framework and some of the scales and the instruments used. But one of the questions is has your child been to a county fair this year? Which is something that certainly wouldn't go down too well in Ireland anyway, but I suppose what he's saying is look, be very careful that your idea of good parenting may be very reflective of your past and your culture.
The essential elements of good parenting are more emotional and psychological and obviously looking after children's physical needs is very important. But not every family has a computer. Not every family values reading as a useful activity, but it doesn't mean that parents can't do things with their children. Not every family has the money to bring their children to the zoo or to play monopoly with them, or not even be interested to do that, but it doesn't mean that they're not good parents. So be very careful about the materials that you use and the expectations that you actually engender.
And then finally, Eileen Monro, who I know is a well known person in Australia, she has very thoughtfully looked at not just assessment frameworks, but a lot of new movements in child protection welfare, particularly the sort of Every Child Matters initiative in the UK. Which of course she doesn't want to criticise or undermine, but just again, she provokes people into thinking very deeply about exactly what implications all these initiatives have.
One of the things she's concerned about is computer based data in that any exercise involved in gathering a lot of information, is inevitably going to involve a lot of data being kept. And just who owns the data, where is it going, who has access to it, and just issues about that. I know in Ireland our government is very committed to using technology more and more in providing services, and there's a tendency to kind of rush headlong into all of these new things without actually thinking of the implications that it has for civil rights. How much we really want this, how useful it is, what information is necessary, is there too much there that's too available to everybody? So she does sort of cast a warning now about that kind of thing.
She's also a little worried about performance indicators and the over-quantification of work. In fact, the sort of tick box sort of mentality that can creep into using a lot of instruments and frameworks, and the implication that the more boxes you tick the better quality your work is. And it's sort of raising questions about that, and just warning not to over-simplify or over-quantify the activities and interventions of child protection systems. And noting that quality is not an easy element to capture, so just to be careful and just again think about what information actually means.
So that's the science. I'll get on to telling you now about our framework. We carried out a consultancy process and what we did was we - I suppose we had a commitment that our framework was going to be informed by practitioners. It's not just an Irish thing. I think it's probably universal. Frontline workers carry out a lot of very difficult work, and they get a lot of memos and emails from on high with different dictates and different guidance. We felt that for our workers to have to work with some new material that was presented to them by academics, who they might feel mightn't have very much action at the frontline, would not be a constructive way to start. So we decided to allow the practitioners to shape the materials, and it turned out to be a very useful way of working.
The messages that we got were very important ones, and one was don't make any assumptions that service users are going to be interested in being assessed. Some are, some aren't, but a lot of them aren't and that's what workers were saying to us. Look, it's all very well giving us these sophisticated materials but sometimes we can't get the front gate because the dog is sent out to meet us, or we can't get into the house or we encounter complete indifference. So we knew that that was an area that we needed to pay attention to.
We knew from previous research that we needed to be gender sensitive, and a lot of the practitioners did reinforce this. We knew that we needed to not exclude fathers and not make any assumptions about mother's responsibility to look after children, particularly in relation to meeting children's needs. And we knew that we needed to focus a lot on non-resident fathers as well, and the value that they could bring. We also were wary about risk, because we didn't want to throw out the baby with the bath water, and I suppose we were kind of fortunate in that the time that we were starting to develop our material the Victoria Climbie enquiry in the UK had been recently published. And one of the comments that was made about that enquiry was that it seemed as if Victoria Climbie had been treated as a child in need, when she should have been treated as a child at risk.
So I suppose that message was there for us and we knew that while we didn't want this to be as risk assessment, we wanted it to have very protective qualities. We knew that our assessment process needed to be clearly spelt out. Now again, I suppose we were fortunate that we had a lot of people advising us who weren't social workers. Social workers have a very strong sense of where an assessment should begin, and where it should lead to and where it should end. But other practitioners, especially people who aren't used to working in a sort of casework style, may not necessarily have the same vision.
So it was made very clear to us that we needed to begin at the beginning and end at what we considered to be the conclusion, and show all the complications and steps, phases and other sort of dynamics that could arise in between. We knew that there'd have to be an emphasis on planning, because that's an area that we were weak on. Child protection plans were often very secondary to child protection assessments. Case conferences could have interesting and long discussions but very little planning coming out of it, and we knew that we wanted workers to reflect very strongly what they were doing and ensure it was evidence based.
So we knew that there were some cases of assessment that go sort of one, two, three, four, five. And we knew that there were some elements of assessment that continue right through the whole process and we wanted to build all of those up and we wanted to use friendly documents. Our practitioners told us very clearly they wanted essentially one document. They didn't want to be carrying briefcases with tools and instruments and scales, and that is a kind of an Irish thing. I think they just wanted something simple, something easy to use and not complicated. I mean, there was a general feeling that at a later stage there could be little sort of side bars developed. And we certainly were aware that a psychologist or a nurse or a speech and language therapist or anybody else in a health related field, may have their own specialist assessment tools and there was a possibility of including those but our basic assessment framework wasn't going to have a lot of extras in it.
So basically how we shaped it was one document, including the tool. No additional scales or measures. The assessment that it was going to carry out was going to be qualitative. It was going to be based on principles, and the principles are very similar to the sort of principles that you would basically work on with seven principles which would be child centredness, child safety, ecological approach, evidence based approach, multidisciplinary and intrusive and the importance of supervision was strongly emphasised.
Time lines is an interesting element for us because again it maybe an Irish thing. In the English framework and I'm not sure about frameworks that you have there, in the English framework it was stated very clearly that 35 working days was the maximum period allowed for an assessment to be carried out. Our workers were saying look, that's ridiculous because you could have - one element of the assessment could be held up. For example, there could be a waiting list for speech and language therapy. Somebody in the family mightn't be available. It might take us quite a long time to engage the family. If there's a non-resident father, it could take us a while to contact them. And if it's seen that we have breached the time line, then anything else that goes wrong on the case is going to be attributed to the fact that we breached the time line. So we really don't want that.
But they did agree that they didn't want assessments to drift, and that assessments shouldn't be allowed to drift. And we had varying - we asked people- it was kind of funny -how long do you think an assessment should take? And a social worker said I think about nine months and a community psychiatric nurse said about three quarters of an hour, so that's what we were working with. So what we suggested was on a per case basis you decide, there should a coordinator for each assessment, and a decision should be made as to what the time line should be.
We agreed that it should be a core assessment. I'll talk a bit later about initial assessments and core assessments, and we felt it should be core assessment and that a very important role would be that of the coordinator or management of the assessment. Who would both begin and plan the assessment and would ensure that all the material was being collected and that a plan was then put in place.
Just to tell you quickly, the method that we used for the consultancy where really we had 15 focus groups, with five groups with practitioners, five groups with senior managers and five groups with frontline managers, who we called team leaders. I don't know if you have an equivalent post here. And we had three information seminars with each of the areas. We were commissioned by three health board areas to do this, three within eight health board areas in Ireland. We now have a unitary system, so it's changed.
And we met with 600 practitioners altogether at these seminars, and in the bigger groups we did surveys asking people to identify what they felt was the important ingredient. So we had quite a lot of material, so it took us about nine months to gather and analyse that, and then we developed a draft set of materials. We delivered the draft set of materials to the areas in September 2003, and with the expectation that we would start evaluating the use of materials in March 2004, given that they'd have had six months to use them. You all know that real life doesn't work like that.
We delivered them in September 2003, some time before the end of 2003 they opened the boxes. And when we went to start our interviews in March 2004 we found that some areas had been using the framework, others had only received it three weeks earlier. Some had it taken very seriously by their management, others had just found it on their desks. There hadn't been much of an effort made into producing it nicely. Some of them just got it by email, so it was a bit messy and I'm just presuming that this sort of thing happens everywhere. So I have to say our evaluation was curtailed by those factors, and our child protection services are under strain and pressure the same way as yours are, so it's understandable.
But anyway, how we carried out our evaluation was there were three of us involved in it. We did in-depth interviews with 24 workers. We looked at 20 case files in-depth. We interviewed eight families and we did a postal survey of almost 100 workers in non-government and statutory agencies, and we had what we called an action learning set. It was basically a day seminar with 24 workers who were involved in coordinating assessments. So we had quite a good sample, and what we found - a lot of interesting findings were actually from the case records, because it's there you really get a sense of what people are actually doing and how they record it.
So what we found was on the positive side the framework was largely successful.in use People liked it. They found it user friendly. They found the practice guidance was useful. At that time interestingly we had - I'll sort of show you the framework and then you'll know what I'm talking about. We had the activities sequentially one to seven, and it was the workers that said to us not all of the activities are sequential, sometimes you have to go back, some things need to run through it, so you need to show concurrent and sequential activities.
We found an under-use of evidence for decision making, which was something we weren't altogether surprised at but it was somehow disappointing. We found deficiencies in documented information of our children. One of our aims was to get a sense of the child from the records and we didn't. We got no sense of the child or their siblings really from the records. Not in every case, but in the majority of cases. We also found that when we looked at the survey results from the statutory and the non-governmental agencies, we found quite a lot of negative comments from the non-governmental agencies, not about the framework, but about the fact we don't know what this is. This suddenly landed in our door. We don't know what they're talking about. So there's a need for more communication between the statutory and the voluntary agencies. Sorry, I tend to refer to the term voluntary, which is what we call our NGO's.
Now I don't want to get boring, so please if you want to ask a question do, and I won't take too long on this because I know you have your own framework coming up. You may not really want to hear all the detail about this one, but this is essentially what it is. Now in the middle is the child, and I just want to go to the next slide to give you what's in the middle there. It should look like a spiral, and I make this little joke about you know the triangle and the English one, well this is an Irish triangle. It's actually a very sophisticated concept. It is not really a snail. It is actually supposed to be a spiral!
I don't know if anybody here's from Scotland, but the Scottish Executive when they saw this were really taken with it, and I think it's sort of a Celtic identification. We wanted the spiral to look - it got a bit stylised in the production, but it's supposed to be a little more fluid than that and to just look like a spiral. And so we felt we didn't want sharp edges in our sort of domain if you like. We felt things should flow. So in the centre there in the darker orange or yellow or however you describe that colour is the individual child, the child's immediate safety and the child's developmental needs, and any additional needs the child may have as a result of a disability, health problem, a cultural issue. And that is the centre, that it's from that that the whole assessment flows if you like. And then the next piece in the slightly paler colour is about parenting capacity, and the factors that impact on parenting capacity.
And the sort of factors that impact on parenting capacity would be domestic violence, mental health issues, addiction, parenting alone, very young parents, parents who grew up in care, parents living in a rural area, lots of issues like that. Then the further one is extended family and community, and it's basically what the last two segments of the spiral can contribute to the first one. That's how we see it. What can the parents do to meet their children's needs. If their ability to meet their children's needs is limited by some factor, what can the extended family and community do to compensate for that? So that's the essence of our child centredness.
And then just going back to the wheel, the colours - now I don't have a copy of the assessment framework here because I've kind of given most of them away, but actually we did send - it should be in your library - we did send you one at an earlier stage. But the colours are of significance because we've colour coded everything in the document. The first segment is responding, the red one, that's where the sequence begins, but before I start talking about the sequence I'm going to talk to you about the concurrent activities, because these are not principles, they're actions or activities that need to underpin the whole assessment process.
The inside one there, the sort of pale purple one, is called engaging, and that I suppose emphasises the importance of engaging siblings, engaging the child, continually checking with the family that they understand what's going on and engaging fathers. And it needs to go right through, because our piloting indicated that families got confused sometimes about whether they were being assessed or what actually is going on.
Then the next one is collaborating, which sort of is self-explanatory I suppose. It's about continually making an effort to keep communication open and coordinating the assessment, because research would show that at the beginning of a piece of work, intra-agency cooperation and inter-disciplinary corporation is good. As the work goes on people revert back into their roles, they get busy with other things and they forget basically to keep in touch with each other. So what we're saying is somebody needs to pay attention to that all the way through the assessment.
And then the third one is safeguarding, and the sense in which we are using safeguarding is that you need to always keep a watchful eye on the child right through the assessment. Don't make any assumptions that just because you think at the beginning the child is safe, that they're going to remain safe. Families change, people move in and out, contracts are broken. A very protective parent may die or move away. Some more dangerous person may move into the family. So that's our three concurrent activities.
And then our steps - I won't go into huge detail because they're fairly self-explanatory. Responding is obviously where you get the request to do the referral and to do the assessment, and you ask the normal questions well why now, what's known already, who do we contact, do the family know? Protecting is where you would do a risk assessment. I know you have your own risk assessment tool here. We borrowed extensively from that, and it's really questions about is there evidence that the child is being harmed? If there is, is the perpetrator still in contact? Is there a protective person there? Is the child able to protect themselves? Does something need to happen now? Those type of questions.
The next step is devising, which is really designing the assessment. Who needs to be involved? When are we going to have meetings? What's the time line? How are we going to ensure the family's feelings through this? How are we going to involve children in a meaningful way?
Then the fourth and fifth steps, gathering and reflecting and sharing, analysing, planning are very significant and very long ones, and they are the ones where you gather the information, you reflect on the information and you share the information. You analyse its meaning - and I will go into some of that in a little more detail - and you plan what's going to happen. So essentially that symbol there of the wheel encapsulates our whole assessment process, and we like the wheel idea because it shows flexibility. If this was three dimensional, electronic, we could flip the steps around. Say you were at the devising stage and you suddenly realised you had to go back and do a bit of protecting, that's okay, so it allows for a little bit of backwards and forwards.
What we did in the document was we had the first part as the tool, the second part as practice guidance and we have tabs on the pages that are the same colours as the different steps, so that it makes it both visually attractive and very quick to use. So if you want to find out more about protecting, a little more detail about risk assessment, you lift up the yellow tab and you get straight to that page. And we also have an index and we have little symbols saying - with a little book symbol saying go to page such and such for more detail.
I know you're probably getting bogged down in detail, but this is the last bit of detail that I'll give you. That up there, when I presented this in New South Wales they thought it was a spider, and I know Australians are very fond of spiders so maybe spiders are...it's not actually!! It's supposed to be a bunch of keys. We used to use one key and then the practitioners said they didn't notice it so we put in a bunch, but I have a feeling that it should be bigger. And the keys are a terribly important part of the assessment process, because it symbolises this is where you ask yourself these key questions and this is how you keep it self-evidence based.
And the key questions - throughout the document, wherever we suggest people gather a piece of information, we put the keys as a reminder. The key questions are first of all, what facts, observations and opinions do you have to support this information? Because what we don't want is people saying this mother is chaotic, this father is aggressive, this child is missing school. We want 'the child is missing school. i.e. They missed 14 days out of the Christmas term. So it's that level of detail. We don't want anything conceptual here. We want facts. We also do want observations and opinions but the opinions have to be informed opinions.
And then the next question is very linked. It's what does this actually mean in relation to the child's safety, welfare and development? And that's where you bring your theory into play, because you know about attachment, you know about resilience, you know about emotional damage. You're trained in all of these areas and you have plenty of research that you can actually access. So you want to know what do these facts mean, how harmful are they? And then again linked to the third question, is how do practice experience, research findings and literature inform this? And we would very seriously encourage people to actually go to the research.
Now we have at the back of our framework documents, we have research summaries, but they're very brief. Now they're better than nothing, but what we would really like is for practitioners to go to something like the Clearinghouse site, or to some of the similar web resources to actually get the research information and that this question should remind them. Then the question is should an intervention be made now? That's a sensible question. If you find the child is out of school you don't wait until six weeks time to actually contact the school authorities or the educational officer, you do it now.
And then the final question is very important, and this came to us really from our practitioners, about motivation and capacity. You need to ask the question is the caregiver aware of the problem, do they have the capacity to do something about it? Do they know that they're part of it, and how far in sort of motivational continuum are they? So we suggest models like the wheel of change, which is often used in addiction studies, to actually look at the parental motivation to change and their actual ability to change. So they're our key questions.
And then this may look a little strange, it's a very stylised clock, but because we found in the piloting that workers weren't giving a sense of the child in their records, we felt there was a need to actively encourage them to get to know the children. Now I know that's sort of sounds very pedestrian to you, because that's what you do all the time. But a lot of practitioners work with children in out of home care and they do very good work, but then they do things like life story books and other - we used to have a little pink book called All About Me, about the child's identity. So we suggest that during an assessment that these materials are also used. And the clock is about knowing what a child's average day consists of.
And we suggest an exercise, where you would go into a child with a blank sheet of paper, draw a clock on it and then chat with the child about what you do, what time do you get up? What do you do at nine o'clock, what do you do at ten o'clock, what normally happens after school so you actually fill in all the activities? So that hence you know the child, you know about their life, you know about the different things they do on different days, and also you know trigger points or risky points in the child's day. So it's quite a useful exercise.
We took it from a piece of work done by a man called Colin Raines in Sheffield, and obviously we've drawn from a lot of other work and we have referenced it very clearly. Now I know we're kind of running slightly out of time, so I'll just talk briefly about the areas for reflection. We do see reflectiveness as very important in carrying out the assessment. It's not to be a mechanistic exercise, it's to be an exercise where you - it's a bit like doing qualitative research, and I'm sure a lot of you have done that. All the time you're accumulating, you're augmenting your knowledge, and it's having an impact on where you're going to go next and where the family will go next.
So we'd say yes, engaging families is very important, making sure you engage siblings as well as the sort of index child if you like, and making a continuous effort to clarify with families that they understand what's going on. Considering their incentive to change, their understanding of the seriousness. I know that's very difficult because I've done quite a lot of work on long term engagement of families, and I know that sometimes they'll have the workers working along one set of knowledge, and families working on another set of knowledge. Where there may not be an absolute meeting of minds about the child's needs, but you can often work a relationship that way and obviously the closer the two lines become, the better the outcome is.
Promoting participation, not assuming that families feel comfortable about setting up meetings. Making it more comfortable for them, and finding little ways. We're suggesting that you actually, where families are able to and there are no language difficulties, get them to actually fill out some of the recording materials. Reflecting on information using the key questions, and then using the evidence so actually referring to research evidence, becoming more research focused.
We didn't actually provide forms and that has been a bit of an issue that we've had feedback on. Workers would have liked more forms. We didn't do it for a practical reason because we were working with three areas, and they couldn't agree on a single way of doing it. So we said okay, you do it, but also Jan had some experience of the materials produced in England, and she was very strongly of the view that if you give workers a form with a box to fill out information, they would just write into that box and that's it. Whereas if you give them endless amounts of space they might write considerably more, and if this is being filled in in an electronic fashion, well then the boxes will expand but we haven't actually reached that stage of sophistication in Ireland yet. But we have had feedback from people who have been using the framework, to say we wish you had given us recording materials so we know that that's an issue.
So what's different about our framework? I don't know whether it is a lot different. We kind of hope it is a bit better than every other framework in the world but it probably isn't. But we sort of feel it is centred in on the child. I haven't time really or the resources here to show you how the assessment would be carried out using the tool, but it's very much what are the child's needs, what's the parents' ability to meet those needs, and what's the community and extended family's contribution towards meeting those needs? So it's not just about the child. It's centred in on the child, because that's the way we like to think about it.
It guides workers through the entire process, rather than just information gathering so it's the whole process including the engaging, collaborating and inclusiveness bits. And hopefully with those key questions it encourages workers to reflect. The issues for training, we see child development being up there very strongly. Child development is an area that most people have studied but not necessarily retained. And we would say okay, it's good to have a good understanding of basic development, attachment, resilience, all of those very key areas, but also know that you have access to other professionals. In Ireland our child protection workers are situated in the health service, so we've very good access to public health nurses who are excellent at child development, so it's a really helpful thing for us.
We also think the training should focus very strongly on issues like addiction, information - what impact does taking heroin have as opposed to a non-opiate drug? What are the side effects of prescribed medication? What are the dynamics in sexual abuse? What are the dynamics in domestic violence? So these are areas workers really need to be au fait with, and even if they don't know the issues, know where to find the issues. Multidisciplinary working goes without saying, assessment skills, and also a lot of focus on influences on decision making.
Eileen Monro, who I mentioned earlier, is really excellent on this area. She's superb and we've quoted her a lot, also Geraldine McDonald, who's an English academic. They're very good at looking at what makes people sort of single-mindedly not take in more information. That workers can have a habit of seeing something and then only taking in the information that reinforces that idea. So it's those kind of things.
Supervisory issue is very similar. Look at the coping mechanisms. Accept that bias and distortion are inevitable and encourage workers to set a challenge. We have a big piece at the back of the framework on how to supervise an assessment. Organisational issues - I'm almost at the end now - within an organisation as I said earlier, not to make it an add-on. Actually make it an underpinning part of the work. To promote multidisciplinary work at a frontline level and at a senior level. To develop the structure and the context, and try to promote a positive image of the system.
I think you're working very hard at that here in Victoria, and I think that your new pathways to referral are very helpful in that respect, because it takes away the tough end of child protection. But we all have a long way to go with it, because you know why. I mean, I don't need to go into the issues, but it really is important to try and promote a positive image of the system.
And this is the last slide, it's the loose ends. There's some questions that I still have about assessment. One is, what is the difference between an initial and a full assessment when all of the guidelines and procedures and protocols all over the English speaking world, say exactly the same things for both. You have to look at exactly the same domains but you have to do one in a week and one in seven weeks, but I still don't know what the difference between the two is and I think that's an area that needs working.
Once size fits all - I don't know. Our framework is supposed to be multidisciplinary. It's very hard to make something multidisciplinary. Maybe that's another question. This point is one that caused huge tension between us and the people who commissioned the research. I think it's just that work is so hard there's an expectation the framework will make decisions, and it doesn't. The framework guides people towards what information you might collect, in order to integrate your professional skill, your practice, wisdom and your competence, everything else, but it won't do it on its own. And then just to - it's a slightly negative to end so I probably shouldn't have put it at the bottom, but just to bear in mind it is quite difficult to bring different professionals on board. I think that's understandable. We all have different professional orientations. We all kind of cluster together and stereotype other professionals, sometimes in a rather comical way. But at the end of the day we have to work together, and I think it just needs to be faced that this isn't easy and it's somebody's job to try and make it a bit easier. So sorry, I feel as if I've been flinging information out at you, but I'm kind of done now so if anybody wants to ask...
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