Making Sense of Child and Family Assessment
Best Practice in Working with Children Series Edited by Brigid Daniel, Pr...
15 downloads
2385 Views
1MB Size
Report
This content was uploaded by our users and we assume good faith they have the permission to share this book. If you own the copyright to this book and it is wrongfully on our website, we offer a simple DMCA procedure to remove your content from our site. Start by pressing the button below!
Report copyright / DMCA form
Making Sense of Child and Family Assessment
Best Practice in Working with Children Series Edited by Brigid Daniel, Professor of Social Work, Department of Applied Social Science, University of Stirling The titles in the Best Practice in Working with Children series are written for the multi-agency professionals working to promote children’s welfare and protect them from harm. Each book in the series draws on current research into what works best for children, providing practical, realistic suggestions as to how practitioners in social work, health and education can work together to promote the resilience and safety of the children in their care. Brigid Daniel is Professor of Social Work in the Department of Applied Social Science at the University of Stirling. She is co-author of several textbooks and practice resources on child care and protection. She was a member of the multi-disciplinary team that carried out a national ministerial review of child protection practice in Scotland.
other books in the series Safeguarding Children in Primary Healthcare Edited by Julie Taylor and Markus Themessl-Huber Foreword by Brigid Daniel ISBN 978 1 84310 652 4
Safeguarding Children Living with Trauma and Family Violence Evidence-Based Assessment, Analysis and Planning Interventions
Arnon Bentovim, Antony Cox, Liza Bingley Miller and Stephen Pizzey Foreword by Brigid Daniel ISBN 978 1 84310 938 9
Safeguarding Children and Schools Edited by Mary Baginsky Foreword by Brigid Daniel ISBN 978 1 84310 514 5
Child Neglect Practice Issues for Health and Social Care
Edited by Julie Taylor and Brigid Daniel Foreword by Olive Stevenson ISBN 978 1 84310 160 4
of related interest The Child’s World The Comprehensive Guide to Assessing Children in Need Second Edition
Edited by Jan Horwath ISBN 978 1 84310 568 8
The Survival Guide for Newly Qualified Child and Family Social Workers Hitting the Ground Running
Helen Donnellan and Gordon Jack ISBN 978 1 84310 989 1
Making Sense of Child and Family Assessment How to Interpret Children’s Needs Duncan Helm Foreword by Brigid Daniel
Jessica Kingsley Publishers London and Philadelphia
First published in 2010 by Jessica Kingsley Publishers 116 Pentonville Road London N1 9JB, UK and 400 Market Street, Suite 400 Philadelphia, PA 19106, USA www.jkp.com Copyright © Duncan Helm 2010 Foreword copyright © Brigid Daniel 2010 All rights reserved. No part of this publication may be reproduced in any material form (including photocopying or storing it in any medium by electronic means and whether or not transiently or incidentally to some other use of this publication) without the written permission of the copyright owner except in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency Ltd, Saffron House, 6–10 Kirby Street, London EC1N 8TS. Applications for the copyright owner’s written permission to reproduce any part of this publication should be addressed to the publisher. Warning: The doing of an unauthorized act in relation to a copyright work may result in both a civil claim for damages and criminal prosecution. Library of Congress Cataloging in Publication Data Helm, Duncan, 1970Making sense of child and family assessment : how to interpret children’s needs / Duncan Helm ; foreword by Brigid Daniel. p. cm. -- (Best practice in working with children) Includes bibliographical references and index. ISBN 978-1-84310-923-5 1. Social work with children. 2. Problem children--Evaluation. 3. Problem families--Evaluation. 4. Child welfare. I. Title. HV713.H383 2010 362.7--dc22 2009043645 British Library Cataloguing in Publication Data A CIP catalogue record for this book is available from the British Library ISBN 978 1 84310 923 5 ISBN pdf eBook 978 0 85700 298 3 Printed and bound in Great Britain by MPG Books Group, Cornwall
Acknowledgements I would like to acknowledge the many people who have kindly offered their help and support to me in writing this book. The incentive to write this book came from the delivery of a suite of child welfare and protection programmes at the University of Stirling and many of the themes addressed in this book have been developed from teaching at the university and dialogue with practitioners who have taken part in the Graduate Certificate in Child Welfare and Protection. I wish to thank students past and present for pushing the debate forward. I have sought permission for some students to use examples from their practice in this book. I have anonymized all examples to maintain the confidentiality of practitioners and service users. Colleagues at the University of Stirling have given me a great deal of practical and moral support. Chris McIlquham and Helen Whincup have unselfishly provided me with access to their course materials and their subject knowledge. They have also been critical friends who have helped me enormously through their constructive feedback on early drafts. I would like to offer particular thanks to Professor Brigid Daniel who, as Head of Department and Series Editor, has been instrumental in bringing this book to fruition. Many thanks for the pragmatic optimism, energy and insight that you have brought to so many developments. Thanks to my parents for helping me understand that I was not a duffer and therefore would not drown. Special thanks to my wife Nancy for her practice wisdom and for cutting me quite a lot of slack while I have been writing this book.
Contents Foreword
9
Bridget Daniel, University of Stirling GLOSSARY
11
1 Making Sense of Analysis
13
2 Searching and Seeing in Assessment
39
3 Building the Picture
65
4 Developing Explanations
93
5 Using Intuition Effectively
121
6 The Child at the Centre
157
7 Developing Practice in Analysis
181
BIBLIOGRAPHY
209
SUBJECT INDEX
217
AUTHOR INDEX
221
List of Figures Figure 1.1 Figure 1.2 Figure 2.1 Figure 3.1 Figure 3.2 Figure 3.3 Figure 4.1 Figure 4.2 Figure 4.3 Figure 4.4 Figure 4.5 Figure 4.6 Figure 4.7 Figure 4.8 Figure 5.1 Figure 5.2
Factors influencing choice of car insurance company Hammond’s cognitive continuum A ladder of partnership (Raynes 2003) The Johari window An example – speaking French Jen’s circumstances Deduction An example of deduction Induction An example of induction Dialectics – a model for effective analysis A model of the decision-making environment The ecology of analysis An example of methods for testing hypotheses Quasi-rationality in the cognitive continuum Some factors differentiating the poles of the cognitive continuum Figure 5.3 Some of the properties of intuition and analysis Figure 7.1 The context for analysis in practice Figure 7.2 Moving on the cognitive continuum Figure 7.3 Cognitive control Figure 7.4 Awareness of thinking Figure 7.5 Amount of information Figure 7.6 Time available Figure 7.7 Memories Figure 7.8 Metaphor Figure 7.9 The cognitive continuum Figure 7.10 A compromised environment for analysis Figure 7.11 A collaborative environment
17 35 44 78 78 79 105 105 105 106 107 116 117 119 148 153 154 182 182 183 183 183 184 184 184 188 202 204
Foreword Our series ‘Best Practice in Working with Children’ aims to support practitioners who work with children across a range of settings. Each book draws together key research and theoretical evidence to inform practice guidance. With this volume we are responding to a need identified in numerous inquiry reports and by many professionals who undertake assessments in their work. It is a common observation that many assessment reports are often sparse on analysis, and in particular analysis of what the information means for the child. Assessment is a complex and challenging task; it entails making sense of large amounts of information, some factual, some impressionistic, some contested. Collecting the information within a multi-disciplinary environment can be difficult enough. Working out what all the information means is a real challenge. In this book Duncan Helm addresses this challenge head on. His starting point is that assessments must lead to improvements for children and their families otherwise they miss the point. He acknowledges that analysis is complex and that it is important to take account of the human aspects of assessment from the perspectives of children, families, practitioners and organizations. To assist practitioners he identifies the various factors that affect the ways in which we collect, sift and evaluate evidence and provides practice-rooted examples of how they can be taken into account. With this addition to the series we aim to provide practitioners with a thoughtprovoking book that offers realistic practice guidance. Brigid Daniel, University of Stirling
9
Glossary Throughout the book I will refer to ‘the practitioner’ in recognition that, while social work remains the key profession in child welfare and protection work, the desire to improve analysis of children’s needs exists across all professions working on behalf of vulnerable children and young people. It is the responsibility of all professionals to consider the welfare of the child. Therefore, the tasks of assessment and analysis are relevant to the many different professional bodies working with and on behalf of children and young people. I will use contracted forms or abbreviations in reference to some of the more lengthy titles and publications in circulation. Audit report – It’s everyone’s job to make sure I’m alright (Scottish Executive 2002) was the report of an extensive audit of child protection practice and systems in Scotland. Sometimes referred to as ‘It’s everyone’s job’, the report is also referred to as ‘The Audit’. CAF – Common Assessment Framework in England. CPD – Continuing professional development. ECM – Every Child Matters. GIRFEC – Getting It Right for Every Child. Heuristic – A form of cognitive shortcut or ‘rule of thumb’ in intuition. Hermeneutic – Belonging to or concerned with interpretation. IAF – Integrated Assessment Framework in Scotland. Ofsted – The Office for Standards in Education, Children’s Services and Skills. Ofsted inspects and regulates care and education in England.
11
12 / GLOSSARY
Reporter – The Reporter is an official employed by the Scottish Children’s Reporter Administration to consider whether compulsory measures of supervision are required. Serious Case Reviews – (or Significant Case Reviews in Scotland) are conducted under different guidance in England, Scotland, Northern Ireland and Wales. They are undertaken when a child or young person dies or is seriously hurt and abuse or neglect is thought to be a factor. Social work – The term is usually used to describe the specific role and responsibilities of a professional with a social work qualification. In this text the wider definition is used to encompass all professions whose role engages them in work on social aspects of children’s development.
Chapter One
Making Sense of Analysis
Introduction Children and young people require the people around them to help them grow and develop and fulfil their potential. Some children and young people are not afforded these supports and opportunities through their own families and may require additional support from their wider world, such as teachers, youth workers or police officers. The experience of abuse and neglect may result in some of these children requiring support from child welfare and protection professionals. Whether support is being provided through universal services (such as through a teacher or health visitor) or through social work intervention or child protection processes, all the professionals involved will be analysing the child or young person’s needs. The sense that we all make of children’s needs is vital to effective practice and improving outcomes for vulnerable children and young people. However, the practice of interpreting children’s needs is both complex and disputed. A clearer and deeper understanding of the process of analysis is required. We have seen significant developments in the assessment of the needs of children and young people (including their need for protection) over the last 20 years. New legislation and assessment models have created an environment where, in theory, assessments should be more analytical and more effective in representing the child’s lived experiences and their consequent developmental needs. However, much of the evidence from practitioners in my teaching and from the literature is that analysis in assessment continues to be an elusive and poorly understood area of assessment work. As a consequence workers feel ill prepared, assessment reports are not effectively presenting practitioners’ analysis and children 13
14 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
and young people feel that they are not being listened to or faithfully represented in assessments (Cleaver, Walker and Meadows 2004; Mudaly and Goddard 2006). Over the last few years, there has been growing recognition of the need to consider and develop professional-level skills in analysis. Findings from reviews of child death inquiries (Munro 1999; Reder and Duncan 1999; Reder, Duncan and Gray 1993) have highlighted the importance of judgement or ‘reasoning’ and the dangers that exist when common errors of reasoning go undetected. Reder and Duncan (2000, p.443) noted that review findings suggested that ‘…problems with assessment and the way that information was managed lay at the heart of many of the tragedies’. The literature on assessment has identified some helpful frameworks to help us think about analysis, usually in conjunction with other wider elements of the assessment task (e.g. Holland 2004; Munro 2008; O’Sullivan 1999). There is also a growing influence from practitioners who have begun to voice their desire to know more about this area of practice. Analysis has taken on a level of mystique that may now be contributing to some of the ongoing difficulties in practice. Practitioners and policy makers want to improve practice but many developments have failed to make a positive impact. Much like risk assessment, a desire for certainty within an atmosphere of stress and anxiety may have resulted in practitioners looking for some form of silver bullet to help overcome barriers to anxiety. Although the conditions in which analysis can flourish are multi-layered, many solutions often lie in core professional skills, knowledge and values. This is designed to be an accessible text that will provide an overview of some key elements of theory, research and practice in analysing children’s needs. While there is a considerable literature on the subject of analysis, most notably within philosophy, economics and psychology, there is a need for further research in relation to analysis within the context of child welfare and protection. In this text I draw on the existing child protection literature and I make reference to some of the more established theoretical frameworks available elsewhere to provide some practical guidance and, I hope, stimulate further development and discussion.
Real-life decisions and practice Sometimes less really is more. While many inquiry reports and the associated literature have, quite rightly, focused on developing greater rigour and depth in analysis, this type of analysis is simply not possible in some circumstances. Faced with large amounts of information and limited
MAKING SENSE OF ANALYSIS / 15
time and knowledge, our analytical reasoning can become overwhelmed. We simply don’t have time to consult with colleagues and the literature. The uncertain and fast-moving decision-making environment can result in practitioners making an unacknowledged move toward more intuitive judgements or even to the avoidance of judgement. To demonstrate the way that we make decisions I would ask you to think about one of the decisions that adults have to make each year. Which insurance company did you choose when you renewed your house or car insurance? (I had to look this up as I had forgotten.) Now we can think about how you made that choice or judgement. There are so many different companies and policies to choose from that making a reasoned choice becomes very difficult. There are so many factors to consider: obviously price is a big issue but you also have to consider previous experiences, the reputation of the company, their excess policy, any available discounts, and so on. My decision was made on the basis of a handful of key facts: 1. I knew the company I had been with up to now. 2. Changing companies takes some effort. 3. Nothing bad had happened to me so far. This seems to be a rather slipshod way of making an important decision but I don’t think I am alone in the way I did this. The ideal picture of reasoned choice is one where all of the various factors in the judgement are carefully identified and their relative merits and demerits compared. The proliferation of internet price comparison sites indicates that we value this way of making decisions, known as optimization. In optimization, the solution to the decision can be called ‘optimal’ when it can be proved that no better solution exists (Gigerenzer 2007). This kind of reasoning is often modelled as ‘maximization of expected utility’. Without constraints of time, knowledge or processing capacity, a rational decision should be possible by ascribing values to arguments for and against a choice and adding up the scores to see which option is the most useful; which has the highest ‘utility’. A young Charles Darwin famously used this method to decide whether or not he should marry. He set out two columns and under each of them laid out the points in favour of marrying or not marrying. Darwin started to list the merits of marriage but gradually began to see more and more problems (such as losing his freedom, having to visit the relatives, not to mention the financial cost of children). Despite the overwhelming evidence that he would ‘maximize his utility’ by not marrying, Darwin concluded decisively that he should marry.
16 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Most of us have had a similar experience at some point where, despite all the apparent evidence in favour of one choice, our intuition tells us to go the other way. Sometimes decisions are simply too important to trust in a vision of decision making that does not match the reality of day-to-day choices and thinking. Even in the relatively simple sphere of car insurance, we can see that this optimizing form of decision making may not be a realistic aspiration. For a start, not all insurance companies are included in the comparison. Companies have to pay a premium to appear on price comparison websites and some choose not to do so. So immediately it is apparent that it is not possible to ‘optimize’ because it can’t be proved that some other insurance company may not offer you a better deal. If we were able to line up all available insurance options next to each other, the difficulties with decision making would not stop there. We would then need to begin to compare the different aspects of the insurance, such as cost, excess policy, courtesy and helpfulness of staff, and so on. However, there is no shared currency to help us decide which of these features is more important to us than the others. Would you prefer to pay a little more and have a courtesy car, or would you rather pay more and have lower excess payments? Would you prefer to pay less but deal with a larger company, perhaps with overseas call centres? The value placed on each of these factors is a personal one and it is complex and time consuming to identify as many of these factors as possible and calculate their ‘utility value’. Figure 1.1 outlines some points for and against insuring your car with one particular company. This list is a brief one. No doubt you would have further considerations to add to it. However, to calculate a utility value effectively, you would need to be able to calculate all the possible consequences of your choice. You would need to be able to calculate the value of each consequence and factor in the probability too. This would take amounts of research, time and effort that really would not be possible or worthwhile. This model of thinking just simply does not reflect the way people have to make decisions in a world of limited time and information.
MAKING SENSE OF ANALYSIS / 17
• Unknown to you previously
Figure 1.1 Factors influencing choice of car insurance company
Reflecting on judgement Box 1.1 Now think about how you make decisions in your work. For example, if you are facing the choice of accommodating a child or supporting them at home, how is this choice made? Take a couple of minutes to note how the choice is made and what methods help you make such decisions.
Presumably you began by considering all the information available, such as the age and developmental needs of the child, the sources and impact of adversity, and strengths in the situation. At the beginning of any assessment, it is vital to ensure that attention is paid to the scope and sufficiency of the information in the assessment. Ecological assessment frameworks help to define these kinds of dimensions but it quickly becomes clear that it is almost impossible to define utility values as described by theories of unbounded rationality. How, for example, should you compare the value of maintaining family links against the value of removing the child from an emotionally neglectful home?
18 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
It has been suggested that social work practitioners favour an intuitive approach to assessment, finding this more in keeping with professional values and more acceptable than the more calculated and technical approach of analysis (Walker and Beckett 2003). This may be seen by some as a key explanation of why practitioners have been repeatedly found wanting in their ability to present good quality analysis of risks and needs in assessments. I do not agree. I would suggest that what has actually been found wanting are the frameworks on which practitioners are expected to nurture the skills and carry out the work of analysis. Rather than continue with the exhortations to improve analysis, perhaps we should be looking at how to make the best of existing intuition and analytical capacity and building the cognitive, professional and organization systems that allow it to grow and develop. Current frameworks for assessment in the UK tend to be triangular models that allow practitioners to consider the interplay between the dimensions of the child’s needs, parenting capacity and environmental factors. The way in which these frameworks are used to support analysis needs careful consideration if we are really to get to grips with the complexity of analysis and move away from a way of thinking that may in fact heighten the chances of intuition taking over in unhelpful ways while we labour under the misapprehension that we are actually in control of our conscious and deliberate analysis. Using the Department of Health (DoH) Assessment Framework as a risk analysis tool means that practitioners have to consider about 787,050 interacting risk relationships (Cooper 2003). How is anyone expected to manage this task? Cooper concludes that while ‘analysis of risk relations is the very heart of risk analysis’ most risk analysis is ‘carried out intuitively’ (2003, p.109). The sheer complexity of some analysis requires intuitive thinking but such thinking is, by its nature, unconscious and therefore not explicable or defensible.
Developing our intuitive thinking Is analysis a skill that can be learnt and developed? Is it an innate capacity that you either have or do not have? The language used to describe the activity of analysis is often more complex and difficult than the activity itself. My belief is that much of the task of analysis, as part of the process of assessment, is a learnt skill and therefore one that can be developed. Much of our analytical capacity is driven along by processes that are not accessible to the consciously reflective brain. In a sense, much of the
MAKING SENSE OF ANALYSIS / 19
activity is happening in the backrooms of our mental processes and can only be brought into the realms of conscious consideration with some effort. However, not knowing how you learn it or how you are doing it does not stop you doing it. What can be done though is to gain a better understanding of some of these processes and by doing so we can focus efforts to develop further the conscious and unconscious skills that make up our analytical capacity. Human decision making is bounded by two main components: the limitations of the human mind, and the structure of the environments in which the mind operates (Simon 1987). While there is room for debate about how far we can go to attend to the limitations of the human brain, it is certain that we can gain a better understanding and grasp of the environment in which these brains operate. While this book is aimed at individuals, it is important that it is borne in mind continually that the brain is only as good as the environment it operates in.
Findings from ‘worst case scenarios’ We tend to make judgements about the world around us based on limited amounts of time, information and thinking power. However, there is still a persistent belief in some areas of practice that the mind is somehow capable of the kind of unbounded rationality described above. The messages from serious case reviews have been worryingly consistent for the last 30 years (Reder and Duncan 2004). Poor communication and poor assessment are repeated features of worst case scenarios (Sinclair and Bullock 2002). It is significant that the recommendations that these reviews have made potentially perpetuate (or at least do not challenge) the dominant view that human rationality is unbounded. It would appear that the review system believes that improving practice through policy and procedure is a primary objective. Hyland and Holme (2009) reviewed the recommendations of 24 serious case reviews. Of 182 recommendations, they classed: • 116 as ‘professional action’ recommendations (requiring someone to do something, usually relating to policy and procedures) • 55 related to resources (producing things like protocols or a database); and • 11 recommendations related to ‘professional knowledge and skills’ (where individuals are recommended to acquire or improve professional knowledge and skills).
20 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Only just over 16 per cent of recommendations paid attention to the actual people doing the analysis and the thinking. This lack of attention to the reasoning that underpins all assessments is worrying. Although effective systems and procedures are essential, they are still operated by workers who are ultimately fallible and dealing with the murky waters of uncertainty and probability. It also leaves workers in a double bind where they are exhorted to work harder to analyse information but are potentially being asked to do this in an unfeasible way (unbounded rationality) and without the necessary analytical tools and methods. Reder and Duncan (2004) point out that in many cases subject to inquiry, the practitioners involved were inexperienced and lacking in confidence but were working with complex, chaotic, high-risk cases. While politicians, policy makers and managers work to improve systems, practitioners are still left to manage these cases as best they can within the limits of their agencies. One issue that emerges here is that of the nature of analysis in relation to experience. In later chapters we consider the nature of intuitive ‘practitioner wisdom’ among other identified forms of knowledge. We also explore the environment within which judgements are being made and consider how teams and agencies can play a valuable part in developing our analytical capacities.
Use of theory Theory is far from benign and practitioners need to ensure that their understanding of theory has not slowed, stopped or become misplaced over the years. Theories cannot model an absolute truth but they can help us understand, explain and bring about change (Howe 1990). Psychological theories in particular are very malleable and liable to be pared down and oversimplified in their application (Taylor and White 2006). While there is not room to enter into a discussion on theory here, many excellent texts exist (e.g. Daniel, Wassell and Gilligan 2002; Howe 1990; Lishman 2007; Milner and O’Byrne 2002) and the use of theory should be a core element of professionally reflective and accountable practice. This book concentrates on what we do with theory and provides practitioners with an opportunity to gain a clearer understanding of the key components of effective analysis in assessment. With such understanding, practitioners may feel more confident and practise in a more competent manner.
MAKING SENSE OF ANALYSIS / 21
What is assessment? Box 1.2 To assess – ‘To evaluate (a person or thing); to estimate (the quality, value, or extent of ), to gauge or judge.’ Oxford English Dictionary
If you ask any group of child welfare and protection practitioners ‘What does the word “assessment” mean to you?’ you are likely to hear a wide range of answers. When I have posed this question to groups of students on child welfare and protection programmes, the answers have tended to reflect topical themes of debate at that point. For example, during a period of intense activity and preparation for agency inspections, many workers’ definitions of ‘assessment’ would focus on risk assessment and the pursuit of accurate prediction and recording of specific risks to children and young people. Ask the question following an input on child development and you could reasonably expect the answers to mention themes such as attachment or parenting capacity. Assessments vary in their focus and different professions need to be able to understand and coordinate the many pictures emerging in different agencies to ensure that the child or young person remains the primary focus. Issues of inter-agency practice are considered in more depth in Chapter 3. Further consideration is given to the challenges of child-centred practice in Chapter 6.
Box 1.3 Assessment can be defined as a systematic process of gathering a range of information relating to a child, to help identify their strengths and needs, in order to decide on appropriate further action (or to confirm that no additional help is required). Assessment can provide a baseline of information against which a child or young person’s future development can be measured. The information may be gathered from a wide range of sources. Department for Children, Schools and Families (DCSF) 2006, p.2
22 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Assessment is defined by legislation and policy. It is also understood in terms of accepted practice norms. This can be problematic and it is vital that a shared understanding is sought. For example, assessments may be carried out in relation to statutory duties to enquire into the circumstances where children’s needs are not being met, but they may also be carried out in relation to child protection concerns where consideration must be given to making the child or young person subject to child protection plans. It is clear that ‘assessment’ as a concept or activity is defined and understood in many different ways. Shared understandings may unite some groups of practitioners but a lack of shared understandings and the presence of implicit assumptions about the definition can equally fragment and undermine practice within and across practice identities. The question ‘What is assessment for?’ can be equally vexed. Is the assessment an outcome in itself or does it exist only to inform a care plan? Is it an assessment of risk, need or both? Is it a picture of a person’s life or the identification of a problem? The aims and focus of the assessment are core to the process of analysis and simply providing child-centred assessment frameworks is not necessarily a recipe for child-centred assessments (Cleaver et al. 2004). The term ‘assessment’ can have many different meanings depending on the context of its use. Although I will be discussing assessments within child welfare and protection/safeguarding, it is worth noting how many different types and approaches to assessment there are in this area of practice. The primary legislation provides the statutory powers and duties that require and allow practitioners to make enquiries into children and young people’s circumstances and carry out assessments of their needs (including their need for protection). Coulshed and Orme (1998) defined assessment as: …an ongoing process, in which the client participates, the purpose of which is to understand people in relation to their environment. It is the basis for planning what needs to be done to maintain, improve or bring about change in the client, the environment, or both. (p.21)
However, almost every section of this statement has been a subject of debate within the literature in recent years. The participation of children and young people in assessment is an area where the reality of practice all too easily departs from the rhetoric of policy. This vital area of practice will be given further consideration in Chapter 6. In this chapter we will take a closer look at assessment as a developing understanding of the child or young person and their world.
MAKING SENSE OF ANALYSIS / 23
Understanding Box 1.4 Hermeneutic – ‘Belonging to or concerned with interpretation.’ Oxford English Dictionary
The notion that assessment is about ‘understanding people’ is reflected in the term ‘hermeneutic assessment’, which describes assessments that develop deeper understandings and emerging interpretations. However, there is evidence that there may be barriers to practitioners carrying out this kind of assessment effectively. For example, it has been shown that professionals’ interpretations may differ markedly from those generated by the people who actually use services themselves and may be based on assumptions and thinking that are not made explicit or transparent (Philp 1979; Rojek, Peacock and Collins 1988). A country-wide audit in Scotland found that many assessments were narrow in focus and concentrated on providing evidence of abuse and neglect without sufficient attention to the ongoing needs of the child (Scottish Executive 2002). This is still a challenge for practitioners when the guidance emphasizes a hermeneutic or interpretative approach but practice is so heavily defined by limited resources and an adversarial court system that emphasizes the importance of providing evidence towards the establishment of a form of ‘truth’.
Is assessment art, science or both? Making sense of children’s needs can require practitioners to use a range of approaches in assessment. As well as the need to create greater certainty through the use of theory and the application of research there is also a need to recognize some of the more inaccessible areas of our analysis such as feelings and intuitive knowledge. Approaches to assessment are often conceptualized as two opposing ends of a particular spectrum. At one end, there are those who would view assessment as a ‘technical-rational’ activity and, at the other end of the spectrum, those who would see assessment as ‘practice-moral’ activity (Hammond 1996; Taylor and White 2001). The key differences between the approaches are outlined below. The technical-rational perspective: • uses empirical research
24 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
• applies theory • uses frameworks to collect information • works towards a ‘truth’ about the child’s needs • helps the worker generate the ‘right answers’. The practice-moral perspective: • offers an interpretation of the child’s needs • is based on values • accepts a variety of perceptions from within the context of the child’s life. There is arguably a potential drive towards seeing assessment as a ‘technicalrational’ activity. There are many, many more frameworks available to practitioners than there were, even ten years ago. Many frameworks are now incorporated within national policy and guidance. This is not without potential hazards though. Hollows (2003) cites Farmer and Owen (1995) and Murray (2001) as evidence that the construction of thresholds through practice guidance (e.g. placing a child’s name on the child protection register) may actually constrict analytical thinking. For example, by focusing analysis mainly on the decision to register or not, many aspects of the child or young person’s life and needs may not be considered as these fall underneath the radar of workers focusing on needs for protection. We will see later on that the ‘art’ vs. ‘science’ dichotomy in assessment is one that impacts on our analysis and needs to be considered in terms of the way that we process information every day to come to best decisions in the face of uncertainty. Perhaps one of the unforeseen consequences of the serious case review system has been the growing expectation within society that all abuse and neglect could (or should) be detected and ended. This desire to believe that all children will be protected from harm does perhaps make for a growing belief that assessments can become more and more accurate and able to identify children and young people who are risk of abuse and neglect, and prevent them from continuing to experience this. Politicians in both central and devolved government have been unable to resist the temptation to make statements about ‘no child ever being hurt again’. With scarce resources, a strident media and growing public disapprobation for individuals and agencies who have been seen to fail in their duty to protect all children and young people from harm, it does not seem too surprising that workers too are less keen to view assessment as interpretive and explanatory and more
MAKING SENSE OF ANALYSIS / 25
inclined to view it as an activity that allows us to identify needs, calculate risks and formulate intervention strategies that can be defended within a risk culture. We all know that people are wonderfully complex and that each person is unique (in the true sense of the word). We know that people do not easily fit into categories and that theories can only go so far in helping us describe and explain individual circumstances. We should also be very clear that any assessment framework is inert without the application of the assessor’s judgement. A framework cannot be operated like a machine. You can’t feed information (data) in one end of a framework and have a nugget of pure truth emerge at the other end. Somewhere in this process, the information has to be processed and analysed by a human being; a human being who must decide on how to interpret this sea of information and how to construct a case out of the emerging themes. The fact that personal beliefs and values are a crucial part of judgement appears to have been played down or even ignored by many within the field of child welfare and protection (Taylor and White 2001). One of the odd things about this focus on assessment as ‘technicalrational’ activity is that the serious case reviews themselves have clearly identified the significance of anxiety, personal values, context and culture for professional decision making (Horwath 2006; Munro 2008; Reder and Duncan 1999) It is as if, despite everyone knowing that we are human, we close our eyes to this reality and persist in the belief that we can make assessment practice safer and more effective if we can somehow engineer human frailty out of it. It is in fact more likely that these perceived human frailties may play a key part in accurate and empathic assessment. A clear and more explicit understanding of the process of judgement and decision making is required. A considerable body of knowledge already exists and some of it is beginning to look at the specific tensions and requirements within child welfare and protection practice.
Can we establish ‘the truth’ in our analysis? Box 1.5 There is no such thing as certainty, but there is assurance sufficient for the purposes of life. John Stuart Mill (philosopher), cited in Hammond (1996, p.13)
26 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
‘Post-modern’ is a term commonly used with reference to the demise of traditionally accepted certainties. For example, religion used to be the cornerstone for society and we still use phrases like ‘gospel truth’ to indicate the strength of this certainty. However, in a ‘post-modern’ society, there are fewer and fewer certainties; religion, science and medicine are no longer untouchable and the globalization of information exchange provides the power to question the previously unquestionable. We are more able and willing to question some of the concepts and rules that were previously accepted. In this kind of society, knowledge is increasingly seen as open to all and ‘expertise’ in any area is open to criticism and question. In the area of child welfare and protection, we have seen a decline in confidence in the workforce and a growth in the willingness of government, media and the general public to ask more pointed questions about the basis for decisions made on behalf of the country’s most vulnerable citizens; children and young people subject to abuse and neglect. It is actually rather difficult to establish a precise meaning for ‘judgement’ (Hollows 2003). One contributor to this complexity is the fact that any definition of ‘judgement’ depends on the professional realm in which the judgement takes place. For example, judgement is required in child protection, plastering, sales and music (to name but a few). Judgement is required to work with people, materials, sounds, space; it is ever present. Judgement can be an affair of the heart and of the head. Each activity requires a different type of judgement though and we need to consider the complexity and nature of judgement with specific reference to the child welfare and protection task. Judgement is an individualistic and subjective process. The ‘data’ that we analyse comes in the form of what we see, hear, smell and feel. The judgement occurs inside what, until recently, has been the ‘black box’ of the human brain. Advances in brain imaging have allowed scientists to access more and more of the physiological processes that occur inside the brain. Psychology has also given us the tools to develop an understanding of how the brain uses past experiences and a knowledge base to inform analysis. Some of this research is now beginning to influence practice and education in child protection work. Goldstein and Hogarth (1997) draw a distinction between judgements and decision making. Others (Arkes and Hammond 1986) feel that there is very little difference between the two. The terms are often used rather loosely and tend to be used interchangeably. In the realm of child welfare and protection risk assessment, Dalgleish (2000) defines judgements as an inference drawn from the data, and decisions as the actions taken on the
MAKING SENSE OF ANALYSIS / 27
basis of these judgements. While judgements are inferences deduced from the available information, decisions are the choices that have to be made about what to do in light of the judgement. It can be helpful to draw a distinction between the thinking and the action. One aspect of practice that is worthy of further consideration is what happens when decisions somehow precede judgements. Many errors that have been labelled ‘errors of judgement’ have actually been errors of decision making (Calder 2008; Hollows 2003). Groups are notoriously problematic environments for making judgements (Milner and O’Byrne 2002). We therefore need to consider how professionals can be supported to make their judgements prior to the decision-making process and how later information should be assimilated into existing judgements.
How are judgements made? Theories of how we make judgements tend to fall into two broad categories or visions of how human reasoning operates: • bounded reasoning • unbounded reasoning. What do these terms mean though and what can they tell us about effective decision making in child welfare and protection work? For most of our time since the ancient Greeks, we have made a distinction between two kinds of knowledge – demonstrable proof and probable reasoning. These visions of rationality offered us certainty and uncertain knowledge respectively (Gigerenzer, Todd and the ABC Research Group 1999). However, it has been argued that we have, over time, moved away from the knowledge of certainty as our faith in the traditional sources of certainty (such as the Church) have been eroded (Daston 1988). Religion and philosophy in particular can no longer offer unquestionable certainty and, in counterbalance, probable reasoning has flourished. We are now more likely to accept that we can only ever have uncertain knowledge about ourselves, other people and the world around us. This has resulted in a growth in the study of probability and the development of mechanisms better to understand its workings. More recently still, interest in the field of intuitive reasoning has refocused our thinking again and we can consider this area now as we examine what we mean by bounded and unbounded rationality.
28 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Unbounded rationality This view of rationality assumes that the human mind has essentially unlimited resources of time, knowledge and computational power. With limitless quantities of these resources, unbounded reasoning allows us to make judgements with certainty. Such models of thinking have been defended for their success in some domains (such as economics) and their suitability for mathematical expression. We have already considered one form of unbounded rationality called ‘maximization of expected utility’ and we will consider the implications of such a model for professional practice. Many contemporary texts (e.g. Munro 2008; O’Sullivan 1999) have tended to lean at times towards a vision of rationality which suggests that we can (or should be able to) see all the elements of a decision and all its potential costs and benefits. For example, the use of decision trees is suggested as a means of clarifying analysis and judgement, and Munro (2008) has noted success in working with students who were using decision trees in practice. This kind of Olympian analysis is often viewed as the most desirable form of reasoning. However, time is a crucial factor in analysis, and judgements that are made under limitations of time and information need to be understood and supported rather than discarded in favour of a vision of rationality that is not attainable. Models of reasoning have to fit with reality and the reality is that our thinking is bounded by various constraints, including time and information. The environment within which the reasoning takes place is also a significant factor and we need to bear this in mind when considering analysis in practice. Rather than expect professionals to ascribe to, and strive to attain, an unrealistic vision of unbounded rationality, perhaps more recent thinking about the way that decisions are actually made in reality could provide some guidance as to how professionals can make more of the resources they have to analyse information and create more helpful explanations on which to base care plans. Bounded rationality describes a model of human judgement that builds on what we actually know about the way the human mind works rather than unobtainable aspirations. The model consists of two main components; the limitations of the human mind, and the structure of the environment in which this mind is working (Simon 1987). In most situations it is simply not possible to work out what the optimal move should be; it is either unknown or simply unknowable within the constraints of time, and so on. In such situations, it is suggested (Gigerenzer et al. 1999) that we employ a series of heuristics (or ‘rules of thumb’) that guide and define the parameters of
MAKING SENSE OF ANALYSIS / 29
our search for information and provide simple rules to help make use of the information. We will explore some of these heuristics later on in this book. We also need to be mindful of the decision-making environment. A rule of thumb that works well in one setting may not be effective in another, so we need heuristics that are flexible enough to be valid in various settings. However, we also need these rules to be sufficiently specific to ensure that they are efficient in adapting to exploit the information structures that they encounter. It is the simplicity of heuristics that make them so robust (Hammond 1996).
What is analysis? Box 1.6 Analysis – ‘The resolution or breaking up of anything complex into its various simple elements, the opposite process to synthesis; the exact determination of the elements or components of anything complex (with or without their physical separation).’ Oxford English Dictionary
Most definitions of analysis concern themselves with a process of breaking something down into its components. The Oxford Dictionary of Philosophy (Blackburn 1996) defines analysis as ‘the process of breaking a concept down into its more simple parts, so that its logical structure is displayed’. Although the tradition of analysis has its roots in Greek philosophy, there are now many different categorizations of analysis, and different areas of expertise (e.g. literature, chemistry, politics or mathematics) have developed their application of the concept of analysis in order to meet the specific requirements of the subject area. We also need to consider where analysis should take place in the process of assessment. Dalzell and Sawyer (2007) suggest that analysis takes place throughout the process of assessment. However, they and others (e.g. Calder and Hackett 2003) also see a specific place for analysis after information has been gathered but before conclusions have been formed. So we need to consider that there may be different ways of analysing information and that these different approaches may lend themselves to particular aspects or parts of the assessment task.
30 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
There is an ever-growing body of knowledge about the nature of abuse and neglect and its impact on child development and longer-term outcomes for those who have been abused and neglected. Alongside the growing body of knowledge, there is a connected requirement for more stringent education and training for those working on behalf of abused and neglected children. Professionals are required to know and apply a wide, and often contested, subject knowledge to extremely complex and dynamic practice situations. The nature of child welfare and protection work is suffused with both emotion and risk. In such an arena, practitioners are required to carry out assessments. At the heart of these assessments is analysis, which we have already defined as breaking down a concept into its fundamental parts, so that it can be explained. There is a recognition in research and evaluations of practice that analysis has often been found wanting or missing in assessment. For practitioners to be able to analyse effectively, there appear to be some prerequisites: • a thorough understanding of child development, parenting capacity and the impact of adversity in the social environment • an ability to apply knowledge critically to build an understanding of each unique situation • a working environment that supports and sustains such activity.
Analysis and dialectics Peter Reder and Sylvia Duncan have studied and written extensively on the subject of serious case reviews (Reder and Duncan 1999; Reder et al. 1993). In Reder and Duncan’s 1999 publication, they proposed that workers adopt a ‘dialectic mind-set’ to counter some of the difficulties with analysis (or a lack of it) that had been contributory factors in so many child abuse tragedies. Not long after this publication, Reder and Duncan noted emphatically in an international journal article that: …a dialectic mind-set is a prerequisite for professional practice, and imparting it should be at the core of training programs for all those who will participate in child protection networks. In addition, it should guide supervision, so that supervisees are encouraged to use their intuitive and analytical capacities to keep up to date with the literature and to consider the merits of alternative interventions. (Reder and Duncan 2000, p.444)
MAKING SENSE OF ANALYSIS / 31
My experience in practice is that most of us in the field of child welfare and protection have not even heard of the dialectic mind-set, let alone managed to incorporate it into assessment and supervision. Unless you have studied philosophy or have been fortunate to connect with professionals and educators who have adopted this model, it is likely that you may be using a dialectic mind-set without appreciating how it works and how it can best be supported. Many people enter into child welfare and protection work because of a desire for equality and justice. Many also enter into this work because of a curiosity about the way people, families and societies work. Dialectics can take these aspects – a drive and a ‘how and why?’ way of thinking – and hone them to be more accurate and effective tools for analysis in assessment. In Chapter 4 I explore this model of thinking in more depth and consider its practical application in this field.
Analytical and intuitive reasoning A number of texts (e.g. Dalzell and Sawyer 2007; Holland 2004; Munro 2008) have already provided practitioners with valuable opportunities to examine assessment practice and develop analytical skills. Some provide a detailed overview of the way in which human analysis and decision making occurs, others provide developmental tools based on these concepts. What this book does is bring the two areas of writing together so that professionals can consider the theory underpinning analysis, described in clear and accessible terms, and use the case studies and exercises in the book to take forward the development of their critical skills and their working environment to promote more effective and robust analysis in their assessments. In life we are continually called on to understand and take meaning from huge amounts of information brought to our brains by the various senses. As psychology and technology have developed, we have begun to understand more fully the incredible feats that the brain performs in making such calculations. We are also now beginning to make sense of the way that different types of reasoning operate. Box 1.7 gives some examples.
32 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Box 1.7 Driving down a side-street you see a cat dart out from between parked cars. In an instant, you have braked, sworn, swerved and resumed your journey. The party is in full swing and some of the guests are getting rather lively. You are having fun but it’s beginning to feel a bit edgy. You make for the door and are heading down the street as the party breaks into a fight.
What unites both these situations is that you had to make sense of information coming at you with complexity and great speed. You made judgements quickly enough to save the cat and your party spirit. All this was done quickly and efficiently because none of the processing got anywhere near your conscious brain. Intuitive thinking is efficient precisely because it is a hardy animal; it can get by very well on limited resources and does not need full information and plenty of time to tell you what to do. This is also its downfall.
What is intuitive thinking? We talk about practitioners ‘acting on intuition’. We have all had experiences where some inner voice told us to do something, or say something. This was not a conscious, deliberated decision. Intuitive reasoning is something that happens below the water-line, so to speak. The huge majority of all information entering the brain is processed unconsciously and, usually, very effectively. However, the literature on decision making has been predominantly sceptical about intuition. Although the debate about the relative merits of these different ways of thinking has gone on for many years, until fairly recently, the prevailing view has been quite negative, with Tversky and Kahneman’s (1974) ‘heuristics and biases’ programme supporting a generally held view of intuition as a source of error and inconsistency that needs to be guarded against and carefully managed. More recent research has questioned the findings of experiments that previously identified intuition as a source of difficulty. As Toda (cited in Arkes and Hammond 1986, p.680) notes, ‘both man and rat are incredibly stupid in the experimental room’, and research that has examined real-life decision making, as opposed to decision making in research environments, has begun to re-evaluate the place of intuition in analysis (Klein 1998).
MAKING SENSE OF ANALYSIS / 33
The concept of intuitive cognition was presented by psychologist Egon Brunswick (Hammond 1996) and forms a key part of the counter-argument of those who champion this form of rationality against its traditional adversary of analysis. Intuitive reasoning has been described as ‘fast and frugal’ thinking (Gigerenzer et al. 1999) because of the capacity of intuitive reasoning to make judgements quickly from limited data. Where does our intuition come from? Gerd Gigerenzer of the Max Plank Institute for Human Development refers to intuition interchangeably with ‘gut feelings’ and a ‘hunch’ to describe a judgement (Gigerenzer 2007, p.16): • that appears quickly in consciousness • whose underlying reasons we are not fully aware of; and • is strong enough to act on. Our ability to make decisions quickly on partial information has also been referred to as ‘evolved capacities’ (Gigerenzer 2007). This term is based on the understanding that we, as humans, have been given capabilities by nature (the way our brains process information or the way our senses help us manage in our environment). However, it is by repeated practice over time that these capabilities can evolve into capacities. These ‘evolved capacities’ give us the heuristic models or ‘rules of thumb’ that we can use to make judgements quickly and on limited information. We may benefit from further thinking about how to develop some of these capacities in the assessment of children and young people’s needs. By developing a clearer understanding of how these ‘rules of thumb’ work we may be able to guard against some of their weaknesses and develop systems that support intuition more effectively as part of a wider range of reasoning styles in practice.
Heuristics (or rules of thumb) Many heuristics too were recognized and captured in common phrases long before we began to explore the science behind these capabilities. For example, the term ‘keep your eye on the ball’ is known to almost everyone regardless of whether or not they play a ball-sport. If we look at this phrase we can see how it represents a rule of thumb known as the ‘gaze heuristic’. It provides a good example of how our current use of these rules of thumb may have its roots far back in our evolution, perhaps coming through our need to hunt and avoid being hunted, to the current day and the example offered next.
34 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
The ‘gaze heuristic’ helps us catch a ball: simple as that. Calculating a ball’s trajectory, so that you can intercept and catch it, is hugely complex, with calculations involving velocity, distance and angle as well as intractable variables such as wind speed or spin. Gigerenzer (2007) suggests that the brain short-cuts all this computation with a simple three-step strategy: 1. fix your gaze on the ball 2. start running, and 3. adjust your running so that the ball rises at a constant rate. Although most players would not be aware that this was what they were doing, these three simple rules underpin success. It explains why it is so much easier to catch a ball when you are moving, and it demonstrates why taking your gaze away from the moving ball can result in you dropping the catch. However, making this rule of thumb known to the conscious brain does not destroy the magic and it can actually help people to learn to catch more efficiently and effectively. With this in mind, we can begin to think about the different types of heuristics that we already use every day. We can think about their suitability and potential pitfalls for reasoning in child welfare and protection work. Finally, we can begin to be more explicit about what makes up our intuition and work on how to make most effective use of this power alongside more conscious and deliberate analysis. There are a number of other heuristics that have been identified. Some of these have a particular relevance for the field of social work and the assessment of needs and risks. In the following chapters we will explore the heuristics shown in Box 1.8 in some more depth, and consider how they may dovetail with existing frameworks for assessment.
Box 1.8 • • • • • •
Recognition heuristic Availability heuristic Anchoring/adjustment heuristics Representativeness heuristic Pattern recognition Emotional tagging
MAKING SENSE OF ANALYSIS / 35
The cognitive continuum There will be times when you will be making judgements solely on intuition. For example, when you are making a home visit or seeing someone in a clinical or office setting you will need to respond rapidly to the evolving picture. A subtle pause or inflection in someone’s speech may suggest to you that a particular line of enquiry should be pursued or ended. The way that a parent and child stand in relation to each other may just not feel right. In these situations you need to make judgements quickly and on limited information. This subconscious processing or intuitive reasoning can be very effective but has also been criticized (e.g. Nurius and Gibson 1990) for its inaccuracy and fallibility. There will also be times when you will be making much more analytical judgements, based more explicitly on organizing principles, theories and evidence. For example, when making a recommendation for permanency, a great deal of time and explicit consideration are required in analysis. When there are sufficient amounts of time and knowledge, judgements can take on a more structured and analytical approach, with more complex and explicit organization and more deliberate and conscious processing. Intuition
Analysis
Figure 1.2 Hammond’s cognitive continuum
There is room for both intuitive and analytical approaches to judgement. Rather than see them as an either/or choice, we can consider them as poles on a cognitive continuum. We move between these poles depending on the nature of the judgement task (Hammond 1996). Because there are a wide range of different circumstances and conditions for judgements to be made in, particularly in terms of time and resources, we need to find a way of making a judgement that matches the features of the environment. To help explore these possibilities, Hammond developed the idea of a continuum. At one end of the continuum there is the fast and frugal approach to judgement, which is intuition. At the other end there is the actuarial judgement, based on robust information and a strong evidence base. The continuum creates a framework to consider the various points along the way between these two extremes. The ‘expert decision maker’ is defined by their capacity to match the right judgement style to the task at hand (Hammond 1996). This is an important definition because it implies that there will be a correlation between the
36 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
type of judgement required and the resources required to support it. For example, if the judgement is complex and the data is expansive, a more analytical style may be appropriate. However, child welfare and protection work is frequently complex and there is often a vast amount of data available from the child, their family, files and other professionals. Time is also almost wholly viewed as the most limited resource available. It is in just these situations that practitioners may be forced towards intuitive thinking when actually it is analytical thinking that is required. The judgement style therefore no longer matches the structure of the task. This has implications for systems and organizations, but it also has implications for workers who need to have the confidence and support to recognize when timescales may contribute to professional dangerousness.
Summary In this chapter I have begun to explore some of the areas of theory and debate that underpin our understanding of the nature of analysis in child welfare and protection assessment. Our definitions of ‘assessment’ may vary depending on our role and setting. For example, an initial assessment in an intake/duty team may consist purely of records checks and phone or email contact with other professionals to establish the veracity of allegations or establish whether the agency has the legal power or duty to intervene or make further enquiries. An assessment in a long-term childcare team, however, may last for weeks or months and be focused on identifying developmental needs, parenting capacity and motivation to change. It is imperative that all assessments begin with a clear and explicitly stated set of aims so that practitioners and service users share purpose and understanding throughout. Considering the literature from the fields of psychology and philosophy we have examined two broad perspectives on the way in which judgements are made. We have seen the potential benefits of some manifestations of unbounded reasoning such as the use of decision trees. Darwin’s ‘marry/ don’t marry’ calculation is a good example of how both bounded and unbounded reasoning can play a part in analysis. When working with both children and adults I have previously used a form of this exercise to explore potential decisions. In Chapter 6 we examine the importance of such exercises to ensure that the young person’s views are truly taken into account in our analysis. In Chapter 7 we examine how some of these tools may be developed further.
MAKING SENSE OF ANALYSIS / 37
The literature on judgement has a long tradition of rivalry and tension between proponents of analytical judgement and those who believe in the value of intuitive reasoning. These debates continue but Hammond (1996) offers a compromise in the form of the cognitive continuum. At one end of the cognitive continuum, intuition provides us with the means to make judgements under uncertainty. Intuition is understood to utilize ‘fast and frugal’ heuristics to make judgements within environmental constraints such as time and knowledge. In Chapter 5 we consider these mechanisms in more depth and consider whether a clearer understanding of intuition could be connected to more effective use of it in assessment. The polar opposite of intuition on this continuum is analysis. When making sense of children’s needs in assessment, we are required to gather the right information from the right people. In Chapter 3 we look at the nature of inter-agency practice and the place of judgement in deciding where to look for information in assessment, and when we have enough information to allow us to stop searching for new information. In Chapter 6 we consider the tendency not to represent the views of children fully or accurately, and we look at some of the causes and consequences of such practice. If we are to become better at analysis we need to be taught how to carry out this task. Chapter 4 draws on the literature to explore a model for analysis in assessment. However, we must also recognize that intuitive and analytical judgements can both ultimately be wrong. Analytical judgements tend to be defensible because the assessor can show the logical process by which they reached their conclusions. However, being able to defend a judgement does not make a wrong judgement right. Intuitive judgements by their very nature are easy to criticize when they are wrong because the assessor can offer no paper trail and no justification for their judgement. Having a ‘hunch’ or a ‘feeling’ is not a strong defence and in an environment such as child welfare and protection, the desire for defensible judgements may be so high that correct judgements founded in intuition may be lost at an early stage in pursuit of a more analytical approach that offers the ephemeral reward of greater certainty and the more tangible goal of transparency. Analysis can take many forms, and practitioners and service users may benefit from a better professional understanding of analysis that incorporates both intuition and more deliberate analysis.
Chapter Two
Searching and Seeing in Assessment
Introduction There is a great deal of research and literature that suggests that our unconscious thinking begins a form of analysis even at very early stages of the assessment where we are gathering information. For example, when looking at a picture, your eye is drawn to particular elements of the picture. For one person, it may be the group of people by the building. For another person, it may be the very straight line of trees receding into the distance. We are looking at the same picture and we are all seeing it whole and complete. However, we all notice different things and can see different things each time we look at the picture. We can also be shown things in the picture that another person has seen but we haven’t. Individuals will all create a unique subjective image of the picture, based on what information was taken in and made sense of. This unconscious process will have been affected not only by our sensory organs but also by our processing through schema, emotions and our banks of memories. These unconscious processes can ultimately dictate what we see, feel, hear and smell. They select which pieces of information we will notice and which pieces of information will remain as part of the background. Cyril Connolly (critic and writer) observed that ‘we are all sentenced to life in the dungeon of self ’. In other words, we all experience the world in our own way and there is no sure way of knowing if anyone else’s experiences are the same. This comment does rather starkly capture the significance of individual perception and you can see why we spend so much of our time trying to figure out what other people are thinking. Our perceptions of the world (and therefore our assessments) are a subjective
39
40 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
interpretation and only ever as valid as the sufficiency of the information gathered and the acuity of our interpretation of it. Our perceptions do not record information faithfully. We don’t take a photocopy of the picture and reproduce it. This understanding is vital to ensuring that the process of information gathering and management in assessment makes best use of our brains’ processing capacity but is also safeguarded against its potential fallibility. The raw data on which assessments are based needs to be gathered from a wide variety of sources. This must include the views and narratives of service users but will also involve the use of historical information from paper-based and electronic data recording systems, identification of relevant information from other professions such as police, education and health, and the massive amounts of complex, layered and ambiguous information from what our senses take in during direct work such as home visits, interviews, contact supervision, and so on. A clearer understanding of how human judgement impacts on information gathering can help us more effectively select what is ‘relevant’ and work within and across professional boundaries in analysing children and young people’s needs.
Gathering information – when the searching stops In this chapter, we will concentrate primarily on one type of heuristic (cognitive short-cut) known as ‘satisficing’. This term was coined and developed initially by Herbert Simon (1955a) and helps us understand the way that human reasoning operates within the reality of the limits of time and resources available. The term is a Northumbrian one and means ‘to satisfy’. Satisficing allows us to make choices along a pathway of decision making when we don’t know much about possible outcomes. Satisficing creates a decision-making short-cut by setting a ‘good enough’ standard for our decisions. When an apparently satisfactory solution is found, the search for further solutions can stop. There may be a better choice round the corner but, as we can’t see round the corner, we can stop looking ahead once we have found an option that meets our aspirational level (Gigerenzer et al. 1999).
Box 2.1 Satisficing in action Faced with a chip pan fire, what would you do? This is potentially a life and death decision but the judgement needs to be made very quickly. Rather than sit down to list all the possible options and then select the
SEARCHING AND SEEING IN ASSESSMENT / 41
one that is the optimal solution, your intuitive reasoning takes the controls. Rather than surveying all the possible courses of action, you are more likely to take one possible course of action and play it through a mental simulation. If it works for you (i.e. if it meets an aspirational level) then you can go ahead and act without considering any further options. If the solution does not meet your aspirational level then you work through the next alternative and so on until a satisfactory course of action is found (Klein 1998).
Baron (cited in Messer and Jones 1999) notes that the ‘satisfactory’ level that is to be met is defined by the personal goals of the person doing the reasoning. Practitioners have been noted to find it difficult to know when sufficient information has been gathered to allow an informed assessment of the child’s needs to be made (McDonald 2001) and this situation provides the potential for practitioners to set aspirational levels that are too low for safe and effective practice. In the example of the chip pan fire in Box 2.1, it is likely that a firefighter may make a different choice to the average person. The optimal solution may be to throw a wet towel over the fire but, without sufficient experience or knowledge, the first apparently satisfactory solution may be to throw water on the chip pan, causing a lethal acceleration in the fire. Not making a decision is in itself a judgement with consequences: not acting quickly in the event of the fire may have fatal consequences. Satisficing may provide a good guide in unknown situations but it relies on previous experience and learning. If such experience is lacking (and years in a job are no guarantee of years of learning) then assistance and conscious thinking are required to ensure that what our intuition judges to be ‘good enough’ is indeed the best solution available under constraints, or if in fact we have stopped our search for alternatives too soon. One crucial area that needs to be explored as part of the setting of aspirational levels is what our goals are. Some are listed below, but these are not goals that commonly find expression in care plans; some may not actually feel safe to share. However, they are there and they have an impact on how quickly we find our satisfactory explanation and stop looking for another. Goals in one possible situation (e.g. an inquiry into domestic violence) include:
42 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
• protect the child • address discrimination • get report in on time • listen to the voice of the child • reduce risk from perpetrator • keep non-offending parent and child together • manage caseload. Some of these are clearly stated professional goals. For example, the duty to protect the child and have regard to their views is enshrined in legislation and guidance. Other goals are driven by professional systems and processes. For example, there are prescribed timescales for the submission of assessment in England and Wales. In Scotland, reports to the Scottish Children’s Reporter Administration are monitored for statistical purposes and thereby create timescales for the submission of reports for children in need. The creation of such timescales, while beneficial in terms of accountability and avoidance of ‘drift’, can also create difficulties when the goal for practitioners and organizations becomes the meeting of timescales, and this has a higher priority than the submission of an assessment that provides appropriate levels of analysis built on meaningful dialogue with children and their families. In such instances, the professional duties of the practitioner are in tension between their professional commitment to childfocused assessments and their professional accountability to legislative and procedural frameworks. High caseloads and pressurized teams may also create a ‘siege mentality’ in which satisficing is affected by the practitioner’s desire to protect themselves and/or their team from further referrals. Values play an important part in the creation of goals and they are too often not subject to sufficient scrutiny. Taking the above goal for example: ‘keep the family together’ can be both a professional and a personal goal. While the legislation recognizes that the family is usually the best place for a child to be brought up, this is tempered by the welfare principle that informs us that children and young people should be brought up by their own families when this does not conflict with their welfare. This is an area of professional judgement that is emotionally and intellectually demanding and practitioners’ anxieties and psychological defences can be a significant contributory factor in such judgements (Smith, Nursten and McMahon 2004; Valentine 1994). Therefore an implicit goal in this scenario may be to avoid confrontation with dangerous and hostile adults; it may be to avoid the certain loss for the child who may need to be looked after away
SEARCHING AND SEEING IN ASSESSMENT / 43
from home; it might be that the practitioner may be subject to psychological defences such as projection, which Menzies (1960 cited in Taylor, Beckett and McKeigue 2008) saw in nursing where aspects of the professional’s own personality were projected onto others to avoid dealing with the responsibilities and tensions that some professional decisions provoke.
Box 2.2 Values in action Bernie has been the support worker for Claire (aged five) and Claire’s mother and father for eight months. In supervision, Bernie has discussed the ongoing problems of domestic violence between Claire’s parents. Bernie has clearly identified strengths for Claire and her parents but Bernie’s supervisor is concerned about the chronic and escalating nature of violence in the home. The supervisor checks this concern with Bernie and Bernie offers a picture of the parents as vulnerable adults who have experienced trauma and loss in childhood, have insecure models of attachment and have already lost the care of their two older children. The supervisor suggests that these issues may actually be significant risk factors for Claire. Bernie disagrees and reiterates her points about family strengths, the parents’ experiences and the potential impact of Claire being accommodated away from her parents.
What is happening here? One possible explanation for what is happening in Box 2.2 lies in the implicit values that Bernie and her supervisor hold. In reflection at the next supervision session, Bernie discusses just how much she likes Claire’s parents and how strongly she wants them to do well. She knew that the situation was growing intolerable for Claire but did not want to be the one to make the judgement that levels of risk were too high for Claire. Bernie did this by projecting this responsibility onto her supervisor. The reflective space offered by supervision and the emotionally intelligent responses of the supervisor allowed this value tension (and its practical consequences) to be addressed in a timely way. The second serious case review into the death of Baby Peter concluded that: ‘The danger is an over-identification with the service user in a wish to support and protect the child’s place in the family’ (Haringey LSCB 2009, p.14). The challenge for individual practitioners and agencies is to manage this in balance with other professional values.
44 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Partnership The guidance and principles associated with our key legislation requires practitioners to work in partnership with children and families (Parton, Thorpe and Wattam 1997). Policy has built the concept of inter-agency partnership into assessment practice. However, the construction of ‘partnership’ in current assessment practice needs careful consideration. The ‘ladder of partnership’ is a useful tool to help get beyond the rhetoric of ‘partnership’ and evaluate what the true nature of the professional relationship might be in any given situation (see Figure 2.1). Full partnership shared working; not necessarily equality
Participation influencing what is going on
Involvement being present
Consultation asked for opinions
Keeping fully informed information provided
No partnership
Figure 2.1 A ladder of partnership (adapted from Raynes 2003)
When it comes to gathering information in assessments, Milner and O’Byrne (2002) suggest that approaches to assessment need to encompass the issue of partnership. Smale and Tuson (1993) identify three different approaches to assessment that demonstrate the way in which power can be shared to varying levels by practitioners depending on the kind of assessment task being carried out: • The questioning model tends to be used with very limited power sharing. The assessor is viewed as the ‘expert’ and will form questions and process answers with little room for the views or interpretations of service users themselves. • The procedural model is largely focused on ascertaining whether or not a particular threshold for intervention has been reached, with a particular focus on criteria for service provision.
SEARCHING AND SEEING IN ASSESSMENT / 45
• The exchange model emphasizes the hermeneutic approach, viewing clients as experts in their own lives, and seeks to facilitate information exchange and the development of interpretations of needs and goals.
Box 2.3 Partnership in practice Smale and Tuson’s three approaches to assessment can be used to consider the nature of different ‘partnership relationships’ in practice. In relation to one particular practice example, consider which approach to questioning you have used predominantly with: • • • •
the child or young person parents or carers colleagues professionals from other agencies.
What do your answers suggest to you about the different types of partnerships you are part of, and what the impact of these relationships will be on information gathering?
Most practitioners believe that working in partnership with parents is generally beneficial and most see it as a priority in their practice (Thoburn, Lewis and Shemmings 1995). Research findings have validated the emphasis on working in partnership with families because of its association with better outcomes for children (Cleaver 2000; Department of Health 1995). Thoburn et al. (1995) found that agency policies and procedures could act as barriers to partnership working. Indeed, more recent documents, such as the Department of Health (DoH) assessment framework (DoH 2002), may actually have created a climate where the drive to work in partnership with parents has actually become problematic, shifting the focus onto parents and away from children. A number of UK reports have criticized practice where the aim of working in partnership with parents has compromised the assessment of children’s needs and has meant that children have been left in situations where they are experiencing abuse and neglect. For example, the Inspection into the Care and Protection of Children in Eilean Siar (Social Work Inspection Agency (SWIA) 2005) commented that: The overwhelming emphasis was on helping their parents (and extended family) to bring up their children. However, in our view there was an
46 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
unhelpful imbalance in the weight given to this and to the rights and duties of parents as against the needs and rights of the children. (SWIA 2005, p.6)
Similarly, the report of the inquiry into the death of Caleb Ness in Edinburgh criticized the professionals involved for maintaining an implicit assumption that Caleb’s parents had a right to care for him and failing to give primacy to Caleb’s right to be safe. The legitimacy of adults’ rights to have the care of their own child is not disputed; however, it is in tension with the right of the child to be safe from abuse and neglect. What is significant about these examples is that the beliefs and values that underpinned the analysis of the facts needed more explicit consideration. Effective assessment requires accountability of values (Reder and Duncan 1999) and the development of this area of practice is explored later on in this chapter. A number of reports have been critical of practice where working in partnership has translated into an unquestioning belief in information given by parents (Laming 2003) and the ‘unspoken assumption that the parents had a right to care for their baby’ (O’Brien, Hammond and McKinnon 2003, p.7). This has resulted in a growing opinion that practitioners in child welfare and protection should exercise ‘routine scepticism’ (Laming 2009). The serious case review into the death of Baby Peter identified that: ‘Agencies were too willing to believe Ms A’s accounts of herself, her care of the children, the composition of her household, and the nature of her friendship network’ (Haringey LSCB 2009, p.14). The accounts of parents, family and carers may be accurate but they may also be manipulated to serve the interest of the adult. Care needs to be taken to nurture scepticism alongside a necessary level of hope if safe, ethical and effective judgement is to be maintained in practice. Practitioners have allowed themselves to be reassured too easily by parental cooperation (O’Brien et al. 2003). Faced with differing accounts between the child and the adults, the professional response has often been to believe the adult (SWIA 2005). One of the key messages emerging across inquiry reports is that analysis was often based on a partial or inaccurate set of information. In gathering information, we are creating the bigger picture from smaller pieces of the jigsaw. Some pieces we pick are false (such as inaccurate records or lies from parents), others are simply missing (such as direct observation and views from children). It may be possible to construct a plausible picture even though pieces are wrong or missing. Therefore, we need to remain alert and critical in information gathering to ensure that we search far enough, we have questioned the evidence rigorously enough and
SEARCHING AND SEEING IN ASSESSMENT / 47
that we remain open to the possibility that we may need to re-evaluate the information again as new evidence comes to light. In an overview of 50 serious case reviews, Ofsted (Brandon et al. 2008, p.18) noted that: Possibly the single most significant practice failing throughout the majority of the serious case reviews is the failure of all professionals to see the situation from the child’s perspective and experience; to see and speak to the children; to listen to what they said, to observe how they were and to take serious account of their views in supporting their needs.
The review went on to note that, at times, the desire to support parents in their task meant that the needs of the child were not the primary focus, and that at times ‘a family support perspective can obscure the need to ensure children are properly protected: the outcome of the massive amount of support provided can be to prop up and perpetuate a profoundly abusive situation’ (Brandon et al. 2008, p.28). Some writers (e.g. Calder and Hackett 2003) have raised concerns that it may be difficult for practitioners to assess risk (such as risk of physical or sexual abuse) while using an assessment framework that is based on assessing needs and identifying strengths within children and their families. There is an argument that, if workers are looking for areas of competence and ability, they may not be looking for weaknesses. If workers are speaking with families about what they can achieve and what they are good at, they may not be speaking to the family about what they appear not to be managing. In other words, the focus on strengths may cloud a worker’s judgement about levels of risk and may prevent them from fully exploring some of their ‘gut feelings’ or intuition about a situation. The development of practice and assessment tools may benefit from approaches that help workers to analyse risks in terms of their likelihood and the potential magnitude of impact on the child or young person’s developmental needs. Risks and needs may then be seen as two sides of the same coin (Aldgate and Rose 2006).
Information from the past Research and inspections have consistently exposed a professional tendency to be biased in favour of current information in preference to information about past history (Farmer and Owen 1995; Munro 1999). Practitioners tend to get caught up in the ‘now’ and fail to pay sufficient attention to
48 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
information from the past (Munro 2008). There has been a failure to consider the chronology and pattern of previous events (Scottish Executive 2002). This body of research suggests that a failure to give due consideration to historical information can result in assessments that gain a false impression based on current parental behaviour and attitude to professionals (Farmer and Owen 1995) and that overlook (or give an overly positive interpretation of ) patterns of behaviour within the family (Munro 2008). Why might we be prone to this tendency to favour current information before historical information? It may be a result in some instances of personal and professional values. For example, a worker from a criminal justice background recently discussed with me their discomfort at asking about parents’ backgrounds in relation to child welfare assessments. The practitioner felt that this was not an area that they had a right to ask people to explore. Part of this value appeared to come from the adult focus of this service, reminding us of the difficulty we can face in maintaining a focus on the child where the child may not be the practitioner’s primary client. Another contributory factor appeared to be a predominantly solutionfocused approach in this student’s work setting, leading to a greater emphasis on the ‘here and now’ than a more psychosocial consideration of the past. The use of solution-focused brief therapeutic interventions has been subject to a number of comments in serious case reviews (e.g. Haringey LSCB 2009) and reminds us once again that theories and approaches are not benign and require critical consideration in professional practice. In an overview analysis of serious case reviews, Brandon et al. (2008) noted a tendency among professionals that they labelled ‘start again syndrome’. This phenomenon was seen when workers were dealing with families where neglect was part of a complex and sometimes overwhelming picture of chronic intergenerational social difficulty. The tendency that Brandon et al. noticed was for workers to focus on the present and to put aside information they had about the past. By only dealing with the presenting difficulty, each individual instance or event was not enough in itself to reach a level of concern that might trigger action. Because information about the past was not accessed or taken on board, the patterns were not seen and the most recent event could not be seen within a wider picture of ongoing unmet developmental need or escalating risk. Historical information needs to be both accessed and understood in terms of children’s developmental needs before an accurate picture can be made of the impact of current adversity on the child. A number of research studies have shown the contribution that historical information can make to a greater understanding of the current circumstances
SEARCHING AND SEEING IN ASSESSMENT / 49
of the family. A study of serious case reviews in England between 2001 and 2003 highlighted the fact that ‘chronologies and genograms were found to have been overlooked or poorly presented…’ (Rose and Barnes 2008, p.69). Practitioners have often failed to obtain required background information and have dealt with information as separate instances, causing them to miss warning signs and fail to identify the connections and patterns emerging (Reder and Duncan 1999). In a study of recurrent errors in the practice of professional workers, Munro (1999) established that professionals were slow to revise their judgements in light of new evidence or information, especially information that contradicted the assessment previously made. Munro’s (1999) study of 45 reports found: • 26 reports that failed to use evidence from past history • 10 reports that failed to take a longer-term perspective which would have enabled appreciation of an emerging pattern of increased risk • 16 reports that did not use written evidence (files; reports) • 12 reports that noted that information was known to others but not collated.
Box 2.4 …the best guide to future behaviour is past behaviour. The family’s way of behaving to date is the strongest evidence of how they are likely to behave in the future. Munro (2008, p.77)
Risk assessments are predictions of the likelihood and magnitude of future harm. All predictions are fallible, but it would appear that the one source of information that could really improve the accuracy of these assessments is the one that practitioners have been regularly paying insufficient attention to: the past. Reder, Duncan and Lucey (2003) provide a comprehensive overview of the usefulness of historical information and make reference to the usefulness of: • a genogram • a chronology of events based on information in documents
50 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
• details of significant events and relationships in the family’s history, concerns about childcare and other problems that have come to the attention of professionals • interventions that have been attempted and whether they were of benefit.
Box 2.5 History taking, which highlights past conflicts and the meaning of events within an interactional framework, has the potential to link parental difficulties with episodes of child abuse. Reder et al. (2003, p.220)
There are also ongoing therapeutic reasons to be concerned with historical information. Fahlberg (1994) suggests that a worker who is willing to help a parent fill in gaps in their past and in the parent’s understanding of their past will be more trusted and effective than a worker who ignores the past. Having experienced the usefulness of such work themselves, the suggestion is that parents might then be more likely to provide that information for their child, whether that child is in their care or not. Workers may need to consider how to respond in helpful ways to those parents who cannot or will not reflect on their own past experiences. Some parents may be unable or unwilling to discuss their own experiences of having been cared for and may struggle with a self-identity that can faithfully represent both the good and the bad in their past (Howe 2005). Practitioners therefore need to use an informed, sensitive and creative approach to offer the best opportunities to service users to express their explanatory frameworks. Where children are confused about what has happened to them, have blanked the memory out, or have had experiences when they were very young of which they have no conscious memory, the worker’s first step should be to research their life history carefully (McLeod 2008). There are therapeutic benefits (such as relief from self-blame or unblocking developmental progress) that can help children make sense of their own selves and support them to be more actively involved in the gathering and understanding of information in their own assessment.
SEARCHING AND SEEING IN ASSESSMENT / 51
Accessible and inaccessible information At the beginning of this chapter we considered the individual’s unique experience of looking at a picture. We all have different experiences of the same picture, depending on what we see and how our brains process the raw data through the various cognitive and emotional filters we have built up over our lifetimes. However, the literature on decision making has identified that certain types of information are more likely to be noticed and recalled. These types of information are therefore more likely than others to form part of our assessment. Munro (2008) advises that the kind of information that people tend to find most accessible is: • vivid, not dull • concrete, not abstract • emotion-laden, not neutral • recent, not in the past • our first impressions. Therefore there is a tendency towards seeing and remembering certain types of information. For example, we will prefer the spoken word to the written word; we will prefer things we can see and feel rather than things only thought of; a crying child may be listened to more than a report of a crying child; what parents do at a meeting today may overtake people’s views of them from the last meeting, and what we do and say in the first five minutes of a contact can set the tone for the rest of the period of our involvement. Clearly, this kind of bias in accessibility has a relevance to all areas of child welfare and protection. We will examine the issue here in relation to the early process of enquiry and information gathering. If we believe that we are more likely to accept and recall vivid information, we should give careful consideration to what makes it vivid in the first place. One aspect of vividness that has already been explored in the literature (Farmer and Owen 1995; Munro 1999) is the tension of ‘recency versus primacy’. Our tendency is to pay more attention to current information than past information about family history, regardless of how important or representative this information may be. This tendency has the potential to be exacerbated by the fact that much of this current information is given verbally, while much historical information is only available though dull, abstract and time consuming file-reading. Speaking to someone is so much more engaging than reading information that we are even further influenced to pay attention to verbal accounts than to written accounts.
52 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
We can see this in practice where practitioners speak more frequently and in more depth to adults. If the child or young person is not spoken to in a similar manner, their testimony will potentially carry less weight with the practitioner because it is not as vivid as the adult’s words. We can also see the phenomenon in case conferences where the spoken word is so influential and where people who are actually at the conference are much more likely to influence outcomes than people who have presented a written report but have not attended. How vivid the information is may also be subject to individual influence. In what is termed the ‘cocktail party effect’ we can see how it is possible for our brains to pick up particular detail very quickly from a background buzz of unwanted information. The effect takes its name from the phenomenon you can experience in a busy room, when someone uses your name in conversation. The person speaking did not raise their voice, did not speak to you and may not even have been referring to you, but nonetheless your brain picked up your name above all the other buzz in the room. Why, because your name is extremely important to you and the use of it in any time or place is immediately of some significance to you. In the same way, particular information may stand out for you during the process of initial enquiries and assessment if it has a particular personal relevance or resonance for you. If you are afraid of spiders, then you are likely to react quickly and strongly if you hear someone mention them. If you have had a particularly emotional experience in your work, it is possible that you will react more quickly and more strongly to this situation when it occurs again. This learning process may be helpful in allowing us quickly to identify information that may be relevant to us individually. However, it also needs to be guarded against so that we do not overlook information that may be equally important but has failed to activate the early warning systems we possess. Reflection is vital to gaining a better understanding of these tendencies and should be a central plank of supervision practice.
Box 2.6 Reflection on accessibility of information When you are drafting a report, use Munro’s categories to think about accessibility of information. For each important piece of information ask yourself, was the information: • vivid or dull
SEARCHING AND SEEING IN ASSESSMENT / 53
• • • •
concrete or abstract emotion-laden or neutral recent or in the past a first impression or sustained and validated?
If your reflections have identified common errors of judgement can you now think about how these potential gaps can be reviewed and analysis improved?
Information is more accessible if it is concrete, not abstract. Things that are tangible (i.e. can be seen, heard and felt) demand attention in a way that intangible conceptual information cannot. You may be fully aware of the death of a friend or family member but the reality of the loss may not really be felt until you visit their grave or see their old house. We can also see this phenomenon at work in relation to the globalization of media and the heightened levels of concern for children’s safety and levels of supervision and monitoring. Levels of crime and risk may not have increased. Indeed, children are much less likely to be killed or injured than they were in previous decades. However, reporting of crimes against children and the risks that they are exposed to has increased. Concrete examples of risk are beamed into our homes every day and this influence is much more readily collected and retained than the quiet but abstract information which suggests that the probability of your child being hurt is not actually as high as it might appear. This tendency needs careful attention in practice, particularly when the child is at risk of neglect rather than deliberately committed acts of abuse. It is recognized that the current child welfare and protection system in the UK is one that tends to be able to respond quite well to specific incidents of harm and abuse but does not respond so well to the needs of children who may not be subject to a specific incident of abuse but are subject to chronic neglect and adversity. It is recognized that it often requires a specific incident to ‘catapult’ such children and young people into the system (Dickens 2007). However, given our long-standing knowledge of the serious developmental impact of neglect on children (DoH 1995; Horwath 2007a; Taylor and Daniel 2005), we need to ensure that the absence of particular elements of children’s lives (such as parental warmth and opportunities to learn and make friends) are given sufficient weight
54 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
alongside evidence of undesirable elements such as physical or sexual abuse, which may be more salient. At the end of Munro’s list of influencing factors is mention of the fact that first impressions last. Munro (2008) notes that we tend to make up our minds about things and then find it very hard to put these beliefs down again. We are loath to change our minds. Particularly when first impressions are potentially made in a vivid, concrete and emotionally charged environment, it is vital that we allow ourselves the chance to review these first impressions and check that the information we have gathered pays sufficient attention to the dull, abstract and historical information that may actually be equal or even greater in importance. Renuka Dent, Director of NCH – The Bridge at the time, speaking at a conference on risk and decision making (Policy Spotlight, London 2006, unpublished) suggested that one measure of risk could be to ‘weigh the file’. The point was well made and one of the issues it touched on was the fact that there may be hugely important information held within files. Therefore, if we do not guard against our tendency to favour vivid, tangible, ‘here and now’ information, we may neglect information held in written form. Failure to gather such information makes assessments inaccurate and raises the potential for professional risk and error. One final consideration in terms of ‘accessible and inaccessible information’ is the impact of our own beliefs and attitudes. Assessments of need should place the person within the environment, but attention to the impact of the wider dimensions (such as housing or access to resources) on parenting capacity and children’s needs has been noticeably missing from the assessments under the DoH Framework (Calder and Hackett 2003; Jack and Gill 2003). It has been suggested that this may be partly because of the fact that such environmental issues are felt by child welfare practitioners to be outside their sphere of influence; a social worker may feel that the wider issues of poverty and deprivation cannot be addressed in their intervention and therefore they do not cover these areas in their assessment. However, it is worthwhile remembering that assessment is not the solving of problems, it is the identification of salient issues. We must first understand before we can affect change. As social and environmental factors impact directly on child development and the capacity of carers to meet that child’s needs, it is vital that assessments take these factors into account. Failure to do so is not only unethical but ultimately produces an incomplete picture of the child’s world that will not inform effective care planning.
SEARCHING AND SEEING IN ASSESSMENT / 55
Direct contact with children First advice would be to start where the child is (McLeod 2008). If you are going to assess a child or young person’s needs and how they have been affected by adversity, should you not start with listening to their own unique subjective views? Every Child Matters (Department for Education and Skills (DfES) 2003) and Getting It Right for Every Child (Scottish Executive 2005) both build on the right to participation enshrined in the UN Convention on the Rights of the Child (1989). Every Child Matters and Getting It Right for Every Child both emphasize the importance of direct contact with children and young people. However, the research carried out with children and young people suggests that significant difficulties exist in putting the laudable aims of the convention into everyday practice. It may seem like common sense to start assessments with the child’s needs and it may be a central plank of good practice but it is not so simple to achieve in practice. Munro (2008) suggests that we tend to minimize or even reject what children and young people say to practitioners in preference for the version of events or explanations offered by other adults. This is particularly important when issues of neglect are prevalent. Neglected children are at one and the same time both at risk of the worst developmental outcomes and the least likely people to be able to tell someone what is happening to them. Mudaly and Goddard (2006, p.103) took the following quote from a 12-year-old girl as part of their research into the experiences of children and young people in assessment: The problem with these people is that they don’t want to hear the truth because the truth is so much harder to understand and so much longer than a lie about the truth…
This quote reflects a stubborn tendency in practice to play down children’s contributions to assessment because the truth is too long and too hard to understand. This child’s feelings may be familiar to those of you who have ever found yourselves trying to explain their actions to an authority figure. For example, when a motorist is stopped by the police, the officer may ask why they were breaking the speed limit. The real answer may involve a complex mix of reasons (not wanting to slow the line of traffic, having overtaken the person directly behind on the last straight and not wanting to let them catch up, music on the radio, etc., etc.) but the answer you give is likely to be much simpler and acceptable because you want the encounter to be
56 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
over as quickly as possible with as positive an outcome as possible. When dealing with an (often unwelcome) unknown authority figure, the natural tendency (for children as well as adults) may be to tell the person what you think they want to hear because you believe deep down the person does not want to hear the truth and/or does not have the capacity to deal with it in a way that will help you. It is curious anomaly that professionals work in the ‘best interests’ of children and young people but have tended to do so without actually consulting with those children and young people to ascertain what their views of their own ‘best interests’ are (Laming 2003; Scottish Executive 2002). Levels of bureaucratic work have risen markedly over the last decade and practitioners are now lacking the time and the practice wisdom that are required for direct work. A critical consideration of our own values and those espoused by our agency is required in relation to our views about children, childhood and their capacity to be an active participant in their assessment. It is not the child’s responsibility to communicate their needs; it is the practitioner’s duty to listen and use the means of communication and engagement that best allow the individual child to express their lived experience and needs.
Observation Observation is a crucial element of assessment (Holland 2004). Observations should allow us to get a picture of what a day in the life of the child looks like (Laming 2003). Particularly in relation to emotional abuse and neglect, it can be the chronicity that is most damaging. Observation therefore needs to be holistic and consider ongoing processes rather than a single event. Horwath (2007a) emphasizes the value of places like family centres and nurseries in identifying the patterns and themes that indicate neglect and are best identified by observers who know the child and can see them over time. White (1997) affirms that home visiting is (or should be) a central feature of social work practice and its knowledge foundations. The strength of practitioners observing in the home is that they see the child in context. Unlike those who only ever see the child in clinical or office settings; we enter into the child’s world. We need to have a good understanding of theory on which to base our observations. Observing interactions between the child/young person and their caregiver is vital to provide information about children’s needs and parenting capacity (Adcock in Horwath 2009). While other books (e.g. Daniel et al. 2002) are better placed to offer a guide to developmental
SEARCHING AND SEEING IN ASSESSMENT / 57
theory and theories of parenting capacity, I would like to emphasize here the damage that can arise from having an insufficient knowledge of developmental theory. Horwath’s (2007a) research into assessment practice identified that some workers find it difficult to portray the picture of family interactions emerging from observations. This can be seen in the kind of case recording which may indicate that the child was seen but offers no information on what was observed. Careful and focused observation, grounded in theory, offers a means to attach meaning to information and begin to make sense of it in terms of the child’s lived experience. Supervisors also need to have a sound, contemporary understanding of theory. Although supervision is important ‘…it will not improve the quality of the practice unless the manager has competent knowledge and skills which are relevant to the requirements of the case’ (Haringey LSCB 2009, p.24). Difficulties can arise in the integration of theory with practice (Horwath 2007a). The law of the instrument (Kaplan 1964) suggests that people favour different approaches depending on the ‘tools’ that their training and professional socialization have given them. Blaug (1995, p.425) offers a useful analogy to illustrate that, without the capacity for reflection, the practitioner can become ‘like a carpenter who, possessing a hammer, tends to see every problem as a nail’. Equally, a lack of understanding or application of theory can lead us to misinterpret observations. Horwath (2007a) examines a simple behaviour such as a child smiling to show the risks here. If the child is observed smiling, then the observer may correlate smiling with happiness. However, smiling does not necessarily equate to happiness. An insecure attachment may mean that smiling is merely indicative of superficial engagement and actually signifies potential unmet needs.
How do we observe? Can we do better? Observation allows practitioners to access different forms of information. For example, a parent may have told you that their child behaves in a certain way at home or that they respond to the child’s needs in a particular way. Observation allows the practitioner to validate what is being said or may identify contradictory or challenging evidence. A parent may have advised you that their young child fails to respond to their attempts to feed him/her. However, observation may reveal that the parent is missing the cues that are being offered by the child, revealing difficulties for the parent ‘tuning into’ their child’s communications rather than a difficulty with the child’s actual feeding behaviour. Rather than just taking one source of
58 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
information (i.e. the parent’s explanation) we need to test with other sources of data to see if they support or challenge the information we have. Just as you might ask for a second opinion on an issue, assessments need to ‘triangulate’ by checking sources of information together. Triangulation is a feature of practical qualitative research and is suggested (e.g. Sheppard et al. 2001) to be an important aspect of assessment in practice.
Box 2.7 Triangulation – taking more than one view Look at a cube straight on and you will see a square; look at a sphere straight on and you will see a circle, but you only have to step to the side to see all three dimensions. By taking only the parent’s views, you only have one dimension. You can add another through your own observations. You could gain yet more through speaking to the child, observing interactions in different places and at different times, and speaking to other people. Where do you usually look for other viewpoints? How can you ensure that you are able to hear the views that challenge your views and not just the views that fit with your own? How do you know that you are speaking to the people that the child or young person thinks are important?
Holland (2004) offers a helpful, brief framework to help us consider best practice in observations: • context • purpose • consent. Context helps to remind us that the time, place and significance of the event will have a bearing on the observation and that we need to be explicit and mindful of the context when attributing meaning to events and phenomena. For example, parents who are being observed will be under pressure and this can make them react in unusual ways. Before the next time you assess a contact visit, consider how you felt the last time you were observed under pressure. For example, when you sat a driving test or attended a job interview, how did you feel and how did you act? Context also needs consideration in terms of the wider implications of power relationships and
SEARCHING AND SEEING IN ASSESSMENT / 59
the impact of issues such as ethnicity and gender on our understandings and interpretations of observations. Purpose allows us to begin to consider which elements of the observation are central to this part of the assessment just now. It may be that the assessment is part of an ongoing process of developing a picture of the child’s needs. Equally, the assessment may be focused on a particular issue or informing a particular outcome, such as a move to alternative care or the creation of a child protection plan. In setting the purpose of the assessment, however, we need to be vigilant to guard against an unhelpful ‘framing’ of the child (Firkins and Candlin 2006; Reder and Duncan 2004) that might curtail our ability to think more widely about their circumstances. For example, if an assessment has been framed as a ‘child in need’ assessment, we may fail to appreciate the extent to which a factor poses a risk to the child’s well-being or safety. As we will discuss elsewhere, our human tendency to arrange the facts to fit our views is a fundamental and pervasive stumbling block in assessment. Munro (2008) terms this ‘observational bias’ – a tendency to notice what supports our beliefs but be less able or willing to notice details that challenge our hypotheses. We give further consideration to overcoming such barriers and developing practice further in Chapter 7. Consent brings our focus back to the ethical dimension of all interventions, including assessment. Assessment is not a neutral act and therefore practitioners need to be reflexive in relation to this area of practice (Holland 2004). Frank discussions with parents and caregivers about the benefits of observation can help and this has been previously validated, for example in the benefits of a ‘cards on the table’ openness and candour appreciated by clients (Farmer and Owen 1995). However, we must also remember the relative powerlessness of children and pay particular attention to methods of obtaining informed consent that are appropriate to age and stage of development.
Practice development – what is relevant? Research and policy have given clear messages that attention needs to be paid to chronology and identifying patterns in the lives of vulnerable children and their families. However, practitioners are still faced with trying to take in a plethora of historical information within limited amounts of time. It can be a struggle to identify what is germane to a succinct, meaningful chronology. The dangers of not providing sufficient detail have been given some consideration. However, providing too much detail can be damaging, as the constraints of time and cognition and information handling skills can
60 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
lead to errors of judgement. In this next section I will propose a number of exercises to help provide space for reflection and the development of skills in gathering and managing information. It can be helpful to take your work with one specific child as the starting point for these exercises. As well as allowing you to practise with just one strand of the complexity of your caseload, it can also help make specific references to developmental stages and needs. Analysis of the ‘evidence’ can be helpful at all stages in the assessment (Calder and Hackett 2003). Within the initial stage of gathering information, the evidence can offer guidance on what to look for and what to select as ‘relevant’ in any particular situation. The relevance we attach to any information depends on the knowledge we apply to analyse the information. Calder and Hackett (2003) identify three different types of knowledge: • empirical knowledge – such as research evidence • theoretical knowledge – both explicit and implicit application • experiential knowledge – accumulated learning built up in reflective practice. On a blank piece of paper, make a note of what information you need to seek in your assessment. Taking the heading above, can you now shift the types of information required into the three classifications? It is recognized that all three types of knowledge are important and should be viewed as complementary rather than hierarchical (Gomm and Davies 2000). However, when it is not possible to clarify which kind of knowledge we are considering, there is the potential for valid, eclectic approaches to become confused and uncritical. As well as illustrating the kinds of knowledge that you may have a tendency to favour in this assessment, this exercise can also highlight those areas where further consideration needs to be given to what kind of information you are seeking and why it is relevant to your assessment.
Practice development – how reliable is the information? Not all information that is gathered in assessment is necessarily as reliable as we might initially think it is (Munro 2008; Reder and Duncan 1999). For example, reliability would mean that if you asked a question on a Monday you would receive the same answer if you asked the same question on a Friday, or if you asked two different people they would both provide the
SEARCHING AND SEEING IN ASSESSMENT / 61
same answer. We need to be able to discriminate between different forms of information at an early stage in assessment. Failure to clarify the reliability and veracity of information at an early stage can lead to information taking on an unwarranted legitimacy that endures in recorded form. Like a fly in amber, the information can remain caught in recording and go unchallenged over time, potentially misinforming subsequent thinking and actions.
Box 2.8 Take the case recording that you have so far and consider each piece of information under the following headings. Is the information: • proven fact or tentative (requiring further checking) • received directly or second-hand • fact, opinion or hypothesis • one-off or part of a pattern?
It is often easier to see the problems with other people’s recording than with our own. Reading through another practitioner’s case notes often raises questions about the veracity of some recording and also the ‘slant’ that may be given by use of language, construction of narrative and selection of information. We need to ensure that we do not come to judgement prematurely and that our ideas remain open to review and reconsideration in the light of new information. For example, the statement ‘The mother obviously loves her child’ may be questioned in terms of proof (Is there evidence to support the claim?), source (Is this the author’s own view or are other views recorded?), factuality (In what way is it ‘obvious’? How has this claim been tested?) and pattern (Has this relationship been stable over time? How do the mother and child relate to other people?).
Practice development – satisficing In satisficing, we recognize that we tend to stop looking for further information or options when we have found something that is apparently good enough for us. How then do we set the level of ‘good enough’? In child welfare and protection, we need to draw on experience in making ‘good enough decisions’ and we need to recognize that our experience may be insufficient to make these kinds of ‘satisficing’ judgements accurately enough. In initial enquiries, therefore, we run the risk of closing the
62 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
enquiry after the first apparently satisfactory explanation is found. Without a framework for the assessment, it is all the more likely that important questions may not be asked and important information is not sought or even understood as relevant. Assessment frameworks offer a set of parameters for the assessment. Some outdated frameworks (e.g. DoH 1988) have remained in use long after they have been superseded and I believe that part of their enduring appeal is the inclusion of checklists of questions to ask. Although the mechanistic use of these lists has been shown to be a cause of concern, practitioners may benefit from easily accessible prompts to remind them of ‘good enough’ levels for judgements. We need to consider how we use current assessment frameworks and how workers know where the edges of their assessment are. How do they know that their ‘satisficing’ has reached an aspirational level that really is ‘good enough’? Practitioners I have worked with have frequently commented on the length of time it takes to complete an assessment using the most recent frameworks. Part of the expert use of any framework may therefore be considered in terms of satisficing and the role of expert intuition in setting appropriate levels for ‘stop searching judgements’. We consider visions of reasoning in more depth in Chapters 4 and 5. However, in Chapter 1 I examined the different visions that exist of reasoning. In consideration of unbounded rationality (where decision makers lay out all the possible options and decide on the best option) ‘decision trees’ can provide a tool for supporting reasoning. A form of limited decision tree can be seen in the guidance to Every Child Matters (section 4.3; DfES 2003b), where referring agencies are advised to consider the five outcomes (healthy, safe from harm, learning and developing, having a positive impact on others, and free from the negative impact of poverty). The guidance advises that the referrer should ask if any of these outcomes are not being met and, if they think they are not and additional services are required, a full assessment should be carried out. This form of guidance appears to recognize the limitations to decision making in referral but also seeks to ensure that the aspirational level of ‘satisficing’ is rigorous enough to avoid too great a risk of ‘false negatives’ where the child was actually at risk but was not picked up by additional services. What are the factors that underlie our ‘aspirational level’? Pick a recent piece of practice for review and consider the following questions: • What were your goals for the welfare and protection of the child? Were you investigating an incident of child protection concern or a broader assessment of unmet need? Are you able to say what the
SEARCHING AND SEEING IN ASSESSMENT / 63
key factors were that informed your decision (whether this was to take further action or not)? • What were the goals you wanted to achieve for yourself ? By thinking about possible goals under the headings of ‘Opportunity’, ‘Motivation’ and ‘Ability’ you might be able to access some of the implicit goals that can impact on satisficing without explicit consideration. • What are your agency’s goals? How are your managers and senior managers interpreting the legislation and guidance? How does your agency (including managers and colleagues) reinforce these aspiration levels? • How might you work to explore whether your judgements were in fact ‘good enough’ in retrospect?
Managing data While acknowledging that paperwork held on agency files must conform to agreed format and protocol, there are opportunities that exist within recording formats that might provide more effective means of managing and sorting the huge amounts of information that assessments can generate (Holland 2004). These examples move away from the rather staid and uncreative ways of thinking that can be generated by some frameworks for assessment and recording. For example: • Margin notes: Additional hard copies of assessment reports and case recording can be used to highlight key themes. This can help you check whether you are being open minded about the hypotheses you are developing. • Key word searches: Soft copy materials may be held on software that allows key words to be searched for. This kind of information about frequency can help guard against some more damaging aspects of cognitive processes such as the availability heuristic and representativeness bias. • Different data displays: Different ways of presenting information can be a powerful tool for making new connections and seeing information that might previously have been difficult to access in terms of our cognitions. Examples include ecomaps, genograms, chronologies, tables and timelines for the assessment process. Mind-maps can help us move away from the linear constraints of
64 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
assessment frameworks and can be extremely useful tools when the limits of deliberate analysis are met and more creative thinking is required to develop insights that can then be developed more explicitly. Think about how you manage data and whether you use any of the methods Holland describes. We all think and learn differently; some of us like to see what other people do and then try it for ourselves, some of us like to read about new ideas first of all, while others like to experiment and learn from experience and feedback. Consider how and when you learnt to manage data in your profession and whether new learning may help develop your practice.
Summary Within Chapter 2 I have examined some of the literature in relation to the processes of gathering information or assessment. While the rhetoric may appear to advise workers to gather more information and be more thorough in all assessments, there is also a need to understand the capacities of human reasoning, both in terms of the search for information and the way in which we make use of this information. As we have seen in the case of chronologies, more is not always better and there are important skills required to identify what information is significant in any given situation. Contemporary frameworks are important in providing the parameters for searching and gathering information. However, the humans gathering this information are subject to the kind of biases that can create an incomplete or inaccurate picture of the child or young person’s needs and experiences. Attention to the issues highlighted in this chapter may help develop some of these skills and understandings further. Our next chapter considers analysis in the context of working across professional boundaries.
Chapter Three
Building the Picture
Introduction Analysis is a task that practitioners can be required to take on alone, often without conscious thought and frequently without opportunities for reflection. However, analysis is heavily influenced by the environment within which the practitioner is operating. For this reason the complex multi-disciplinary nature of child welfare and protection requires specific consideration. In this chapter I consider the way information is gathered by different professionals in different agencies. I reflect on how different professionals (such as health, education, housing and police) analyse the information they have. I then consider how information is shared between professionals. There are a multitude of mechanisms for assessment across professional boundaries. Each one requires information to be communicated effectively across boundaries, which are not just links in communication but are also bridges for values and professional understandings. Communication is a crucial element of shared assessment. However, given the comparative ‘youth’ of child welfare and protection practice, and the subsequent lack of empirical research on it, it may be worthwhile giving further consideration to the basis for the assumption that communication is the key to multi-professional assessments. One of the common themes emerging from inquiries into child deaths is poor inter-agency communication (Sinclair and Bullock 2002). Despite the recognition of this fact and the instigation of many initiatives to address this weak link in any practice chain, ineffective communication between agencies remains a significant problem and one that appears to have been particularly immune to attempts to eradicate it (Brandon et al. 2008). Changing practice to support effective communication requires 65
66 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
action at all levels and in all areas, from individual practice to governance, from inter-agency systems to ongoing training and development. At an individual level, this chapter aims to identify some key aspects of interagency communication and their significance in practice. We then explore how these inherent communication errors manifest themselves in practice and consider how practice can recognize and respond to the challenges.
Accessing information The Data Protection Act 1998 sets out eight principles for the processing of confidential data and addresses the issues of rights of access by the data subjects, and of disclosure to other parties by the data holder. Section 27 of The Children Act 1989 authorizes social services departments to request help from other agencies: education, housing, health, other local authorities. The Children (Scotland) Act 1995 section 21 provides a similar requirement that health authorities and other local authorities shall assist another local authority carry out its duties towards children and young people in need. The Children Act 2004 section 11 (2) sets out professionals’ responsibilities in England and Wales, ensuring that any agency, in discharging their functions, will give regard to the need to safeguard and promote the welfare of children. Despite the legislative frameworks provided by these Acts and the recent governmental guidance (HM Government 2008) there still appears to be a lack of understanding about information sharing in child welfare and protection, and ongoing concerns that sharing information about a child at risk or in need may breach confidentiality laws (Laming 2009). The process of assessment requires us to gather information from many sources. Some information will come directly from interviews and work carried out with children and young people and their families. Further information may be accessed from other professionals (such as teachers or substance misuse workers) and some may be held by files and data management systems (e.g. police records and local authority records). Before we can even start to think about the meaning of information, we first of all have to get our hands on it. The barriers to sharing information are considerable. Take the example of local general practitioner (GP), Dr Sheppard given in Box 3.1.
BUILDING THE PICTURE / 67
Box 3.1 Dr Sheppard’s big decision This doctor has been GP to the Rush family for ten years now. She has seen both their sons born and helped the family with a range of health issues, some big, some small, through the years. More recently, there have been some more unusual visits from Mrs Rush. Mrs Rush has come in to speak about seven-year-old Paul as she says that he is out of control and wonders if he has attention-deficit hyperactivity disorder (ADHD). She has described Paul as ‘really bad, he’s evil’. Mrs Rush talks about having to lock Paul in his room and that Mr Rush has said he ‘will not be held responsible for what happens if Paul keeps winding him up like this’.
What does Dr Sheppard do? Should she speak to someone? National guidance clearly emphasizes the duty on all professionals to act on concerns, with the first step usually consultation with an experienced colleague. The English guidance (Department for Education and Skills (DfES) 2003a) advises that, where a practitioner has concerns about a child’s welfare, they should discuss them with their manager or named designated health professional or teacher or, in emergencies, the police. Scottish guidance (Scottish Office 1998) offers the same advice and notes that the practitioner may also contact the social work department, police or Reporter’s Office for advice. Who will Dr Sheppard speak to though? Should Dr Sheppard say something to Mrs Rush right now? Openness and honesty are recognized as practitioner attributes that children and families value in child welfare and protection work. However, anxieties and uncertainties about this area of practice can prevent some professionals from engaging appropriately with families about their difficulties. How does Dr Sheppard raise the child protection concerns with Mr and Mrs Rush? Not only does this require Dr Sheppard directly to challenge Mr and Mrs Rush’s current understanding of Paul (as ‘ill’ or ‘bad’) but also to broach the possibility that Mr and Mrs Rush may be the source of the difficulties, rather than Paul. GPs are autonomous professionals, so Dr Sheppard can’t necessarily expect a manager to offer guidance or a colleague to offer a confidential chat. Why not speak to social work? Well… • The last time Dr Sheppard called she was told that her referral was not a child protection matter.
68 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
• She does not know what will happen if social work get involved. • It could be totally overblown and the Rush family might not get any help anyway. • Mr and Mrs Rush may not contact the GP the next time their child is ill and the child may suffer as a result. The idea of saying nothing at all to anyone at this point does begin to look rather appealing. Dr Sheppard is not alone and this scenario could equally apply to a teacher or a community member. These concerns are common to many people who would potentially make a referral to social work services about child welfare and protection concerns. GPs have expressed concern about a fear of litigation and it is recognized that health services are particularly concerned about sharing confidential information in child welfare and protection (Laming 2009). We are all subject to the Data Protection Act 1998. This means that we must all seek consent before making referrals, unless this endangers children. Without the benefits of support and experience in such decisions, some professionals may make poor judgements.
Box 3.2 In making the decision you must weigh up what might happen if the information is shared against what might happen if it is not and make a decision based on professional judgement. HM Government (2008, p.21)
The guidance (HM Government 2008) notes that ‘necessity’ and ‘proportionality’ are key factors in making decisions about sharing confidential information, and that these are based on ‘professional judgement’. What then is this ‘professional judgement’ based on? Munro (2008) offers a consideration of ‘clinical judgement’ that appears to come close to exposing the difficulties inherent in making such a judgement. Munro (2008) advises that clinical judgement is built up and tested through professional experience. In terms of child welfare and protection (where base rates are relatively low), those weighing up the potential outcomes may be making decisions without sufficient experience to call on. This could potentially result in judgements biased by high anxiety about loss (such as breakdown of the professional relationship, complaints or even
BUILDING THE PICTURE / 69
litigation) against a more nebulous and removed possible gain (child welfare and protection). Although reporting is not mandatory in the UK (as it is in some countries) there is little room for potential referrers to explore concerns with child welfare and protection professionals. The establishment of strong local networks appears to be an important factor in improving the opportunities for professional concerns to be discussed and shared safely and effectively. For those of you working in the field of child welfare and protection, you might view Dr Sheppard’s decision as relatively uncomplicated and potentially amenable to resolution. However, a quick review of one’s own practice might suggest that you have something in common with the GP. We all have a tendency to tailor our communication to fit our audience. In some instances this means that we need to ‘turn the volume up’ to get the results we desire. For example, when making a referral to any agency, it helps to know what their referral criteria are and then make sure that your client more than meets them. Duty social workers are used to being told quite categorically by referrers that ‘this is a child protection matter’. At other times we may play down or even avoid acknowledging some elements of a situation. For example, we may excuse some elements of neglectful parenting because the family in question are living in poverty. So analysis is not benign; we actually select and weigh information to construct a particular picture or narrative. There is a tendency among professionals to think about how they themselves would cope in such situations and make judgements based on this identification with the parent or carer. However, the fact that the neglect is a consequence of material deprivation does not stop it affecting the child in need in terms of the Act. While empathy with parents and carers is essential it should never overshadow empathy with the reality of the child or young person’s experiences and needs. Weaknesses or gaps in analysis may often come to light once the assessment has developed and been made subject to scrutiny (such as line manager verification). However, it is worthwhile remembering that communication is a mind-set (Reder and Duncan 2003) and that we must remain curious and interested; not just in what is being said but why. If we are to gain the fullest and most accurate picture of any situation, we need to be aware of what facilitates communication across boundaries.
Frames and labels Professionals undertaking continuing professional development (CPD) programmes in Scotland have given me valuable feedback as to what
70 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
influences their analysis. Social workers gather information from others and therefore are pivotal in deciding what goes into an assessment and what is left out. This application of a professional lens has been referred to as ‘framing’ the child at risk (Firkins and Candlin 2006). It is understood that the risk to the child is defined or ‘framed’ in terms of observed and reported information. However, it is also argued that the child at risk is framed by the worker’s judgements based on hypothesis and implication. Firkins and Candlin (2006) carefully examined and coded written reports from child protection workers, leading to some interesting and relevant findings. For example, there appeared to be a tendency for the reports to ‘localize’ the assessment of risk. That is, practitioners tended to look for risks closely related to the concerns reported in the referral. The broader consideration of risk was missing in these reports. Consider the scenario described in Box 3.3.
Box 3.3 Jasmine – framing a risk assessment A referral has been received from a local authority primary school. Jasmine is six years old. She has clear bruising to her cheek and jaw but she could not say how she got the bruises. A joint forensic interview and medical are arranged and an initial risk assessment carried out.
The medical and interview will focus on physical injury and culpability but there will be opportunities within the assessment to look at more holistic issues of risk. For example, information may be held by health, police or the local authority. Home visits and discussions with other professionals will gather further detail. However, if the main focus is on physical injury, it is possible that other information is not gathered or it may be unconsciously screened out or given less weight because it does not fit our ‘frame’ for Jasmine and the risk we think she is exposed to. If Jasmine’s life is one of constant threats, put-downs and blame from her parents, then emotional abuse should be a major concern, but would the risk assessment pick this up? ‘Of course!’ you say, and in the hands of skilled and experienced workers, this may be true. The crucial part now is the judgement of the worker and their ability to see the wider picture. The risk assessment must take a range of observed phenomena and spoken dialogue and work this into a written account. This involves the assessor translating and transforming complex, sometimes incoherent and contested information into a coherent and plausible account. Regardless of the framework used (whether actuarial or clinical) the very act of
BUILDING THE PICTURE / 71
risk assessment is interpretive. This is very relevant in terms of current frameworks such as the Common Assessment Framework (CAF) in England and the Integrated Assessment Framework (IAF) in Scotland, as these ecological frameworks locate risk within the broader context of children’s needs, requiring the assessor to frame risks in terms of unmet needs. Firkins and Candlin (2006, p.289) identified a ‘…tendency for the practitioner to form a hypothesis of risk and then to find evidence to support this frame’. This appears to put the cart before the horse and suggests that frameworks for assessment may not actually be being used to support a wider analysis but simply to justify a judgement that was made unconsciously much earlier in the process. It is possible that the basic questions of ‘who is at risk from what and in which situations’ (Firkins and Candlin 2006, p.277) are at risk of being circumvented by the natural tendency of assessors to localize their consideration of risk to the original framing on the presenting issues. The use of current assessment frameworks has increased workloads in some areas (Cleaver et al. 2004). However, this may be viewed positively if the additional time and resources are being spent on more thorough and accurate risk assessments. The time that it takes to more fully consider risks flowing from all three dimensions of the triangle (child’s needs, parenting capacity and the environment) may be the time that it takes to guard against this premature framing of risk and the consequent ceasing of the search for alternative hypotheses. The message would appear to be that we need to be wary of ‘framing’ the risk assessment rigidly and that we should use risk assessments to support our professional judgement rather than as tools for actual decision making.
Practice development – accountability of values Describing any act as abuse or neglect involves moral judgement. However, definitions are many and varied, and professional responses are contested (Munro 2008). It has been noted that although qualifying training does pay a lot of attention to the issue of ‘values’ this has not necessarily translated into qualified practitioners who can go beyond talking about values actually to demonstrate accountability for values (Milner and O’Byrne 2002). If professionals are to practise across different professional value sets, then there needs to be some means for expressing and considering values in a more explicit way. When was the last time you explicitly stated what your professional role is? My own estimate (in terms of social work practice) is that I last
72 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
made an explicit statement when I was working as a practice teacher. Social workers in the UK have codes of conduct that provide the ethical domain for practice (Adams, Dominelli and Payne 2009), but practitioners may be less certain about the ethical frameworks for other professions. In practice, more inter-professional contact is required by current policy developments. This in turn creates a wider set of professional values to understand and negotiate. The opportunities for values tensions to remain buried therefore increase. The following three exercises create ways of exploring different values at different levels: 1. Individual: Write down in your own words and phrases what you personally feel you are trying to do in your current role in relation to child welfare and protection. Now look at your professional codes of conduct and child protection guidance. Review your own definition of your role and note the areas of connection and dissimilarity between the two. Pay particular attention to values and beliefs about children, families, the impact of abuse and neglect, and professional responsibilities. 2. Within the ‘helping team’: When beginning an assessment, make a list of key people who you will make contact with. Check with each person (appropriate to role and stage of development): Have we discussed the aims and boundaries of this assessment? How do I know this person is clear in their understanding? You may have explained something to the best of your ability but this does not necessarily mean you have been understood. 3. Within your own team: Other developmental exercises are discussed in Chapter 7 and it is important that a safe and secure environment is created for learning. Within a learning environment it is much more likely that values and uncertainty can be discussed in a positive and developmental way. To explore different values in a non-threatening way, each take a post-it note and write three of your own beliefs on it about: • children and young people • parents and families • your professional organization. Within a small group it may be preferable to print these out to avoid identifying individuals. Swap the Post-its around so that no one has their own statement and then read them all out. Each person should offer a
BUILDING THE PICTURE / 73
constructive comment about what the statements say to them about team values and opportunities for development. ‘Framing’ as a concept has applications in various aspects of assessment practice. Milner and O’Byrne (2002) identified the importance of workers understanding their agency’s role as a frame to any assessment. The aims of the assessment must be clearly correlated to the role of the agency as defined by legislation and translated into practice through guidance. Agencies have a marked tendency to protect their own boundaries (Quinton 2004). It is therefore all the more important that appropriate structures and policies are developed to support genuinely shared assessment and translate the rhetoric into practical frameworks. Practitioners need to be supported and allowed by their agencies to analyse the child’s needs without subverting their analysis to meet the requirement to conform to agency boundaries. Research suggests that practitioners tend to take a rather procedural approach to assessment and actively narrow the range of factors they consider in their assessments (Scott 1998). This tendency is significant in many ways. Families have overlapping needs, and services need to continue to develop their capacity to overlap. Particularly for children on the edge of child welfare systems (such as neglected children and young people) the consequences of ‘under-lap’ may involve long-standing unmet developmental need and significant long-term damage.
Box 3.4 Jasmine – Scenario 1 Jasmine’s parents denied that the injuries were deliberately inflicted. No conclusive proof could be found regarding Jasmine’s injuries. Initial enquiries did not reveal any further information as the head teacher did not think she could speak about minor concerns that were not ‘child protection’. The case was closed.
Box 3.5 Jasmine – Scenario 2 Deliberate injury was denied and forensic evidence was inconclusive. However, Jasmine’s school noted that Jasmine was poorly dressed in comparison to her brothers and had very low self-esteem. Further enquiries explored the possibility of emotional abuse and neglect.
74 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
The professional lens What is the relevance of framing to analysis? In the report of the inquiry in Cleveland (Butler-Sloss 1988) Dame Butler-Sloss noted that different professionals tended to view the child from different perspectives. For example, a doctor may see the child primarily through consideration of the child’s broken arm, while a playground supervisor may see the child through the child’s play and friendships. It is therefore vital that we look through each of these professional lenses if we are to see the whole picture. It’s not just about the information each professional holds. We are not like boxes or filing cabinets because the very act of receiving, processing and giving information shapes the ‘facts’ into our unique individual understandings. The way in which we gather, arrange, hold and share information about children is shaped by a wide variety of influences including our experiences, professional training and socialization and the nature of the assessment model we are using. This framing can direct subsequent analysis with terrible consequences (Reder and Duncan 2004). For example, a (mis)diagnosis of scabies was given to explain skin lesions on Victoria Climbié. This framing of Victoria as a ‘child with scabies rather than a child who may have been physically abused’ (Reder and Duncan 2004, p.104) was then transmitted from one professional to another. This piece of analysis became stuck and resistant to reframing. More careful consideration of the way in which we frame our judgements may benefit practice in terms of both our own analysis and our understanding of the way in which other professionals shape their part of the shared process of analysis.
Hearing and seeing children and young people in need There is a natural tendency for workers to view their own agency and its role to be of primary importance. Indeed, for many agencies, children and young people may be viewed as secondary clients (O’Sullivan 1999), with adults being the primary client (e.g. in relation to substance misuse or disabilities). In life, we strive not to be too egocentric and see things from others’ points of view. However, this can be very difficult and it is often those situations that put our ego and identity under most strain that can cause us, in a very human sense, to lose sight of other people’s perspectives. It would appear that legislation and policy have not always been successful in challenging this tendency and may even exacerbate it in some cases. If we look at some of the key agencies charged with responsibility for
BUILDING THE PICTURE / 75
children and young people, we can see the potential damage that can arise from professional insecurity and uncertainty about identity. If we start with a universal service, we can consider the possibility that teachers might view their primary responsibility as the education of children and young people. In the course of the average day this may mean teaching a class about modern history or biology. If concerns arise about a child’s health (e.g. a nosebleed in class) this becomes the responsibility of health services through the school nurse. However, when it comes to child welfare and protection, there are areas of responsibility that are perhaps less clearly defined and less fully ‘owned’ by someone in a teacher’s role. There are tensions here between the responsibilities parents and professionals share in respect of children and young people. If, instead of a nosebleed, the concern was that the pupil could not see very well and might need glasses, this could be defined as a health need and the pupil would see an optician. But what if the pupil’s parents did not take their child to the optician? Now we have a teacher who cannot support the pupil’s learning because of a health issue and parents who appear to have failed to discharge their parental responsibilities. The boundaries are now fuzzy, the picture more complex and the ‘ownership’ of the responsibility much less clear and defined among professionals.
Box 3.6 Jen is 14 years old. She has recently moved to her current school and is provided with additional supports to ensure that teaching and assessment methods account for her needs relating to her sight and hearing impairments. Jen has been suffering headaches and nausea. She has not spoken to her teachers about this as she feels that she does not really know any of them well enough yet. Jen has also not spoken to anyone yet about the impact of this. Her parents are caught up in their own arguments and drinking so Jen tries not to involve them. Jen feels miserable and lonely and wants things to be the way they were before the family moved.
Clearly defined structures and assessment frameworks allow teachers to assess a child’s attainment in specific areas of the curriculum but such frameworks and structures have not historically been available to help these same teachers make judgements about a child’s attainment in terms of their
76 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
wider development and welfare. So, while a teacher can say with confidence that Jen has scored poorly in her biology assessments and has additional learning needs, they will be feeling less confident about their assessment of Jen’s needs if she has been coming into class looking uninterested and has become withdrawn and isolated from her friends. The responsibility to look further into Jen’s welfare may be clearly defined in the legislation but how does policy, local guidance and management structure translate this responsibility on the ground in the classroom? It will take time and effort for the teacher to look into Jen’s circumstances, speak to her and work out what the matter might be. It is recognized that teachers want to do the best for their pupils, but it is also apparent that there are few positive reinforcers to promote this kind of work. Indeed, any activity that detracts from the measurable outputs of preparation and delivery of teaching, assessments, progress reports, and so on, comes at a cost to the teacher. It could be suggested that there are actually quite a number of incentives for the teacher either to play down their concerns, or note them but not act or try to engage another professional in the hope that they will be able to take on the work required. Other agencies will look at Jen’s circumstances through their own professional lens and are likely to view their own area of practice as of greater importance than that of the teacher, with perhaps a sideways glance at the practice in the school, which they may view as unsatisfactory. The health professional seeing Jen will view their responsibility as the identification and addressing of health needs. While the teacher takes care of the biology exam results, the optician can take care of Jen’s poor eyesight and the impact that this and the attendant headaches and nausea have on her health. Up to this point, both these universal services have been promoting Jen’s welfare in concord with Jen’s parents; they have been acting to support the discharge of parental responsibilities in terms of Jen’s welfare and development. But what happens to this complex yet stillfunctioning model if Jen’s parents do not cooperate and do not discharge their parental responsibilities? This is where hearing and seeing (really hearing and seeing) the child or young person becomes crucial in universal services. If the teacher had merely attended to their core tasks in education, then the crucial links between poor academic performance, declining social presentation and poor eyesight might never have been made. A significant number of adults struggle their way through school only to have dyslexia diagnosed when they are an adult. It would appear that, for many of these adults, the links between their childhood educational attainment, social presentation and
BUILDING THE PICTURE / 77
learning difficulties were satisfactorily explored. The health professional would not have been able to assess Jen’s eyesight unless her parents acted themselves. So what then does the teacher do? It’s at this point that the boundaries between professional concerns and responsibilities become very important. The current drive from Every Child Matters (and Getting It Right for Every Child in Scotland) is towards professionals forming a team around the child, and if we are to meet the challenges of effective multi-disciplinary work, it is imperative that we develop a framework for practice that recognizes the tenacity of restrictive professional identities and the need for professionals to understand how their area of expertise (their ‘piece of the jigsaw’) fits into the wider picture of the child or young person’s health and welfare. The recognition of difficulty and, crucially, the possibility that the understanding of this difficulty may lie outside their professional expertise is not a simple matter. Donald Rumsfeld (former US Secretary for Defense) was lampooned for a speech at the onset of the second Iraq war which noted that there were things that they (the US government) knew, things that they did not know and things that they did not know they did not know. Although he rather lost the press on that occasion, he was making a valid point and one that is very relevant to child welfare and protection work. In Jen’s case the teacher knew some things (falling grades, losing friends), didn’t know others (Jen’s parents’ substance misuse) and didn’t know that they didn’t know others (the letter to the parents was never read and Jen was lying when she said that she had been to the optician’s last week). The unknown unknowns are the ones that cause the greatest difficulty and require great care and nurturing to address.
The Johari window This model provides us with a way of considering not just what we know, but what some of the limitations to our knowledge may be. Over-confidence and unwarranted feelings of certainty can lead to errors of reasoning and analysis. By considering the limits to our knowledge, we consider the possibility that we may need to revise our analysis in the light of further information (see Figures 3.1 and 3.2).
78 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Things we know
Things we don t know that we know
Things we don t know
Things we don t know that we don t know
Figure 3.1 The Johari window
French for ‘thank you’ is ‘merci’
Most words ending in ‘…ant’ are the same in French so I can guess how to say ‘assistant’
What does ‘quotidient’ mean?
The reason my neighbor never says hello is because he only speaks French
Figure 3.2 An example – speaking French
Rumsfeld’s point was that it is possible not to be aware that a vital piece of knowledge is missing. This may be familiar to those of you who have been asked at the beginning of a training event to make a note of what you hope to gain from the day (such as ‘information about new legislation’ or ‘clearer understanding of attachment theory’). However, unless you know what is going to be covered, you can’t know what you are going to gain. Unless the scope of the event is clearly known to you, then your hopes
BUILDING THE PICTURE / 79
in terms of knowledge gain are nothing more than that, just hopes. For example, if you are attending a conference with the title ‘Assessing Needs’ you might expect to learn more about assessing children’s needs but the conference might actually be focused on adult substance misuse and you will be learning about areas that you have no prior knowledge of at all. You don’t know that you don’t know something until the boundaries to the specific field of knowledge have been identified. What is the relevance of this to child welfare and protection? If we accept that life is complex and sometimes rather arbitrary, we can accept that we can never, individually, conceptualize all the possible formations of facts that could describe a child’s needs and the risks they face. There will always be information that is not known to us. Being able to stay in uncertainty for longer may help improve analysis in assessment (see Figure 3.3).
Figure 3.3 Jen’s circumstances
Jigsaws and analysis – building the picture Frameworks such as the CAF (Common Assessment Framework) and the IAF (Integrated Assessment Framework) help set the parameters and form a scaffolding for the gathering of information, but they rely on us, fallible human beings, to be put into action and it is necessary to understand that the wider picture will never be fully formed and that certainty, however comforting, is ultimately illusory. The Audit (Scottish Executive 2002)
80 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
noted that children’s lives are like a jigsaw, with different agencies and individuals having responsibility for different pieces. Parents and children tend to hold the largest pieces of the picture. Universal services (e.g. health visitors and teachers) hold some key pieces and, for some children, social workers and the police also hold some pieces. Imagine a jigsaw (as this is a popular assessment analogy) without any straight edges; nothing to suggest to you where the end of the puzzle is. This is your assessment of a child’s needs. You have a picture emerging and you need to consider each new piece of the jigsaw to see where it fits and how the picture develops as new pieces are added. However, there are no boundaries that allow you to say ‘That’s it! We now have all the information we need.’ There is no picture on the box so you are building your image afresh every time. Can you recognize any of the images forming? Do the pieces really fit or is there lack of connection that you don’t really want to admit to yourself ? Do all the pieces look like sky to you? This analogy is worth taking further to expose the complexity of the assessment task and the level of skill and resources required to undertake such work effectively.
Box 3.7 One lesson that has repeatedly come out of the inquiries into children’s deaths is that one professional rarely sees many pieces of the jigsaw puzzle. Sharing information is crucial for children’s safety. Munro (2003, p.4)
The picture on the box Jigsaws come with a picture to help you. I’m not sure how many people would willingly start a jigsaw puzzle without a picture to guide them. However, as children’s needs are unique to the individual, you will never really have a full or absolutely faithful picture to follow as you build the jigsaw of their developmental needs. What you do need, however, is a picture of what children’s needs and development should look like. This is where professional knowledge of child and adolescent development is a crucial component of the assessor’s skills inventory. Theories of child development underpin assessments of need and risk. For many workers, this knowledge may either be lacking or difficult to make explicit. There is a recognition that many social work qualifying courses have lacked a sufficient level of input on child development. More recently (Laming 2009) call
BUILDING THE PICTURE / 81
for further specialization and probationary arrangements have emphasized the need to attend to this knowledge gap. Although ‘practice wisdom’ or tacit knowledge has been granted more authority than before, difficulties remain for many workers in offering a ‘reflection on practice’ (Schön 1983) that makes explicit the theory and the evidence base that underpin their professional judgement or reasoning. To build this particular jigsaw you need to have a clear picture of what childhood, child development and children’s needs look like. Only once these images can be held in mind can you go on to build the unique and continually evolving picture of the individual child or young person’s lived experience.
Where are the edges? There are a number of parameters that potentially form the boundaries to the jigsaw of analysis. Some of them may in themselves be problematic constructs. For example, in many serious case reviews, practitioners were found to have narrowed the focus of their assessment (and therefore analysis) to fit within a narrow aperture of agency function (Reder and Duncan 2004). Agencies need to work together to compare the pieces of the jigsaw they hold. Overlapping activities and pictures can be inconvenient and time consuming. Underlapping pictures have the potential for large areas of a child’s life to be missed. The literature on assessment (e.g. Scourfield 2003; Taylor and Daniel 2005) has previously highlighted the dangers and consequences of such gaps in relation to failures to pay sufficient attention to men in assessment (either as strengths or risks).
But it’s all sky? A good understanding of the developmental needs of children and young people brings a sharp and attuned eye to the building picture. However, making sense of large amounts of raw data can perhaps be compared to completing a jigsaw that is made up of pieces that all appear to look the same. It is overwhelming. It can be depressing and deskilling. It certainly takes a long time before you can be sure of anything. Integrated assessment frameworks offer an important guide so that we can begin to look at the different shapes and see how they fit together. The dimensions of children’s needs and parenting capacity provide frameworks within which we can begin to ask some of the how and why questions.
82 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
There’s no picture on the box We have an increasingly accurate idea of what children’s needs are. We also have an increasingly sophisticated system for gathering, analysing and recording those needs. However, the individual needs of the child cannot be specifically defined; individuals are unique and development never stops so needs are not static. You therefore can’t say ‘Done it! There you go, there’s a picture of Jen’s needs’ because there are unknown unknowns. As children and young people’s needs are constantly changing (and the capacity of caregivers to meet those needs is also in continual flux) one of the most important things we can do is recognize that we need the assistance of other people to ensure that, as far as possible, we have considered everything we know and are alive to the presence of important knowledge that has yet to be found. Child protection cannot be separated from a wider consideration of welfare (Laming 2003) and therefore practitioners in universal services must be attuned and open to the possibility that what they are seeing could just possibly be the tip of the iceberg and that a closer look at the child’s lived experience may be required. In this chapter we consider what kind of help we can give to and gain from colleagues across professional disciplines.
Should we start with the edges? When completing a jigsaw puzzle, it is usual to start by identifying all the pieces with straight edges and building the picture from the edges inwards; it gives you a more limited search to start with a frame on which to build the emerging picture. However, when building a picture of a child’s needs there is often a great deal of information to consider and many different places to start building the picture. Any assessment should start with the child’s developmental needs. Assessment requires gathering a range of data continuously, but the analysis (or the emerging picture) should always start with the child; only once a picture of the child’s unique needs has been gained can you assess the capacity of the caregiver to meet those needs or the impact of the environment on those variables. Indeed, in relation to child neglect it is all the more important that the child’s needs become the primary focus of our emerging picture. If the first pieces of your analysis focus on parenting, then there is potential for the emerging picture to focus on what parents can and can’t do, rather than what the child needs and is not getting. By focusing on parenting initially, there can be an unhelpful focus on the physical maintenance of the child’s body. This focus fails to account for a large section of developmental needs
BUILDING THE PICTURE / 83
that are not physical in nature but are social and emotional. This oversight can lead to the kind of ‘grubby but happy’ assessments that negate children’s emotional experiences and what has been referred to (Garbarino, Stocking and Collins 1980) as the meaning for the child in the emotional message of neglect.
Incomplete pictures Ask yourself ‘what is the focus of my assessment?’ The focus of an assessment is akin to a spotlight, illuminating a small area of the wider stage. The focus may be a specific incident of harm and abuse. This small bright pool of light can make it easy to focus solely on the presenting issue of concern and fail to ask questions about other details that fall outside the light. For example, an enquiry into allegations that parents have been drunk and arguing may focus the assessment on incidents of domestic violence and alcohol use; how and when they have occurred, who was present, what is the likelihood of further events and what will the consequences of this be. Outside this specific focus there will be glimpses of other information. Like the spotlight on the stage, you will be aware of things happening outside the spotlight but not sure what they are. The question is ‘do I need to look into this in more depth?’ This appears to be a crucial question in practice; how far can any assessment go before it has gone beyond its remit or the constraints of time and resources? Our paramount concern is the welfare of the child, not our organization. While it is incumbent on professionals to recognize and understand the duties and limitations of their organization, we should never lose sight of our primary duty to children and young people. We do a disservice to service users if we do not keep an open mind to what is happening on the edges of our specific enquiry. Ecological frameworks can really help us to think about the wider world of the child but we need to be able to switch on the lights on these other areas of the stage. Only by working effectively with colleagues across professions is it possible to access the full picture. It is then up to professional judgement to decide which areas need further exploration and testing. This is a clinical judgement; one made on the basis of professional training and learning. As we will see in Chapter 5, this is an area of practice where a better understanding of the working of analysis and intuition may help improve our ability to pick up the signals from outside the spotlight.
84 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Communication The intricacies of human communication are a complex matter to begin with. Most of us know what communication consists of, including writing, speaking, facial expression, art, storytelling, and so on. However, the specific work of childcare and protection brings particular challenges that need to be understood and addressed. Serious case reviews have commented regularly on communication as a contributory factor in poor outcomes, but they have tended to focus on the practical and physical aspects of communication rather than the psychological nature of communication. There is in fact a remarkable lack of attention paid to the process of inter-professional communication, given its prominence in serious case reviews. The centrality of communication in the findings of serious case reviews suggests a need for training that ‘imparts a mind-set that enables (practitioners) to think their way through an assessment and appreciate the psychology of communication’ (Reder and Duncan 2004, p.112). Think about how you make sense of communications in your assessments. Communication is incessant and multi-formatted, including speaking to people directly and on the phone, writing and reading letters, emails, reports, and so on. Communication occurs inside the overt contact too; it’s in the tone of voice or the choice of words and it’s in the reading of body language and facial expressions. It is impossible to avoid communicating and Reder and Duncan point out that some of the most powerful messages can be given through ‘silence, ignoring or choosing to be absent’ (2003, p.86). Unlike computers, we do not communicate by mechanistically transferring data. The process of human communication is one in which we must attribute meaning to the messages conveyed (Pearce 1989). There are many barriers to effective communication in multi-agency practice and rather than focus on the policies and procedures of communication what we need to do is develop and foster a communication mind-set; communication as a way of thinking that needs to be given explicit consideration and development (Reder and Duncan 2004).
Metacommunication – a communication mind-set The accompaniments to words are a vital part of communication and have been referred to as ‘metacommunication’ (Reder and Duncan 2004), where the subject of discourse is the relationship between the people communicating (Bateson 1972). Tone of voice, inflexion, posture, facial
BUILDING THE PICTURE / 85
expression, all add further detail about the message, the message giver and their relationship to the message receiver. Box 3.8 provides an example of metacommunication that highlights the importance of: • past experience • professional identity • cognition; and • relevant knowledge.
Box 3.8 Gathering together large amounts of information is not an assessment. Sharing it does not constitute a child protection plan. Professionals must take the next step to state why they attach significance to some issues and not to others. Their thinking behind these judgements must be explicit. Only by being so can they be challenged and debated. Social Work Inspection Agency (SWIA) (2005, p.7)
Past experience may make the message receiver sensitive to subtle aspects of the message. In this instance, it is possible that the duty worker may be experiencing some emotional stress, as duty work commonly involves screening of many referrals against a backdrop of high case loads and inadequate resources. Instead of being able to hear the concerns, the worker is already a step ahead, defending against a perceived demand that they must respond and intervene. Professional identity is an important consideration both in terms of self-identity and beliefs about other professions. Brandon, Owers and Black (1999) correlated many communication failures with low levels of trust and respect between professions. The consequences of unhelpful metacommunications could be further to entrench negative stereotyping and inflexible responses in inter-agency practice. If the duty worker in this scenario identifies themselves strongly with their organization, they may be susceptible to a ‘siege mentality’ and a belief that that it is their responsibility to defend the agency against further referrals. Reder and Duncan (1999) noted their concerns about practitioners missing warning signs and treating information discretely so that a threshold of concern was not reached. In their later work (Reder and Duncan 2004) there is a link made between these emotional stresses and the unconscious moves that
86 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
are made to self-protect. Emotions act as outriders and give us a ‘quick, rough-and-ready response and orientation which help steer us through the first moments of the situation’ (Howe 2008a, p.40). However, without time and space for conscious reflection, these emotional responses can lead to inaccurate and damaging responses. If metacommunication is about thinking (Reder and Duncan 2004) then communication will be susceptible to the same pressures as human reasoning. Workers need cognitive skills to be able to identify, within a tide of information, what is relevant, what is significant and when they may need to seek information from wider sources. Munro (2008) identifies the human tendency to be attracted to bright, recent and vivid information. Part of the cognitive skill of good communication then should be to ensure that vital information which may be abstract or dull is not missed in communication. This is particularly true of case files, when vital chronology or case history is not accessed, leading to inaccurate and incomplete analysis. Both players in the communication must have a shared language and relevant knowledge. Damaging assumptions can result in the message losing the meaning it was intended to have. As someone who works for vulnerable children and young people, you are constantly required to make judgements (e.g. is a child’s presentation indicative of abuse?). These judgements are subject to scrutiny and you must be able to explain why you have made them. You therefore require experience and a language to allow you to make your judgement explicit and share it with others. A knowledge of child development and the consequences of abuse and neglect must be developed and maintained alongside a communication mind-set. In the scenario above, both the caller and the duty worker may have been in agreement that the child may have a level of unmet need; it’s simply that the social work service needed a higher level of concern before they could justify intervention. However, the message inside the conversation that the referrer may have taken away is that social work services do not respect the caller’s judgement, do not care about this child and are not concerned about their welfare. Not only may the referral not be recorded properly, but the caller will be less likely to call social work again should a similar concern arise. How could the duty worker have handled the call to lessen the chance of faulty metacommunications to have arisen? One predisposing factor would be the presence of what Howe (2005) refers to as ‘mind-mindedness’, where there is a curiosity about the mental processes of the person we are communicating with. If we are willing and able to speculate about the
BUILDING THE PICTURE / 87
meaning in the message (which, as reflexive activity, is affected heavily by environmental influences such as time and stress) then our communications may be more effective and rewarding. Reder and Duncan (2004) suggest that supervision provides opportunities to rehearse and practise communication skills. They also provide tips that can be used as the basis for professional development in a range of ways: • Ask the recipient to repeat the message you have given. • Summarize conversations and action points at the end of a call. • Plan telephone calls and reflect on the aims of the communication. • Visualize the other person’s work setting. • Map professional networks and identify influences on thinking. • Practise making a case synopsis. One suggestion comes from an inquiry report considered as part of Brandon et al.’s (2008) study of serious case reviews. It was noted that differences in professional concern (and therefore often differences in thresholds) were a feature of cases where things had gone wrong and were also rarely satisfactorily resolved. In one case where a health visitor had written numerous faxes and letters to social care agencies, outlining her concerns, this had not effected change. Brandon et al. (2008) suggest that the health visitor might have been more successful in expressing her concern if the letters had been followed up verbally. Reder and Duncan (2004) have demonstrated that the content of communications goes far beyond the words and sentences used. Email is a prevalent means of communication but one in which many practitioners are not trained and for which generally accepted protocols have yet to be fully developed and shared. In this kind of communication environment, direct face-to-face communication between professionals may be crucial to guard against some common errors of communication.
Box 3.9 Caller says: ‘I have concerns about this child.’ Duty worker hears: ‘I want you to do something about this now.’ Duty worker says: ‘This case does not reach our thresholds for intervention.’ Caller hears: ‘We do not share your concerns.’
88 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Discourse analysis Use of language in communication is a complex business. We negotiate our way through the enormous complexities of communication through the unconscious application of cognitive techniques to provide short-cuts and quick directions. Occasionally, such as in child welfare and protection practice, there is a need for a level of accuracy and consistency that requires communication skills of an altogether higher order. At this point we need to look at some of the work of disciplines such as sociology and linguistics to understand more fully some of the potential pitfalls in communication. Students attending a programme in child welfare and protection practice came from a wide variety of professional backgrounds and roles. While the programme was designed to meet the needs of all professions (e.g. health, social work, education, etc.) it became apparent that staff who were not social workers felt at a disadvantage at times. One area of feedback was that of language; some students felt that the use of jargon and acronyms could exclude those who did not use such terms commonly. For example, a social worker may refer to an ‘SBR’ knowing that this means ‘social background report’ but a clinical psychologist may not know what this acronym means. A health practitioner may refer to ‘DNA’ knowing that this means ‘did not attend’ but a social worker may dismiss this as some obscure reference to genetic material. Furthermore, they get the feeling that they should know. Since everyone else knows it would make them look stupid to ask for an explanation. The careful use of ground rules and skilled facilitation by the tutor can reduce the use of exclusive language. Despite this, though, language in the teaching environment continues to be an issue. This is because language serves social functions, one of which is to connect and shape social groups and cultures. Take this example: ‘The coffee has gone everywhere; fetch a mop.’ ‘The coffee has gone everywhere; fetch a brush.’
Very quickly, you have made sense of both statements and reconciled the apparent contradiction between the two (Gladwell 2005). This is because you know that coffee can be both a liquid and a solid (either granules or beans). Without this knowledge, you are immediately off the map without a compass. Now take the following sentence: ‘Lorraine has a lot of male visitors.’
BUILDING THE PICTURE / 89
Students on our programme were asked to come up with as many different interpretations of this sentence as possible. We usually had to set a strict time limit on the exercise because the different permutations were almost inexhaustible. Interpretations included Lorraine having a large family with many brothers visiting, Lorraine being gregarious and preferring male company to female, and Lorraine being involved in prostitution. This exercise has supported groups of practitioners to consider the way in which group norms and values are transmitted through language. It has highlighted the potential for multiple interpretations and the importance of checking that the appropriate meaning has been conveyed. Some of the students who took part in this exercise noted that their agencies have policies that do not allow them to use certain terms. In this instance, they advised that they were not allowed to use terms such as ‘prostitute’ or ‘street worker’. This would mean that they would have to find other ways of recording this information, potentially having to use allusion and euphemism instead of accurate and unambiguous language. It was noted in the Caleb Ness Inquiry (O’Brien et al. 2003) that Caleb’s mother, Shirley was reported as ‘working in the sex industry’. If workers follow this example and use such a term it removes a lot of important detail of what this means for the child in this situation and the potential risks to their well-being. The facts need to be set out clearly and analysed in terms of their significance for the child or young person.
Practice development – communicating meaning This exercise can be carried out as part of social work supervision, peer or group supervision or a development exercise. Take a report that you have recently written or contributed to. Go through the report and highlight every adjective in the description of home circumstances. For example, ‘The kitchen was dirty, with bags of refuse spilling onto the floor. The bathroom was very smelly and unhygienic.’ Now read out a selection of these adjectives to your supervisor and ask them to say what they think the word means in the context of a child welfare and protection report. Note their responses and together look at the report they came from. Consider the following questions: • Did your interpretations of the words match each other? • Was there further information in the report that would have made the meaning clearer to the reader?
90 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
• What might be the consequences of a reader taking a different meaning from the one you intended? Inter-professional communication requires us to think not just about the giving and receiving of information but the cognitive processes by which we construct meaning out of this information. Regular contact with other professionals can support good inter-agency collaboration, but such contact is too often based on individual work and focused on specific assessments and interventions. Creating opportunities for additional informal contacts between key staff and agencies can be beneficial. Reciprocal arrangements between health visiting teams and social work teams, for example, can allow members of each group to see the other group in operation and build a better understanding of their wider responsibilities and priorities. Informal meetings such as occasional scheduled coffee meetings can allow staff from different agencies to meet away from case-specific work and can help develop higher levels of mutual trust and respect. Think about making time to develop these links as ways to enhance these important factors in inter-professional collaboration (Cleaver et al. 2008).
Summary Legislation and policy provide the basic framework for sharing information in child welfare and protection. However, the transfer of information is mostly a mechanistic process and the nature of inter-professional practice has a strong influence on the creation of understanding and the development of analysis in practice. Through a consideration of the way in which professionals ‘frame’ their analysis, we can recognize the tendency for agencies to protect their own boundaries (Quinton 2004) also involves a tendency for professions to create boundaries of understanding as they apply their professional lens of practice knowledge. To ensure that there is shared understanding of the lived experience and needs of the child, there needs to be space within multi-disciplinary practice to discuss the roles of those involved and the areas of knowledge that each of them brings to the growing picture. Inter-agency collaboration is supported by good communication and we need to think about communication as a cognitive activity influenced by the relationship between the communicators (Reder and Duncan 2004). Communication is a two-way process: just because we have explained something to the best of our ability, this does not mean that the person we are talking to has understood what we are saying. Referrers often do not receive effective feedback from social workers after referral (Cleaver et al.
BUILDING THE PICTURE / 91
2004; Holland 2004), and this is an area of practice that could be improved (Horwath 2007a) with more attention paid to the place of cognition and reasoning in communication. Anecdotal information from students on our programmes suggests that many local authorities are aware of the need to improve practice in this respect. It is recognized that humans have a tendency to create explanations for things quite quickly and find it hard to let go of these views, even when later evidence suggests that they may be wrong (Scott 1998). It is also recognized that humans carrying out analysis can gather information selectively to support their preferred view. If professionals across all services are to work effectively together with the child at the centre of analysis, then these tendencies need to be recognized and addressed. Consideration needs to be given to improving inter-agency practice at all levels, from creating opportunities for enhancing local networks to the provision of multi-professional education and continuing professional development.
Chapter Four
Developing Explanations
What is a hypothesis? The development of a hypothesis is central to analysis in assessment. Dictionary definitions tend to agree that a hypothesis is a tentative explanation. It is a way of explaining something observed or considered so that this explanation can be further tested and checked.
Box 4.1 Definition of hypothesis 3. A supposition or conjecture put forth to account for known facts; esp. in the sciences, a provisional supposition from which to draw conclusions that shall be in accordance with known facts, and which serves as a starting-point for further investigation by which it may be proved or disproved and the true theory arrived at. Oxford English Dictionary
Holland (2004) sounds a note of caution about using ‘explanation’ as a synonym for ‘hypothesis’ as this may imply that we can explain the underlying cause of the family difficulties, whereas such understanding is likely to elude a simple ‘explanation’. Developing hypotheses (or tentative explanations) in conditions of uncertainty is a key skill in analysing information and making sense of it in relation to the lived experience of the child. In this chapter we consider some of the dangers and some of the consequences of limiting the development of explanations in assessment
93
94 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
and we look at ways in which we can create frameworks for practice that support the development of explanations more effectively.
Hypotheses in child welfare and protection Within all forms of assessment we are continually required to offer tentative explanations for what is happening. We are trying to make sense of all the information our senses are exposed to and trying to make order and find patterns among all the sensory clutter and information overload. Human reasoning provides us with the capacity to create hypotheses at different levels of conscious thought. Some explanations may be unconscious and intuitive. For example, when a parent is shouting and leaves the room halfway through a child protection case conference, you will have already begun at an unconscious level to form possible explanations built around your knowledge of the person, sociology and stress. For example, you might hypothesize that they are diverting and manipulating, or that they are in a ‘fight or flight’ state, or that they are leaving to avoid a worse outcome such as public humiliation or uncontrollable anger. Other explanations may be reached by a much more conscious and deliberate way of thinking. For example, if a child of five years old is angry all the time and does not want to play with other children of their age, you might consider theories of attachment and child development and you may want to carry out more enquiries and do more thinking before forming some kind of possible explanation for this behaviour. This may take time, information and the help of other people.
Explanations developed too quickly Research into the psychology of judgement has demonstrated a very strong and consistent tendency in humans to form one favourite explanation quite early on in the process of assessment and then cling to that explanation, even when there is evidence available to suggest that the chosen explanation might not be the right one or the best one (Plous 1993). There appears to be a problem here that is extremely relevant to assessments that try to make sense of children’s needs and the risks they face. Snyder (cited in Arkes and Hammond 1986) demonstrated that once a person has decided on their favoured explanation they are likely to selectively seek evidence that confirms their preferred hypothesis and are unlikely to select information that might challenge their explanation. This is now recognized to be one of the most important human failings to be
DEVELOPING EXPLANATIONS / 95
aware of in assessment. It is often referred to as ‘verificationism’ (Scott 1998; Sheppard 1995) or ‘confirmatory bias’ (Munro 2008; Plous 1993). We have a tendency to form our views fairly early on in proceedings and then unconsciously select and weigh the information emerging in a way that ensures our early beliefs will be supported rather than tested (Munro 2008). This biased information gathering is likely to lend support to the hypothesis and, in turn, the answers lead to growing confidence in the hypothesis. Confirmatory bias can be seen in many people’s experiences of flat-pack furniture. All the pieces are laid out and the process of selfassembly starts with the aid of some brief guidance notes. It doesn’t seem quite right but you see the number of holes matching up and don’t see the raw chipboard where there should be a finished surface; you may know deep down that you have got it wrong but you keep tightening the screw anyway. Inquiries and serious case reviews have highlighted some of the ways in which this confirmatory bias can feed into ineffective and damaging judgements and decision making in child welfare. At one end of the scale, verificationism can result in agencies not taking action when they should. Brandon et al. commented on the management of caseloads under pressure and noted that in one instance ‘the current climate in (local authority) would have put pressure on staff to keep as low as possible the numbers of children looked after’ (Brandon et al. 2008, p.87). In a climate of limited resources and high caseloads, confirmatory bias may allow practitioners to conclude that a child or young person is not at risk or does not meet a threshold for intervention when, in fact, a more balanced examination of the evidence would reveal factors that disconfirm this early hypothesis that no further action is required. At the other end of the scale, confirmatory bias may result in children and parents being subject to investigation and even prosecution through over-confident professionals failing to acknowledge the evidence that challenges their beliefs. Munro (2008) advises that we may unconsciously use a number of techniques to avoid seeing challenging evidence: • avoidance • forgetting • rejecting • reinterpreting. Avoidance can result in unhelpfully limited or cursory information gathering. A noted feature of many inquiries and reviews has been the tendency for
96 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
practitioners to listen to adults and believe their versions of events rather than listening to children and giving precedence to their views. By failing to engage with children and young people in ways that really help them speak about their lives, we unwittingly avoid the information that may challenge the explanations dominating our thinking. Forgetting is something that human brains need to do. We have to forget or else our memories would become overloaded almost immediately. Instead of perfect recall of all experiences, our brains give us a reconstruction based on heuristics; the short-cuts that allow us to make a full picture out of partial information (Gigerenzer et al. 1999). However, this ability comes at a cost and we must forget so that we do not use old (possibly outdated) information (Bjork 1978). We are also more likely to forget information about tasks that have been completed (Gigerenzer et al. 1999). This research suggests that memory is not like a library to dip into and retrieve information at a later date but is more like a rapidly moving construction with snippets and snatches of things being grabbed and used to see if a fuller picture can be drawn up. The nature of human memory makes it prone to heuristic bias. Clearly, we have a tendency to remember recent events more than those long in the past. However, we also have a tendency to remember things that are vivid not dull, verbal not written, tangible not abstract (Munro 1999). All of these biases suggest that not only must we record information as soon as possible after the event but we must also fight our natural preferences in order to select the dull, abstract, written information that is contained in case files. It may not be what your intuition advises you to do when you are busy and pressed for time but the failures of human memory, coupled with the failure to access such information, are a dangerous combination. Rejecting and reinterpreting can take place when the evidence offered is challenging. Professionals, parents, children and young people will all give information in a way that tends to their needs. With this in mind many practitioners may be wary of accepting this information. While it is right to sceptical, it is also important to ensure that evidence is not rejected summarily because of the source. Lord Laming’s advice to take a stance of ‘respectful uncertainty’ (Laming 2003) signifies an important support for the need to remain in uncertainty for longer. While there are immense pressures for practitioners to reach (or appear to be in) a position of certainty very early on, the messages from research on judgement suggest that we should not leap to judgement and care must be taken to check thoroughly all information regardless of source. Hypotheses can come from many different sources. Although professionals may be able to present their hypotheses more coherently than service users
DEVELOPING EXPLANATIONS / 97
or non-professionals, this does not mean that professionally generated hypotheses are necessarily more accurate (Holland 2004). We need to generate hypotheses with caution and a critical approach; psychological theory in particular (such as attachment theory) can be so potentially malleable as to be used selectively to support almost any hypothesis (Taylor and White 2006). For example, a child may be seen to have an insecure attachment to their parent and this could be used either to explain why a foster care placement is needed or why the child needs more ‘time in’ with their parent and would be damaged by a foster placement. The alluring and pervasive nature of confirmatory bias makes it extremely significant in practice. We need to develop strategies to counter this tendency and we also need to reaffirm professional confidence as a key motivating factor in ensuring that the picture is seen clearly and fully. I look in more depth at strategies for managing confirmatory bias in Chapter 7.
Building hypotheses Box 4.2 [A] hypothesis being a mere supposition, there are no other limits to hypotheses than those of the human imagination. John Stuart Mill (cited in Robson 1974)
As children we tend to be more imaginative than we ever are as adults. Experience and memory help us to anticipate what comes next and our improving recognition of cues can help us make sequential links more effectively as we grow and develop. As a consequence our hypotheses may become more limited over time. Our frugal thinking may unconsciously eliminate or discount unlikely hypotheses at an early stage, leaving a smaller pool of explanations that our experience tells us to expect in such situations. As we saw in Chapter 2 ‘satisficing’ means that our experience can help us select choices quickly and effectively without having to weigh up every single possibility. However, child welfare and protection operates in the realms of the statistically abnormal and we are expected to analyse situations where events and actions may not mirror those in the wider world. If we do not have theoretical frameworks to order our analysis around, then hypothesizing is likely to be a confusing, piecemeal activity with little
98 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
logical connection, for example, between our analysis of a young person’s needs and the impact of their carer’s parenting capacity. Equally, if we are not supported to think outside the box (in terms of both our particular role and the confines of our experiences) we may limit our potential hypotheses and therefore our capacity to develop sufficient alternative explanations to offer a rigorous test of our reasoning. It is important to work alongside children and their families to develop ways of understanding. As discussed in Chapter 1, we are in an era of practice where the technical-rational focus of the late 1980s and early 1990s may be ceding to a more practice-moral interpretation of the assessment task. Although serious case reviews may still primarily respond to child deaths with recommendations to encourage procedural adherence and systems responses (Hyland and Holme 2009), there is a growing body of support for returning professional judgement to the front line. It is vital that practitioners develop more than one hypothesis (Milner and O’Byrne 2002). For example, if a young person is not going to school you will want to answer the question ‘why are they not going to school?’ as well as looking at the needs and risks that will flow from them missing out on going to school. Say in gathering information it comes to light that the child’s father suffers from agoraphobia and depression. He and his daughter tend to spend the day together, either on their PlayStation or watching television. It might be reasonable to hypothesize that the girl may have taken on a caring role within the family and that, rather than trying to make school more attractive, the intervention should focus on improving the father’s mental health as a means to reducing the caring responsibilities that have been getting in the way of school attendance. What if it is not the father’s ill health that is at the heart of the young person’s non-school attendance? Confirmatory bias (Munro 2008) might result in blinkered thinking where the focus remains the father’s health, despite evidence to the contrary. It is therefore important that lots of different possible explanations are considered at an early stage in the assessment. Where are her friends? Has she been bullied? Have older siblings had similar or different experiences? Have there been changes such as a move of house or the loss of a family member? There appear to be two main ways of developing hypotheses – we can either develop them in a linear, one-after-the-other fashion or we can develop a raft of competing hypotheses at the same time (Sheppard 1995). Brunswick (cited in Arkes and Hammond 1986) suggested that analytical reasoning could be likened to the switching of trains at a multiple junction, with lots of well organized courses of action available but only one leading
DEVELOPING EXPLANATIONS / 99
to the right destination. The analogy is a helpful one as it indicates potential fragility in analytical reasoning. When complex judgements need to be made quickly, intuitive reasoning may often be the more effective method. If we view our developing hypotheses as a series of tracks or options then we can see that we will have to make a choice at some point; even doing nothing still leaves you heading down a particular path. We require a process that allows us to weed out the less convincing ideas, leaving only those that are robust enough to stand up to testing. It is more likely that child welfare and protection practice requires practitioners to develop explanations by comparing lots of competing explanations at the same time rather than a more deliberate but unnatural process of progressing our possible ways of understanding one by one. This requires rigour in reasoning and an ability to stay in uncertainty and avoid forming a fixed view at an early stage. Where you do this hypothesizing may not be where you can record it. For example, driving back to the office from a home visit, you are likely to be chewing over what you have heard people say and what you have seen in the house and in behaviour. In addition to the concerns about fallibility of memory there is also a need to ensure that time itself does not become the final arbiter of hypothesis selection. There are likely to be a great many possible explanations in your head at this stage, but how many actually make it far enough back to your desk to stand a chance of surviving to the point where they become part of the written assessment? The use of the notebook or digital recorder is a vital skill in ensuring that hypotheses are generated in sufficient numbers and with sufficient breadth to offer the required levels of rigour in assessment. Use mind-maps, use questions and prompts, do whatever you need to do to ensure that the door remains open to alternative suggestions as well as your own firm favourites.
Models for supporting analysis in more depth Making sense of data involves processing it. The complex and subjective nature of assessment means that quantifiable measures are lacking. Actuarial approaches have benefits and can be useful tools in assessment. Validated (actuarial) risk assessment tools do exist and are used quite frequently in some areas of practice such as criminal justice social work. Within child welfare and protection work there are not many tools that have been validated and their use needs to be evaluated carefully. This means that practitioners rely on their professional (or ‘clinical’) judgement to draw inferences from raw data and turn it into information. Where actuarial
100 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
approaches are used, there is commonly a place within the framework for a record of professional judgement, so that discrepancies between the clinical and actuarial conclusions can be examined in more detail. It is rather depressing that, despite research, policy and guidance to the contrary, practitioners continue to treat assessment as if it is a one-off event (Milner and O’Byrne 2002). Assessment should be an ongoing process and therefore so should analysis. Effective clinical judgement should actually be viewed as a series of judgements rather than a single process (Hollows 2008). Hollows (2008) offers a helpful framework for supporting a more cyclical model of judgement: • critical appraisal/hypothesizing • holding judgements • issues judgements • strategic judgements • evaluation judgements. This first step of Critical appraisal/hypothesizing has been added to an earlier model (Hollows 2003). This is the stage when the practitioner (in theory) sifts through the information available and begins to critically evaluate its validity and relevance. However, we know that one of the difficulties is that many judgements have to be made without any real opportunities for hypothesizing, and pressures of time can result in the available information being overlooked or interpreted in ways that may be unhelpful or even damaging to the child or young person. Hollow’s model allows for judgements to be made that are open to revision, and this is a vital element in any judgement framework if we are to avoid confirmatory bias where we fail to revise our views despite mounting evidence to suggest that we should. Information at the early stages of assessment and enquiry tends to be uncertain and incomplete; we need to be able to make decisions but also to accept that our judgements will not be terribly robust at this point and we will potentially need to revise our initial intuitive analysis at a later date. The damage comes when we do not review these holding judgements. Particularly when working in busy intake settings, a siege mentality can set in when the over-riding concern for the team or agency may become defence against further workload rather than a consideration of whether the needs and risks in the situation trigger the agency’s statutory powers and duties. The holding judgement acknowledges that some decisions need to be made quickly but that they are not ‘forever’ judgements. A ‘holding judgement’ allows the
DEVELOPING EXPLANATIONS / 101
worker to come to preliminary findings about how to stabilize the situation and respond in the short term. Issues judgements now follow, with a drawing out of key issues in the short term and the longer term. In terms of analysis, this may indeed be a crucial point in the assessment, where inadequate or incomplete analysis could lead the assessment in unhelpful or uncertain directions. At this stage in the assessment we need to move along the cognitive continuum (Hammond 1996) so that our fast and frugal thinking does not lead us to incorrect or inaccurate judgements. Careful consideration needs to be given to the implications of past information. This information may come from many sources, such as sizeable case files or interviews with children, young people, families and fellow professionals. None of these sources can be accessed quickly without considerable risk of some common errors of reasoning. Issues judgements take time and one of the key skills that needs to be developed here may not actually be to do with analysis itself; if we are ever to use our analytical skills, we must first safeguard the time to do this. Therefore one of the key factors for success may be the skill and confidence a worker needs to recognize the scale of the task and to negotiate with management to ensure that they too realize the need for the worker to be given the required time to complete this crucial stage of the assessment. Strategic judgements turn hypotheses into actions and this includes the development of strategies for managing issues identified and developing effective interventions. At this stage, the worker’s skills are vital to ensuring that there is a clear connection between the analysis of the information and the recommended course of action. Too often, written assessments contain what Reder and Duncan (2000, p.444) refer to as a ‘dissonance between assessment and action’, where there is no apparent logical connection between the practitioner’s analysis and their recommendations. For example, there may be a number of significant risk factors identified but the practitioner has recommended no further action. Better outcomes are more likely to flow from clearly articulated judgements that offer an evidence-based analysis that is logically connected to the proposed intervention strategy (Hollows 2003). Furthermore, as all interventions are necessarily bounded by resource implications, being clear and analytical about how particular resources are expected to address specific issues may improve the chances of resource allocation (Tunstill 1997). Within the local authorities that I have worked with on evaluation and case-file audits, the consistent message from those who gate-keep resources was that they would be more likely to allocate resources to a case where the worker had presented a clearly reasoned analysis with specific attention to how
102 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
the required resource would address the child’s needs, either directly or through modification of parenting capacity or the wider environment. Evaluation judgements appraise the latest evidence in terms of the efficacy of intervention and whether earlier judgements need to be revised. In this way, the process of judgement is more cyclical and in keeping with a critically reflective mind-set. Time passes and situations change. Sometimes professionals do not quite see this shift and a gap can begin to form between the reality of a situation and the professional’s view of it. Good practice (and by inference, good organizations) need to be able to come back to the hypotheses that were originally generated and check again their validity. Because of the impact of common errors of reasoning, we may need help with this task. For example, attributional bias creates a tendency for humans to attribute success to themselves and failure to other people. In child welfare work this may translate into beliefs that an intervention has failed because of the service user rather than the nature of the service provided. Support from other people is a crucial part of the evaluation judgement and we look in more detail at this area of practice in Chapter 7. The practical difficulties of supporting such hypothesis development do need to be openly acknowledged though. Hollows (2008) suggests that, within the critical appraisal stage, there should be a ‘sceptical examination of the available information’, which leads to a ‘holding judgement’. This should afford an initial assessment in the short term and provide room for more detailed analysis of the issues in the case and how best to respond in the longer term. Writers from the wider field of decision making (e.g. Gigerenzer et al. 1999) and within the specific area of child protection (e.g. Munro 2008) have already identified the difficulty of knowing when we have all the available information and how easy it is to believe that we have a good picture when, actually, large chunks are missing or inaccurate.
Dialectic mind-set or ‘how and why?’ thinking Analysis not only needs to take place all the way through an assessment but it actually needs to start before the case is even referred (Dalzell and Sawyer 2007). Holland (2004, p.127) notes that ‘analysis is a process which pervades an assessment from its very beginning’. Before any information has been considered, practitioners need to develop and maintain a ‘reflective’ or ‘dialectic’ mind-set (Dalzell and Sawyer 2007; Reder and Duncan 1999). What does it mean to have such a mind-set? One practitioner in a teaching session once referred to needing to have a ‘how and why?’ mindset in assessment, and this definition appears to capture a key element of
DEVELOPING EXPLANATIONS / 103
critical reflection; there needs to be a drive and interest in understanding the reasons for events or phenomena and there needs to be a willingness to accept that we never reach an absolute ‘truth’ but that we can keep building towards a better understanding (Reder and Duncan 1999). Bentovim et al. (2009, p.88) reflect the ‘how and why?’ mind-set in setting the following questions as core questions in analysis: • What needs of the child are being met – and how? • What needs of the child are not being met – and why? When, for whatever reason, we lose our interest in the ‘how and why?’ or begin to believe that we know all there is to know about something, our capacity for analysis is potentially compromised.
Box 4.3 The ‘how and why?’ mind-set – an example When you make a home visit it is sometimes noticeable that everyone in the family has a particular seat in front of the television. Without a ‘how and why?’ mind-set, there is no reflection on why this occurs or what the significance might be for you or the family. However, most practitioners will have experienced this phenomenon before and will have begun to form some ideas about what it means. Explanations may include physical needs, access to resources, power in relationships, etc. However, without critical reflection at some level, these observations can go unprocessed and may not contribute to your assessment. If you can build, consciously or unconsciously, on these observations you can develop explanations and fit another potential piece of the jigsaw into the life of the child or young person whose needs you are assessing.
Having a ‘how and why?’ mind-set is crucial to promoting analysis. It would also appear that many of us in practice have this mind-set but still struggle with analysis, particularly in the written form. This may in part be because of the lack of training and education on analysis in qualifying programmes and continuing professional development. Without the theoretical framework to support analysis, all this natural curiosity and drive may lack coherence and direction. Reder and Duncan (1999) suggest a helpful framework for understanding how the process of analysis operates. Drawing on the extensive literature on philosophy, they promote
104 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
the notion that practitioners can develop knowledge through developing and comparing contradictory standpoints or arguments. As in a courtroom, practitioners are required to defend their arguments and should expect to be challenged. These competing viewpoints battle it out through dialogue and argument. Weak arguments are defeated by stronger ones. Those that survive are refined and developed further. This is what is referred to as ‘Socratic method’ (Dalzell and Sawyer 2007; Reder and Duncan 1999).
What is Socratic method? Although it comes with a philosophy label, Socratic method is something we all do when we debate and argue. The Socratic method was named after the Greek philosopher, Socrates. In such a form of reasoning, enquiry and debate take place between individuals with opposing viewpoints. By asking and answering questions we facilitate rational thinking and help to draw out ideas. Rather like a court of law, there are opposing arguments and each ‘team’ will attempt to question and test the other while defending and supporting their own stance. Reder and Duncan (1999) refer to this form of reasoning as ‘dialectics’ as it involves an oppositional discussion; one point of view is opposed against the other; with the opposing views validated, contradicted, supported or weakened by turns. The literature on reasoning often refers to key methods of reasoning known as induction and deduction. This area of knowledge (which touches on philosophy, mathematics and psychology) can be slightly overwhelming but it is worth taking the time to gain a clearer understanding of this part of the process of analysis. Although the terms may not be familiar, it may be helpful to think about how these different approaches to analysis will affect our practice. Deduction begins with a theory and sets out to prove or disprove the theory’s validity. For example, the theory is that humans are mammals. We apply the theory to Dave, who lives in Islington; because Dave is a human he is therefore a mammal (QED). Deduction uses experimentation, observation and adaptation to test theories and hypotheses as to whether they are valid or invalid. Induction begins with observation and uses the generation of hypotheses to begin to develop an understanding of the phenomenon being observed. Unlike deduction, induction begins with observations and then sets out to try to establish more general sets of rules from these observations. For example, a child lives in an isolated village where there are only brown cows. The child observes the cows and reasons that, as these cows are
DEVELOPING EXPLANATIONS / 105
brown, all cows are brown. This inductive reasoning will stand true until further observations (such as seeing the black cows in the next village) are made and the child needs to revise their thinking. While deduction may have applicability in research, induction is likely to be the more frequently used approach to the kind of open-ended and tentative exploration that is carried out in assessment practice, as the examples in Figures 4.1 to 4.4 illustrate.
Theory
Hypothesis
Observation
Hypothesis Connie is a child and should therefore present attachment behaviours when her security is threatened
Observation The interaction between Connie and her mother is observed when her mother leaves the room
Confirmation
Figure 4.1 Deduction Theory Children will activate attachment mechanisms in times of danger or stress
Confirmation Connie does not appear to notice her mother leaving. The theory must therefore be invalid
Figure 4.2 An example of deduction Observation
Figure 4.3 Induction
Pattern
Tentative hypothesis
Theory
106 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Observation Connie is reported by her mother to be unlike her siblings: she doesn’t like cuddles and is hard to soothe
Pattern Connie’s mother is very cold with her when she drops her off at the nursery. Connie struggles to make friends and does not seem able to let staff know when she is hungry or tired
Tentative hypothesis Connie’s social and emotional development may have been affected by the parenting she has received
Theory Cold and potentially hostile parenting may have caused Connie to develop an avoidant attachment strategy that minimizes reliance on other people
Figure 4.4 An example of induction
We may need to cut across these two traditionally distinct research strategies if we are to engage more fully with the interpretive (or hermeneutic) aspects of assessment (Sheppard 1995). While we need to ensure that we are not dogmatic in our development of explanations, we also need to maintain a deductive rigour that can go missing in the kind of theorizing practised in the field (Taylor and White 2006). Observation is at the heart of induction because all the later parts of reasoning flow from our observations. However, observations cannot be devoid of preconceptions, which are themselves forms of theories (White 1997). For example, as soon as a parent reports that their child is different from their siblings your mind automatically begins to rummage through a selection of possible explanations. You have already sparked off your ‘how and why?’ thinking and will be judging incoming information in light of the kinds of hypotheses that are forming. Equally, knowledge cannot be advanced without observation and it is difficult to see how the theory could exist without observation. Lishman (1991) quotes Susser to note that ‘to practise without theory is to set sail without a map. Theory without practice is to not set sail at all’. The interdependence of theory and practice is dynamic and our application of theory to practice itself needs to be open to critical reflection if we are to offer consistency and clarity in our analysis. In reality, induction and deduction are interlinked because knowledge cannot be developed without observation and this observation cannot escape from the backdrop of theory that we apply to derive meaning and
DEVELOPING EXPLANATIONS / 107
understanding. A retroductive approach (Sheppard 1995; White 1997) seeks to ensure that analysis does not simply confirm initial impressions and that all the evidence is properly considered, whether or not it supports the practitioner’s favoured explanations. The rigorous evaluation of evidence and the adoption of a sceptical attitude are central to analysis and we will now see how such analytical rigour can be embedded in practice. Reder and Duncan (1999, p.101) offer a dialectic model for analysis (Figure 4.5), based in the philosophical tradition of reasoning. Although judgement and decision making are often bound closely together, it is important to distinguish between a judgement (an inference drawn from the data) and a decision (an action taken on the basis of the judgement) (Dalgleish 2003; Goldstein and Hogarth 1997; Hollows 2003). Reder and Duncan (1999) view assessment as the step between hearing about a problem and doing something about it. To ensure that we only make decisions after making judgements, we need to think carefully about the best means of supporting judgement in practice. The concept of the ‘cognitive continuum’ (Hammond 1996) suggests that there are times when, by necessity, our reasoning is quick and intuitive. At other times, we have opportunities for more deliberate and explicit reasoning. The model in Figure 4.5 gives a useful template from which to develop practice that seeks to guard against the common errors of judgement that have so far been identified (e.g. Scott 1998; Sheppard 1995; Munro 2008).
Figure 4.5 Dialectics – a model for effective analysis
108 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
While this model is more easily applicable to those situations where there is time for discussion and debate, it is still helpful to think about its guiding principles in situations where you are making judgements alone. For any piece of information you may ask: • What might help explain this? Hypothesis • Are there alternative explanations? Antithesis • What is the most likely explanation just now? Synthesis • How will I measure and check my explanation? Interventions
Develop and test many possible explanations Milner and O’Byrne consider the hypothesis part of this model. In a slight reworking of the basic concepts, they advise that workers should seek to construct ‘multiple, testable hypotheses’ (2002, p.67). Based on the approach used in good qualitative research, they highlight the tendency for humans to support rather than challenge their initial explanations. They therefore argue for appropriate levels of resources and supervision rather than a continued acceptance of the short-cuts and surface approaches that have been highlighted in so many serious case reviews. Even if such obstacles can be overcome, practitioners will continue to be required to make judgements in difficult and uncertain circumstances. However, with the knowledge provided by such models we can begin to ensure that our judgements are as sound as possible within the confines of our organization and profession. Synthesis is a crucial part of the dialectic method and its importance is not to be underestimated. It lies at the heart of making your analysis coherent and it underpins the validity of conclusions and recommendations. Analysis is usually defined in terms of breaking things down into their constituent parts, whereas synthesis is defined as building them back up. Your synthesis is the part where your analysis informs your conclusions and recommendations. These conclusions may direct the following intervention or they may inform the need for further enquiry. The cyclical nature of the model is important as our hypotheses must be open to testing and challenge and we must be ready to make revisions in light of changing circumstances and new information.
DEVELOPING EXPLANATIONS / 109
Car engines, analysis and synthesis We can employ an engineering metaphor to explore this model in more depth. If someone who knows nothing about engines puts diesel in a petrol engine they will understand that the engine will not work, but will not know why and therefore cannot do anything to address the problem. However, someone could acquire sufficient knowledge (e.g. attend a class or read a book) to enable them to identify the problem and solution. Or, more likely, they will know their limitations and contact a mechanic to have a look. Similarly, without a sound knowledge of child development, any analysis of a child or young person’s needs will be flawed because it lacks foundation. If this foundation is shaky or missing, the assessment will be immediately compromised. This will have significance for the analytical capacity of social workers and other professionals contributing to and carrying out assessments. Knowing the limits of your knowledge is important but this knowledge needs to be allied with a willingness and ability to link with other professionals who have this requisite knowledge. If you are analysing an engine, you will need sufficient knowledge to dismantle the engine and locate the difficulty. In parallel with child welfare and protection, you may have been given some information to guide you. For example, you may have been told that there was white smoke billowing out of the exhaust and that the engine stopped working soon after that happened. You then have to take all the information you have and begin to think about what this may mean; what is significant and what is not. Just like child welfare and protection practice, there are pitfalls for those who do not listen to what they are being told or form one strong hypothesis early on and fail to revise it in light of future information. We need to ensure that we form multiple testable hypotheses in our analysis (Reder and Duncan 1999). If we fail to do this then our ideas can’t fight it out and we can’t allow natural selection to take place. If we only ever form one or two hypotheses then they are bound to be the ones that survive, no matter how inadequate or inaccurate they might be. If we move on from hypothesis, we next come to antithesis. Antithesis is the process by which your ideas are tested to see if they will stand up to scrutiny. If the mechanic believed that the engine block was cracked, they may then have to advise the customer that the whole engine needed to be replaced. This would be hugely costly. Instead of simply accepting this hypothesis, the analytical mechanic would propose the antithesis – the opposite of whatever they proposed. By doing this, they put the theory to a rigorous test. So, they then consider the opposite; that it’s not a cracked block. Instead of simply looking for evidence to prove they were right, they
110 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
now have to look for evidence to prove they were wrong. In the same way, hypotheses about children and families need to be subject to antitheses; you need to test your beliefs by trying to prove the opposite. For example, you may firmly believe that the marks were caused by the child’s older sibling. After all, she has a history of violence and has openly stated how much she hates her baby sister. Instead of patting yourself on the back and moving on, you must test this idea with the antithesis; that it was not the older sister who made the marks. You then need to look again at all the evidence; what people said, the way some things made you feel, timings, everything now needs to be looked at from the other angles. Most people can probably take an engine apart but this does not necessarily mean they understand how it works or how it can be put back together again. Similarly, being able to describe a child’s needs or a parent’s strengths and difficulties does not lead to insight unless meaning can be ascribed to these observations. Too much of the content of many assessment reports is not actually analysis but description. It can be argued that good analysis takes time that is not often available to workers. However, page after page of directionless description takes a long time to write and a long time to read. To make best use of the scarce resource of time we need to become better at providing informed analysis instead of copious narrative. Each piece of information needs to be considered in light of the question ‘What does this mean for this child?’ The term synthesis has an element of finality about it that appears to be at odds with our understanding of some of the difficulties with human reasoning. If we are prone to confirmatory bias then we need to view synthesis as a step along the way rather than our final destination. Assessment must be dynamic, not static. This means that our synthesis (our most likely explanation) is only valid here and now. We need to be able to bring our analysis to a conclusion so that we can use our assessment to underpin action and intervention. However, assessments and interventions need to be reviewed and evaluated regularly. The following example was provided in an assignment on assessment written by a social worker in a child health setting. It provides a good example of dialectics in practice and is shared with the practitioner’s kind permission. The child in question had autism and had associated needs with regard to communication and a range of social, emotional and behavioural issues. A routine medical examination identified bruising that might have been indicative of sexual abuse or may have been a consequence of the child’s bowel difficulties. In carrying out the investigation the practitioner gave
DEVELOPING EXPLANATIONS / 111
consideration to a broad range of possible explanations and worked through each one looking for confirming and disconfirming evidence. The practitioner identified that many of the possible indicators of child sexual abuse were also features of the child’s autism. The particular vulnerability of this child (such as their communication difficulties and need for multiple intimate carers) was given explicit consideration and taken into account in both the specific investigation and in the ongoing assessment and intervention plan.
The analytical practitioner – opportunity, motivation and ability In addition to difficulties that can arise as a consequence of pitfalls in cognitive processing, we also need to consider the way in which practitioners operate and some of the practical considerations involved in critical appraisal. When I have asked practitioners ‘Where do you do your thinking about work?’ most responses echo Morrison’s (1997) account of the middle manager who described herself as: …paid for ‘doing’ – outputs, tasks and so on; as far as ‘thinking’ was concerned she should do that at home or at the weekend, but as for ‘feeling’ she should not bother to do that at all. (Morrison 1997, p.193)
This is a rather dispiriting reflection on practice that not only devalues analysis but actually appears to militate against it. It is almost as if the consequences of thinking and feeling are too dangerous or uncomfortable to be tolerated by either the individual or the organization. At an individual level, analytical thinking may be hampered by the psychological defences that workers use to manage the kind of feelings generated by child welfare and protection work. Practitioners have described anxiety in relation to child and family work with words such as ‘stressful, worrying, terrified, nerve-wracking and scary’ (Taylor et al. 2008, p.26). Accounts from children and young people suggest that workers may protect themselves in direct work with children and young people by minimizing abuse and disengaging emotionally from their clients (Mudaly and Goddard 2006). We may be physically present but we are somehow emotionally absent in the eyes of the child. A lack of emotional congruity and validation of children and young people’s experiences can, at best, reduce the effectiveness of analysis and, at worst, reduce people to objects rather than subjects.
112 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Thinking can be a difficult pursuit at the best of times. Anyone who has recently written an essay or assignment will know just how difficult it can be to knuckle down and organize our thoughts. Other mundane but more straightforward tasks (such as cleaning or ironing) can become rather enticing. Even when you have started the work of thinking and analysing, it can be a frustrating and challenging process and one that can easily be interrupted. Recognition of these facts makes it all the clearer that good intentions are not enough. If we are to find a place for thinking and analysis we need to create the structures and environment that create a physical and mental space for thinking and a means of supporting effective hypothesis development within the space available. At both an individual and organizational level, it can be easy to become hooked on ‘doing’. There are certainly plenty of opportunities for ‘doing’ and it may be easier and more rewarding to attend to some of these ‘clanging bells’ than the quieter alarms that signal the need for thinking. The ‘professional accommodation’ (Morrison 1997) of responsibility can result in workers taking on individual responsibility and feelings of failure and blame for issues that are actually structural and organizational in nature. Morrison (1997) suggests that we may psychologically try to manage the stress and anxiety of child protection work by taking on more and more personal responsibility for events and outcomes. For example, although the real issue may be the unmanageable caseload, the worker’s response may be to try to attend to this as an individual: ‘If only I could be quicker at case recording’, ‘Anna gets all her home visits done on time, why can’t I?’ Victoria Climbié’s social worker, Lisa Arthurworrey, had actually accumulated 52 days off in lieu leading up to Victoria’s death (Laming 2003). ‘Doing’ without sufficient time and support for ‘thinking’ and ‘feeling’ can result in intervention without sufficient analysis and understanding. We are potentially more readily rewarded for ‘doing’ than for ‘thinking’. For example, telephone messages and emails need to be responded to quickly and prompt responses tend to gain workers positive feedback from colleagues, clients, managers and other professionals. However, analysis may be less easily recognized and rewarded. How often have you praised someone or been praised for thinking? It tends to be the products of analysis that gain reward, such as recognition of a good assessment report. Such motivating feedback can be in short supply and it is vital that managers ensure that practitioners who have the ability to analyse are afforded the opportunity and motivation to exercise their skills. Of the workers that I have spoken to, most suggest that the office is not a good place for thinking. For example, working in the environment
DEVELOPING EXPLANATIONS / 113
of the open-plan office can provide little opportunity for quiet reflection (Dalzell and Sawyer 2007). Part of this may obviously be down to constant distraction from phone calls, emails and colleagues. It is also noted by many that sitting staring into space looks suspiciously like daydreaming and, at the very least, not being actively engaged in practical tasks must be frowned on in an environment that is defined by ‘doing’ rather than ‘thinking’ or ‘feeling’. A second consideration in the working environment is the way in which critical appraisal (or hypothesizing) is carried out. What are the tools and materials that professionals use to explore, sift and consider the raw data they are analysing? Internalized processes (the thinking and reflection tasks) tend to be done alone and many practitioners refer to the importance of journeys for this purpose. Time spent alone on the bus, walking or in the car is time for critical appraisal of the day’s work. However, the mechanisms for capturing the resultant judgements appear to be missing and we are reliant on memory to ensure that these considerations are there to return to when we are next in work. As one participant in the ‘Analysis in Assessment’ project put it: You don’t tend to have a pen and paper to hand when you reflect, as it is more likely to occur when you are doing something else, such as driving or washing up! (Dalzell and Sawyer 2007, p.5)
Part of the repertoire of skills that the practitioner must build up if they are to remain in the job for long is their ability to put boundaries on their work and ensure that their professional and personal life is held in a balance that is healthy and satisfactory for that individual. The unhealthy intrusion of professional life into the personal world can lead to stress and burn-out. However, the need to ‘close the door’ on work at the end of the day may mean that opportunities for reflection are unhelpfully curtailed. Although some reflection time on the way home may allow the practitioner the opportunity to review experiences and manage emotion and stress, it may not afford sufficiently structured opportunities for the practitioner to develop existing hypotheses or create a lasting memory or record of their thinking that they can return to for further development. The role of ‘other’ is crucial in assisting critical reflection, and talking is an essential part of reflective practice (Ruch 2002). As well as discussion with colleagues and other professionals, regular, meaningful opportunities for appraisal tend to involve another person, either in peer review or line supervision. These are crucial elements in the process of critical reflection and we look at the development of such practice opportunities in more depth in Chapter 7. What is worthy of note here however is just how
114 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
frequently these opportunities are lacking in practice. Particularly in cases where agencies are under considerable strain already, quality peer support and line management may subsequently be under threat, thereby compounding the difficulties faced by workers in judgement and decision making. If opportunities for individual thinking, or thinking with the help of another person, are potentially limited, should we be looking to alternative methods of supporting critical analysis? Some opportunities already exist (see Box 4.4 below). What room is there to develop tools further though? The literature on memory and processing has brought great popularity for writers such as Tony Buzan (e.g. 2002), with new ways of understanding and supporting thinking. Since the mid-1970s a growing popular interest in human thinking has developed into a recognition and desire to improve our capacity for memory and processing. The development of the ‘mindmap’ is one example of how the non-linear nature of thinking can be more effectively harnessed through the use of appropriate tools. Given the relatively negative messages that are returning about the usefulness of assessment frameworks for supporting analysis (Crisp et al. 2007) it may be worth considering how basic technology (like pens and paper) as well as more advanced information technology can be harnessed to support creative and critical thinking in practice. Milner and O’Byrne (2002) suggest that the use of tools such as memos or flip-charts can be useful in helping practitioners manage data and guard against too narrow a focus being taken to the evidence available. Ecomaps and genograms are already widely used and it may be that further development of such tools can effectively support more robust development of hypotheses in practice. For example, many people already use mind-maps and the availability of good software makes this a useful tool for practice.
Box 4.4 Supporting critical analysis – some examples • Workshops and clinics commissioned from voluntary organizations allow workers to take ‘complex’ or ‘stuck’ cases to an outside body to aid analysis. • Staff development services and universities working in partnership to provide a series of workshops focused on analysis in assessment. • Use of team meetings to share and review learning from training and study.
DEVELOPING EXPLANATIONS / 115
Organizations and the environment for analysis There can be a strong effect when workers’ thresholds for response are different from the thresholds their agencies employ (Dalgleish 2003). For example, a worker may feel that the level of need in a child’s life merits intervention, but has been told by their manager that the referral is not enough of a priority to warrant allocation and no further action should be taken. Dalgleish’s work appears to suggest that workers and organizations somehow police their own borders and find ways of making the difference in thresholds ‘disappear’. Dalgleish (2003) calls on evidence from earlier studies which suggests that the consequences of a mismatch between a worker’s threshold and the agency’s threshold have the potential for a negative impact on practice: if the worker’s threshold for action was lower than the agency’s, there was the potential to affect the worker’s health and performance. Alternatively, the worker could work round the problem by unconsciously manipulating the case data to provide clearer support for their decision. Frameworks may not actually be a magic bullet for analysis and, in reality, workers may actually arrive at a decision and then ‘fill in’ the framework retrospectively in such a way as to support their conclusions. This is not to say that these actions are conscious or deliberate but it does point to the growing body of evidence that indicates the need for a more effective set of supports for analysis in assessment (Crisp et al. 2007). Decision theorists (Simon 1987) tend to emphasize the importance of the decision-making environment, not just the abilities of the human mind. Previous examples have tried to illustrate this; for example, driving requires intuition and fast unthinking responses, while decisions like moving house or changing jobs require slower careful deliberation. The decision-making environment in social care can be conceptualized in a variety of ways to illustrate the importance of the environment and, perhaps, the futility of trying to address one part of the decision-making system without concomitant change in the other areas. In Figure 4.6 I have set out a model of the decision-making environment to demonstrate the interactive nature of analysis. We have key components in the individual practitioner, their supervisor and their organization. While each of these factors requires attention in its own right, we must not overlook the way that these component parts interact with each other.
116 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Decisionmaking environment
Organization
Figure 4.6 A model of the decision-making environment
The decision-making environment is created by the worker, the people around them and the wider influences of their profession and employing agency. Supervision and the role of the line manager are crucial. Not only does the line manager have to support effective analysis but they also have to ‘look both ways’ in the organization (Milner and O’Byrne 2002), creating a tension between their support for practitioners’ child-centred analysis and their responsibilities for management of limited resources. All three elements of the decision-making environment interact and the development of more effective analysis cannot be achieved unless the development of practitioner skills in analysis is matched by the development of effective supervision and the creation of frameworks for assessment that can allow practitioners to remain longer in uncertainty and develop multiple testable hypotheses. The decision-making environment can also be visualized as a set of Russian dolls (the toys with one doll opening to reveal another smaller one inside). In terms of the analysis in assessment, the worker is held within the supervisor’s role and they in turn are held by the organization (see Figure 4.7). All three must change shape at the same time for it to be sustained. If a worker, supervisor or organization changes unilaterally, the parts no longer fit and the change becomes unsustainable. Organizations have a level of inertia which means that change may come slowly. If a practitioner is to change their ‘shape’ in terms of practice, their supervisor becomes a vital transition zone.
DEVELOPING EXPLANATIONS / 117
Organization
Supervisor
Worker
Analysis
Figure 4.7 The ecology of analysis
Milner and O’Byrne (2002) viewed the political climate for assessment as a very important aspect of decision making. In their view, a political climate that focuses on risk but also limits resources makes for a very difficult environment for assessment. In light of these views, we are potentially in a strong position currently to reassert the place of analysis in assessment. The key frameworks for child welfare and protection assessment across the UK now more clearly frame risk within a wider holistic consideration of the child or young person’s needs. Indeed, in Scotland Getting It Right for Every Child (Scottish Executive 2005) views risk and need as ‘two sides of the same coin’ (Aldgate and Rose 2006), which necessitates a more nuanced analysis of risk and a move away from the search for actuarial tools that has been seen in other areas of assessment, such as criminal and youth justice.
Developing multiple testable hypotheses In any assessment there comes a time when you must move from gathering and sorting information to making sense of it all in relation to the child or young person’s needs. In many assessment frameworks there is even a section titled ‘analysis’. This is where you may need to develop additional ways of ‘showing your working’ on paper so that you can set out your thoughts initially and ensure that you can return to them and refine and reshape them over time. Scott and Walker (IDeA Presentation, Oxford) suggest the use of hypothesis trees but you may prefer memory maps or
118 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
other ways of presenting information. The key is that you write down your first hypothesis and then keep writing until you have come up with a list of alternative explanations. Sheppard (1995) suggests that we can either examine each hypothesis separately, one by one, or we can explore all of them at the same time, seeing which ones emerge as the strongest as the assessment progresses. These hypotheses need to be reasonable but the difficulty may be actually that there will be possible explanations out there that you simply don’t know about. For example, if your computer has stopped working, it may be difficult to work out the reason why because you do not have the level of IT knowledge required to come up with explanations. The use of consultation through formal and informal supervision is a vital way of drawing on the knowledge and experience of others to create and test hypotheses. Tools for hypothesizing need to be personal and pragmatic. They need to make sense to you and they are no use if you don’t use them so they have to be accessible and easy to use. Keep a transparent wallet at the back of your file so that you can hold on to these maps and make it part of your practice to use them. Research (e.g. Scottish Executive 2002) suggests that assessments tend to be better in short-term work and that the quality of assessments can reduce in the longer term, leading to ‘drift’ and a failure to revise risk assessments. Particularly in longer-term work then, it is imperative that you create regular opportunities for reviewing your hypotheses and checking their validity in light of the latest circumstances and information. Review opportunities exist naturally where children and young people are subject to child protection registration or are looked after by the local authority. If these opportunities do not exist for any child or young person on your caseload, you need to ensure that alternative points for review are created and systems exist to ensure their continued reappearance in your diary. Reder and Duncan (1999) advise that we create hypotheses that are ‘testable’. We need to be willing to take our ideas out into the field of practice and check their validity against other sources of data. Dalzell and Sawyer (2007) used the following exercise in a group setting but there is no reason why this could not equally be used on an individual basis. Draw a two-column table and put each hypothesis in a box in the left-hand column. Then for each hypothesis, make a note next to it of the method that will be used to test the validity of the hypothesis. In Figure 4.8 you can see the possible explanations generated for the situation of a child of three who is not meeting her developmental milestones and initial home
DEVELOPING EXPLANATIONS / 119
visits indicate possible issues around parental mental health and material deprivation.
Hypothesis • Organic reasons for delay • Attachment issues • Parental preoccupation • Other unknown adult in home
Method for checking hypothesis • Check with health visitor and general practitioner • Observe parent/child interactions • Complete ‘daily hassles’ sheet • Check with housing and police
Figure 4.8 An example of methods for testing hypotheses
When carrying out assessments it is important to build self-questioning into practice. While high levels of self-doubt can be incapacitating, high levels of confidence can be equally damaging and can blind us to the reality of the situation. When reviewing information about a child or young person’s circumstances run each piece of data past the filter of the following questions: • Is this fact or opinion? • Can it be proven? • What is the evidence that supports the explanation? • What evidence might challenge the explanation? • What are my strongest feelings about this situation? • How might my feeling affect my thinking?
Summary Developing hypotheses or tentative explanations lies at the heart of conscious and deliberate analysis. Through a combination of inductive and deductive reasoning we use theory and observation to draw inferences from the raw data and ascribe meaning to events, actions, and so on. We are now
120 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
more aware of some of the common errors of reasoning that can negatively affect the validity and accuracy of our analysis. The American philosopher and educator John Dewey believed that ‘Genuine ignorance is more profitable because it is likely to be accompanied by humility, curiosity, and open-mindedness…’ (Dewey 1910, p.177) Being able to admit to ourselves and others that our hypotheses may need revision takes professional confidence and organizational support. A drive for the reduction of uncertainty has been shown to be unrealistic and unachievable (Hammond 1996) and practitioners need to be educated to work within uncertainty. To this end knowledge should not be seen as information simply to be replicated or applied; knowledge needs to be seen as created through critical reflection and theory and research to develop deepening understandings of clients and their difficulties (Taylor and White 2006). Adopting the principles of good qualitative research may help improve the quality of assessments (Milner and O’Byrne 2002). Good assessments take time and we need time and support to avoid a siege mentality that may see analysis shut down too early to prioritize the agency before the child or young person. Quality assessments require practitioners to move from intuition to analysis. However, analytical thinking is prone to bias and error just as intuition is. Accurate and empathic analysis requires rigour in individual practice but it is vital that this individual practice is supported within the organization.
Chapter Five
Using Intuition Effectively
What is intuition? Box 5.1 Intuition – ‘Immediate apprehension by the intellect alone: a particular act of such apprehension.’ Oxford English Dictionary
Many writers in the field of child welfare and protection discuss the concept of intuition and its place in the wider sphere of making judgements about and on behalf of vulnerable children and young people. However, not many of them actually give a lot of space to defining what we mean by intuition. Furthermore, the general tone of writing suggests that intuition may be something that we all make use of, but it needs to be treated with caution. The ‘What’s bad?’ literature (such as serious case reviews, inquiry reports and overview analyses of such publications) tends to focus on the downsides to intuitive judgement. This tendency follows a strong tradition begun in the 1970s with Tversky and Kahneman’s (1974) highly influential ‘heuristics and biases’ work. By attaching the value-laden term ‘bias’ to heuristics, these important features of intuitive thinking have been inseparably linked, thereby creating a lasting image of intuition as reasoning that is muddled, inconsistent and problematic. More recent research (e.g. Gigerenzer et al. 1999) has begun to challenge the hegemony of the ‘heuristics and biases’ work. There is an evidence base now that strongly suggests that the research methodology originally applied 121
122 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
to intuition may have been a source of error. New approaches to researching intuitive judgement have shown intuition to be more effective and reliable than suggested by Tversky and Kahneman’s (1974) earlier work. However, even in the field of psychology there is still vigorous and ongoing debate about the place and nature of intuition. Although more recent reports into child welfare and protection practice (e.g. Hawthorn and Wilson 2009; Laming 2009) have begun to encourage and support practitioners to make better use of intuition, there is still relatively little available in terms of the ‘What works?’ literature that provides the necessary frameworks to harness intuition in an effective way in practice. Although we are beginning to understand intuition more fully in relation to assessment and analysis, the over-riding attitude in the literature is still one of negativity and caution. Recent work on supervision (Children’s Workforce Development Council (CWDC) 2009) has a handy sign next to the section on ‘intuition and bias’, just so you know what to think about intuition. It has a road-sign warning triangle with an exclamation mark in it to signify a source of danger. The message clearly is still that intuition is a loose cannon and a source of danger, to be guarded against and constrained rather than understood and employed. While the wider literature on intuition is now beginning to question some of the earlier concerns about intuitive judgement, there is still some way to go before such work can be applied with greater confidence in the field of child welfare and protection. Munro (2008) uses metaphors that liken intuition to a good secretary who needs a personal trainer to keep the worst excesses of intuition under control. I would agree with Munro that intuition requires careful handling, but I would suggest that this is true of any reasoning style, wherever on the ‘cognitive continuum’ it may sit. Both intuition and analytic thinking need to be better understood and more explicitly considered before we can learn to use these tools more effectively in the challenging environment of child welfare and protection. Wilson (2002) offers the notion of intuition like an autopilot on an aeroplane, with the conscious mind delegating a lot of complex and demanding processes quite safely to the adaptive unconscious. The emphasis may need to be placed on when it is safe to use the autopilot and when the conscious mind needs to take the controls. The danger may be that current guidance appears to view analytical reasoning as inherently superior to intuition. Practitioners are given the implicit message that more time for explicit, rational analysis is required. However, the features of the decision-making environment, such as pressures of time, complexity and
USING INTUITION EFFECTIVELY / 123
uncertainty, may result in workers continuing to work on intuition without truthfully acknowledging this to themselves or their organizations. Intuition comes from the Latin word ‘intueri’ which means literally ‘to look inside’ or ‘to contemplate’. Most mainstream contemporary uses of the world tend to gather around suggestions of intuition as knowledge without reasoning, insight, something quick and without conscious effort. More recent research and writing has reflected a general move away from the view that intuition is part of perception to understandings of intuition as part of the process and apparatus of judgement. Intuition as a concept is echoed in common usage, with phrases like ‘gut reaction’, ‘a woman’s intuition’, ‘instinctive reaction’ or ‘acting on a hunch’ all demonstrating some of our beliefs and values with regard to this form of reasoning. Intuition is a way of thinking that we all employ (usually very effectively) in day-to-day life.
Box 5.2 An example of intuition As your train pulls into the platform, you begin the process of choosing a seat. There is probably not much conscious thinking going on; no voice saying to you ‘go further down the platform where the train’s likely to be quieter’, ‘get one by the window’, ‘not that one; it’s too close to the toilet’, ‘not next to them, they look uncomfortable with people’. There is however an inner monologue that is issuing all these commands and warnings and this is the voice of your intuition guiding you without conscious effort.
Where does intuition come from? It appears to be heavily influenced by some deep-seated instinctual responses, such as an aversion to sources of disease, or dangers such as aggression. For example, most people find the sight of a dead animal quite uncomfortable and will seek to divert their senses from it by moving away, looking away, not breathing through the nose; we instinctually or intuitively know that exposure to such material may be potentially harmful to us as a source of pathogens. Babies very quickly develop sensory and motor skills that allow them to look into the eyes of their caregivers. Again, there appears to be an intuitive understanding, not a learnt one, that faces are the doors to people’s minds. In trying to make sense of emotions and their expression, the child seeks meaning in their carer’s face.
124 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
This process of attunement is fundamental to secure attachments and relies on the instinctual drive in babies to look for the minute and subtle cues in facial muscles that say ‘I’m happy’ or ‘I’m puzzled’.
Box 5.3 Smiling, orienting toward others, shared gaze, looking where others are looking, and imitating facial gestures and movements are all driven by instinct and serve to jumpstart processes of bonding and communication. Cozolino (2002) cited in Howe (2005, p.27)
One group of people who demonstrate the impact of not having the ability to read faces as the clue to the inner world of others is people with autistic spectrum disorders. Klin et al. (2002) demonstrated that the impact of autistic spectrum disorders can be an absence of this ‘mind-reading’ intuition. Klin’s research tracked eye movements with participants watching films and found that, although most participants were instinctually attracted to looking at faces and eyes, people with autism did not look at faces but more often looked at inanimate objects. Without this intuitive capacity for ‘mind reading’ – what Baron-Cohen (1995) referred to as ‘mind-blindness’, there really is little to be gained from looking at faces, and alternative methods of problem solving have to be found and developed.
Box 5.4 An example of mind-reading intuition In the course of a routine child welfare enquiry, a home visit is made by the child’s health visitor and the duty social worker. The child appears at ease and plays on the floor close to her mother. Both parents acknowledge the concerns discussed and provide plausible explanations for events. There appears to be no significant level of risk or unmet need and both workers leave the house. On the way back to the car the health visitor asks the social worker ‘How do you think that went?’ The social worker was about to comment on what was said and how the parents acted but instead takes a risk and admits ‘That felt odd.’ Despite all the positive indicators, something did not feel right. This prompts the health visitor to note what she thought was a fleeting
USING INTUITION EFFECTIVELY / 125
look of fear on the mother’s face at one point. This discussion about intuitive feelings tipped their analysis from overwhelmingly positive to sceptical and provoked a decision to ask more questions about the family’s details and background.
Intuition is often equated with a gut feeling. This suggests an element of ‘somatization’ – our thinking has somehow found a physical outlet for its expression. Just as a dread of school can result in a somatized illness such as toothache, our intuition often only reaches us in a physical manifestation. Planalp (1999) views the emotions as outriders, giving us early warnings. In a way our intuitions are similar; they give us an early warning but it is then up to the conscious brain to decide what to do with the warning. Frameworks for assessment do not usually provide a place for the consideration of ‘feelings’, and many practitioners are, quite rightly, nervous about recording sections of assessments that are, at that point, nothing more than a hunch or a feeling. Recent research (Soon et al. 2008) has provided some challenges to our notions of free will by suggesting that our decisions are actually made by the unconscious brain long before we make a conscious decision. With the use of brain scanning and sophisticated software, researchers have shown what happens in the human brain just before a person makes a decision. People were studied making a simple choice of whether to press a button with their left hand or their right hand. Imaging showed that the part of the brain that makes this decision was active up to seven seconds before the participants actively decided to use a particular hand. Although the study could not show how the decision was finally made, it does point to the enormous importance of subconscious judgements in our supposedly conscious judgements and decisions. This is particularly poignant when we place so much faith in professional judgement that may, in reality, be beyond our conscious control and understanding.
How does intuition work and where does it come from? Intuitive decision making is now understood to take place in the parts of the brain that humans have maintained from much earlier evolutionary times (Munro 2008). We share this ‘old’ part of our brain (the cortex) with
126 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
other animals and it is this part that manages the ‘fast and frugal’ (Simon 1987) thinking that has kept us, generally, out of trouble so efficiently for all these years. One area of capability that makes us humans so evolutionarily effective (and perhaps so terrifying) though is not our quick reflexes or speed of action. What defines us is our enormous curiosity and inventiveness. Our intelligence and creativity as a species come to us courtesy of the evolution of an enormous prefrontal cortex. The neocortex in most mammals is fairly well developed, but is still quite small and smooth in relation to humans, whose neocortex is much larger and contains many folds and convolutions that serve to expand the available surface area (Bee and Boyd 2007). The neocortex gives humans the processing power that facilitates analytical thinking. However, Demascio (cited in Munro 2008) notes that the neocortex was not developed for rationality independent of the old brain core (subcortex). In fact, it is the neocortex and the subcortex working together that provide the basis for human reasoning. Gigerenzer and colleagues (1999, 2007) have done much to challenge the long-accepted rule that all intelligence is deliberate and conscious. While most accepted wisdom has emphasized the importance of rational, deliberate reasoning, more recent work has begun to recognize that very often we know what we should do; we just don’t know why we should do it. In Chapter 1 I began to map out the different visions that have been proposed about the way human beings make judgements. Some believe in unbounded rationality – a vision of judgement based on an omniscient mind that pays little heed to the limitations of time or computational capacity. In this model we make decisions by carefully examining every single piece of information, ascribing values to each possible outcome before choosing the option with the highest value. Others believe in bounded rationality – this view of judgement assumes that we can never have access to every single piece of information, nor do we have the time or thinking capacity to be able to process it all. Therefore we must find ways of taking short-cuts and making judgements on partial or incomplete information. Gigerenzer (2007) believes that intuition, as a form of unbounded reasoning, consists of two main features: • heuristics (or rules of thumb) • evolved capacities. First we explore what these rules of thumb look like and consider the theory and messages from research about how intuitive judgements are made. The
USING INTUITION EFFECTIVELY / 127
latter part of the chapter then looks at the way in which intuition has been considered by researchers and practitioners in child welfare and protection work. Finally, we explore how some of the findings from contemporary research may begin to influence the development of models for supporting judgement that build on some of these evolved capacities.
Heuristics or rules of thumb Rules of thumb help us make different types of decisions, such as rules to help us direct our searches (with elimination strategies and classifications), know when to stop searching (‘satisficing’ heuristics) and what to do with the results of our searches (such as ‘one-reason’ decision rules). Tversky and Kahneman (1974) identified three key heuristics, but more recent work has expanded on these models and many of the findings of these original pieces of research have been questioned in terms of experimental methodology and the robustness of the theoretical models generated when subjected to statistical modelling. We consider some of the key messages and debates emerging, but it should be emphasized that work on judgement and decision making is complex and rapidly developing.
The recognition heuristic – ‘Have I seen this before?’ Recognition is our capacity to distinguish between things we have experienced previously and things we have not: the new and the old (Gigerenzer 2007). The evolution of a capacity to judge quickly ‘Have I seen this before?’ has been seen as a key aspect of much animal and human behaviour. For example, this capacity allows an animal to make a snap judgement about whether or not something is likely to be safe to eat, or whether the approaching animal is likely to be a threat.
Box 5.5 The recognition heuristic You are attending a conference in a nearby city. As you walk into the foyer you see some people you know. You wave and plan to go over to speak to them. All around you are people that you do not know and you pay them little attention. However, there is a third group of people; their faces are familiar and you feel that you have seen them before, you just can’t quite tell where or when. This is the powerful recognition heuristic in action.
128 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Research (Standing 1973) demonstrated the amazing power of human recognition. After being shown 10,000 pictures for just five seconds each, participants were able to recognize an average of 8300 two days later. Although our capacity for recognition of faces is particularly well developed, these pictures were of a wide range of subjects; some ‘normal’ and some ‘striking’, pre-selected for their vividness. Regardless of the subject of the picture, recall rates were extremely high. Although we may legitimately ask questions of recognition percentages as the numbers go up, the absolute number of pictures recognized keeps going up. The recognition heuristic is understood and consistently utilized in the world of marketing. This rule of thumb about choosing between two alternatives can be expressed as ‘If you recognize one object but not the other, then infer that the recognized object has a higher value’ (Gigerenzer 2007, p.113). Therefore, you may be more inclined to buy your car insurance from a recognized company rather than from one you have not heard of before. If you recognize the brand of cereal there is an assumption that it is better or tastier than one you have not heard of. Marketing seeks to ensure that we recognize a brand or product and that we create positive associations with that object so that this heuristic can be exploited. Taken into the world of child welfare and protection, this heuristic should help us understand more clearly some of our value judgements. For example, as parenting is usually carried out by women, we are more likely to recognize parenting as ‘mothering’. Mothers as parents are therefore potentially more likely to be recognized than fathers as parents; the heuristic applies a higher value to things we recognize (have seen before), so ‘mothering’ is viewed as better than ‘fathering’. White English-speaking Christian images flood our perceptions, whereas images of minority ethnicity, language and faith groups are notably missing. If you ever want to see the power of the recognition heuristic on your own thinking, take the Implicit Assumption Test at www.implicit.harvard.edu/implicit. The recognition heuristic should not be confused with another rule of thumb known as the ‘availability heuristic’. The availability heuristic (Tversky and Kahneman 1974) concerns the speed and order with which we can bring to mind items that are in our memory. Recall however is not as strong a capability as recognition and the recognition heuristic only concerns itself with whether an item is in our memory or not: we have either experienced this before or we have not.
USING INTUITION EFFECTIVELY / 129
Representativeness heuristic – ‘Does this come from a group I know?’ This is a rather abstract concept so it may be worthwhile starting with an example that a number of authors (e.g. Gigerenzer 2007; Plous 1993) have used to demonstrate the kinds of biases that can flow from this heuristic. The question in Box 5.6 should show how this can work.
Box 5.6 The Linda problem Linda is 31 years old, single, outspoken and very bright. She majored in philosophy. As a student, she was deeply concerned with issues of discrimination and social justice, and also participated in anti-nuclear demonstrations. Which of these is the most likely alternative? A. Linda is a bank teller. B. Linda is a bank teller and is active in the feminist movement.
It is more likely that you have chosen the second option; answer B. More people feel that Linda is likely to be a feminist bank teller than merely a bank teller. This is despite the fact that it has to be statistically less likely that Linda is both a bank teller and active in the feminist movement. The rules of probability are undisputable that the co-occurrence of two events (bank teller and active in the feminist movement) cannot be more probable than one event (bank teller). Despite knowing this, we still opt for answer B. It has been shown that we are all prone to this bias, known as the ‘conjunction fallacy’ (Tversky and Kahneman 1982). When provided with increasing levels of detail, we become increasingly blind to statistical probability and more likely to choose the option we have more vivid images of. Does this mean that this heuristic is therefore always going to be a potential source of error? We regularly face situations where we need to make a decision about which category something belongs to, and we need to make this decision quickly and with limited information. For example, if you see someone approaching you as you walk alone on a quiet, dark street, you will need to decide quickly whether you keep walking towards them or take another course of action. It is likely that your classification of the threat that the person poses will be based on some simple cues such as gender, size, clothing, and so on. This is an example of fast and frugal decision making,
130 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
which uses the representativeness heuristic to help us with judgement and keep us safe. Gigerenzer et al. (1999) took another look at the ‘Linda problem’ experiment and raised important questions about Tversky and Kahneman’s (1982) research and the proposed dangers of the conjunction fallacy. While the original researchers were looking at statistical relevance (two cooccurring events cannot be more likely than one alone), Gigerenzer looked at the framing of the question and how this may influence judgement. He suggested that our tendency to choose the unlikely option (Linda is a bank teller and active in the feminist movement) is actually the wise choice if we take ‘probable’ in its non-statistical meaning (plausible, believable). If the question is posed as in Box 5.7, different responses begin to emerge.
Box 5.7 There are 100 people who fit the description of Linda. How many are A. bank tellers? B. bank tellers and active in the feminist movement?
The way in which the question was posed was crucial (Hertwig and Gigerenzer 1999). Posed in the way above, the conjunction fallacy disappears. Our intuition tells us that if we are being provided with this information then it must be relevant. This suggests that, while we need to be wary of bias from levels of detail available, we also need to be aware of conversational norms and the assumption that the speaker is being relevant. So the issue of representativeness may be a cognitive issue but it may also be relevant to communication skills. We perhaps need to be particularly interested in the ‘mediator’ (Gigerenzer et al. 1999, p.42) as the variable in the environment that influences the judgement. We correlate the things we recognize with values (e.g. best worst, highest, smallest, etc.) but, when we have no direct experience of these things ourselves, we rely on the ‘mediator’ to help us ‘see round the corner’ and make that judgement. In the absence of direct information about the criteria, we make use of a surrogate correlation. For example, we may not know how a young person broke their jaw as they will not say and both their parents deny any knowledge. Direct information is therefore unavailable. However, mediators exist in media reporting of child abuse
USING INTUITION EFFECTIVELY / 131
and violence, and in the literature on areas such as domestic violence, child development, parenting capacity and the impact of adversity on both. These mediators are likely to be the sources that inform our ‘gut feelings’ about possible explanations.
Practice examples What do you think may be the possible mediators in these examples? 1. A child has been sick for a long time and no organic cause can be found. What do you think is causing this? 2. A young person is displaying worryingly sexualized behaviour. What might this signify? 3. A parent has been growing less cooperative and is often not in when you visit. What do you think might be influencing this behaviour? Running through these examples myself, I find my answers tend to cover a lot of ground – such as: 1. Induced fictitious illness, undiagnosed but real medical symptoms, somatized psychological difficulties or accidental poisoning. 2. The young person has been sexually abused or exposed to inappropriate sexual behaviour. 3. The parent might have been upset by me or my agency; they may have a new partner or have something to hide. What are the mediators though? What have I used to try to see round the corner to make the correlation between what I am seeing and what understanding I am trying to create? Theory? Quite possibly but not in an explicit manner. Media? Definitely: I have just read a report on a child killed by her mother’s partner where the mother reduced cooperation because of her partner’s influence and her involvement in drugs and prostitution. What we need to be aware of is the validity of the mediator. We may be using mediators that paint an inaccurate picture for us. For example, media representations of induced illness create very vivid images that rise to the fore when considering such presenting illness. However, the strength of these thoughts does not reflect the statistical likelihood of this being the cause of the illness. Equally, there has been seen to be a preponderance of negative images of men in social work literature (Clapton 2009), which may have led me towards thinking about the influence of a man on someone reducing contact with an agency. We need to consider that the most vivid
132 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
and immediate thought may not be accurate. We need to ensure that we seek and test out a number of different possible explanations, and be ready to question our own and other people’s views. Perhaps heuristics have been masquerading as values and we need to ensure that values are discussed in a clear and explicit way so that their influence on our judgement can be considered.
Anchoring and adjustment Answer the question in Box 5.8:
Box 5.8 Test A Question: Is the probability of a child whose parents use heroin being neglected greater or less than 10%? Answer: Question: What do you think the exact percentage is? Answer:
If you were asked the question in Box 5.9, do you think you would give a different answer?
Box 5.9 Test B Question: Is the probability of a child whose parents use heroin being neglected greater or less than 70%? Answer: Question: What do you think the exact percentage is? Answer:
As you have seen the two questions together, you are likely to give the same answers, but separately these questions can lead to very different estimates. When tested, people consistently offer lower percentages for question A and higher percentages for question B. In each of these two pairs of questions the first question provides an ‘anchor’ for the second question. In this way the first question is highly influential for the estimates given to the second
USING INTUITION EFFECTIVELY / 133
question. Research (Quattrone 1982; Tversky and Kahneman 1974) has shown that this tendency is pervasive across a variety of examples including familiar and unfamiliar topics, numbers and non-numerical topics and very extreme anchors. People fail to adjust sufficiently from anchor values, regardless of topic or any incentives. A discussion of best- or worst-case scenarios can lead to unintended anchoring effects (Plous 1993) so the need for multiple anchors is imperative. For example, the messages about outcomes for children looked after away from home are very negative; we know that outcomes (such as education, mental health and income) for this group tend to be poor. We also know that professional levels of aspiration for this group are low too. The anchoring effect of the findings on poor outcomes may be influencing us at an unconscious level to underestimate the potential of children and young people in foster placements and residential units. Be aware of very high or low anchors and generate an extreme opposite for yourself as a counter. Starting your bidding very high or very low will affect people’s following judgements. Laming’s call for an approach of respectful uncertainty (Laming 2003) or healthy scepticism is not merely a reminder not to take things at face value. In terms of the power of anchoring, we must also be willing to question whether or not previous evaluations have unduly influenced our current views.
Availability heuristic – ‘Do I have a memory of this?’ Tversky and Kahneman (1973) proposed the ‘availability heuristic’ as a way of understanding how people make their internal calculations when estimating quantities or frequencies. They found that the way people make such estimates tends to be based purely on what can be brought to mind rather than trying to access the full picture. When faced with a novel situation, your mind calls on memories of similar situations to guide decision making. However, those memories that persist are a filtered selection and it has been found that we are more likely to be able to recall details that are vivid rather than dull or pallid (Plous 1993) and involve human communication rather than written information (Taylor and Thompson 1982). It has been suggested that the availability heuristic may be a significant contributor to errors and biases in judgement. It is therefore an aspect of intuition that merits further investigation. People infer the likelihood of something from how easy it is for them to access their mental sample of previous similar events. In general, frequent events are easier to recall or imagine than infrequent ones. It makes sense
134 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
that you should be more likely to recall memories of frequent events, but our judgement is affected by the environment in which we operate and the environment can make the availability heuristic problematic. For example, research has shown that our decisions can be sensitive to the size of the group affected by them; if we think that our decision is going to affect a small group, rather than a large group, we are more likely to take risky decisions (Wang 1996). In evolutionary terms, our capacity to estimate frequency might be a useful adaptation for survival but we need to understand when it can become a source of error too. Availability in memory is heavily influenced by sources of information such as the media, advertising and fiction. This means that some events are mentioned more frequently than they actually occur and this can skew our judgement when considering the likelihood of them occurring again. Take the example of child abduction. Although this is an extremely rare occurrence, the high prominence of a few examples has led many people to a disproportionate estimation of the chances of this happening to their own family. We know that shark attack is highly unlikely (anywhere in the world let alone in the UK) but that knowledge cannot protect you from hearing the theme music from the film Jaws when swimming in the sea. Despite our knowing that these events are highly unlikely we just can’t help reacting the way we do; our intuitive reasoning cannot be stopped, only better understood. The availability heuristic is about recall not recognition. It is the assessment of frequency (or probability) based on what can be brought to mind (Gigerenzer 1999). It follows the maxim ‘If you can think of it then it must be important’ (Esgate and Groome 2004). Although this rule of thumb may still be of relevance, the environment in which judgements are made is very important and, as we will see later, this particular heuristic is important when considering the impact of modern society and technology on human recall. The availability heuristic has implications for the way we analyse information and the way in which we record information so that other professionals are more likely to make accurate judgements of frequency. Research has shown (Sherman et al. 1985 cited in Plous 1993) that being able to imagine an outcome can influence a person’s belief in the likelihood of that outcome occurring. We really do operate on the belief that something which can be brought to mind must be inherently important to us. Subjects who had been asked to imagine themselves and their symptoms after reading a description of an illness were more likely to think they could catch the disease than subjects who had not been told
USING INTUITION EFFECTIVELY / 135
to imagine their own illness but simply to predict likelihood. Availability in mind has been shown to increase with the vividness of the memory. More vivid information is thought to be more available in memory and therefore more likely to inform judgement than information that is dull and abstract. The power of imagination is clearly powerful but there are also some outcomes that may be so repellent to us that we seem to go into denial about their likelihood (Rothbart 1970 cited in Plous 1993). This form of cognitive denial may be relevant to both practitioners and clients, considering some of the very poor outcomes that each of these groups may be trying to avoid. For example, we may find the idea of a child being killed by their parent absolutely repellent. The prospect of this outcome may be so horrifying that simply being able to imagine it may not actually make it seem more likely.
Pattern recognition Although ‘pattern recognition’ has some very obvious links to the recognition heuristic, this term was not used in any of the key texts on the subject until the new research by Margolis in the late 1980s (Hammond 1996). The concept was more fully explored in terms of naturalistic human judgement by Gary Klein when he examined the way professionals such as fire-fighters make decisions under significant limits of time and information. Munro (2008) cites the work of Klein (1998) to examine the potential relevance of pattern recognition in child welfare and protection work. Klein’s work suggested that humans use metaphor and storytelling in their intuition and that this allows us to draw parallels between previous experiences and what we are facing now. This form of reasoning requires the practitioner to match features of the present situation to their bank of memories of previous situations and to begin to build a narrative that can be examined and evaluated. Although the decision makers in Klein’s work could not say exactly what prompted a decision, they were able to review their actions in retrospect and identify a number of significant cues in the overload of data that they appear to have intuitively picked up. For example a fire-fighter’s decision to evacuate the building was intuitive and immediate. However, in review, they were able to identify the significance of subtle patterns in heat, noise, and so on, which told them that this was a new situation and that this created a potential threat. Later research (e.g. Hertwig, Hoffrage and Martignon 1999) has demonstrated that heuristics can be equal to or more effective than more expensive methods of reasoning when operating in environments where
136 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
knowledge is scarce. Rather than having to scan through all the options available, this heuristic makes use of ‘satisficing’ (Simon 1987) to pick one course of action for a quick mental ‘play-through’. If it works well enough (i.e. it is above an ‘aspirational level’) then it can be put into action without having to go through the alternatives. If it is not up to standard, then the next best choice is taken, repeating the mental ‘play-through’ until a satisfactory course of action has been identified. This kind of naturalistic risk judgement may be carried out by workers in a variety of situations where judgements need to be made quickly with incomplete information, from intake/duty calls to interviews and therapeutic interventions. However, it is important to emphasize the ‘expert’ element of this model: experience is not enough; the practitioner must have been able to learn more than technical mastery to begin to make these kinds of judgements effectively. This takes time plus opportunities for reflection and the support of a learning environment. A move to a systems approach in serious case reviews (Fish, Munro and Bairstow 2008) is a welcome move forward and it may be worthwhile considering the approach that Klein (1998) took in his research to explore expert decision making. The process of professional review of an event after the fact appears to have all the hallmarks of some of the best practice in debriefing. Consider this with reference to learning organizations.
Emotional tagging If you think back to some of the most taxing decisions you have made, these memories are likely to have a strong emotional content. Thinking back to a decision to apply for a job that changed your life, the memory is suffused with happiness and excitement. Remembering the decision to challenge someone about their aggression brings a shiver of fear back to you. Learning through experience happens at a subconscious level as well as through a conscious process of reflection. While much of the literature has concentrated on the deliberate analytical part of the experiential system, the impact of affect (the physical and cognitive manifestation of emotion) also has a strong unconscious influence on our analytical capacity. Scottish philosopher David Hume once said ‘Reason is, and ought to be, the slave of the passions’ (Hume 1734). This appears to run contrary to some fairly stubborn notions of logical and rational judgement where emotion is seen as an unwelcome distorting influence on reasoning. However, since earliest philosophical records, and particularly since the Enlightenment, there has been acceptance that we are not governed by
USING INTUITION EFFECTIVELY / 137
our rational capacities and that our capacity for analysis must take account of the emotional world (our own and other people’s). The literature on reasoning and judgement suggests that there is much to be gained from a consideration of what emotion lends to our judgement. Munro (2008) calls on Demasio (2006) to consider the phenomenon of ‘somatic markers’. This term refers to the largely unconscious emotional content of our recollections of events or images. As an event occurs it is placed in the short-term memory. The seat of long-term memory and the seat of emotional processing are physiologically closely connected and this creates strong links between affect and memory. Two structures called the hippocampus and the amygdala lie close together in the limbic region of the human brain. The hippocampus is thought to be central to learning and memory of facts. The amygdala on the other hand is thought to be the part of the brain that processes emotions. As many of our senses (such as sight, smell and hearing) go straight to the amygdala, we have the capacity to respond very quickly to stimuli; much more quickly and effectively than we could if we left this bit of the processing up to the rational consciousness. Unsurprisingly, given their proximity and many connections, the amygdala and hippocampus work together to make strong connections between emotion and memory. Some of our most powerful and lasting learning comes from emotionally charged events. The emotions attached to a memory can be positive or negative and these emotions are revisited when our memory of the event is recalled. For example, for most people, their memories of events like birthdays or Christmas are pleasant (with positive emotions such as happiness or excitement connected to them). Memories of events like exams or interviews are more likely to carry negative emotions such as fear or shame. Even when not consciously accessed or considered, the impact of these connected emotions is palpable. These emotional tags are thought to provide a quicker and more efficient guide to judgement in a complex and uncertain environment. If the feelings the situation provokes are pleasant, they generate actions and thoughts likely to recreate those feelings. If the feelings are unpleasant (such as fear or shame) they provoke actions and thoughts likely to avoid those feelings. Negative emotions sound the alarm and positive emotions provide an incentive or target (Gilovich, Griffin and Kahneman 2002). The affect heuristic, like all cognitive short-cuts, is unavoidable. You can’t guard against it by simply trying not to let it happen because the affect system operates before the conscious brain. Zajonc (1980) offers the example of a house; when we look at it we don’t just see a house, we
138 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
see a pretentious house, a beautiful house or we may see an ugly house. We make judgements based on what positive emotions are generated and it is possible that we make choices based on these emotions primarily and then justify these choices with virtuous reasons (Gilovich et al. 2002). When the emotional mind finds a connection between a feature of current events and an emotionally charged memory, it triggers the feelings that went with the original event in memory (Goleman 1995). If this happens, we can feel as if we are actually experiencing the past event again. This has a relevance for practice, both in terms of the implications for children, young people and adults who have been traumatized and abused, and for workers who deal with stressful and traumatic events on a regular basis. The affect heuristic also has great importance when it comes to making decisions in uncertainty. When faced with choices, we are averse to loss. Tversky and Kahneman (1974) developed ‘prospect theory’ to help to increase understanding of how intuition can affect judgement. They found that the way risk decisions were framed made a huge difference to the choices that people made. Faced with the prospect of gain, people are more likely to play it safe, but faced with the prospect of loss people are more likely to take risks. Affect heuristics prime us to avoid things that have generated negative emotional tags for us. This loss aversion is then compounded by the risks we have a tendency to take to avoid loss. When it comes to the unconscious brain, it is not the amount of loss or gain that is important, it’s the winning or losing that is the primary concern and we are strongly programmed to avoid loss (Gilovich et al. 2002). Howe (2008a) notes that people who have suffered abuse, neglect and trauma can find that stress causes the more primitive regions of the brain to take over from the conscious, reflective cortex, promoting fight or flight responses before any other. This can help us understand the powerful and sometimes puzzling reactions that are elicited from clients. As many workers also have experiences of abuse and trauma themselves, it is necessary to consider the possibility that professionals too may exhibit behavioural reactions that appear somewhat exaggerated for the circumstances. Supervision is a key part of an organization’s capacity to hold, support and contain their workers. Current developments suggest a longer-term move away from the managerialist agenda of the late 1980s and early 1990s towards an increased recognition of the importance of the therapeutic relationship (Scottish Executive 2006) and a reinvestment in relationship-based services (Howe 2008a) and emotionally intelligent organizations (Morrison 2007).
USING INTUITION EFFECTIVELY / 139
More recent texts (e.g. Howe 2008a) are beginning to offer guidance and support to child welfare and protection workers in terms of the emotional dimension of analysis in assessment. Emotions act as our outriders and offer important information about situations as they unfold.
What’s the problem with intuition? Intuition may have been recognized in popular culture for a long time but it has only relatively recently been subject to more rigorous examination in research. Although it may be a powerful tool, our understandings are relatively underdeveloped, and in the face of mainstream thinking (such as Socratic analysis and unbounded rationality) it is understandable that practitioners and educators alike have been less informed about this area of thinking and less tempted to explore this new approach and move away from the touchstones of judgement that emphasize logic and conscious rationality. Judgement needs to be open to scrutiny and only those with high levels of power are likely to be able to justify the use of intuition and resist demands for analytical reasons. Common sense is always on the side of the author (Hammond 1996) and, while a judge or politician may be able to cite intuition in reaching a legal judgement, it is highly unlikely that practitioners will be allowed to make decisions based on someone’s gut instinct. A manager will want to see a well reasoned and evidenced analysis of a child or young person’s needs before allowing a particular resource to be allocated or a course of action followed. Additionally, intuition is intangible, so when intuitive judgements are found to be wrong, there are no analytically justifiable reasons in the first place and any reasons offered after the fact will be ad hoc and therefore easy to criticize (Hammond 1996). Therefore intuition needs to be connected to conscious analysis. Intuition may guide but it cannot be de-coupled from analysis. What we can do though is gain a better understanding of the processes of intuition and harness this knowledge to paint a fuller picture of judgement – conscious and unconscious. Klein (1998) demonstrated the importance of experiences in shaping our intuition. You need to have experience of a specific decision environment to ensure that the heuristic your brain uses is specific or flexible enough to manage the task. There are many different rules of thumb, as we see from the selection above. For fast and frugal thinking to remain useful it is important that not too many heuristics are developed or we would not be
140 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
able to make the necessary selection efficiently. Instead, we rely on these rules of thumb being sufficiently flexible to be useful and accurate enough to manage a range of different environments in which judgements need to be made. However, we are exposed to many different environments and we need to adapt to them and gain experience before our reasoning can be more fully relied on.
Box 5.10 For example, prior to a career in social work I skippered a small passenger ferry. In this career I learnt to recognize tidal currents until I could intuitively respond to the swirls I could see in the water or a vague pressure I could feel on the wheel. I also learnt about people and could quite accurately begin to predict who would drink too much and who would be more likely to refuse help and fall on disembarkation. Although the first of these skills was of no use at all in social work, it is possible that the second was even counter-productive. I learnt to recognize patterns of behaviour in a specific environment but people act differently on a boat trip from the way they act at home, and the actions I have needed to take in these different environments have also been different.
Experience is crucial to making the best choices in specific environments. In child welfare and protection work the long-standing problems with recruitment and retention mean that many practitioners refer to themselves as ‘experienced’ after only two or three years in practice. Although reflexivity can harness experiential learning very effectively, we need to be wary of intuitive thinking that does not fit the decision-making environment. Modern psychology has demonstrated that there are actually very few differences in cognitive capacities between men and women. What does appear to make a difference is what we think we are good at. For example, when asked to rate themselves on the level of their intuition, women rated themselves more highly than men. When the validity of these beliefs was tested, the men in the study actually had slightly better intuition than the women (Gigerenzer 2007). It is noticeable that popular culture and idiom refer to female intuition but not male intuition. A feminist perspective may allow us to see the connection between women being inferior to men and intuition being inferior to logical analysis. In a field of work where the majority of practitioners are female but the majority of senior management
USING INTUITION EFFECTIVELY / 141
are male, it is possible that gender-based values may also have an impact on how able we are to recognize and value the use of intuition in practice. The long-established view of intuition has been a predominantly negative one. However, this position has been challenged and we are now in an exciting but potentially risky period of development where the power of intuition is more fully recognized but its legitimacy in practice is not yet established. While there is a growing body of literature about the benefits of intuitive reasoning, there is still a need for further applied research into judgement in child welfare and protection practice. While there are voices calling for workers to use intuition more, these are met by voices chastising practitioners for failings of reasoning or for not being analytical enough. In such a period of development, it may be beneficial to start by gaining a fuller understanding of the continuum of reasoning styles and the strengths and weaknesses of each. Once we have a better understanding of intuition we may be more able to gain the benefits while guarding against unintended consequences.
Working effectively with the representativeness heuristic A common question that we intuitively ask in practice is ‘How probable is this?’ For example, how probable is it that this child’s behaviour is linked to a specific issue (such as parental substance use) or how probable is it that this family will be able to make use of the supports offered? This question is at the heart of the representativeness heuristic. When making judgements under conditions of uncertainty, intuition allows us to complete a picture by filling in some of the blank areas with guesses built on previous experiences. Within child welfare and protection work, this heuristic can help us make decisions quickly and effectively. Experience built up over years can effectively exploit intuitive reasoning, assuming that the years of practice you have experienced have been furnished with opportunities for critical reflection and learning. If, however, the years of experience have been characterized by anxiety, reactive fire-fighting practice and overloading, there is always the possibility that this heuristic could work against the best interests of the child. An example of the potential damage that can arise from a bias in representations can be seen in the death of Jasmine Beckford in 1984. Although there were 11 different indicators of neglect in Jasmine’s life, professionals appeared to categorize the case in terms of physical abuse from Jasmine’s father. Because of this representation (or ‘frame’), workers
142 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
understood the risk to be diminished with the departure of Jasmine’s stepfather, Maurice Beckford. When he left the house workers concluded that the risk of physical abuse left with him. By framing the case in terms of abuse, workers failed to pay due attention to the information available, which indicated a significant risk of neglect. By reaching for readily available representations of parenting and family, practitioners may have sought to avoid the loss of family and, in doing so, unwittingly opted for the riskier option. The potential for intuition to become a source of error and bias has been considered by Messer and Jones (1999) in terms of our human tendency towards stereotyping to fit things into schematic boxes. Popular but illinformed beliefs are widespread and even though professional training can help practitioners recognize these, our conscious minds may still be influenced. For example, although it is widely understood that both men and women can and do sexually abuse children (see e.g. Saradjian and Hanks 1996), a glance at any bibliography or selection of newspaper headlines can illustrate the danger of this heuristic leading us to discount information that may suggest sexual abuse by a woman because the majority of accounts and representations are about sexual abuse by men; the representativeness heuristic can lead us astray. Other schematic boxes can be all too easily seen in child welfare and protection. From very early on professional intervention, Victoria Climbié was viewed as a child ‘in need’ in terms of housing. This particular construction of Victoria’s life appears to have followed her around, making it hard for practitioners to reframe what they were seeing and hearing as further information about a child at risk. We considered the work of Firkins and Candlin (2006) in Chapter 3 when we reviewed multi-agency practice. Their research considered the way that risk assessment tools were used in child protection. They found that, although risk assessment tools should be used to consider all the aspects of risk that the model covered, in reality workers tended to form more localized frames for their construction of risk and tended to form a hypothesis (about who was at risk from what) and then ‘find the evidence to fit this frame’ (Firkins and Candlin 2006, p.289). Detail is important but can be misleading. A high degree of specificity can make a scenario look likely because it convinces us that it is part of the bigger representative group. However, probability dictates that the more specific the scenario is, the less likely are the chances of it occurring.
USING INTUITION EFFECTIVELY / 143
Positives and negatives are not on a see-saw The representativeness heuristic can lead people into believing that a run of positive or negative outcomes can influence further outcomes. In statistical terms this is untrue; a coin that has landed heads up ten times still has a 50:50 chance on the next toss. However, there is a stubborn persistence in the intuitive belief that negative events can provoke further negative events. In any chance process we should remember that past events will have no effect on future outcomes (Plous 1993). However, we should remember that while outcomes in child welfare and protection are hard to predict with accuracy, they are usually far from random. Truly random events can and do occur. A child may be born with a particular temperament; parents who are already struggling with their new baby may be affected by crime or a catastrophe like a house fire. However, outcomes are often not chance events but are causally correlated with parental or environmental factors. For example, a child may fall only a couple of feet but acquire a significant brain injury; a parent may die of lung cancer leaving two young children without their mother or father. While statistically improbable and tragic, such events may be linked to parental factors such as levels of child supervision or smoking. These links require attention and analysis in terms of their meaning for the child. When it comes to risk assessment, we must distinguish with clarity those features of the scenario that are positive and those that are negative (including past events). We must ensure that in evaluating strengths and weaknesses we don’t view risk as self-correcting. Simply because we have noted an accumulation of positives, this does not cancel out the negatives; we must see evidence of the reduction of risks as well as the increase in strengths. For example, the parent of the child with a brain injury may now provide good levels of physical care for their child, but this does not mean that the issue of supervision has been resolved. Because of the human tendency to gather evidence selectively to support our favoured explanations it is important to examine strengths and negatives carefully to ensure that our intuitive judgement is supported by a considered analysis of the impact of both strengths and negatives on the child’s developmental needs.
Average is normal Exceptionally good or poor outcomes may be nothing more than that – ‘exceptional’. For example, when a child is praised for doing very well in a test they may not do so well the next time they sit a test. This does not
144 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
mean that the praise caused the regression or that the child should not be praised for fear of provoking failure. It only means that their very good performance was unusual and that they followed it up with a more normal performance thereafter. When measuring and evaluating the efficacy of interventions we need to take care in our interpretations. We have a number of cognitive hurdles to clear and it helps to remember that one swallow does not make a summer and gains in any situation need to be sustained over time.
Working with the availability heuristic Do I have a memory of this? This heuristic can be very subjective, as we have all been exposed to different influences and will have different sets of memories. We will therefore make different judgements based on which memories come to mind most easily. This can be illustrated by variations between levels of fear of crime, as opposed to actual levels of crime. For example, recent media polling suggests that we are increasingly concerned about levels or crime and we believe that crime levels have risen. However, statistics (British Crime Survey (BCS) 2008) show that most forms of crime are either relatively static or dropping. It has been suggested that higher levels of media coverage and more frequent and accessible reporting of crime may be affecting our judgement here. The more we see something then the more probable we think it is, regardless of actual frequency. Messer and Jones (1999) used the example of Christopher Clunis to demonstrate this phenomenon. Christopher Clunis (who was chronically ill with schizophrenia) stabbed Jonathan Zito to death in London in 1992. Levels of interest in this crime, and respective reporting, meant that the public perception of frequency of such crimes by people with mental health problems was very inaccurate in relation to actual reported crime. The importance of the availability heuristic can be readily seen in assessment work. First, those carrying out assessments are regularly exposed to events and circumstances that are, by their very nature, abnormal and unrepresentative of wider statistical patterns. Professional-level analysis needs to be based on a sound understanding of frequency rates. However, information about such rates is frequently unavailable to the practitioner, either because the research base is not there or because the practitioner cannot access it within the timescales they operate to. Second, the residual nature of statutory services can mean that the practitioner’s experiences of outcomes may be negatively weighted. Although positive outcomes (such
USING INTUITION EFFECTIVELY / 145
as a parent ceasing their heroin use) do occur, there are many negative outcomes in practice (from parents refusing to cooperate, through young people whose offending behaviour does not alter, to children who are accommodated only to be abused and neglected further). These negative images are amply reinforced by inaccurate and punitive treatment of child protection work in the popular media. Without support and critical reflection these negative outcomes can become the more readily available memories. Recall of poor outcomes can potentially lead to a form of learnt helplessness where workers can begin to practise as if further poor outcomes are unavoidable. To prevent them becoming inured to the unacceptability of some children’s lives (Scottish Executive 2002) workers need opportunities not only to review what needs to be done better but to understand what promotes positive outcomes, and have success noted and celebrated. If we are to begin to make more accurate distinctions based on probability then we need to know how to judge likelihood in a specific situation against best available information about wider prevalence. This aspect of evidencebased practice requires practitioners to be able to access and understand statistics on relevant issues (e.g. prevalence rates of parental drug and alcohol use). Access to good sources of evidence is now much more readily available. We will consider some ways of developing capacity to utilize these resources in Chapter 7. However, we need to remember that child welfare and protection is an area of practice that is, thankfully, statistically abnormal. Therefore, any evaluation of base rates needs to be given critical consideration. With such small numbers and such complexity to each case, it is important that we pay attention to statistics on prevalence but do not use these in a rigid way that might be counterintuitive to professional analysis. Therefore skills need to be developed not only in accessing statistical data but in using them effectively in support of analysis.
Working with the recognition heuristic Have I seen this before? In the examples above we have considered the way that intuition tries to fill in the gaps to help us see round the corner and make connections when the information is missing or incomplete. Sometimes our gut feelings go unnoticed but often they are there but not openly acknowledged, creating bias and error below the waterline of conscious thought. For example, we may not know what strengths a particular father may possess in terms of parenting capacity. However, the ‘mediator’ that is the mirror helping us look round the corner may be the literature, which has tended either to undervalue male parenting or
146 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
present men predominantly as risks (Daniel and Taylor 2001). As men are less frequently discussed in relation to parenting, the correlation is made that, because men are less frequently mentioned, they have lower value as parents. This is the basis of a damaging assumption that has been suggested to underlie an ongoing failure to engage with men in assessment and could potentially overlook strengths or underestimate risks. The recognition heuristic is an early warning system that lets you know that this is something you have experienced before. The first step in developing practice might therefore be to improve our capacity to hear this message and respond appropriately. When something rings a bell for you, consider whether this may be a consequence of recognition. Do make a note of what you felt, when and in relation to what event. Do review those tentative notes with colleagues; this has the benefit of aiding your own thinking about the significance of your recognition and also pooling the experiences of a wider group of people. Particularly in teams that are settled over a long time, the level of local knowledge can be one of the strongest assets available, and a sense of curiosity about explaining these recognitions can potentially lead to more effective ‘search techniques’, based on higher aspirational levels, and more willingness to look for alternative explanations.
Working with pattern recognition Munro (2008) identifies this as an important facet of reasoning, but one that needs to be handled with caution. First of all, the need to recall previous events requires the practitioner to have a level of expertise that may not be available to some or that may be optimistically overestimated. Second, the potential for bias and distortion in this form of intuitive reasoning is such that reviews and checks are required to guard against error. It is therefore vital that the time and place for more deliberative thinking is also recognized and safeguarded. The place of the learning organization is highlighted in Munro’s comment: Although intuition plays the dominant part in the emergency situation, conscious, deliberative thought is also crucial in the overall process of learning…helping novices see the connections between details or seeing cases as a whole, rather than focusing on specific items of information in isolation. (Munro 2008, p.100)
Experienced practitioners should have developed very good abilities to recognize patterns and respond to signals appropriately. While less
USING INTUITION EFFECTIVELY / 147
experienced practitioners may still have to develop this ability further, the use of experienced colleagues and line managers is an important part of both checking current analysis and developing these skills.
Working with emotional tagging We have considered a number of aspects of intuition so far. Like any of these facets of our unconscious thinking, emotional links are made in our memories whether we like it or not. Rather than trying to dismiss and quieten these signals, we may actually benefit from more open and supportive reflection on their meaning and message. ‘In many of our day-today concerns, feelings outbid thought’ (Howe 2008a, p.91). Regardless of our beliefs in the power of rational thought it would appear that emotions do play a vital part in analysis and we need the support of others to manage the strong emotions engendered by stressful situations. Like the shape under the water that triggers that readily available connection to the shark in Jaws, some of our most traumatic memories are the ones that readily trigger emotional responses when we experience something similar again. This emotional tagging impacts heavily on our cognition and behaviour. I once accommodated three screaming children while their mother stood on the front doorstep with her arms folded. The horror of that event for the children, their mother and me was discussed to an extent but it is only with the benefit of hindsight that I have been able to acknowledge the influence that this had on me, from an inability at the time to see the children’s perspective fully to a longer-term heightened wariness of making duty visits close to 5 o’clock. Like many people, my aversion may not have been acknowledged and unconscious attempts to manage these emotions may have led to unnecessary risks in later practice. The place of support and the ethos of the organization are central to the successful management of emotion and reason in such work. All forms of supervision and support should involve self-reflection and analysis so that the practitioner’s use of self can be maintained and developed (Howe 2008a). The place of the learning organization is vital here.
Box 5.11 If organizations fail to support, ‘hold’ and ‘contain’ their workers, they are in danger of blunting, even destroying the most important resource they have – the emotionally intelligent, available and responsive social worker. Howe (2008a, p.187)
148 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Intuition and analysis – the cognitive continuum The popular image of the relationship between intuition and analysis has been that of a fight. One must overcome the other; but which one would win? The success of any particular style of reasoning depends on the conditions of the task at hand. Both forms of judgement have their strengths and weaknesses but two particular issues regarding analysis in assessment may be worthy of further consideration: 1. We do not appear to have the systems in place currently to make best use of practitioners’ intuition. 2. Practitioners are struggling to make their analysis clear and explicit in writing. It is not so much a question of developing one style of reasoning in favour of the other, but rather of developing practice that allows the strengths of a range of cognitive styles to be harnessed and matched to the task at hand. These two styles of thinking (intuitive and analytical) are not irreconcilable opposites but are two ends of a range that we can move back and forth along, mixing the balance of reasoning strategies to fit the circumstance. This scale has become known as ‘the cognitive continuum’ (Hammond 1996), which captures the notion that cognition (or reasoning) can be fluid and that our reasoning is not a choice between intuition and analysis but a combination of both styles in varying degrees. Between the poles of analysis and intuition, there is a broad middle ground referred to as ‘quasirationality’, simply meaning that it is, to a degree, a mixture of intuition and analysis, often referred to as ‘common sense’ (Hammond 1996; see Figure 5.1).
Intuition
Quasi-rationality
Figure 5.1 Quasi-rationality in the cognitive continuum
Analysis
USING INTUITION EFFECTIVELY / 149
In Chapter 1 the two scenarios in Box 5.12 were considered:
Box 5.12 Driving down a side-street you see a cat dart out from between parked cars. In an instant, you have braked, sworn, swerved and resumed your journey. The party is in full swing and some of the guests are getting rather lively. You are having fun but it’s beginning to feel a bit edgy. You make for the door and are heading down the street as the party breaks into a fight.
If the cat had darted out and you began to measure angles, trajectories and velocity you would not have managed the situation as effectively as your unconscious brain. Analytical thinking was not an option because the adrenalin had already spiked and you were engaged in action before any of this got anywhere near your conscious thinking. You had one shot at it, you didn’t kill the cat, and you may even have added a bit of valuable experience to help you if such a thing should happen again. If you had stayed at the party and tried to figure out why you were feeling edgy, it’s unlikely that you would have avoided the fracas. By the time you had analysed the facial expressions you were seeing, formulated multiple testable hypotheses and considered the body of literature on the subject, you would probably have been the unwilling participant in a rather unseemly scrum. Analytical thinking was not an option because your intuition was already onto it, telling you in no uncertain terms that it had a bad feeling about this and it was time to get out. Equally, it is clear that intuition is limited by intangible nature. It is not acceptable for practitioners to make life-affecting decisions purely on instinct, so there comes a time when we need to offer a deeper and more conscious analysis. The comforting part of the cognitive continuum is the suggestion that it is possible to carry out both types of reasoning. By proposing this continuum, Hammond gave us a model to help give explicit consideration to finding the right blend of intuition and analysis to meet the requirements of the specific task. The skill is being able to move between intuition and analysis without ever releasing your grip on either of the two (Polanyi cited in Hammond 1996).
150 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Hammond suggests that ‘When the limit of one’s rationality is encountered, one begins to draw upon intuitive cognition and vice versa’ (Hammond 1996, p.150). This is an important statement because it asks us to think about where these limits are and when we know that we have reached them. In the case of intuition, the limits might be imposed by the decision-making environment. For example, having worked on intuition in a home visit, you will need to take analytical steps in developing an assessment. However, what happens when you reach the limits of explicit and deliberate analysis? The suggestion from Hammond is that you will then need to utilize your intuition. In situations where information is lacking and outcomes are uncertain, it may be possible, if not likely, that many decisions that we believe to be rational judgements may actually have been formed beyond the limit of our analytical capacity by our intuition. Using intuition is not the problem. Indeed, it can help us generate flashes of inspiration and pick out ideas that our rational analysis could not. The problem is that we may not then take these intuitive thoughts back to the workshop of analytical thinking and therefore not test our hypotheses with sufficient rigour.
Intuition in practice – making the most of evolved capacities We have established that, like it or not, our judgement and therefore the decisions that we make are influenced by unconscious intuition. We have explored just a few of the ‘rules of thumb’ that have been exposed and studied, and we have begun to think about their possible implications for child welfare and practice. Box 5.13 gives a series of exercises and examples to begin to take this area of practice a little bit further forward and to provide some supports to help you use the power of intuition within a cognitive continuum.
Box 5.13 Creating frameworks to support analysis Think about your current caseload of children and young people in need. How many children are you currently working with? e.g. 12 children under 5, 12 children at primary school and 8 young people in adolescence.
USING INTUITION EFFECTIVELY / 151
You will do a lot of thinking about these children. Where and when does this thinking happen? e.g. writing case notes, preparing for home visits, supervision. In the last week, what have been the main areas of your thinking? e.g. understanding and interpreting information, evolving care plans, anticipating parental presentation. How has this thinking been done? e.g. with other people or alone? In assessment report writing, case recording, while walking or driving?
The vast majority of your thinking is likely to be ‘fast and frugal’ analysis, where much of the processing is done at a subconscious level. This is a crucial element of your ability to efficiently manage the vast amounts of raw information you receive each week about the children on your caseload. What we will do now (Box 5.14) is find space to take some of the most urgent issues in your caseload and give your conscious brain an opportunity to consider all the information your unconscious brain has been working on. Fast and frugal analysis can be very helpful, but only when it is accurate, and we know from research that intuitive analysis is subject to a great many influencing factors.
Box 5.14 Identify two opportunities in your working week when you can stop and think in more depth about a particular concern or persistent uncertainty that you have identified. You may only have five minutes but you will make every one count. 1. Make a note of the concern. 2. Note what you know and what you don’t know yet. 3. Identify how you are going to fill the gap in your knowledge. For example: 1. Samantha is at a high level of risk but I know that no foster carer will be able to look after her if we accommodate her. 2. We know that Mrs Lucas is not meeting Samantha’s needs because of her own alcohol use but that she can manage when she is not drinking.
152 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
3. What we don’t know is whether Mrs Lucas can stop drinking in time for Samantha. We also don’t know how Samantha is when other people are looking after her. 4. Speak to substance misuse worker about assessment of Mrs Lucas’s alcohol use and motivation to stop drinking. Speak to Samantha’s school about her care needs and explore with the family times when Samantha is looked after by people other than her mother.
Finding your feet on the cognitive continuum There are three main problems facing the practitioner making judgements (Hollows 2003): 1. To what extent should I employ intuition or analysis, or a mixture of both? 2. How do I know what the right thinking style is in any situation? 3. How can the correct thinking style be supported? In the exercise above, you were asked to think more explicitly about some areas of your analysis in one case. By focusing on a smaller range of indicators (one particular concern) and making your reasoning more explicit (to yourself and in writing) this will have moved your style of thinking from intuition towards analysis. It is possible to gain a better understanding of how these moves are made and gain more control over matching thinking style to the task at hand. I will consider these questions in more detail here and explore developing practice in this area in Chapter 7.
Moving on the continuum When and how do you move your thinking style from predominantly intuitive to predominantly analytical and vice versa? When and how do you know to move? There must be a good match between the judgement style and the structure of the judgement task. We therefore need ways of describing both tasks and cognitive styles. It has been proposed that thinking (cognitive) tasks can be placed on a continuum in terms of their ability to induce intuition, analysis or a mixture of both. Some of the key factors differentiating the poles of this continuum are set out in Figure 5.2.
USING INTUITION EFFECTIVELY / 153
Figure 5.2 Some factors differentiating the poles of the cognitive continuum
You can see from the examples above that a home visit may require an intuitive style of thinking as you will be faced with a lot of information in the form of words, gestures and interactions, home conditions, and so on. However, as you move towards writing your assessment, the task is more likely to induce analytical thinking as you will need to make explicit what the implications of these circumstances are for the child or young person’s needs and establish your legislative and professional mandate or action. If you do not move your judgement style to meet these different types of task, you will be applying the wrong tool to the job. To help match thinking style with the judgement task we need to name some of the properties of intuition and analysis to allow them to be measured. Hammond (1996) proposed the ones shown in Figure 5.3.
154 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Analytical thinking
• Thinking widely about a lot of information Figure 5.3 Some of the properties of intuition and analysis
What moves our cognitive approach along the continuum? Some influencing factors come from within us and some are externally driven. An unexpected requirement to make a judgement quickly will provoke a move to intuitive thinking. For example, new information in a home visit such as a sound from upstairs may require an immediate judgement that means time for analytical cognition is not available. Demands for more time and more rule-governed thinking (such as explicit application of theory) move us towards analytical cognition. For example, if our judgement is challenged by someone, we may be required to take more time to establish our reasoning and explicitly identify the evidence base being used. Failures of cognitive tactics can be disempowering and demoralizing. For example, it can dent your confidence to be told that your assessment report is lacking in analysis. Equally, it can be bewildering when you cannot think quickly enough and then find yourself out of your depth in a quickly moving situation like a home visit. However, it may be helpful to consider these kinds of pressure in terms of cognition. Perhaps your assessments lack analysis because you are still bringing intuitive thinking to an analytical task. Perhaps you are out of your depth in the home visit because you are trying to apply analytical thinking to a task that requires intuitive thinking. An understanding of the need to match task to style can help here and, with such understanding, a failure of cognition may actually stimulate a move on the continuum; if intuition has not proven successful, there may be a requirement to move to a more analytical position.
USING INTUITION EFFECTIVELY / 155
A change in the decision-making environment may also stimulate a move. However, the changing environment requires not just one movement but a constant readjustment or ‘oscillation’ (Hammond 1996) and it is worth remembering that, as the nature of the task changes quite fluidly, so does the cognitive style that we need to apply to the task.
Summary Intuition plays an important part in our analysis. When we are trying to make sense of information about children, their needs and circumstances, our intuition contributes to our analysis in ways that are inaccessible to our conscious, deliberate reasoning. Intuition has been shown to be a form of analysis seated deeply in the evolution of human capacities such as face recognition. Research into the role of intuition in judgement and decision making has been highly influential in the way we view this form of analysis in child welfare and protection. Intuition has been shown to be prone to error and bias, potentially leading to poorly formed judgements and decisions. Developing a clearer understanding of some of these potential pitfalls may allow practitioners to avoid or reduce the impact of them on assessments. More recent research has asked searching questions of the methodology employed in seminal research on intuition and heuristics. A move away from the laboratory into judgement in the field has challenged some assertions about the weaknesses of intuition. There is a growing view that intuitive thinking is not so much cognitive miserliness but fast and frugal thinking, which can be a highly effective approach to analysis in conditions of uncertainty and complexity. Intuition needs to be utilized in collaboration with analytical thinking. Rather than see these forms of thinking as mutually exclusive, the concept of the cognitive continuum sees intuition and analysis as two ends of a range of thinking styles, with a middle ground of ‘quasi-rationality’ allowing for a subtle blending of the two. Being able to match the correct style of thinking to the task at hand is vital to effective analysis, and practitioners need to be capable, motivated and supported to move between intuition and analysis without losing their grip on either.
Chapter Six
The Child at the Centre
Introduction This chapter explores the legislation and policy that guide the work of practitioners carrying out assessments of children and young people’s needs and the risks that they face. The experiences of children and young people in assessment have been captured in a number of studies, with a stark gap becoming obvious between the rhetoric of the guidance and the reality of children and young people’s experiences of assessment. This chapter explores some of the possible reasons why practitioners are not always managing to fulfil their duty to establish and have regard to the views of the child in their analysis. The consequences of such practice are considered before I review some opportunities and tools for practice development to help ensure that assessment effectively places the child or young person at the centre of all analysis.
Childhood and children – perspectives and values Childhood is a social construct and, as such, childhood is a concept that is constantly changing and developing. Currently, the rapid pace and sheer magnitude of change appear to have created tensions between our aspirations and the reality of practice. The dominant discourse is one in which children are still largely viewed through the lens of parental responsibilities, with children viewed as passive dependants or offshoots of their parents (Buckley 2008; Moss and Petrie 2002). We seem to be struggling to share an understanding of ‘childhood’ in the context of child welfare and protection. Views on what we mean by childhood and children are expressed in our news reporting, our popular 157
158 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
media and in our personal and professional values, thoughts and actions. However, we seem to find ourselves caught between poles. On one hand, we appear to view children as innocents and fledglings who may be damaged by involvement in analysing their own needs and circumstances. On the other hand, children and young people have been portrayed as demons or dangerous people who cannot be trusted to know or control themselves in a way that would allow them to contribute as partners in analysis. Some of our views appear to mirror Rousseau’s image of childhood as a time of innocence and of children as vulnerable, dependent and in need of protection (Sayer 2008). A series of high-profile inquiries and investigations continues to emphasize our communal view of children as being both dependent on adults but also at risk from them. Ongoing reporting into the deaths of children and young people at the hands of parents and carers raises society’s bile and strengthens the notion that ‘something’ must be done. However, a rush to protective action and rigidity in response to the attempts of children and young people to speak in confidence may have resulted in a child welfare and protection system that is failing to provide children and young people with the levels of participation and control they desire (Baldwin 2000; Daniel and Vincent 2004). At the other end of the spectrum is the view of children and young people as demons; a threat and the embodiment of societal decline (Jenks 1996). Although the reality is that adults perpetrate the majority of crime and children are more frequently the victims of crime, there is a strong societal tendency (frequently perpetuated by the media) to perceive and respond to children and young people as a threat to be controlled and overcome. In a form of the group decision-making problem or ‘group think’, the tendency of late has been to target children and young people in the anticipation of freeing the next generation from societal difficulties. In the face of a lack of success, interventions may not so much have been re-evaluated as merely ‘ratcheted up’ (Prout and Hallet 2003, p.13). Dependency can take physical form, particularly in younger children who rely on parents and caregivers to meet their basic developmental needs. Dependency is also constructed through, for example, income and social security policies (Fox Harding 1996), education systems and housing provision (National Children’s Home (NCH) 2008). Although there has been a move towards rights for children and young people, there remain sizeable barriers to the rights of children and young people to participate fully in assessments.
THE CHILD AT THE CENTRE / 159
A focus on children and young people The professional duty to hear the voice of the child is enshrined in Article 12 of the UN Convention on the Rights of the Child (1989): States Parties shall assure to the child who is capable of forming his or her own views the right to express those views freely in all matters affecting the child, the views of the child being given due weight in accordance with the age and maturity of the child.
The Children Act 1989 for England and Wales and the Children (Scotland) Act 1995 for Scotland emphasize the following values: • The best interests of children are paramount. • Their welfare should be safeguarded and promoted. • Their views should be heard. • The rights and responsibilities of parents (and other legally responsible adults) should be respected. In translating these values into action it is worth bearing in mind that these legislative frameworks cannot separate out needs and rights. Nor can they avoid the assumption that the needs of children and young people are inextricably linked to the needs of their families (Baldwin 2000). There are many competing voices in the debate about rights, and it is important to ensure that the rhetoric of the Convention and ‘hearing the voice of the child’ finds its way through legislation and policy to actual direct practice. In Scotland, the commitment to hearing the voice of the child is expressed through the Children’s Charter, which was created by and with children and young people. The Charter is translated into action through the Framework for Standards. The 13 statements about what children expect adults to do when they are experiencing harm include: • involve us • listen to us • get to know us • speak with us • take us seriously. In England and Wales, the guidance on the Common Assessment Framework (Department of Health (DoH) 2000, p.10) requires that ‘the child is seen and kept in focus throughout the assessment and that account is always taken of the child’s perspective’. In Scotland, the Guide to Getting It Right
160 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
for Every Child (Scottish Executive 2007a, p.16) requires that ‘children and young people should have their views listened to and they should be involved in decisions that affect them’. We have a growing body of research and literature that emphasizes the importance of ensuring that the child’s lived experience is understood and reflected in our assessments (Munro 2008; Reder et al. 1993). The need to speak directly to children exists right across the spectrum of services. Ofsted (2008, p.17) identified that professionals have frequently failed to speak to children directly, and they note that universal services (such as health and education) are crucial here as their ‘practice and expertise…is critical to the safety of children’, particularly those on the fringes of the child protection system. The focus of analysis is decided by the assessor, but assessors are influenced by numerous factors, such as the presenting circumstances, the team ethos and the guidance provided. However, they are also guided by macro-level issues and internal factors. Assessments in the 1970s and 1980s emphasized a forensic approach, lending itself to the identification of physical abuse to the detriment of sexual or emotional abuse or neglect (Horwath 2007b). A move to a more holistic developmental approach to assessment in the late 1980s was not without difficulty either. For example, Woodcock (2003) criticized workers for focusing too heavily on parents’ capacity to carry out certain parenting tasks, rather than a psycho-social analysis of the parents’ circumstances. This focus on past events and parents’ histories may not sit easily with a practitioner schooled in solution-focused approaches or brief interventions. More recently the DoH Framework in England and Wales, and the Integrated Assessment Framework (IAF) in Scotland, have both come under scrutiny with regard to the assessment of risk within these needs-based frameworks (Aldgate and Rose 2006; Calder 2008).
Children’s perspectives and experiences Despite the considerable steps that have been taken in the last 20 years to secure better rights for children, there are still some significant difficulties in representing children’s views and experiences in assessment. An overview of the findings of 50 serious case reviews carried out between April 2007 and March 2008 (Ofsted 2008, p.18) noted: Possibly the single most significant practice failing throughout the majority of the serious case reviews – the failure of all professionals to see the situation from the child’s perspective and experience; to see
THE CHILD AT THE CENTRE / 161
and speak to the children; to listen to what they said, to observe how they were and to take serious account of their views in supporting their needs.
Despite the emphasis on partnership and participation in qualifying courses, and the many initiatives from government, there seems to be very little evidence that practitioners are actually managing to keep children and young people at the heart of their analysis. There is a significant gap between our stated aims and our actions when it comes to focusing our assessment practice on the child or young person who the assessment is actually about. Children and young people want to have their views taken into account and to have their experiences listened to and respected (Cleaver et al. 2004). However, it would appear that this is not happening routinely and that practitioners find it difficult actually to ‘hear’ the experiences of children and young people (as opposed to simply listening). The unconscious messages given by some practitioners can even leave children feeling that they are responsible for the practitioner’s discomfort and emotional distance (Mudaly and Goddard 2006). Despite the intended benefits of the Common Assessment Framework (CAF), practitioners are still failing to engage with children in assessment (Gilligan and Manby 2008). The guidance clearly states that the assessment ‘involves working with the child and, as appropriate, their family, and completing the assessment with them’ (Department for Education and Skills (DfES) 2006). Despite this, children and young people are not routinely or meaningfully involved in their assessments. Children and young people feel that practitioners do not believe them or take their views seriously and talk to the people who they think are important (Cleaver et al. 2004). In one study 72 per cent of the children and young people who were the subject of an assessment were not present at the completion of their assessment form (Gilligan and Manby 2008). Children and young people benefit from practitioners taking time to explain what is happening and why (Cleaver et al. 2004), but the reality is that children are not being routinely and meaningfully involved in their own assessments. Although Scotland has not prescribed timescales for assessment like England and Wales, there are still measures through statistical recording for the Scottish Children’s Reporter’s Administration (SCRA) that are being used to enforce timescales for submission of reports to the Children’s Hearing (which provides the legal decision-making apparatus for the Scottish child welfare and protection system). Although timescales are an important guard against drift, they are also frequently
162 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
viewed by practitioners as a barrier to effective participation by children and young people. If there is not sufficient time to build the relationship, how can the assessment be truly representative of the child’s views? Many children experience child welfare and protection interventions as frightening and difficult to understand. Such stressful events create a very challenging environment for decision making and reasoning, and they impact on our capacity to remember clearly. If you cast your mind back to a stressful event that you yourself have experienced (such as a traffic accident or being physically threatened) it is likely that you will have remembered the emotion much more clearly than the details. The way our brains work means that the emotional memory of stressful events tends to persist but the memory of the detail is lost. Children may not show their distress openly; some children and young people (adults too) may have avoidant models of attachment which mean that they do not view other people as sources of understanding and security. Such people are likely to keep distress to themselves, showing an outward facade of coping. Regardless of the outward presentation we need to ensure that children and young people are left with something that is accessible and will serve as a reminder of what was discussed and decided (Cleaver et al. 2004). Aldgate and McIntosh (2006) in a study of kinship care in Scotland found that where children had been spoken to, they were clear about their care future. However, only one third of the children in the study thought that they had been talked to about how long they would stay in their placement. Some practitioners have been found to be worryingly lacking in fundamental communications skills (Forrester et al. 2008). With a communication mind-set (Reder and Duncan 2004) we emphasize the twoway nature of communication and the responsibility on the practitioner not only to provide the message but also to ensure that it has been received and understood.
Barriers to hearing the voices of children in assessment The gap between the rhetoric and the reality is quite stark. The literature and research would suggest that the following all have a part to play in what has gone wrong (and by inference, what we need to attend to): • our values and views about children and childhood • professional socialization and role • opposition to the children’s rights agenda • motivation
THE CHILD AT THE CENTRE / 163
• practical opportunity • dealing with children’s views. Almost all workers that I have spoken to in the provision of post-qualifying education say that they do not carry out as much direct work with children and young people as they would like to. Some no longer do as much as they did and some, more recently qualified, report that they have never done this kind of work. Some refer to themselves as ‘care managers’ who are not expected to carry out such work, and others live under the constant strain of understanding that they should be doing this work but being unable to do so because of the size of their caseload and levels of bureaucratic responsibility. There is insufficient time to engage meaningfully with children and young people in many instances. However, there is also a lack of confidence and professional understanding of how crucial the child’s lived experience is in developing any effective analysis of their needs. In an evaluation of serious case reviews, Brandon et al. (2008) found that a key issue running through these situations where some of the worst possible outcomes had occurred was the failure of professionals to speak to the child alone. An accompanying feature was the undue reliance placed on what the parents said. Parents, and particularly the mother, appear to have had the ability to persuade professionals of their commitment to parenting and convinced them that they had genuinely learnt from experience and matured to a point where the risks (of abuse) were low. This tendency to shift the focus away from the child has been noted in both social work and health organizations (Herron 2000; Scottish Executive 2002). In her report of the Cleveland Inquiry, Dame Butler-Sloss (1988) dealt with a number of issues in terms of communication and multi-agency working. One of the most enduring phrases to come from her report however was the recognition of the need to view ‘the child as a person and not an object of concern’ (1988, p.245). In the desire to act in the best interests of the children in this case, different professions became opposed and entrenched, with each profession viewing the child through their own professional lens but each allowing their own values to overtake the voice of the child. We still seem to have significant difficulties seeing the child as a person in assessment. Children’s views are still routinely mediated by others. For example, reports can contain the child’s views as voiced by their parent or carer and children are often viewed simply as an adjunct to parents (Buckley, Whelan and Holt 2006). Children are still not routinely seen on their own for assessments. Children are routinely under-represented in reports. Holland (2004) notes a fairly representative report from her Costal
164 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Cities study in which eight pages of the report were given over to a lively depiction of the parents’ lives but only two pages were devoted to the lives of all four of the children together. Child welfare and protection assessments are active documents with many different audiences and highly critical readers. Reports will be read by children, parents, professionals and decision makers. The report will lead and define the construction of a shared analysis leading to actions. This creates tensions for practitioners who must find ways of incorporating the views and interpretations of service users that may not match their own and may even undermine the practitioner’s judgement and explanations. All too often, children and young people’s views are not incorporated. Children and young people’s voices are silenced in social work narratives in various ways (Hall 1997). One sure way to do this is by not reporting the voices in assessments. Despite the commitment of practitioners in Horwath’s survey (2005), children were only physically seen on 28 out of 48 home visits made by social workers following referral. Children’s voices also can be silenced by presenting children and young people as objects described through shallow and mechanistic application of developmental norms (Hall 1997; Horwath 2007b). Our implicit beliefs about children and young people may potentially have an unconscious impact on our actions. Hall (1997) found that practitioners presupposed what children might say rather than letting them speak and reporting their opinions. Practitioners appear to hold their own beliefs and interpretations as more worthy or accurate than those of the children whose needs they are assessing. Practitioners can present the voices of children as subjective, biased or untrustworthy. Our use of language in reports can do this quite openly or in more covert but potentially more pernicious ways. For example, in the Coastal Cities study Holland noted that, in one case where a child’s views concurred with those of the practitioner, the boy was described as ‘sensible’, but in another where the girl wished to stay with a carer deemed unsuitable by the social worker, the girl was described as ‘whimsical and materialistic’ (2004, p.74). There are difficulties inherent in a system that assumes a concurrence between children’s needs and families’ needs (McLeod 2000). The current child welfare and protection system limits the ability of children and young people to access services on their own terms. It may be that the lack of confidentiality and flexibility inherent in the current systems not only affects accessibility for children and young people but may also impact on those of us working within the system. Many children do not want professionals to know about their abuse and neglect because they are worried that
THE CHILD AT THE CENTRE / 165
practitioners will over-react and that the children themselves will lose control over what is happening. The reality of professional intervention, however, was experienced by these children as a lack of reaction; those who did tell people what was happening experienced under-reaction rather than over-reaction (Buckley 2008; Vincent and Daniel 2004). Inadequate resources and pressured working environments impact negatively on practitioners’ thinking (Morrison 2005; Reder and Duncan 2004). One element of this pressure is the need to prioritize work and for workers to live with the reality that they cannot provide a service for all the children and young people who they assess to be ‘in need’. It is perhaps consequential that workers may unconsciously defend themselves in communicating with children and young people: practitioners may maintain an emotional distance and minimize the content of what they are hearing from children about abuse and neglect (Mudaly and Goddard 2006). It would appear that, in the face of a challenging and deeply uncomfortable picture of the truth (coupled with a real or perceived lack of power to effect change) practitioners may find this reality too hard to deal with and use psychological defence mechanisms to protect themselves. Practitioners need to be able to ‘hear’ the reality of children’s narratives, and to do this the practitioner needs to be able to hold the child in mind. This in turn requires the practitioner to be held in mind by their agency, with management and supervision playing key roles. The provision of effective support is crucial to ensure that practitioners’ analysis is truly informed by the reality of the child or young person’s lived experience.
Professional confidence The challenging emotional context of child welfare and protection can create anxieties which result in incomplete and impaired analysis in assessment (Cooper 2005; Horwath 2006). Horwath (2005, 2007a) reports the findings of research into the beliefs of practitioners about their role in relation to child protection. In response to a questionnaire, while 80 per cent of social workers in one study responded that they believed that decisions should be based on what the child wants (pending the ability to make informed choices), only 28 per cent of other (non-social work) professionals agreed. This difference is significant and perhaps indicates some of the pressure social workers come under to conform to wider adult values that give precedence to the views of adult professionals before the views of children and young people.
166 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
David Howe (2008b) noted that we are working with adults, many of whom may have incomplete or disorganized internal working models. Very subtle signs of fear or disengagement on the part of the worker may cause that adult to activate their deep-seated attachment-based behavioural responses, including difficult responses like avoidance and attempting to control the worker. In the same way, children who have been abused and neglected may have models of adults as inconsistent, uninterested, frightened or frightening. Slight and unconscious signals from the worker may have a huge significance for the child. It is therefore very important that you are appropriately prepared and supported to undertake such work. Support is required to leave ‘fears and assumptions behind and (endeavour) to engage with the world of the child, both internal and external’ (Crompton 2007, p.395).
Practice development Thomas and O’Kane (2000) suggest that practitioners lack a repertoire of creative methods of working with children and young people. They believe this to be related to: • lack of training • lack of confidence • lack of opportunity. A lack of training and confidence might be important but a lack of opportunity for direct contact with children must be overcome. This issue needs to be tackled at every level but there is no merit in skilled and dedicated workers waiting for the inertia at the top to be overcome. For practitioners to be true advocates for children’s rights there needs to be a determination that assessments will always be based on direct observation and communication with children and young people. New opportunities can be accessed or created to increase and rehearse skills in direct work. Informed and creative solutions to this significant gap in practice should be a key concern of all involved in child welfare and protection work.
Communicating with children The introduction of new assessment frameworks has sought to facilitate the participation of children in assessment. However, the introduction of the CAF has not improved partnership with children in the same way that it has managed to improve partnership with parents (Cleaver et al. 2004).
THE CHILD AT THE CENTRE / 167
This appears to confirm a number of studies over some time, all of which suggest that communication with children in the context of child welfare and protection is both complex and difficult to achieve (for example, Cleaver 2000; O’Quigley 2000; Sinclair, Garnett and Berridge 1995). In this section we explore in more depth the matter of direct contact and communication with children and young people in seeking to facilitate their participation in analysis. Assessments can be carried out within the timescales set out, but where assessments have not been completed within time this has been shown to be a result of organizational and resource issues (Cleaver et al. 2004). Anecdotal evidence from practitioners in continuing professional development (CPD) programmes in Scotland suggests that pressures to complete assessments quickly is directly impacting on the amount of time practitioners can devote to direct communication with children. It is vital that we are clear about the purpose and aims of each contact before any engagement with adults or children. O’Sullivan (1999) sees the practitioner making decisions in an environment of limited resources as caught between three different approaches to defining needs: • establishing client-defined need by asking the empowered client • establishing practitioner-defined need by applying professional judgement • establishing bureaucratically defined need by applying rules and procedures. These approaches can be compared to the different approaches to assessment that I considered in Chapter 2 (Smale and Tuson 1993 cited in Milner and O’Byrne 2002): • exchange model • procedural model • expert model. The model suggests that we can approach the task of assessment in different ways, each of which demonstrates different sets of values about the practitioner, the service user and the purpose of assessment. Most literature suggests that current hermeneutic assessment frameworks such as the CAF and IAF require an exchange model, where the service user is viewed as an expert in their own life. The failure to engage meaningfully with children and young people in their own assessments (Cleaver et al. 2004) suggests that practitioners still feel that their version of the ‘truth’ must over-ride
168 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
the views of a child, who could not be expected to know what is good for them (McLeod 2008). Although we as practitioners may feel that we have little choice but to accept the level of resources available to us, we do not have to limit the possibilities for intervention by avoiding the views of children and young people in assessment. A primary aim of contact with children and young people therefore is to: • develop meaningful partnerships • create time and space for communication • co-create methods and avenues of communication based on the individual child’s unique strengths and preferences. Crompton (2007) identifies the key elements in direct communication to be the people involved, and the time and space dedicated to the child. She suggests that it is important ‘to be clear about the distinction between “therapeutically informed intervention”…and longer-term therapeutic work which requires more specialist skills’ (2007, p.394). Specific therapeutic contacts and forensic interviewing are specialized areas of direct communication and should not be undertaken without further specialist training. However, working within specific roles and remits, we will all have a level of contact with children and young people and different reasons for communicating directly with children and young people. For example: • assessment: • gathering information • communicating information • learning about needs, views, plans and feelings… • intervention: • developing self-awareness • confidence, self-esteem • social competence • building trust • forming relationships • managing external and internal realities. Children’s views are being sought in ways that do not enable them to use the kind of communication skills that they are most competent in. As a result of being required to communicate in ways that suit adults rather than children and young people, they are being wrongly judged as incompetent.
THE CHILD AT THE CENTRE / 169
Adults may be comfortable dealing with abstract concepts and verbal communication. However, communication techniques that are concrete and tactile have been shown to be more successful in work with children and young people (Thomas and O’Kane 2000). Practitioners therefore require the skill and determination to ‘find methods of communication that enable children to demonstrate their competence’ (Thomas and O’Kane 2000, p.819). A variety of techniques can be used to communicate with children and young people, including drawing, games, storytelling and materials such as ‘feelings cards’ and ‘response cards’. You may be carrying out direct work with children and young people or you may be responsible for directing others in their direct contact with children and young people (for example as a manager or someone working with another professional who has more opportunity for direct contact). What methods of communication are you or your colleagues using primarily? If you are relying mainly on methods of communication that rely on the adult-friendly mediums of discussion and report writing, make it part of your development plan to develop your skills and knowledge of communication with children and young people.
Accountability of values Assessment would be enhanced if it were based on some of the tenets of good qualitative research (Milner and O’Byrne 2002). One tenet that may be worthy of further consideration here is that of ‘accountability of values’. Like a piece of research, assessment practice should be clearly guided by professional values. These values should be explicitly stated and shared with children and young people. The Children’s Charter (Scottish Executive 2004) provides a useful expression of such values. The Charter lists 13 messages from children and young people about what they expect from practitioners when they have difficulties or problems. It includes the following messages that are of particular relevance to including children and young people in assessment and analysis: • get to know us • speak with us • listen to us • take us seriously • involve us • respect our privacy.
170 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
The translation of such values into action requires practitioners and organizations to reflect critically on current methods of communication and the level to which analysis incorporates children’s own perspectives on their experiences and ideas about what kind of support would be most helpful for them. Too often the question in child protection is ‘Do we have a case?’ rather than ‘How is the child?’ (Holland 2004; Scott 1998; Stevenson and Hallet 1980). These kinds of frames perpetuate practice that marginalizes and objectifies children and young people in their own assessments. Analysis requires us to ask of each piece of information ‘What does this mean for the child?’ To be able to answer this question with any accuracy or validity, it is imperative that practitioners find ways of engaging with children and young people. By doing so we are more likely to be critical of adult interpretations and draw on children and young people’s own views and understandings of their lived experiences.
Marginalizing children in assessment By asking children and young people to communicate in ways that suit adults (such as talking, reading and writing) we play to adult competencies and not those of children and young people. Practitioners should use a variety of different methods in assessment, as some methods of assessment are more likely to limit analysis to a limited set of hypotheses (Holland 2004). For example, speaking to a child may allow us to ask open questions, probing questions, and so on, and thereby build a better understanding of the issues arising. However, if the issues do not arise, how can they be developed? Open-ended work has been found to be effective in assessment; enabling children to express their wishes and feelings (as opposed to questions and answers) (Thomas and O’Kane 2000). Although this kind of contact may take more time, the approach allows more of the child’s possible explanations (or hypotheses) to be aired and explored.
Box 6.1 Lee was six years old when the head teacher and Lee’s social worker asked me to become involved as the school-based family support worker. Lee had been exposed to his mother’s chaotic substance misuse during the first three years of his life. By the time he came to live with his grandmother he was difficult to care for and struggled at school. He was constantly active, emotionally volatile and very aggressive.
THE CHILD AT THE CENTRE / 171
Lee ran away from me and he ran around me. He tested me out and took time to become easier in my company. I used food, play and toys to allow Lee to explore his feelings and map out his view of the school. By doing this, we were able to identify those places where he felt safest and those people in the school who were important to him. By gaining a better understanding of what school meant to Lee we could gain a clearer understanding of where Lee could establish a ‘secure base’ for over 30 hours each week.
The use of tools and techniques, such as working together to examine ‘what my day was like’ or the daily hassles questionnaire, can reveal important issues that come from the child’s perspective. However, the tools and questionnaire introduced by the Assessment Framework (DoH 2000) do not appear yet to have been fully integrated into practice in England and Wales (Cleaver et al. 2004) and are not part of the assessment framework (Scottish Executive 2005, Scottish Executive 2007a) in Scotland. They can also highlight the chronic nature of issues in the child’s life. Although adults may view events such as death and divorce as highly stressful, selfreporting by children and young people (e.g. Vincent and Daniel 2004) identifies chronic issues such as bullying and friendships as the most important things.
Engaging with children and young people A practitioner on a child protection course recently provided an excellent example of the importance of seriously engaging with children. Well intentioned professionals have the power to do considerable damage as a consequence of listening but not really hearing what children and young people are trying to tell them. In this practice situation, the child’s mother had been subject to domestic violence and her partner had left the family home as a consequence. However, the young girl in the family had been reported by a number of different professionals to be asking after her ‘daddy’ and wanting to know where he was. This was taken to be a sign that the man was important to the girl and that attempts should be made to progress the intervention so that contact between them could be reintroduced. The practitioner was allocated to the girl and began to meet with her and build their relationship. Over a few visits the practitioner used play, songs and stories to begin to understand the child’s world more
172 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
clearly. What emerged was that when the girl had been asking ‘where’s daddy?’ she was not asking because she missed him. Quite the contrary; she needed to know where he was because she could only keep safe from the threat that he posed by always knowing where he was. Failure to really engage with this girl would have resulted in her being actively placed in regular direct contact with the source of her fear.
Box 6.2 How do you think that worker analysed the information collected? Direct work with the child was the crucial piece of practice but it was just the first step in making sense of this child’s needs. If you were that worker, where do you think you would have carried out the analysis that led to this insight? What kind of values, skills, knowledge and environment support such judgement?
Agency While the literature clearly identifies that children and young people want practitioners to listen to them, it also shows that children and young people feel entitled to set the agenda for conversations (McLeod 2008). We do a disservice to children and young people when we view them as helpless recipients of services or as objects of concern. The concept of ‘agency’ is becoming more widely recognized and this is an important step forward in working with and on behalf of children. The concept of agency is captured by Mullender et al. (in Hallet and Prout 2003) in relation to children and young people’s experiences of domestic violence. In-depth interviews demonstrated the depth of thinking that went into responses to domestic violence. For example, children were aware of the context and severity of attack – some knew of the futility of talking to someone who was drunk and others based their approaches on what had succeeded in the past (such as walking suddenly into the room). Recognition of ‘agency’ means that we need to build relationships with young people to develop the requisite trust with them so they can share their true thoughts and feelings (rather than what they think we want to hear or what may be more convenient). Once trust underpins the relationship then we might be able to build on what children and young people think and know works, rather than what professionals think might be best for them.
THE CHILD AT THE CENTRE / 173
The people Within our communication we need to be mindful of the child’s needs throughout. Hanks and Stratton (2007) suggest that abused children may take refuge in denial to avoid the destructive effects of recognizing what is being done to them. Working with denial takes time, skill and empathy. Most practitioners would identify ‘empathy’ as a crucial element of practice but it is worthwhile reminding ourselves of Carl Rogers’ definition of empathy as ‘a continuing process whereby the counsellor lays aside her own way of experiencing and perceiving reality, preferring to sense and respond to the experiences and perceptions of her client’ (Rogers 1951, p.39). If we are to be truly child-centred we must find ways of ensuring that our analysis encompasses the child’s own experiences and perceptions. A move towards a culture of ‘case management’, a growth in bureaucratic and administrative requirements (Scottish Executive 2007) and a focus on more structured and time-limited assessments (Crompton 2007) may have undermined the practice base in direct communication. If we are not in a position to have sufficient levels of meaningful contact with children and young people in assessment, how can we seek to include their views in analysis? If we can identify who is important to the individual child we may be able to build on these links directly in supporting the child’s participation in assessment, and indirectly in providing information from those who know the child best.
Box 6.3 The helping hand When you are working with a child or young person, drawing can be a powerful tool in exploring their world and views. The ‘helping hand’ can provide a way of considering children’s social networks and the nature of different relationships. The child takes a piece of paper and draws round their hand to leave an outline on the paper. Use this outline to name those people who are important to the child, with a name or a picture on each finger. Discussions can then help explore the meaning of these relationships, often with surprising results. For any children that I have worked with, this exercise has demonstrated how important their pet is to them and for some it has named people who were very important to the child but missing from the assessment report.
174 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Time Rouf (1989, p.10) provides a salient reminder of the importance of making time to see children and young people and the consequences of allowing other work to take priority: ‘…remember that a lot of children are on their own. Don’t let them down. If you arrange to go out, then go out.’ Some children and young people may be separated from parents and siblings, some may have few friends, others may be alone in the psychological sense of having no secure base and no one keeping them in mind. The impact of failing to honour commitments to children in such adversity should never be underestimated or forgotten. While other imperatives (such as urgent telephone calls and report deadlines) will have consequences if not attended to, it is vital that, once made, a commitment to make contact with a child or young person is maintained wherever possible. For the majority of school age children, school takes up much of their working day. It can be tempting to use time within the school day for direct sessions but this should not be done in a way that undermines academic progress or the importance of schooling. Some would advocate never using the school for direct work. Such work has the potential to make some children feel ‘different’ and stigmatize them. It is also possible that school is an unsuitable venue for other reasons. For example, some children experience school as a place of predictability, normality and security in a world that is otherwise capricious and dangerous. Bringing direct work into this setting may be an intrusion of the outside world into this protective environment. It is therefore crucial that there is meaningful discussion with the child so that their views and feelings on venue can be taken into account (this may include your understanding of their non-verbal communications). In many respects, professional working patterns can leave very little time within which to carry out direct work. Crompton (2007) reminds us of the need to work within times that anticipate the child or young person’s other commitments and interests. This means identifying suitable times and recognizing that your work may need to fit in around family mealtimes, TV programmes and waiting for friends. A further aspect of time that needs consideration is how long your session will last. This is a decision that needs to be made on the basis of each individual child or young person’s needs. While age and stage of development may sometimes be the same, each child has a unique developmental pathway and it may take time to establish the most effective timescales for direct work with any one child.
THE CHILD AT THE CENTRE / 175
Box 6.4 Children and young people are relatively powerless when speaking to adults. The very nature of questions creates a power imbalance because it is a conversational rule that questions require answers. Children and young people need to be empowered in contributing to analysis of their needs and circumstances. One way of addressing the power imbalance is to allow the child or young person to select the place where they will work with you and the timing of the meeting. Car journeys are often very good for facilitating discussion. The lack of direct eye contact and the privacy are helpful. Familiar journeys also allow the child to time their discussion with you as they will have a clear idea of when the journey (and therefore the discussion) is coming to an end. How else can we develop practice to give children more power in their direct contacts with you?
Space Consider the spaces where you are in direct contact with children. What kind of messages might the child or young person take away about themselves from the setting? What kind of messages do you want them to take away? While our agencies need to support direct work with appropriate facilities, we also need to be mindful of the individual child’s needs and we need to be creative in making use of the space around us. Shapiro (in Crompton 2007) notes that many workers create ‘defended spaces’ where they can work with children, in cupboards, backs of halls, empty spaces in buildings. One of the things that Crompton sees as central to the purpose of direct work is to help the child have a sense of: • being an individual • being cared about. This can be done simply, for example, by ensuring that your phone is off and you are uninterrupted, or by buying pens/books that ‘belong’ to that child.
176 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Reviewing and reflecting on practice McLeod (2008, p.106) gives the following ten suggestions for making it easier for children and young people to have their views heard and understood by practitioners: 1. Stop, look and listen. 2. Keep an open mind. 3. Give the child some control. 4. Start from where the child is. 5. Give permission to talk. 6. Avoid direct questions. 7. Offer prompts and triggers. 8. Provide information and explanations. 9. Encourage questions. 10. Check out understandings. If you wish to develop practice in direct work with children you may benefit from reflecting on past work. Feedback is most effective if given quickly after the event, so think about your next home visit or contact with a child when you get back to the car or office. To what extent do you think you were able to carry out the top ten elements of practice? What do you think got in the way of you carrying them all out as fully as you might have wished? Now, can you identify three barriers to effective practice that need to be addressed?
A day in the life The Report of the Victoria Climbié Inquiry (Laming 2003) identified that the primary aim of assessment should be to get a picture of a day in the life of the child. This is a helpful reminder that practitioners’ analysis is only as good as the information available and the accuracy and validity of the interpretation. Communication with children and young people should help practitioners move away from treating them as objects for analysis to treating them as partners in the creation of deeper understanding. By finding ways of gaining a picture in the day of the life of a child we can start with the child and their needs, rather than parents or professionals and their needs. Horwath (2007b) suggests the use of clocks with children and young people to establish the detail of what happens at different times
THE CHILD AT THE CENTRE / 177
of the day. For example, speaking about what happens in the morning can provide detail about the child’s self-care skills, parental supervision and resources such as food or toothbrushes. A simple tool to explore ‘my day’ with children and young people can be created by dividing a piece of paper into six boxes. Each box represents a different time of day from first thing in the morning to last thing at night. Through writing, drawing and narrative, children and young people can provide a clear and cohesive analysis of their day, their strengths and weaknesses, their needs and wishes, and their unique and subjective views of their own lives. Play is a powerful means of developing a relationship with a child and providing opportunities to develop an understanding of the child’s world and means of communicating (Horwath 2009). Practitioners often voice concerns about the difficulties of interpreting the meaning in children’s play. While it is possible to draw some tentative hypotheses from play, these possible explanations need to be checked out with the child themselves and practitioners need to be aware of the potential for practice where we give priority to adult interpretations. Such practice is potentially compounded by the human tendency to come to conclusions too quickly and weigh information selectively to support our own favoured hypothesis (Munro 2008; Reder and Duncan 2003; Scott 1998). Before any attempt is made at analysis, play opens up communication in a way that identifies and supports children and young people in making sense of their experiences and needs.
Cultural review – age Researchers may improve the quality of their interviews through developing methods for critical reflection (McCracken 1988). Given the growing recognition of the inter-connections between qualitative research and assessment practice (Milner and O’Byrne 2002), writers (Dalzell and Sawyer 2007; Holland 2004) have begun to adapt the format further to consider culture within the specific culture of welfare assessments. If you take the stance that childhood is an oppressed minority state, then the need to review culture, values and assumptions becomes all the more pressing in relation to age. The following set of questions should be considered in relation to each specific child or young person as your assessment commences: • What do I know about children/young people of this age? • Where does my knowledge come from?
178 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
• What biases or values may I hold (positive or negative)? • What do I know about children’s needs at this age? • What might surprise me about this child/young person and why would this be a surprise? • How might I be perceived by this child? • What impact might my assessment have on their life; tonight, next month, next year? • What norms do I take with me from my team and organization (e.g. hierarchies of risk, resource implications, etc.)? Such reflective processes are more effective when carried out with other people, particularly within supervision, but also across professions to ensure that common errors of group decision making are guarded against (Holland 2004). The inclusion of children and young people in analysis and assessment of their needs is an area of practice that is affected by individual practitioner skills and values. However, prevailing constructions of children and childhood influence team and organizational practice. The conditions for critical reflection need to be considered at all levels, not just by the individual practitioner.
Summary Children and young people need to be listened to. Not only do our legislative and policy frameworks require it, but it works. Children who have been listened to are more likely to understand what is happening to them and why (Aldgate and McIntosh 2006; Cleaver et al. 2004). Their voices can challenge the deceit and manipulation that some adults perpetrate (Laming 2003). Listening to children and young people has also been shown to identify their needs more accurately and lead to improved outcomes (Bell 2002; Triseliotis et al. 1995). The voices of children and young people are routinely missing from assessments. This is of concern for a number of reasons. If children and young people are not seen and spoken to alone, then we can fail to notice their signs of distress (Laming 2009) and fail to act when children and young people most need support and protection (Brandon et al. 2008). Time remains one of the most limited resources that impacts on practitioners’ capacity to engage meaningfully with children and young people (Laming 2009). While efforts must continue to address the issue at all levels, there are opportunities for practitioners to raise the level of
THE CHILD AT THE CENTRE / 179
involvement that children and young people currently have in their own assessments. Seeing children alone is important and practitioners need to reflect openly on any situation where this has not been possible so that the causes and consequences can be given critical consideration. There are many practitioners in universal services who are in close contact with children and young people for much of their week. Working with children and young people can help to identify those people who we need to speak to, and can contribute to our growing understanding of the child’s unique needs and experiences. Incorporating the views of children and young people in assessments requires us to utilize a full range of cognitive styles. In direct contact, the rapidly moving flow of information or ‘cues’ in the environment means that intuition is likely to play a major part in our reasoning. Intuition is developed through experience and reflection: therefore, opportunities must be created to practise and hone these skills. Although qualifying programmes do have to provide an education in communication, it is an area of practice where practice wisdom is very important and critical reflection on experience is required to harness this capacity. Making sense of children’s needs also requires deliberate conscious analysis. We need to ensure that children and young people’s own explanatory frameworks are given due consideration as some of the many tentative hypotheses that need to be developed and tested. Finally, we are reminded that listening to children and young people, in itself, can contribute to improved outcomes. Involving children in assessment and planning can promote self-efficacy, self-belief and range of problem-solving skills (McLeod 2008). Promoting children and young people’s resilience through their inclusion in assessment and planning can harness ‘the therapeutic potential of the everyday’ (Gilligan 1999, p.195).
Chapter Seven
Developing Practice in Analysis The fact that you are reading this book suggests that you are already interested in the subject of analysis and keen to explore ways of improving this area of practice. You already possess the motivation to learn and develop practice. Motivation needs to be harnessed to ability and opportunity if practice is to flourish (Horwarth 2007a). In this chapter I offer some practical steps towards developing existing individual analytical skills and creating more opportunities to embed effective analysis in practice. The task of understanding children and young people’s needs is influenced at all levels and I will therefore take an ecological perspective to the development of practice. The main focus for criticism in practice is often the individual practitioner, which means that the main focus for improving practice is individual practice (often through policy and procedural responses). However, there is also a recognition that individual practitioner development is not the sole requirement in improving assessment. A systems approach may be beneficial in pursuit of best practice, as demonstrated by the approach to enquiries advocated in professions such as medicine and aeronautics (Munro 2005).
An ecological approach Figure 7.1 illustrates the context for analysis in practice. The practitioner is central because analysis is a process of human reasoning that cannot be replicated or replaced by systems and procedures. However, human reasoning (whether intuitive or analytical) is fallible and needs to be held and developed through dialogue; the implicit needs to be made explicit and subjective interpretations need to be scrutinized through objective and critical reflection. The place where these vital processes take place is usually in some form of supervision. It is therefore imperative that supervision is 181
182 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
provided and that the supervisor has the capacity to support and develop the practitioner’s analysis. Leadership and the ethos of the organization affect analysis directly and indirectly in terms of our professional aims and values and the creation of the environment in which analysis can take place.
Organization
Supervisor
Practitioner
Analysis
Figure 7.1 The context for analysis in practice
Children and young people have needs that move at a vastly quicker pace than the timescales for change in organizations. Improving analysis across all levels of organizations is central to improving judgements and ultimately improving outcomes for children and young people. Organizations can be likened to big oil tankers; it may take a very long time for them to react when they are required to change course. As practitioners and supervisors, we can either view ourselves as passengers, powerless to do anything but sit and wait until change happens, or we can view ourselves as agents of change. In this chapter I provide some examples of the ways in which analysis can be more effectively embedded in practice.
Practitioner development – moving on the cognitive continuum Intuition
1
2
3
4
5
6
Figure 7.2 Moving on the cognitive continuum
7
8
9
10
Analysis
DEVELOPING PRACTICE IN ANALYSIS / 183
In Chapter 5 I considered the need to match our style of cognition to the task structure. There are two parts to this consideration: the task and the cognition. We start by exploring the kinds of judgements we need to make and where on the continuum they may lie. It’s relatively easy to think of situations where you are predominantly using intuition or analytical reasoning. For example, a phone call from an upset service user will require you to work on intuitive reasoning, while preparing a report for a child protection conference will require more explicit analysis. What we may need to improve is our understanding of the middle ground. For example, where on the continuum in Figure 7.2 would you place the examples of the phone call and the report? What is it about these tasks that informed where you have positioned the style of thinking required? The two major forms of cognition (intuition and analysis) can be differentiated by a number of characteristics (Arkes and Hammond 1986). By considering the following characteristics, we can establish which style of cognition is best matched to the task: • Cognitive control (Figure 7.3) – To what extent are you able to direct your thinking? Low
1
2
3
4
5
6
7
8
9
10
High
Figure 7.3 Cognitive control
• Awareness of thinking (Figure 7.4) – How conscious are you of your thinking? Low
1
2
3
4
5
6
7
8
9
10
High
Figure 7.4 Awareness of thinking
• Amount of information (Figure 7.5) – How many different pieces of information are you considering?
Few
1
2
3
4
Figure 7.5 Amount of information
5
6
7
8
9
10
Many
184 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
• Time available (Figure 7.6) – How much time do you have to make your judgement? Little
1
2
3
4
5
6
7
8
9
10
A lot
Figure 7.6 Time available
• Memories (Figure 7.7) – In what way are you calling on your memory in this judgement?
Events
1
2
3
4
5
6
7
8
9
10
Theories
Figure 7.7 Memories
• Metaphor (Figure 7.8) – How are you representing information? e.g. pictures, smells, feelings, or words and numbers?
Sensory
1
2
3
4
5
6
7
8
9
10
Verbal
Figure 7.8 Metaphor
Intuitive cognition is called for when we have little awareness of our thinking and low levels of control over our reasoning; when there are multiple fallible sources of information and we need to make the judgement quickly. We call on memories of previous events to help aid intuitive judgement, and the metaphors we employ are likely to be representative (such as imagery). Analytical cognition on the other hand requires a high level of awareness and control over our thinking. We focus on a few indicators at a time and they tend to be more reliable. We take more time over our judgement, as we need to consider details explicitly and consciously, including checking for potential sources of error. Instead of calling on memories of previous experiences, we call on memories of complex principles such as theoretical models and frameworks. Metaphor is more likely to be verbal or associative. Where on the cognitive continuum would you place the examples in Box 7.1? What kind of judgement style do you think you would apply to
DEVELOPING PRACTICE IN ANALYSIS / 185
these two tasks, and do you think there would be any difference in the way you would approach the two different situations?
Box 7.1 Example one You are discussing a new piece of work with a colleague. They have recently begun an enquiry into reports of neglectful parenting. Your colleague describes the house, detailing issues such as broken furniture, soiled carpets, no bedding for the children and rotting food and mould throughout the kitchen.
Example two You are discussing a new referral with a professional from another agency in a different part of the country. They are describing the house where the family previously lived, detailing issues such as broken furniture, soiled carpets, no bedding for the children and rotting food and mould throughout the kitchen.
Example one is strongly weighted towards intuitive thinking. Your discussion does not have a particular objective, so you are not likely to have chosen to think consciously about making judgements here. Your analysis therefore remains largely subconscious and beyond your direct control. When you hear the description of the home conditions you share a level of understanding with your colleague; you know them and therefore know the way their beliefs and attitudes shape the way they view the information they have collected about the home circumstances. You hear about a wide range of issues and begin to create a gestalt overview of what this might mean taken as a whole. You rank and compare the sensory images created with previous experiences. Quickly, and with a good deal of complex and uncertain information, you can decide whether this is something that requires further attention or not. Example two looks very similar on the face of it, but there is a significant difference in the conversation. In this example, you do not know the person you are talking to and your discussion is goal oriented; you are taking a referral that may provide you with a professional responsibility to respond. In trying to make sense of the discussion you are more likely to be consciously thinking and using deliberate strategies to clarify, follow up and query the emerging information. You will still be provided with a lot of information,
186 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
but this time you will not have shared experiences by which to gauge the subjective interpretations offered by the caller. You still do not have much time but you may take slightly longer to form a judgement and have points you want to discuss further. You will need to make a judgement about whether the referral is appropriate and reaches your agency’s thresholds for action. You will therefore be calling on theoretical frameworks more explicitly and will also be affected by the need to justify any action taken. Your understanding of the situation will not be an overall image but a more specific representation built on specific details (e.g. what are the carpets soiled with? What has been the impact on the children’s development?). In example two, the lack of shared understandings required a move away from intuition towards analysis. Failure to recognize the change in the decision-making environment would result in the practitioner trying to apply the wrong judgement style to the task. As you can see from the properties of different cognitive styles, some elements remain the same (e.g. there is still little time for thinking and a lot of indicators, i.e. information). However, there is also a shift towards more explicit, conscious thinking and consideration of organizing principles (such as theory and organizational factors).
Box 7.2 Linking judgement to task – an audit tool Take a couple of minutes to note down the kinds of situations you have been involved in today that have required you to make judgements; for example, driving to work, looking through your emails, attending a meeting, writing a report. For each task, ask yourself where on the continuum your judgement style might be positioned in terms of: • time available for thinking • consciously controlled thinking • memories of events or theories. Gaining a better understanding of the way in which our judgement styles vary in response to different tasks is an important step towards more effective analysis. For example, if you are trying to think consciously about theory in a fast moving and complex home visit, you may be trying to apply analysis where intuition may be more effective. If you are writing a report and are thinking about individual events and issues but not the overarching theories, you may be relying on intuition when analysis is required.
DEVELOPING PRACTICE IN ANALYSIS / 187
Using intuitive thinking when analysis isn’t working Children and young people can be forced into a position of ‘incompetence’ by professionals. Although children may be highly competent in many ways of communicating and understanding (such as play or storytelling) we can render them incompetent if we require them to communicate in ways that suit adults but not children (such as written word and lengthy direct conversation) (Thomas and O’Kane 2000). In a similar way, the systems that we use to support analysis may also render practitioners incompetent because they do not actually allow them to make use of their competence effectively. When it comes to analysis, we seem to be better at doing this verbally than in writing. Practitioners who can offer complex and informed analysis in supervision can struggle to record these reflective judgements on paper. Supervision therefore plays an important part in providing opportunities for dialogue and reflection in the production of written analysis. We need to recognize that, in terms of analysis, more is not always better. I began this book with this same assertion and we return to it now in consideration of developing practice. Child welfare and protection is, by its very nature, defined by irreducible uncertainty and inevitable error. The research on which we base our practice has its limitations, and theories can be used in both helpful and unhelpful ways. In such circumstances, more information may actually provide a sense of certainty that is not warranted and may misinform judgements (Gigerenzer et al. 1999; Hammond 1996). We may also find that a form of ‘assessment paralysis’ (Reder and Duncan 1999) can take hold, whereby practitioners become fixated on particular diagnostic issues and can’t successfully resolve them and move forward. At times when strongly analytical styles of cognition cannot move things forward, a move towards intuition may allow us to make use of our competence in intuitive thinking and deliver insight and inspiration that was not available through conscious analysis. Creating space for creativity and intuitive thinking is not a replacement for conscious deliberate analysis; it is complementary and needs to be utilized rather than eradicated from practice. In assessment, it may be worthwhile employing alternative methods of exploring and recording your analysis to complement the assessment and recording tools required of your agency. It is possible to use additional copies for annotation and word-processing tools such as key-word searches to begin to map out repeating patterns and draw out facts that may lie dormant in a more linear reading of the file. The use of a mind-map (see Buzan 2002 for example) can help us make use of the way our brains work with images and associations to order and access information.
188 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Mind-maps help us move away from the linear constraints of most assessment formats and begin to make connections that utilize other learning and thinking styles. Multiple radial images help us make connections and see the relevance of information that otherwise may lie dormant; important but unseen and unvalued.
Task structure The properties of the particular judgement task facing the practitioner will influence the kind of cognitive activity that will take place, from intuition, through quasi-rational ‘common sense’ to analytical judgement. The key property of the task is whether it requires precision or robustness. In conditions of uncertainty and gaps in information, we require a style of cognition that is robust and can survive in these conditions. In conditions like these, intuition is the required cognitive style. In situations where precision is required and indicators are fewer and less fallible, the task will induce analytical cognition. In situations where there are very clear and reliable indicators (such as irrefutable evidence of physical abuse) we can rely more heavily on analytical thinking; like a navigator using lighthouses and marker buoys, we can use these indicators to direct us with a level of certainty. However, many indicators in child welfare and protection are not reliable (such as behaviour), and these fallible indicators are more like the subtle signs in the water that the navigator must be able to recognize and react to. Where the indicators are fallible, we need to be able to use our intuitive reasoning effectively. Where on the continuum in Figure 7.9 would you place the following tasks in terms of the degree of certainty and precision required: • direct work with a child • supervision • telephone call to a consultant paediatrician • home visit prior to a case conference?
Intuition
Quasi-rationality
Analysis
Figure 7.9 The cognitive continuum
There are no right or wrong answers to these scenarios. Only the very most or least technical judgements will be placed at the poles of the task
DEVELOPING PRACTICE IN ANALYSIS / 189
structure continuum. Most situations actually require practitioners to make judgements that are a mix of both intuition and analysis. What we need to consider next is whether we have the right cognitive style for the task and how we might develop our skill and awareness of matching judgement to the task. We will consider individual practice here before moving on to consider how teams and organizations can support practitioners in their analysis.
Listen to the pros and the cons In Chapter 4 I introduced the concept of verificationism whereby we tend to gather and interpret information quite selectively to support our preferred explanations. Scott (1998) explored the possible reasons why we tend to make these sorts of inaccurate judgements. One concept that can help us think about how we make judgements is that of ‘cognitive schema’, which can be viewed as frameworks through which we filter and organize information into shapes that make sense to us. Many of these frameworks are developed through our qualifying training (e.g. psychological and sociological theories). A concern of Milner and O’Byrne (2002) was that practitioners may have a tendency to ‘fit’ the facts of the case to their chosen theoretical framework. Individuals, organizations and educationalists must therefore nurture the ability of practitioners to use theory in a critical and explicit fashion as a strong foundation for reflective analytical practice. Other cognitive frameworks may be less clearly acknowledged and can stem from individual characteristics and experiences, including organizational pressures. This can help us understand how someone from a different professional background can view the same situation as us from a completely different angle. It also helps us to understand how workers can change their way of viewing situations over time as circumstances change. For example, one worker I knew had ways of interpreting information that were very similar to my own. Over time though, he became more willing to accept risk than I was and I noticed this change commence from the point when he became the manager of a child welfare team with rapidly increasing demands being placed on it during a time of dwindling resources. Being able to justify the closure of a case meant that my colleague had to satisfy not only organizational benchmarks for closing the case but also his own professional benchmarks. I believe that in managing this tension, he was beginning to either overestimate what had been achieved in the
190 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
intervention or underestimate the impact of adversity on the children and young people he was working to support.
How do we recognize and deal with bias? Most judgements in assessment are made on a clinical basis. That is, they are founded on a mix of formal knowledge from professional training, values and reasoning skills built up through personal and professional experiences (Munro 2008). This means that our judgements are uniquely subjective and not necessarily an accurate or faithful picture of reality. The role of practice experience is important in judgement, but if we are to deal with bias in our professional judgement, we must first accept that bias is not just possible but probable. Then we can find ways of bringing it out into the light for consideration. The key to this is reflexivity. Milner and O’Byrne (2002, p.58) advise that reflexivity ‘involves checking one’s interpretations of the data with people who do not necessarily have a vested interest’. This is a challenge to our current system of line managed supervision, as line managers tend to have a considerable investment in the assessment, both in terms of professional accountability and resource implications. Alternative opportunities for reflection do exist however and it is worthwhile considering other models. For example, a model of clinical supervision is used in medical practice and in countries such as Australia it is common practice for practitioners to purchase their own supervision independently for external consultants.
Box 7.3 Checking judgements The role of the ‘critical friend’ can be very beneficial in developing effective analysis. To manage conformational bias, we need to create opportunities deliberately for someone else to check our thinking. This person needs to be able to offer feedback that is supportive of you as a person but asks critical questions of your hypotheses. Who currently provides you with this support? If it is lacking, who could you develop this relationship with and what would need to happen to embed this in practice?
DEVELOPING PRACTICE IN ANALYSIS / 191
Avoiding verificationism There is actually very little psychological research in the literature on decision making on how to avoid such confirmational errors (Plous 1993). However, one strategy shown to be effective in research is to focus on motivational factors (Snyder et al. 1982 cited in Plous 1993). In this research, interviewers were advised that the people they were interviewing would be likely to view certain questions as closed-minded or prejudiced. As a consequence, interviewers appeared to be sensitive to this possibility and consequently solicited fairly equal levels of confirming and disconfirming evidence. In practice we may therefore benefit from approaching all interviews and discussions with clients and other professionals with the belief or mind-set that whoever we are speaking to may think that we have already made up our minds and are just going through the motions.
Disconfirming As we saw in Chapter 4, a crucial part of the cycle of analysis is to test our hypotheses rigorously in what is known as ‘antithesis’. At this point on the analytical process, we test our tentative explanations by proposing the opposite or ‘null hypothesis’. For example, if you are trying to explain a child’s difficult behaviour at mealtimes, you may feel strongly that the difficulties are linked to the parent’s quick temper and irritability. To avoid confirmatory bias (i.e. only seeing the evidence that supports your explanation and not the evidence that challenges you) it should be embedded in practice that you always consider the opposite and try to seek evidence that disconfirms your favourite explanation (i.e. that the difficult behaviour is not linked to the parent’s temperament). For example, instead of carrying on questioning about anger and irascibility, explore the possibility that the parent is patient and calm when feeding the child. Reframing our hypotheses and seeking disconfirming evidence does not come easy and there is not much in the way of research to suggest that simply considering that you may be wrong does actually overcome tendencies toward confirmatory bias (Plous 1993). However, technique can be learnt and this way of questioning judgement needs to become ingrained in practice. Below are examples of the kind of hypotheses that tend to be generated around child welfare and protection concerns. For each explanation, try to reframe the statement to ask the opposite and set questions that are likely to gain disconfirming information as well as confirming information:
192 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
• This child is not developing because they are neglected. • This parent’s drinking is a response to domestic violence. • The school are not providing all the facts because they don’t trust social work. • The marks on the child’s arm are a result of ringworm. • Poor financial decisions in this family are a consequence of the parents’ learning difficulties. Consider where in your practice you can ask more disconfirming questions. Research (Brockner and Rubin 1985) suggests that the people carrying out studies into psychological biases are prone to repeat in their research exactly the same biases as those they are investigating. Simply saying to yourself ‘I must not be biased’ is not enough. Being aware of a tendency towards bias can help avoid it; it has been shown that over-confidence in decision making can be reduced if decision makers can consider why their judgements might be wrong (Koriat, Lichtenstein and Fischhoff 1980; Lord, Lepper and Preston 1984). However, confirmatory bias is such a strong tendency that it needs attention at all levels.
Box 7.4 Strategies for avoiding verificationism Individual: Be aware of this tendency, accept that your judgement may be wrong, seek disconfirming evidence. Agency: Social workers should demand good quality supervision. All practitioners should actively seek supportive opportunities for critical reflection. Be prepared to explore judgement, seek ‘devil’s advocates’and ‘critical friends’ to help see other perspectives and test your thinking. Organizations: Accept the uncertainty in practice and teach the skills required to think in this environment, create and maintain supervision policy, build checks for conformational bias into points of review.
Primary legislation and guidance across the UK emphasize the need to raise the levels of involvement of children, young people and their families in decision making and planning. Research has shown that we are falling short of aspiration in our practice and we are routinely not involving children and young people fully enough in their own assessments. Underpinning all analysis should be a commitment to developing our understanding of children and young people’s experiences. Shakespeare’s Hamlet captured
DEVELOPING PRACTICE IN ANALYSIS / 193
the powerfully subjective nature of analysis: ‘There is nothing either good or bad, but thinking makes it so.’ If intuition and analysis are to be effective, all our thinking needs to reflect openly on what the meaning of any information is for the individual child or young person concerned. One final note to individual practitioners about the cognitive continuum: keep moving. Our intuitive and analytical forms of cognition are meant to work together and this means that we need to be able and willing to move fluidly up and down between the two poles of the continuum. Intuitive judgement may have worked effectively in your home visit because it was robust and allowed you to begin to make sense of the child’s needs even when information and time were lacking. However, this intuitive reasoning needs to be given precision and the task now is to move along the continuum towards analysis. This requires more time, fewer, more reliable indicators and more deliberate conscious use of organizing theories and frameworks. Equally, when conscious analysis has taken you as far as it can, you will need to move towards intuition again to gain further insight and new ways of creating understandings from the raw data. Creativity and, crucially, other people are important supports to the kind of critically reflective practice required here.
The role of supervision in analysis A key theme is the role supervision has in ensuring that the focus remains on the child. The potential for workers to ‘lose the child’ has long been recognized (Brandon et al. 2008; Laming 2003, 2009; Scottish Executive 2002). Through dialogue (or dialectics), supervision plays an important part in assisting practitioners to unpick and unpack what they have seen, heard, read and felt (Hawkins and Shohet 2000). In other words, supervision helps with the task of analysis. The difficulties practitioners experience in analysing the information they have, and in particular thinking ‘What does this piece of information mean for this child?’, has been discussed in previous chapters where we have examined some of the structural, psychological and emotional barriers to effective practice. Consequently, the role supervision can and does play in addressing these barriers cannot be underestimated. The functions of supervision are highly connected to the practitioner’s capacity for accurate and empathic analysis. In addition to the practical management tasks, supervision is also necessary to monitor and support the worker in terms of skills, knowledge, values and the emotional context, all of which impact on the practitioner’s capacity for analysis and cognitive
194 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
approach to the task (Gadsby-Waters 1992). We have already noted the effect the decision-making environment has on analysis and the tendency for practitioners to limit their hypothesis development (Milner and O’Byrne 2002) and stop searching before a satisfactory level of exploration has been carried out (Simon 1987). Supervision plays a vital part in protecting practitioners from such errors and supporting them in creating a sufficient number of hypotheses that can be tested and refined. Support and feedback not only give clarity of role and help manage stress but also facilitate a climate for good and imaginative practice (Pritchard 1995). As Lord Laming said, ‘Effective supervision is the cornerstone of safe social work practice. There is no substitute for it’ (Laming 2003, p.211). Staff who are in direct contact with children and their families must maintain a focus on the needs of the child, and the capacity of parents to meet their children’s needs (Social Work Inspection Agency (SWIA) 2005). Front-line managers therefore make a significant difference to the performance of any social services organization (Social Services Inspectorate 1999 cited in Scragg 2003). A number of elements of supervision need to be in place if the process is to work, although the nature and level of each element may change over time. Supervision that focuses on the administrative and professional elements but lacks any real psychological investment is likely to be ineffective and even counter-productive (Morrison 2005). Supervision should provide a level of security for practitioners. Attachment theory suggests that we need to be provided with a secure base so that we can feel safe to explore. To be able to explore the emotional context for practice we need this secure base, and where this is lacking, our capacity to maintain empathy and understanding is compromised. We can see this in examples where practitioners have overidentified with the child or adults (Munro 2008), and where practitioners have been unable to acknowledge the reality of what children and young people are trying to tell them (Mudaly and Goddard 2006). A key role of supervision is therefore not only providing help dealing with stress (as a secure harbour) but also creating a climate for good and imaginative practice (Pritchard 1995) where our hypotheses are not cursory and we can embrace the full spectrum of thinking styles. If supervision is not a routine element of your area of practice, you may wish to consider how you can access the kind of supports that have been shown to help manage the emotional and cognitive challenges of child welfare and protection work.
DEVELOPING PRACTICE IN ANALYSIS / 195
Discrepancies and checking for them Considering alternative hypotheses is difficult to do on your own. It can be difficult to think about things from new angles and it is much easier to generate new and competing explanations with the help of a critical but supportive other person. If judgements are not fully accessible to the conscious brain then this conscious effort is not going to be effective (Arkes and Hammond 1986). As Schön said: When inquiry into learning remains private, it is also likely to remain tacit. Free of the need to make our ideas explicit to someone else, we are less likely to make them explicit to ourselves. (Schön 1987, p.300)
Use your supervisory and supportive relationships to get someone to do the questioning with you. Dailey (1952) and later Slovic and Fishhoff (1977) (both cited in Arkes and Hammond 1986) have shown the validity of this technique and the benefits of maintaining alternative hypotheses for a long time, not just a one-off checking process. The role of ‘devil’s advocate’ should be an explicit and agreed area of any supervision agreement. Supervisors and colleagues can play a vital role in dialectics (Reder and Duncan 1999) or critical thinking by questioning the explanations put forward, as would happen in an adversarial setting like a court. As well as encouraging more rigorous analysis, this also may curb the tendency to move from a practicemoral perspective to a technical-rational perspective when the practitioner is faced with a genuinely adversarial setting. The use of dialectic methods supports rigorous analysis and should therefore help the practitioner maintain the focus on the child. However, the need to maintain a focus on the child goes beyond simply checking explanations. In the inquiry into the death of Caleb Ness, discussions about the child were viewed as ‘routine and superficial’ and failed to jolt the social worker out of complacent expectations (O’Brien et al. 2003, p.55). It is therefore important that both supervisor and supervisee focus discussion at all levels (the child, their family and wider world) on what the meaning and significance of any information are for the individual child.
Decreasing reliance on memory In Chapter 4 I explored the relevance of memory to the development of hypotheses or ‘explanations’. Memory is an important factor in our human tendency to cling to beliefs and not let go of them even in the face of mounting evidence. Techniques for not recognizing information
196 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
that challenges our beliefs include avoidance, forgetting, rejecting and reinterpreting (Munro 2008). We may not remember some things because they do not fit with our hypothesis. For example, a practitioner who is concerned that a child is being scapegoated at home may remember the negative comments made during a home visit but may not remember the examples of love and concern shown by the parents at other times. When the child draws pictures and speaks about staying home when her brothers went to the zoo, this might be interpreted as the child being left out, whereas the reality may be that this was a specially created time for the child and her father without her brothers taking up his attention. Being aware of the tendency is a good start but simply being aware may not be enough of a safeguard. Critical reflection in a supportive environment can provide an important bulwark against such tendencies. Rather than simply accepting or challenging a practitioner’s judgement, the literature on naturalistic judgement (e.g. Klein 1998) suggests that it may be fruitful to help the practitioner to review how they reached the judgement. Supervisors should check the validity of the information being considered by the practitioner and help them explore the process of gathering and analysing information that led to the judgement. We are all likely to have experienced that feeling at some point when our explanation or ‘story’ begins to feel less definite and our attempts to justify it begin to feel weak or less certain. This may be an indicator that we have selectively marshalled our memories and sources of information and have created an inaccurate or unsubstantiated picture. The task of the supervisor is in helping the practitioner recognize the possibility of bias. The skill of the supervisor is in supporting the practitioner to manage uncertainty and helping them build up their synthesis into a more helpful and accurate picture again. Critical reflection can only really be sustained in an appropriate environment. This should therefore be your first step – audit your supervisory and supportive relationships in terms of their capacity to support reflection. Can you express feelings, including uncertainty? If not, then either this must be addressed or you will need to look elsewhere for support. Work with your supervisor or supporter to create an explicit statement of ground rules for supervision. Supervision must take account of professional accountability, but it is a hollow exercise without recognition of the importance of the judgement on which that accountability rests. Use more than words. Verbal communication is only one way of sharing meaning and developing understanding. Consider using a flipchart, whiteboard or simply paper to generate hypotheses. Quick-think
DEVELOPING PRACTICE IN ANALYSIS / 197
exercises work well in training to generate a wide range of possibilities before focusing in on a few examples for deeper consideration. Using such exercises can help to widen your peripheral vision to take in explanations that are perhaps not immediately obvious; explanations don’t have to be the most probable to be possible still, and it is crucial to think as widely as possible in this process. Take roles. Like a court of law, supervision should be a place where your arguments are tested out, which requires someone to take an opposing stance. This can be emotionally demanding and it is necessary to be explicit about when and why someone is taking this approach. The supervisor can be given licence to play ‘devil’s advocate’ and can use this role to test your argument, identify and test the weaknesses and offer alternative explanations. An excellent means of guarding against our natural confirmatory bias is to take this role yourself and take on the role of prosecution against your own hypotheses.
Group supervision How supervision should look is a subject of ongoing debate. Some commentators have suggested that the supportive and management functions of supervision can be separated (Stanley and Goddard 2002) while others (Hughes and Pengelly 1997) highlight some of the difficulties of doing this in terms of accountability and the potential for gaps or duplication. Many of you in education and health settings do not routinely receive linemanaged supervision and need to create opportunities for critical reflection with others. In addition to the individual model of supervision (formal and informal), group supervision can be helpful in supporting analytical practice in many settings. Kadushin and Harkness define group supervision as ‘the use of a group to implement the responsibilities of supervision’ (2002, p.390). Just as individual supervision needs to be bounded by clear structures and have a clear purpose, so too does group supervision (Brown and Bourne 1996). Brown and Bourne highlight that when considering the use of group supervision, the following factors need to be explicitly considered: • Boundaries: These include group membership, attendance, confidentiality (including limits), regularity and timing. • Tasks: These could include practice consultation, providing support to individual team members, dealing with agency issues, developing the team.
198 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
• Structure: This includes use of time, activities and content. • Roles: Who chairs, who keeps record, who facilitates. • Type of facilitation: Is this to focus on structure, including keeping to time, is it to focus on content, e.g. summarizing and focusing discussion, or is it to enable participation? • Methods: This could include group discussion, role play, exercises (1996, p.148). There are a number of potential advantages of group supervision, including the possibility that members of the group can learn from each others’ experiences, can share common problems and solutions, and that the process can help the group develop a sense of identity and common purpose. There are also a number of potential disadvantages. Within individual supervision, it is easier to meet the learning and professional development needs of the particular individual, and it is more difficult within group supervision to meet the needs of everyone in the group. If the group is an established one, it can be difficult for a new member of staff to join. Although group cohesion may be positive, it may also mean that unhealthy coping strategies or views can be developed or maintained, and it can be difficult for an individual to challenge within a group. Many forums already exist for discussing child welfare and protection casework in groups (such as early intervention and integrated team meetings). These kinds of meetings could usefully be developed to provide opportunities for reflection and improved analysis through informal group supervision. Team meetings can be utilized in ways that support and nurture analytical practice. Such developments can be exciting and can provide an antidote for the sometimes dull and mechanistic nature of such meetings. However, making best use of these opportunities requires effort and commitment and this commitment needs to be understood and shared by the team. Team leaders or managers and senior practitioners play an important role in embedding such practice in the reality and pressure of operational roles.
DEVELOPING PRACTICE IN ANALYSIS / 199
Box 7.5 Developing analytical practice – team meetings Sharing articles: At each meeting, one member of the team is to report back on an article they think is relevant to the team. References: If a worker identifies a useful reference, this can be fed back to the team. Identifying resources from the web: Identify quick and freely accessible sources of evidence and knowledge. Case presentations: Use the team meeting to review examples of positive practice and share thinking on difficult issues. External speakers: Identify links with universities and other organizations. Attend training as a team: It can be cheaper to commission training for the whole team than to attend many events individually. Presentations: Staff who have been on training should expect to present a summary to the team.
Organizations Leadership and the culture of the organization are crucial in supporting critically reflective practice (Dalzell and Sawyer 2007) and in ensuring that practitioners are provided with the skills and environments required to match judgement styles to the tasks at hand. This includes appropriate amounts of time where more analytical styles of cognition are required, and suitable supports to harness fast and robust reasoning where more intuitive styles of cognition are required. Analysis involves explicit reasoning with reference to complex principles. Therefore qualifying education needs to nurture practitioners’ ability to understand theory and practice through critical analysis. Organizations need to provide workers with the motivation and the opportunity to maintain and develop their skills and knowledge. Some agencies set an excellent example for others to follow; creating a strong culture of learning and an expectation that utilizing theory and research is the norm rather than the exception. In addition to creating access to sources of evidence, agencies also need to ensure that practitioners are provided with opportunities to learn the skills required to use such tools ethically and effectively. Many practitioners refer to the mixed messages they receive about the use of theory and research in assessments. While there appears to be encouragement to make such references within
200 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
assessments, some practitioners report largely negative feedback when they actually include them. While practitioner skills do need maintenance and development, agencies also need to ensure that any development of an evidence-based approach to practice is strategic and coordinated across the organization. Analysis is an essentially cognitive process, but we are aware of the enormous impact the environment has on human cognition. Some aspects of the decision-making environment are unlikely to change – such as the uncertainty and anxiety that define much practice in child welfare and protection. However, the physical environment can be changed, and organizations need to think about how to create environments that support rather than undermine analysis in practice.
Box 7.6 Adequacy of resources…includes properly designed premises, with appropriate interview and office facilities, secretarial back-up, dedicated time for regular supervision and learning and sufficient time to read files, to write up notes, to discuss cases with colleagues, to consult inhouse libraries and to think. Reder and Duncan (2004, p.111)
Reder and Duncan (2004) argue that inquiry reports have consistently indicated the need for improvements in resourcing, training and practice but have been responded to through bureaucratic changes (such as restructuring or further monitoring and protocol). What kind of changes might be made to the environment that could benefit analysis? The physical environment should send a message to children and young people that they are valued and respected. Positive images of children and young people should be seen. Interview rooms and public spaces should reflect a child-centred organization. Front-line staff are crucial, and administrative staff often provide the vital first representation to a child or young person of what the agency should mean to them. The physical environment for effective analysis can come in many forms but has some core features. The environment must provide space for thinking. This means that practitioners need opportunities for thinking alone and thinking with other people. The increasing use of open-plan offices may actually reduce the levels of both kinds of opportunities as
DEVELOPING PRACTICE IN ANALYSIS / 201
workers are unable to find space and quiet, and may also feel unable to justify pausing for thinking and discussion in an atmosphere that says that ‘doing’ is the important activity and that an absence of ‘doing’ (such as thinking and discussing) may be viewed negatively. Unless practitioners are supported actually to access resources such as in-house libraries or journal subscriptions, these resources will be underutilized. Time is one of the scarcest resources in child welfare and protection work. A limited amount of time for judgement promotes intuitive reasoning, even when the task requires analytical reasoning (Hammond et al. 1986). If organizations are seriously intent on promoting analytical practice then they must provide practitioners with the requisite time required for this form of reasoning. Although the supervisory relationship has been identified as an important contributor to analytical practice, both the supervisor and the supervisee are held within a larger organization system. Organizations are the vessels within which practitioners and managers engage with analysis. The impact of the organization’s leadership and ethos is therefore an important concern. Conflicting priorities arise from service users, public and media perceptions, professional responsibilities and budget and resource constraints (Hughes and Pengelly 1997). Child welfare and protection organizations operate in an environment where error is inevitable and responses to such error are punitive. There is perpetual tension between society’s wish for all children and young people to be kept safe and the amount of money it is willing to spend on this (Munro 2008). These competing priorities can result in anxieties that can permeate organizations at all levels. The interactive and cumulative nature of anxiety means that its impact is often subtle and unconscious (Morrison 2005). The work of child welfare and protection is not easily reduced to a set of rules to guide action, despite the best efforts of policy makers to improve practice through procedure and policy (Hyland and Holme 2009). Conditions that are defined by irreducible uncertainty and inevitable error make judgement necessary (Hammond 1996). If practitioners are to exercise judgement effectively, then the organizational context must be taken into account.
202 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Organizational anxiety and analysis
Figure 7.10 A compromised environment for analysis (adapted from Morrison 2005)
The model in Figure 7.10 depicts a compromised environment for analysis and can help us to understand the impact of anxiety on organizations and practitioners (Morrison 2005). The model suggests that, if an organization is unable to tolerate anxiety, this is likely to provoke fight or flight responses. In such an environment anxiety and uncertainty are seen as weakness and a threat to the organization. If a practitioner is given the message (directly or indirectly) that anxiety is not acceptable, then the practitioner is unable to find effective and appropriate ways of managing their anxiety. This in turn can lead to the kind of responses that are the chemical and behavioural consequences of anxiety. The ‘hit it as hard as you can or run away’ response to danger manifests itself in practice through tactics such as avoidance or attack, conflict and grievances, sickness and resignations. These behaviours in themselves create further stress and anxiety for the practitioner and those around them. Another rule often observed alongside ‘hit it as hard as you can or run away’ is ‘deny it’. The power of denial is very strong and can often result in practitioners taking a stance of almost wilful ignorance. Unable to find more effective strategies to regulate these enormously strong feelings of anxiety,
DEVELOPING PRACTICE IN ANALYSIS / 203
the practitioner begins to gain some form of psychological protection by physically and cognitively ‘looking the other way’. Menzies (1970) noted that these defence systems include: • depersonalization (such as dismissive and derogatory attitudes towards service users) • detachment (creating emotional space between practitioner and child) • rigid definition of task (following procedures rather than thinking critically) • reframing and minimizing (playing down or exaggerating some facts) • clinging to the familiar (continuing to apply what you know even if it’s not working). Such defences are likely to have a damaging impact on the practitioner’s capacity for effective intuition and analysis. Withdrawing from the emotional content of child welfare and protection work seriously constrains the practitioner’s ability to empathize. How is a practitioner expected to walk in someone else’s shoes or understand the day in the life of a child if they are unable to tolerate such realities or cope with the feelings that are generated? Forming a judgement in such circumstances is dangerous for the practitioner, since coming to a conclusion creates a risk that the conclusion is wrong. Such circumstances create an incentive to delay (Beckett et al. 2006), which leads to drift and a failure to take decisive and timely action for vulnerable children and young people. Procedural adherence may help the practitioner survive in such a climate but at great cost. Agencies create more and more policy and protocol in attempts to avert blame when failings occur. Inquiries pay more attention to whether or not correct procedure was followed than to the quality of professional judgement (Munro 2008). It follows that stressed and unhappy workers are likely to pay more attention to following rules than to thinking critically about their work (Menzies 1970). However, mere dogged adherence to procedure is not a safe tactic in child welfare and protection. The kind of indicators that practitioners are considering in child welfare and protection work are very likely to be fallible indicators. For example, a change in a child’s behaviour or the onset of soiling could be an indicator of abuse or neglect but these indicators could also be attributed to many other benign factors. Such complexity and uncertainty are the hallmarks of an environment that requires intuitive reasoning.
204 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Procedural adherence in such circumstances is like a ship’s captain who has only learnt to navigate by lighthouses and marker buoys. Without these constant dependable markers, the captain has no way of navigating safely because they have never developed the intuition that would allow them to respond to the multiple fallible indicators in the currents and shape of the coast. Only intuition learnt through experience would allow them to operate well in such conditions of uncertainty. Practitioners who are stuck in procedural adherence are unable to utilize intuition and are unlikely to apply their analysis in a sufficiently rigorous manner to avoid errors or reasoning. Anxiety reduces our capacity for both intuitive and analytical thinking.
Functional organizations
Struggle/ Persistance
Figure 7.11 A collaborative environment (adapted from Morrison 2005)
A collaborative environment (Morrison 2005) is represented in the model in Figure 7.11. Organizations that can tolerate anxiety and uncertainty can provide opportunities for learning and reflection. Within such an environment, anxiety can be expressed and acknowledged openly, and healthy levels of uncertainty not only accepted but actually valued. Being able to remain in uncertainty for longer is an important safeguard against coming to conclusions too quickly and failing to look for further information and other possible explanations. Rather than clinging to the familiar (Menzies
DEVELOPING PRACTICE IN ANALYSIS / 205
1970) practitioners are able to take risks and try new, creative approaches. The collaborative environment facilitates learning, and reflective practice allows opportunities to deepen insight and resolve problems. The security and open systems of feedback provide practitioners with the motivation and confidence to keep investing cognitive and emotional energy in their work. The functional organization can provide opportunities for workers to make the best use of both intuition and analysis. Intuition is a skill that is developed through experience (Munro 2008). However, many studies have shown that experience is not actually related to the empirical accuracy of judgements, suggesting that many experts ‘…may simply have had a great deal of experience of getting it wrong’ (Hammond 1996, p.278). But without reflection, we are unlikely to learn from experience. It is therefore important that opportunities are created for explicit reflection in practice and on practice (Schön 1983). Trained intuition (Hammond 1996) is enhanced through explicit and deliberate review of past practice. Such reflection can therefore help practitioners gain insight and learn from mistakes. Feedback is at its most helpful when it is timely and specific, and focuses on what has contributed to success or failure (Klein 1998). All practitioners involved in child welfare and protection work can benefit from such feedback. A teacher who makes a referral to the child protection team needs to know what the outcome of their enquiry is so they can learn how good their own judgement was in making the referral. The child protection worker needs to know the longerterm outcome so that they can learn how accurate their initial assessment was. Creating a culture where constructive feedback is expected may help to enhance learning and also address the difficulties in communications that have featured in so many serious case reviews (Reder and Duncan 2004). Analytical reasoning skills are more likely to be enhanced by formal teaching and reading (Munro 2008). However, have you ever considered how and where you learnt to analyse information? The process of dialects (Reder and Duncan 1999) is not usually an explicit part of a curriculum, but the heart of dialects, the oppositional discussion, can be seen in educational settings from primary schools to universities. Developing a logically defensible hypothesis and then subjecting it to scrutiny is the essence of debate. We need to ensure that education not only provides practitioners with knowledge but the skills to apply that knowledge in a critical and reflective manner. Training may be crucial so that practitioners can develop technical competence, but education is required to ensure that critical thinking, or a ‘how and why?’ mind-set, can be brought to bear in analysis:
206 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
…if leaders demonstrate open-mindedness; recognition that they can make mistakes and always learn from them; and that getting at the truth is more important than winning the argument; then they are better placed to encourage this ethos throughout the whole organization. (Dalzell and Sawyer 2007, p.131)
Since 2007 Ofsted has had responsibility for carrying out serious case reviews. The lessons learnt from these, often inadequate, inquiries (Ofsted 2008) are part of a wider debate about how we can learn effectively from those cases that have gone so terribly wrong. Traditionally, inquiries stop searching for explanations with the identification of human error and a set of responses encompassing punishment for the wrongdoer, increased levels of monitoring and protocol, and a reduction in the role of human reasoning. However, as we have seen, human judgement is formed within the influence of the environment. Rather than focus on identifying human error, it is suggested (Munro 2005) that a focus on the systems that surround human judgement would be more effective. Rather than trying to reshape human thinking, it would appear more logical and pragmatic to think again about how best to support practitioners to exert their emotional and cognitive capacities in making judgements. Taking a systems approach, like the approach that has been taken to accidents in engineering and the aeronautics industry, may provide a way forward. If we accept that child welfare and protection is defined by uncertainty and unavoidable error, then serious case reviews are likely to continue to draw the same conclusions and make the same recommendations time and time again. A desire to improve practice may more usefully consider the wider context within which practitioners analyse children and young people’s needs.
Summary Human rationality is bounded by the environment in which we operate (Gigerenzer et al. 1999). Therefore any consideration of professional analysis needs to consider not only the individual practitioner but the wider team and organizational systems. An understanding of the way in which intuitive and analytical forms of cognition are developed and function may provide practitioners with a clearer and more explicit understanding of professional judgement and analysis. The cognitive continuum provides an opportunity to see these two forms of cognition working together through compromise rather than rivalry (Hammond 1996). Creating the conditions in which workers can make best use of this continuum of cognitive styles involves developing practice at all levels of the system.
DEVELOPING PRACTICE IN ANALYSIS / 207
Being able to match the structure of the judgement task to the right form of thinking is crucial. In this chapter we have considered the features of the task (or information environment) that are more likely to induce intuitive cognition and those that are more likely to induce analytical cognition. An awareness of the nature of the task and the nature of the different forms of thinking may allow for a more effective match and a way of understanding what happens when there is a mismatch between task and judgement style. Both intuition and analysis are fallible. Intuition is a robust means of thinking when there are high levels of information and uncertainty but little time for thinking. However, intuition is subject to potential bias, and practitioners need to be able to move away from intuition towards analysis at appropriate times to make more explicit and defensible sense of information dealt with initially by fast and frugal heuristics. Analysis provides precision through conscious process and overt reference to logical argument (Hammond 1996). Analysis is also fallible, and practitioners need to guard against common errors of reasoning such as ending the search for information and explanations too quickly and failing to revise judgements in the light of new information (Munro 1999). Supervision plays a vital part in both the emotional and cognitive aspects of analysis. Effective use of supervision is crucial and, in an era when supervision is often lacking and managerial in focus, it is vital that both supervisors and supervisees are aware of the centrality of good supervision in effective analysis. If practitioners are to respond to what children and young people want from child welfare and protection systems they will need to be able and willing to listen to children and young people and actively engage with them as active sentient agents in their own assessments. We need to be more willing to engage with children and young people in ways that harness the means of communication in which they are most competent. We also need to be able to hold the child in mind throughout. For practitioners to respond to these challenges repeatedly and consistently, organizations need to address the barriers to effective and empathic understanding of children and young people’s needs and experiences. The focus of serious case reviews has tended to be on the individual practitioner as the source of error (Munro 2005). However, given the repetition of findings from inquiries and organizational responses (Reder and Duncan 1999, 2003) there is a growing recognition of the need to review the inquiry system (Fish et al. 2008). The decision-making environment has a crucial impact on our cognitive approach to analysis, and a systems approach may provide the way forward to allow practitioners more effectively to bring analysis to bear on children and young people’s needs.
Bibliography Adams, D. (1979) The Hitchhiker’s Guide to the Galaxy. London: Pan Macmillan. Adams, R., Dominelli, L. and Payne, M. (eds) (2009) Social Work: Themes, Issues and Critical Debates, 3rd edn. Basingstoke: Palgrave Macmillan. Aldgate, J. and McIntosh, M. (2006) Looking After the Family: A Study of Kinship Care in Scotland. Edinburgh: SWIA. Aldgate, J. and Rose, W. (2006) A Discussion Paper Outlining an Approach to Assessing and Managing Risk Within the Getting It Right for Every Child Practice Model. Available at www.scotland.gov.uk/Topics/ People/Young-People/childrensservices/girfec/Practitioners/ToolsResources/AssessmentRisk, accessed on 26 September 2009. Arkes, H.R. and Hammond, K.R. (1986) Judgement and Decision Making: An Interdisciplinary Reader. Cambridge: Cambridge University Press. Baldwin, N. (ed.) (2000) Protecting Children, Promoting Their Rights. London: Whiting & Birch. Baron-Cohen, S. (1995) Mind-Blindness: An Essay on Autism and Theory of Mind. Cambridge, MA: MIT Press. Cited in J. Allen and P. Fonagy (eds) (2006) Handbook of Mentalization-Based Treatment. Chichester: Wiley. Bateson, G. (1972) Steps to an Ecology of Mind: Collected Essays in Anthropology, Psychiatry, Evolution and Epistemology. Aylesbury: Intertext. Batmanghelidjh, C. (2007) Shattered Lives: Children Who Live with Courage and Dignity. London: Jessica Kingsley Publishers. Beckett, C., McKeigue, B. and Taylor, H. (2006) ‘Coming to conclusions: social worker’s perceptions of the decision-making process in care proceedings.’ Child and Family Social Work 12, 54–63. Bee, H. and Boyd, D. (2007) The Developing Child, 11th edn. London: Pearson/Allyn & Bacon. Bell, M. (2002) ‘Promoting children’s rights through the use of relationship.’ Child and Family Social Work 7, 1, 1–11. Bentovim, A., Cox, A., Bingley Miller, L. and Pizzey, S. (2009) Safeguarding Children Living with Trauma and Family Violence. London: Jessica Kingsley Publishers. Birchall, J. and Hallet, C. (1995) Working Together in Child Protection. London: HMSO. Bjork, R.A. (1978) ‘The Updating of Human Memory.’ In G.H. Bower (ed.) The Psychology of Learning and Motivation 12, pp.235–259. New York: Academic Press. Blackburn, S. (1996) The Oxford Dictionary of Philosophy. Oxford: Oxford University Press. Blaug, R. (1995) ‘Distortion of the face to face: communicative reason and social work practice.’ British Journal of Social Work 25, 3, 423–439. Brandon, M., Belderson, P., Warren, C., Howe, D. et al. (2008) Analysing Child Deaths and Serious Injury through Abuse and Neglect: What Can We Learn? A Biennial Analysis of Serious Case Reviews. Nottingham: DCSF. Brandon, M., Owers, M. and Black, J. (1999) Learning How to Make Children Safer: An Analysis for the Welsh Office of Serious Child Abuse Cases in Wales. Norwich: University of East Anglia/Welsh Office. British Crime Survey (BCS) (2008) British Crime Survey 2008. London: Home Office. Brockner, J. and Rubin, J. (1985) Entrapment in Escalating Conflicts: A Social Psychological Analysis. New York: Springer-Verlag. Brown, A. and Bourne, I. (1996) The Social Work Supervisor. Buckingham: Open University Press.
209
210 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Buckley, H. (2008) Service Users’ Perceptions of the Irish Child Protection System. Dublin: Department for Children and Youth Affairs. Buckley, H., Whelan, S. and Holt, S. (2006) Listen to Me! Children’s Experience of Domestic Violence. Dublin: Children’s Research Centre, Trinity College Dublin. Butler-Sloss, E. (1988) Report of the Inquiry into Child Abuse in Cleveland 1987. London: HMSO. Buzan, T. (2002) How to Mind Map. London: Thorsons. Cairns, K. and Stanway, C. (2004) Learn the Child. Helping Looked After Children to Learn. A Good Practice Guide for Social Workers, Carers and Teachers. London: BAAF. Calder, M. (ed.) (2008) Contemporary Risk Assessment in Safeguarding Children. Lyme Regis: Russell House Publishing. Calder, M. and Hackett, S. (2003) Assessment in Child Care: Using and Developing Frameworks for Practice. Lyme Regis: Russell House Publishing. Children’s Workforce Development Council (CWDC) (2009) Right from the Start: Supervision Guide For Social Workers. Available at www.cwdcouncil.org.uk/nqsw/pilot-programme, accessed on 27 July 2009. Clapton, G. (2009) ‘How and why social work fails fathers: redressing an imbalance, social work’s role and responsibility.’ Practice: Social Work in Action 21, 1, 17–34. Cleaver, H. (2000) Fostering Family Contact. London: TSO. Cleaver, H., Walker, S. and Meadows, P. (2004) Assessing Children’s Needs and Circumstances: The Impact of the Assessment Framework. London: Jessica Kingsley Publishers. Cleaver, H., Walker, S., Scott, J., Rose, W., Ward, H. and Pithouse, A. (2008) The Integrated Children’s System: Enhancing Social Work and Inter-Agency Practice. London: Jessica Kingsley Publishers. Cooper, A. (2003) ‘Risk and the Framework for Assessment.’ In M. Calder and S. Hackett (eds) Assessment in Child Care: Using and Developing Frameworks for Practice. Lyme Regis: Russell House Publishing. Cooper, A. (2005) ‘Surface and depth in the Victoria Climbié Inquiry Report.’ Child and Family Social Work 10, 1–9. Coulshed, V. and Orme, J. (1998) Social Work Practice, 3rd edn. Basingstoke: Palgrave. Coulshed, V. and Orme, J. (2006) Social Work Practice, 4th edn. Basingstoke: Palgrave. Crisp, B., Anderson, M., Orme, J. and Lister Green, P. (2007) ‘Assessment frameworks: a critical reflection.’ British Journal of Social Work 37, 1059–1077. Crompton, M. (2007) ‘Individual Work with Children.’ In K. Wilson and A. James (eds) The Child Protection Handbook. London: Bailliere Tindall. Dalgleish, L. (2000) cited in A. Hollows (2003) ‘Making Professional Judgements in the Framework for the Assessment of Children in Need and their Families.’ In M. Calder and S. Hackett (eds) Assessment in Child Care: Using and Developing Frameworks for Practice. Lyme Regis: Russell House Publishing. Dalgleish, L. (2003) ‘Risks, Needs and Consequences.’ In M. Calder and S. Hackett (eds) Assessment in Child Care: Using and Developing Frameworks for Practice. Lyme Regis: Russell House Publishing. Dalzell, R. and Sawyer, E. (2007) Putting Analysis into Assessment: Undertaking Assessments of Need. London: National Children’s Bureau. Daniel, B. and Taylor, J. (2001) Engaging with Fathers: Practice Issues for Health and Social Care. London: Jessica Kingsley Publishers. Daniel, B. and Vincent, S. (2004) An Analysis of Children and Young People’s Calls to Childline about Abuse and Neglect. Edinburgh: SWSI/Scottish Executive. Daniel, B., Wassell, S. and Gilligan, R. (2002) Child Development for Child Care and Protection Workers. London: Jessica Kingsley Publishers. Daston, L. (1988) Classical Probability in the Enlightenment. Princeton, NJ: Princeton University Press. Davie, R., Upton, G. and Varma, V. (eds) (1996) The Voice of the Child: A Handbook for Professionals. London: Falmer Press. Demasio, A. (2006) Descarte’s Error, 2nd edn. London: Vintage Books. Department for Children, Schools and Families (DCSF) (2006) An Introduction to Assessment to Support CAF Training: Handbook to Support Practitioners. Available at www.dcsf.gov.uk/everychildmatters/ resources-and-practice/IG00119, accessed on 19 November 2009.
BIBLIOGRAPHY / 211
Department for Education and Skills (DfES) (2003a) What to Do If You’re Worried a Child Is Being Abused. London: TSO. Department for Education and Skills (DfES) (2003b) Every Child Matters. London: TSO. Department for Education and Skills (DfES) (2006) The Common Assessment Framework for Children and Young People: Practitioners’ Guide. London, TSO. Department of Health (DoH) (1988) Protecting Children: A Guide to Social Workers Undertaking a Comprehensive Assessment. London: HMSO. Department of Health (DoH) (1995) Child Protection: Messages from Research. London: HMSO. Department of Health (DoH) (2000) Framework for the Assessment of Children in Need and Their Families. London: HMSO. Department of Health (DoH) (2002) Safeguarding Children: The Joint Chief Inspector’s Report on Arrangements to Safeguard Children. London: HMSO. Department of Health (DoH) (2003) 12th Annual Report of the Chief Inspector of Social Services. London: HMSO. Dewey, J. (1910) How We Think. Boston, MA: Heath. Dickens, J. (2007) ‘Child neglect and the law: catapults, thresholds and delay.’ Child Abuse Review 16, 77–92. Esgate, A. and Groome, D. (2004) An Introduction to Applied Cognitive Psychology. New York: Psychology Press. Fagan, D. (1998) ‘Child abuse and neglect: the knowledge base of the A&E nurse.’ Accident and Emergency Nursing 6, 30–35. Fahlberg, V.I. (1994) A Child’s Journey through Placement. Ilford: BAAF. Farmer, E. and Owen, M. (1995) Child Protection Practice: Private Risks and Public Remedies. London: HMSO. Firkins, A. and Candlin, C. (2006) ‘Framing the child at risk.’ Health, Risk and Society 8, 3, 273–291. Fish, S., Munro, E. and Bairstow, S. (2008) Learning Together to Safeguard Children: Developing an InterAgency Systems Approach for Case Reviews. London: SCIE. Forrester, D., Kershaw, S., Moss, H. and Hughes, L. (2008) ‘Communication skills in child protection: how do social workers talk to parents?’ Child and Family Social Work 13, 41–51. Fox Harding, L. (1996) ‘Recent developments in “children’s rights”: liberation for whom?’ Child and Family Social Work 13, 141–150. Gadsby-Waters, J. (1992) The Supervision of Child Protection Work. Aldershot: Avebury. Garbarino, J., Stocking, H. and Collins, A. (1980) Protecting Children from Abuse and Neglect: Developing and Maintaining Effective Support Systems for Families. San Francisco, CA: Jossey-Bass. Gigerenzer, G. (2007) Gut Feelings. London: Penguin. Gigerenzer, G., Todd, P. and the ABC Research Group (1999) Simple Heuristics that Make Us Smart. Oxford: Oxford University Press. Gilligan, R. (1999) ‘Enhancing the resilience of children and young people in public care by mentoring their talents and interests.’ Child and Family Social Work 4, 3, 187–196. Gilligan, P. and Manby, M. (2008) ‘The Common Assessment Framework: does the reality match the rhetoric?’ Child and Family Social Work 13, 177–187. Gilovich, T., Griffin, D. and Kahneman, D. (2002) Heuristics and Biases: The Psychology of Intuitive Judgement. Cambridge: Cambridge University Press. Gladwell, M. (2005) Blink. London: Penguin. Goldstein, W.M. and Hogarth, R.M. (1997) ‘Judgement and Decision Research: Some Historical Context.’ In R.M. Hogarth (ed.) Research on Judgement and Decision Making: Currents, Connections and Controversies. Cambridge: Cambridge University Press. Goleman, D. (1995) Emotional Intelligence. New York: Bantam Books. Gomm, R. and Davies, C. (eds) (2000) Using Evidence in Health and Social Care. London: Sage/Open University Press. Hall, C. (1997) Social Work as Narrative: Storytelling and Persuasion in Professional Texts. Aldershot: Ashgate. Hallet, C. and Prout, A. (eds) (2003) Hearing the Voices of Children: Social Policy for a New Century. London: Routledge Falmer.
212 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Hammond, K. (1996) Human Judgment and Social Policy: Irreducible Uncertainty, Inevitable Error, Unavoidable Justice. Oxford: Oxford University Press. Hammond, K. (2000) Judgments under Stress. Oxford: Oxford University Press. Hammond, K., Hamm, R., Grassia, J. and Pearson, T. (1986) ‘Direct comparison of the efficacy of intuitive and analytical cognition in expert judgement.’ IEEE Transactions on Systems, Man and Cybernetics SMC 17, 5, 753–770. Hanks, H. and Stratton, P. (2007) ‘Common Forms and Consequences of Child Abuse.’ In K. Wilson and A. James (eds) The Child Protection Handbook. London: Bailliere Tindall. Haringey LSCB (2009) Serious Case Review: Baby Peter. Executive Summary. London: Haringey Local Safeguarding Children Board. Hauser, T. (1991) Muhammad Ali: His Life and Times. New York: Simon & Schuster. Hawkins, P. and Shohet, R. (2000) Supervision in the Helping Professions, 2nd edn. Oxford: Oxford University Press. Hawthorn, J. and Wilson, P. (2009) Significant Case Review: Brandon Muir. Dundee: Dundee Children and Young Persons Protection Committee/Chief Officer’s Group. Herron, H. (2000) ‘Supporting health visitors in child protection.’ Community Practitioner 73, 9, 751–753. Hertwig, R. and Gigerenzer, G. (1999) ‘The “conjunction fallacy” revisited: how intelligent inferences look like reasoning errors.’ Journal of Behavioural Decision Making 12, 275–305. Hertwig, R., Hoffrage, U. and Martignon, L. (1999) ‘Quick Estimation: Letting the Environment Do the Work.’ In G. Gigerenzer, P. Todd and the ABC Research Group Simple Heuristics that Make Us Smart. Oxford: Oxford University Press. HM Government (2008) Information Sharing: Guidance for Practitioners and Managers. Nottingham: DCSF. Holland, S. (2004) Child and Family Assessment in Social Work Practice. London: Sage. Hollows, A. (2003) ‘Making Professional Judgements in the Framework for the Assessment of Children in Need and their Families.’ In M. Calder and S. Hackett Assessment in Child Care: Using and Developing Frameworks for Practice. Lyme Regis: Russell House Publishing. Hollows, A. (2008) ‘Professional Judgement and the Risk Assessment Process.’ In M. Calder (ed.) Contemporary Risk Assessment in Safeguarding Children. Lyme Regis: Russell House Publishing. Horwath, J. (ed.) (2009) The Child’s World: The Comprehensive Guide to Assessing Children in Need, 2nd edn. London: Jessica Kingsley Publishers. Horwath, J. (2005) ‘Identifying and assessing cases of child neglect: learning from the Irish experience.’ Child and Family Social Work 10, 2, 99–110. Horwath, J. (2006) ‘The missing assessment domain: personal, professional and organizational factors influencing professional judgements when identifying and referring child neglect.’ British Journal of Social Work 37, 1285–1303. Horwath, J. (2007a) Child Neglect: Identification and Assessment. Basingstoke: Palgrave Macmillan. Horwath, J. (2007b) ‘Safeguarding Children: The Assessment Challenges.’ In K. Wilson and A. James (eds) The Child Protection Handbook, 3rd edn. London: Bailliere Tindall. Howe, D. (1990) An Introduction to Social Work Theory. Aldershot: Ashgate Publishing. Howe, D. (2005) Child Abuse and Neglect. London: Macmillan. Howe, D. (2008a) The Emotionally Intelligent Social Worker. Basingstoke: Palgrave Macmillan. Howe, D. (2008b) BASPCAN Conference, Stirling. Hughes, L. and Pengelly, P. (1997) Staff Supervision in a Turbulent Environment. London: Jessica Kingsley Publishers. Hume, D. (1734) ‘A Treatise of Human Nature.’ Cited in A. Herman (2003) The Scottish Enlightenment: The Scots’ Invention of the Modern World. London: Fourth Estate. Hyland, H. and Holme, C. (2009) ‘Survey of health recommendations arising from 2006 Working Together Chapter 8, Serious Case Reviews. How to achieve better learning?’ Child Abuse Review 18, 195–204. Jack, G. and Gill, O. (2003) Missing Side of the Triangle: Assessing the Importance of Family and Environmental Factors in the Lives of Children. London: Barnardos. Jenks, C. (1996) Childhood. London: Routledge.
BIBLIOGRAPHY / 213
Kadushin, A. and Harkness, D. (2002) Supervision in Social Work, 4th edn. New York: Columbia University Press. Kaplan, A. (1964) The Conduct of Inquiry: Methodology for Behavioural Science. San Francisco, CA: Chandler. Kershaw, C., Nicholas, S. and Walker, A. (2008) Crime in England and Wales 2007–08 British Crime Survey. London: BCS. Klein, G. (1998) Sources of Power: How People Make Decisions. Cambridge, MA: MIT Press. Klin, A., Jones, W., Schultz, R., Volkmar, F. and Cohen, D. (2002) ‘Abnormal ventral temporal cortical activity during face discrimination among individuals with autism and Asperger’s syndrome.’ Archives of General Psychiatry 59, 809–816. Kohli, R. and Mitchell, F. (eds) (2007) Working with Unaccompanied Asylum Seeking Children: Issues for Policy and Practice. Basingstoke: Palgrave Macmillan. Koriat, A., Lichtenstein, S. and Fischhoff, B. (1980) ‘Reasons for confidence.’ Journal of Experimental Psychology: Human Learning and Memory 6, 107–118. Laming, Lord (2003) The Victoria Climbié Inquiry Report. Norwich: The Stationery Office. Laming, Lord (2009) The Protection of Children in England: A Progress Report. London: The Stationery Office. Lishman, J. (ed.) (1991) A Handbook of Theory for Practice Teachers in Social Work. London: Jessica Kingsley Publishers. Lishman, J. (ed.) (2007) Handbook for Practice Learning in Social Work and Social Care: Knowledge and Theory, 2nd edn. London: Jessica Kingsley Publishers. Lord, C., Lepper, M. and Preston, E. (1984) ‘Considering the opposite: a corrective strategy for social judgement.’ Journal of Personality and Social Psychology 47, 1231–1243. Lorenz, K. (1961) King Solomon’s Ring. London: Methuen. McDonald, G. (2001) Effective Interventions for Child Abuse and Neglect. Chichester: Wiley. McLeod, A. (2008) Listening to Children: A Practitioner’s Guide. London: Jessica Kingsley Publishers. McLeod, M. (2000) ‘What Do Children Need by Way of Child Protection? Who Is to Decide?’ In N. Baldwin (ed.) Protecting Children, Promoting Their Rights. London: Whiting & Birch. Menzies, I. (1970) The Functioning of Social Systems as a Defence against Anxiety. London: Tavistock Institute of Human Relations. Messer, D. and Jones, F. (1999) Psychology and Social Care. London: Jessica Kingsley Publishers. Miller, G. (1956) ‘The magical number seven, plus or minus two: some limits on our capacity of processing information.’ Psychological Review 63, 81–97. Milner, J. and O’Byrne, P. (2002) Assessment in Social Work, 2nd edn. Basingstoke: Palgrave Macmillan. Morrison, T. (1997) ‘Emotionally Competent Child Protection Organizations: Fallacy, Fiction or Necessity?’ In J. Bates, R. Pugh and N. Thompson Protecting Children: Challenges and Change. Aldershot: Arena. Morrison, T. (2005) Staff Supervision in Social Care: Making a Real Difference for Staff and Service Users, 3rd edn. Brighton: Pavilion. Morrison, T. (2007) ‘Emotional intelligence, emotion and social work: context, characteristics, complications and contributions.’ British Journal of Social Work 37, 2, 245–263. Moss, P. and Petrie, P. (2002) From Children’s Services to Children’s Spaces. London: Routledge Falmer. Mudaly, N. and Goddard, C. (2006) The Truth is Longer than a Lie: Children’s Experiences of Abuse and Professional Intervention. London: Jessica Kingsley Publishers. Munro, E. (1996) ‘Avoidable and unavoidable mistakes in child protection work.’ British Journal of Social Work 26, 793–808. Munro, E. (1999) ‘Common errors of reasoning in child protection work.’ Child Abuse and Neglect 23, 745–758. Munro, E. (2003) Victoria Climbié Inquiry: Discussion Paper on Identification. Available at www.victoriaclimbie-inquiry.org.uk/Evidence/p2subs/pdfs/Sem2/invited/Eileen20Munro.pdf, accessed on 10 April 2007. Munro, E. (2005) ‘Improving practice: child protection as a systems problem.’ Children and Youth Services Review 27, 375–391. Munro, E. (2008) Effective Child Protection, 2nd edn. London: Sage.
214 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Murray, J. (2001) De-Registering Child Protection Social Work. Sheffield: Sheffield Hallam University. National Children’s Home (NCH) (2008) NCH Factfile. London: NCH. Nurius, P. and Gibson, J. (1990) ‘Clinical inference, reasoning, and judgment in social work: an update.’ Social Work Research and Abstracts 26, 2, 18–25. O’Brien, S., Hammond, H. and McKinnon, M. (2003) The Report of the Caleb Ness Inquiry. Edinburgh: Edinburgh and the Lothians Child Protection Committee. Ofsted (2008) Learning Lessons, Taking Action: Ofsted’s Evaluations of Serious Case Reviews 1 April 2007 to 31 March 2008. London: Department for Children, Schools and Familes (DCSF). O’Quigley, A. (2000) Listening to Children’s Views: The Findings and Recommendations of Recent Research. York: York Publishing Services Ltd. O’Sullivan, T. (1999) Decision Making in Social Work. Basingstoke: Palgrave Macmillan. Parton, N., Thorpe, D. and Wattam, C. (1997) Child Protection, Risk and the Moral Order. Basingstoke: Macmillan. Pearce, W. (1989) Communication and the Human Condition. Carbondale, IL: Southern Illinois University Press. Philp, M. (1979) ‘Notes on the form of knowledge in social work’. Sociological Review 27, 1, 83–111. Planalp, S. (1999) Communicating Emotions: Social, Moral and Cultural Processes. Cambridge: Cambridge University Press and Editions de la Maison des Sciences de l’Homme. Plous, S. (1993) The Psychology of Judgment and Decision Making. New York: McGraw-Hill. Pritchard, J. (1995) Good Practice in Supervision: Statutory and Voluntary Organisations. London: Jessica Kingsley Publishers. Prout, A. and Hallet, C. (eds) (2003) Hearing the Voices of Children: Social Policy for a New Century. London: Routledge Falmer. Quattrone, A. (1982) ‘Overattribution and unit formation: when behaviour engulfs the person.’ Journal of Personality and Social Psychology 42, 593–607. Quinton, D. (2004) Supporting Parents: Messages from Research. London: Jessica Kingsley Publishers. Raynes, B. (2003) ‘A stepwise process of assessment.’ In M. Calder and S. Hackett (2003) Assessment in Child Care: Using and Developing Frameworks for Practice. Lyme Regis: Russell House Publishing. Reder, P. and Duncan, S. (1999) Lost Innocents: A Follow-Up Study of Fatal Child Abuse. London: Routledge. Reder, P. and Duncan, S. (2000) ‘A required mind-set for child protection practice: comments on Munro (1999).’ Child Abuse and Neglect 24, 443–445. Reder, P. and Duncan, S. (2003) ‘Understanding communication in child protection networks.’ Child Abuse Review 12, 82–100. Reder, P. and Duncan, S. (2004) ‘Making the most of the Victoria Climbié Inquiry.’ Child Abuse Review 13, 2, 95–114. Reder, P., Duncan, S. and Gray, M. (1993) Beyond Blame: Child Abuse Tragedies Revisited. London: Routledge. Reder, P., Duncan, S. and Lucey, C. (2003) Studies in the Assessment of Parenting. Hove: BrunnerRoutledge. Robson, J. (Ed) (1974) The Collected Works of John Stuart Mill Vol VII – A System of Logic Ratiocinative and Inductive; Being a Connected View of the Principles of Evidence and the Methods of Scientific Investigation. London: Routledge and Kegan Paul, Chapter XIV. Available at http://oll.libertyfund. org/?option=com_staticxt&staticfile=show.php%3Ftitle=246&chapter=39862&layout=html& Itemid=27, accessed on 19 November 2009. Rogers, C. (1951) Client-Centered Counselling. Boston, MA: Houghton-Mifflin. Rojek, C., Peacock, G. and Collins, S. (1988) Social Work and Received Ideas. London: Routledge. Rose, W. and Barnes, J. (2008) Improving Safeguarding Practice: Study of Serious Case Reviews 2001–2003. Nottingham: Department for Children, Schools and Families (DCSF)/Open University. Rouf, K. (1989) ‘Journey through Darkness: The Path from Victim to Survivor.’ In G. Lindsey and A. Peake (eds) Child Sexual Abuse: Educational and Child Psychology. Disley: The British Psychological Society. Ruch, G. (2002) ‘From triangle to spiral: reflective practice in social work education, practice and research.’ Social Work Education 21, 2, 199–216.
BIBLIOGRAPHY / 215
Ruch, G. (2009) Post-Qualifying Child Care Social Work. London: Sage. Saradjian, J. and Hanks, H. (1996) Women Who Sexually Abuse Children: From Research to Clinical Practice. Chichester: Wiley. Sayer, T. (2008) Critical Practice in Working with Children. Basingstoke: Palgrave Macmillan. Schön, D. (1983) The Reflective Practitioner: How Professionals Think in Action. New York: Basic Books. Schön, D. (1987) Educating the Reflective Practitioner: Towards a New Design for Teaching and Learning in the Professions. San Francisco, CA: Jossey-Bass. Scott, D. (1998) ‘A qualitative study of social work assessment in cases of alleged child abuse’. British Journal of Social Work 28, 73–88. Scottish Executive (2002) ‘It’s everyone’s job to make sure I’m alright’: Report of the Child Protection Audit and Review. Edinburgh: Scottish Executive. Scottish Executive (2004) Protecting Children and Young People: The Charter. Edinburgh: Scottish Executive. Scottish Executive (2005) Getting It Right for Every Child: Proposals for Action. Edinburgh: Scottish Executive. Scottish Executive (2006) Changing Lives: Report of the 21st Century Social Work Review. Edinburgh: Scottish Executive. Scottish Executive (2007a) Getting It Right for Every Child: Guidance on the Child’s or Young Person’s Plan. Edinburgh: Scottish Executive. Scottish Executive (2007b) Process Review of the CPRP, a Three-Year Initiative with the Goal of Improving Protection of Children at Risk of Neglect and Reducing the Number of Children Who Need Protection. Edinburgh: Scottish Executive. Scottish Office (1998) Protecting Children: A Shared Responsibility. Edinburgh: HMSO. Scourfield, J. (2003) Gender and Child Protection. Houndsmills: Palgrave Macmillan. Scragg, T. (2003) Managing at the Front Line: A Handbook for Managers in Social Care Agencies. Brighton: Pavilion. Seligman, M. (2004) Authentic Happiness. New York: The Free Press. Sheppard, M. (1995) ‘Social work, social science and practice wisdom.’ British Journal of Social Work 25, 265–293. Sheppard, M., Newstead, S., DiCaccavo, A. and Ryan, K. (2001) ‘Comparative hypothesis assessment and quasi triangulation as process knowledge assessment strategies in social work practice.’ British Journal of Social Work 31, 6, 863–885. Simon, H. (1955a) Models of Man: Social and Rational; Mathematical Essays on Rational Human Behaviour in Society Setting. New York: Wiley. Simon, H. (1955b) ‘A behavioural model of rational choice.’ Quarterly Journal of Economics 69, 99–118. Simon, H. (1987) Cited in G. Gigerenzer, P. Todd and the ABC Research Group (1999) Simple Heuristics that Make Us Smart. Oxford: Oxford University Press. Sinclair, R. and Bullock, R. (2002) Learning from Past Experience – A Review of Serious Case Reviews. London: Department of Health. Sinclair, R., Garnett, L. and Berridge, D. (1995) Social Work and Assessment with Adolescents. London: National Children’s Bureau. Smale, G. and Tuson, G. with Biehal, N. and Marsh, P. (1993) Empowerment, Assessment, Care Management and the Skilled Worker. London: National Institute for Social Work. Smith, M., Nursten, J. and McMahon, L. (2004) ‘Social workers’ responses to the experience of fear’. British Journal of Social Work 34, 541–559. Social Work Inspection Agency (SWIA) (2005) A Report into the Care and Protection of Children in Eilean Siar. Edinburgh: Scottish Executive/Social Work Inspection Agency. Soon, C.S., Brass, M., Heinze, H.J. and Haynes, D.J. (2008) ‘Unconscious determinants of free decisions in the human brain.’ Nature Neuroscience 11, 5, 543–545. Standing, L. (1973) ‘Learning 10,000 pictures.’ Quarterly Journal of Political Economy 69, 213–225. Stanley, J. and Goddard, C. (2002) In the Front Line: A Handbook for Managers in Social Care Agencies. Brighton: Pavilion. Stevenson, O. (2007) ‘Where are we now? Themes and future directions.’ In K. Wilson and A. James (eds) The Child Protection Handbook, 3rd edn. London: Bailliere Tindall.
216 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Stevenson, O. and Hallet, C. (1980) Child Abuse: Aspects of Interprofessional Co-operation. London: Allen and Unwin. Taylor, C. and White, S. (2001) ‘Knowledge, truth and reflexivity: the problem of judgement in social work.’ Journal of Social Work 1, 1, 37–59. Taylor, C. and White, S. (2006) ‘Knowledge and reasoning in social work: educating for humane judgement.’ British Journal of Social Work 36, 937–954. Taylor, H., Beckett, C. and McKeigue, B. (2008) ‘Anxieties and defences of social workers.’ Child and Family Social Work 13, 23–31. Taylor, J. and Daniel, B. (eds) (2005) Child Neglect: Practice Issues for Health and Social Care. London: Jessica Kingsley Publishers. Taylor, S. and Thompson, S. (1982) ‘Stalking the elusive “vividness” effect.’ Psychological Review 33, 403–408. Thoburn, J., Lewis, A. and Shemmings, D. (1995) Paternalism or Partnership? Family Involvement in the Child Protection Process. London: HMSO. Thomas, N. and O’Kane, C. (2000) ‘Discovering what children think: connections between research and practice.’ British Journal of Social Work 30, 819–835. Triseliotis, J., Borland, M., Hill, M. and Lambert, L. (1995) Teenagers and the Social Work Services. London: HMSO. Tunstill, J. (1997) ‘Implementing the Family Support Clauses of the 1989 Children Act.’ In N. Parton (ed.) Child Protection and Family Support: Tensions, Contradictions and Possibilities. London: Routledge. Tversky, A. and Kahneman, D. (1973) ‘Availability: a heuristic for judging frequency and probability.’ Cognitive Psychology 5, 207–232. Tversky, A. and Kahneman, D. (1974) ‘Judgement under uncertainty: heuristics and biases.’ Science 185, 1124–1131. Tversky, A. and Kahneman, D. (1982) ‘Judgements of and by Representativeness.’ In D. Kahneman, P. Slovic and A. Tversky (1982) Judgement under Uncertainty: Heuristics and Biases. Cambridge: Cambridge University Press. UN Convention on the Rights of the Child (1989) Geneva: United Nations. Valentine, M. (1994) ‘The social worker as “bad object”.’ British Journal of Social Work 24, 71–86. Vincent, S. and Daniel, B. (2004) ‘An analysis of children and young people’s calls to ChildLine about abuse and neglect: a study for the Scottish Child Protection Review.’ Child Abuse Review 13, 158–171. Walker, S. and Beckett, C. (2003) Social Work Assessment and Intervention. Lyme Regis: Russell House Publishing. Wang, X.T. (1996) ‘Framing effects: dynamics and task domains.’ Organizational Behaviour and Human Decision Processes 68, 147–157. Webb, S. (2006) Social Work in a Risk Society: Social and Political Perspectives. Basingstoke: Palgrave Macmillan. White, S. (1997) ‘Beyond retroduction? – Hermeneutics, reflexivity and social work practice.’ British Journal of Social Work 27, 739–753. Wilson, T. (2002) Strangers to Ourselves: Discovering the Adaptive Unconscious. Cambridge, MA: Harvard University Press. Woodcock, J. (2003) ‘The social work assessment of parenting: an exploration.’ British Journal of Social Work 33, 87–106. Woodward, R. (2005) So You’re Going to Live in Foster Care: Here’s What Other Children Who’ve Been There Have to Say.’ Information leaflet. Glasgow: The Fostering Network Scotland. Zajonc, R. (1980) ‘Feeling and thinking: preferences need no inferences.’ American Psychologist 235, 151–175.
Subject Index affect heuristics 137–8 analysis building up 79–83 checking for discrepancies 195 and cognitive continuum 152–5, 182–6 context for 181–2 definition of 29–30 in depth 99–102 development of 13–14 and dialectic mind-set 102–4 and dialectics 30–1, 107–8 and ‘doing’ 112, 201 framing 74, 115, 150–2 and intuition 187–8 and judgement 17–18, 26–7 learning 18–19 and maximization of expected utility 15–17 need for 13–14 and optimization 15–17 within organizations 115– 17, 199–206 and practitioners 111–14 and serious case reviews 19–20 supervision in 193–4, 196–8 support for 114 ‘truth’ in 25–7 and unconscious thinking 39–40 and use of theory 20 and working environment 112–13
analytical thinking 31–2, 111–13 assessment completeness of 83 and data management 63–4 definition of 21–2 in depth 100 and direct contact with children 55–6 framing 69–71 and hermeneutics 23 and inter-agency partnerships 44–7, 65–6 and observation 56–7 and political climate 117 practical-moral perspective 23–5 technical-rational perspective 23–5 and use of past information 47–50 availability heuristics 133–5, 144–5 Baby Peter case 43, 46 Beckford, Jasmine 141–2 children and agency concept 172 barriers to listening to 162–5 communicating with 166–9, 173, 176 confidence in dealing with 165–6 culture of 177–8 day in life of 176–7
217
direct contact with 55–6 engaging with 171–2 listening to 74–7, 159–60 marginalizing 170–1 perspectives of 160–2 and practice development 166–78 space for 175 and teachers 75–7 time for 174–5 understanding 157–8 Children Act (1989) 66, 159 Children Act (2004) 66 Children (Scotland) Act (1995) 66, 159 Climbié, Victoria 74, 112, 142, 176 Clunis, Christopher 144 cognitive continuum 35–6, 148–50, 152–5, 182– 6, 188–9 Common Assessment Framework (CAF) 71, 79, 159, 161 communication and discourse analysis 88–9 and metacommunication 84–7 and practice development 89–90 use of 84 Connolly, Cyril 39 Darwin, Charles 15–16 data managing 63–4 Data Protection Act (1998) 66, 68
218 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
deduction in Socratic method 104, 105, 106–7 Department of Health Assessment Framework 18 dialectic mind-set 102–4 dialectics and analysis 30–1, 107–8 and antithesis 109–10 and Socratic method 104 and synthesis 108, 110 discourse analysis 88–9 Eilean Siar inspection report 45–6 emotional tagging 136–9, 147 Every Child Matters (DfES) 55, 62 framing information 69–71 in analysis 74, 115, 150–2 in practice development 73 Getting It Right for Every Child (Scottish Executive) 55, 117, 159–60 hermeneutics and assessment 23 heuristics 33–4 and affect heuristics 137–8 and availability heuristics 133–5, 144–5 and emotional tagging 136–9, 147 and intuition 126–7 pattern recognition in 135–6, 146–7 and practice examples for 131–3 and recognition heuristics 127–8, 145–6 and representativeness heuristics 129–31, 141–3
and satisficing 40–3 hypotheses and antithesis 109–10 avoidance in 95–6 building 97–9 in child welfare 94 development of 94–9 definition of 93–4 and memory 96, 195–7 multiple 108–11, 117–19 sources for 96–7 and synthesis 108, 110 testing 117–19 and working environment 112–13 induction in Socratic method 104–5, 106–7 information accessible 51–4 accessing 66–9 building up 79–83 and childhood neglect 53–4 concrete 53 framing 69–71 and Johari window 77–9 and practice development 60–1 spoken 51–2 written 51–2 see also past information Integrated Assessment Framework (IAF) 71, 79, 160 intuition and analysis 187–8 and availability heuristics 133–5, 144–5 and cognitive continuum 148–50, 152–5, 182–6 definition of 121–3 and emotional tagging 136–9, 147 framing 150–2 and heuristics 126–7 and normality 143–4 and organizations 205 origins of 123–5
pattern recognition in 135–6, 146–7 practice examples for 131–3 problems with 139–41 and recognition heuristics 127–8, 145–6 and representativeness heuristics 129–31, 141–3 working of 125–7 Johari window 77–9 judgement in analysis 17–18, 26–7 bias in 189–93 and cognitive continuum 35–6, 148–50 and critical appraisal/ hypothesizing 100 and evaluation judgements 102 and holding judgements 100–1 and issues judgements 101 making 27 and strategic judgements 101–2 learning analysis 18–19 maximization of expected utility 15–17 metacommunication 84–7 multiple hypotheses 108–11, 117–19 Ness, Caleb 46, 89, 195 observation and assessment 56–7 best practice 57–9 triangulation 58 optimization 15–17 organizations and analysis 115–17, 199–206 functional 204–6 and intuition 205
SUBJECT INDEX / 219
parents and past information 50 and role in partnership assessment 45–6, 163 partnerships and assessment 44–7, 65–6 and listening to children 77 and role of parents in 45–6, 163 in serious case reviews 47, 65–6 past information in assessment 47–50 in serious case reviews 48, 49 see also information pattern recognition 135–6, 146–7 practice development and accountability of values 169–70 and children 166–78 and communication 89–90 and information 60–1 relevance of 59–60 and satisficing 61–3 values within 71–3 rationality models of 28–9 recognition heuristics 127–8, 145–6 representativeness heuristics 129–31, 141–3 satisficing 40–3, 61–3 serious case reviews and analysis 19–20 and listening to children 163 and partnerships 47, 65–6 and public perceptions of 24–5 and use of past information 48, 49 Socratic method 104–8
theory use of 20 values in practice development 71–3 verificationism 95–6, 189–93
Author Index ABC Research Group 27 Adams, D. 72 Aldgate, J. 47, 117, 160, 162, 178 Arkes, H.R. 26, 32, 94, 98, 183, 195 Arthurworrey, Lisa 112
167, 171, 178 Collins, S. 23, 83 Cooper, A. 18, 165 Coulshed, V. 22 Crisp, B. 114, 115 Crompton, M. 168, 173, 174, 175
Bairstow, S. 136 Baldwin, N. 158, 159 Baron-Cohen, S. 124 Bateson, G. 84 Beckett, C. 18, 43 Bee, H. 126 Bell, M. 178 Berridge, D. 167 Bjork, R.A. 96 Black, J. 85 Blackburn, S. 29 Blaug, R. 57 Bourne, I. 197 Boyd, D. 126 Brandon, M. 47, 48, 65, 85, 87, 95, 163, 178, 193 British Crime Survey 144 Brockner, J. 192 Brown, A. 197 Buckley, H. 157, 163, 165 Bullock, R. 19, 65 Butler-Sloss, E. 74, 163 Buzan, T. 114, 187
Dalgleish, L. 26, 107, 115 Dalzell, R. 29, 31, 102, 113, 118, 177, 199, 206 Daniel, B. 53, 56, 81, 146, 158, 165, 171 Daston, L. 27 Davies, R. 60 Demascio, A. 126, 137 Department for Children, Schools and Families (DCSF) 21 Department for Education and Skills (DfES) 55, 67, 161 Department of Health 45, 53, 62, 171 Dewey, J. 120 Dickens, J. 53 Dominelli, L. 72 Duncan, S. 14, 19, 20, 25, 30, 49, 59, 60, 69, 74, 81, 84, 85, 86, 87, 90, 101, 102, 103, 104, 107, 109, 118, 162, 165, 177, 195, 200, 205, 207
Calder, M. 27, 29, 47, 54, 60, 160 Candlin, C. 59, 70, 71, 142 Children’s Development Council (CWDC) 122 Clapton, G. 131 Cleaver, H. 14, 22, 45, 71, 90, 161, 162, 166,
Esgate, A. 134 Fahlberg, V.I. 50 Farmer, E. 24, 47, 48, 51, 59 221
Firkins, A. 59, 70, 71, 142 Fischhoff, B. 192, 195 Fish, S. 136, 207 Forrester, D. 162 Fox Harding, L. 158 Gadsby-Waters, J. 194 Garbarino, J. 83 Garnett, L. 167 Gibson, J. 35 Gigerenzer, G. 15, 27, 28, 33, 34, 40, 96, 102, 121, 126, 127, 128, 129, 130, 134, 140, 187, 206 Gill, O. 54 Gilligan, R. 161, 179 Gilovich, T. 137, 138 Goddard, C. 14, 55, 111, 161, 165, 194, 197 Goldstein, W.M. 26, 107 Goleman, D. 137 Gomm, R. 60 Gray, M. 14 Griffin, D. 137 Groome, D. 134 Hackett, S. 29, 47, 54, 60 Hall, C. 164 Hallet, C. 158, 170, 172 Hammond, K. 23, 26, 29, 32, 33, 35, 46, 94, 98, 101, 107, 135, 139, 148, 149, 150, 153, 155, 183, 187, 195, 201, 205, 206, 207 Hanks, H. 142, 173 Haringey LSCB 43, 46, 57 Harkness, D. 197 Hawkins, P. 193
222 / MAKING SENSE OF CHILD AND FAMILY ASSESSMENT
Hawthorn, J. 122 Herron, H. 163 Hertwig, R. 130, 135 HM Government 66, 68 Hoffrage, U. 135 Hogarth, R.M. 26, 107 Holland, S. 14, 31, 56, 58, 59, 63, 91, 93, 97, 102, 163, 164, 170, 177, 178 Hollows, A. 24, 26, 27, 100, 101, 102, 107, 152 Holme, C. 19, 98, 201 Holt, S. 163 Horwath, J. 25, 53, 56, 57, 91, 160, 164, 165, 176, 177, 181 Howe, D. 50, 86, 124, 138, 139, 147, 166 Hughes, L. 197, 201 Hume, D. 136 Hyland, H. 19, 98, 201 Jack, G. 54 Jenks, C. 158 Jones, W. 41, 142, 144 Kadushin, A. 197 Kahneman, D. 32, 121, 122, 127, 128, 129, 130, 133, 137, 138 Kaplan, A. 57 Klein, G. 32, 135, 136, 139, 196, 205 Klin, A. 124 Koriat, A. 192 Laming, Lord 46, 56, 66, 68, 80, 82, 96, 112, 122, 176, 178, 193, 194 Lepper, M. 192 Lewis, A. 45 Lishman, J. 106 Lord, C. 192 Lucey, C. 49 McDonald, G. 41 McIntosh, M. 162, 178 McKeigue, B. 43
McKinnon, M. 46 McLeod, A. 50, 55 McLeod, M. 164, 168, 172, 176, 179 McMahon, L. 42 Manby, M. 161 Martignon, L. 135 Meadows, P. 14 Menzies, I. 43, 203 Messer, D. 41, 142, 144 Milner, J. 27, 44, 71, 73, 98, 100, 114, 116, 117, 120, 167, 169, 177, 189, 190, 194 Morrison, T. 111, 112, 138, 165, 194, 201, 202, 204 Moss, P. 157 Mudaly, N. 14, 55, 111, 161, 165, 194 Munro, E. 14, 25, 28, 31, 47, 48, 51, 52, 54, 55, 59, 60, 68, 80, 86, 95, 98, 102, 107, 122, 125, 126, 135, 136, 137, 146, 160, 177, 181, 190, 194, 196, 201, 203, 205, 206, 207 Murray, J. 24 National Children’s Home 158 Nurius, P. 35 Nursten, J. 42 O’Brien, S. 46, 89, 195 O’Byrne, P. 27, 44, 71, 73, 98, 100, 114, 116, 117, 120, 167, 169, 177, 189, 190, 194 Ofsted 160, 206 O’Kane, C. 166, 169, 170, 187 O’Quigley, A. 167 Orme, J. 22 O’Sullivan, T. 14, 28, 74, 167 Owen, M. 24, 47, 48, 51, 59 Owers, M. 85
Parton, N. 44 Payne, M. 72 Peacock, G. 23 Pearce, W. 84 Pengelly, P. 197, 201 Petrie, P. 157 Philp, M. 23 Planalp, S. 125 Plous, S. 94, 95, 129, 133, 134, 135, 143, 191 Policy Spotlight 54 Preston, E. 192 Pritchard, J. 194 Prout, A. 158, 172 Quinton, D. 73 Reder, P. 14, 19, 20, 25, 30, 49, 59, 60, 69, 74, 81, 84, 85, 86, 87, 90, 101, 102, 103, 104, 107, 109, 118, 160, 162, 165, 177, 195, 200, 205, 207 Rogers, C. 173 Rojek, C. 23 Rose, W. 47, 117, 160 Rouf, K. 174 Rubin, J. 192 Ruch, G. 113 Saradjian, J. 142 Sawyer, E. 29, 31, 102, 113, 118, 177, 199, 206 Sayer, T. 158 Schön, D. 81, 195, 205 Scott, D. 73, 94, 107, 117, 170, 177, 189 Scottish Executive 23, 48, 55, 56, 79, 117, 118, 138, 145, 160, 163, 169, 171, 173, 193 Scottish Office 67 Scourfield, J. 81 Scragg, T. 194 Shemmings, D. 45 Sheppard, M. 58, 95, 98, 106, 107, 118 Shohet, R. 193
AUTHOR INDEX / 223
Simon, H. 28, 40, 115, 136, 194 Sinclair, R. 19, 65, 167 Slovic, P. 195 Smale, G. 44, 45, 167 Smith, M. 42 Social Work Inspection Agency (SWIA) 45–6, 85, 194 Soon, C.S. 125 Standing, L. 128 Stanley, J. 197 Stevenson, O. 170 Stocking, H. 83 Stratton, P. 173 Taylor, C. 23, 25, 43, 53, 81, 106, 111 Taylor, H. 120, 133, 146 Thoburn, J. 45 Thomas, N. 166, 169, 170, 187 Thompson, N. 133 Thorpe, D. 44 Todd, P. 27 Triseliotis, J. 178 Tunstill, J. 101 Tuson, G. 44, 45, 167 Tversky, A. 32, 121, 122, 127, 128, 129, 130, 133, 138 Valentine, M. 42 Vincent, S. 158, 165, 171 Walker, S. 14, 18, 117 Wang, X.T. 134 Wattam, C. 44 Whelan, S. 163 White, S. 23, 25, 56, 97, 106, 107, 120 Wilson, K. 122 Woodcock, J. 160 Zajonc, R. 137