Abstract

BackgroundIn the Canadian province of Quebec, placing children in foster care is an exceptional measure whose ultimate goal is family reunification. When child-protection workers decide that reunification is unlikely, they must design permanency plans that ensure continuity of care and stable relationships for the child. Most studies of this important decision-making process have focused on individual practitioners as if they acted alone. This process is collective, interactive, and influenced by various contextual elements. ObjectiveThe objective of this exploratory study was to examine the collective, interactive aspects of the decision-making process involved in permanency planning. Participants and settingThe participants were key players involved in child-protection decisions at an Integrated University Health and Social Services Centre (CIUSSS). MethodsThe theoretical approach of this study combines Giddens's structuration theory with ethnomethodology. Data were collected through interviews with 16 key players and nine months of observing advisory-committee meetings. ResultsIn making permanent placement decisions, the participants must engage in extensive interactions with one another. They must also apply various institutional (clinical, legal, and managerial) logics with differing goals and differing operational frameworks, the tensions among which make the process more complex and challenging. ConclusionsOur findings highlight the complexity of making permanent placement decisions and the importance of interaction and collaboration in this process. These findings suggest that management of this process should focus not on holding practitioners accountable and penalizing them for mistakes, but rather on providing adequate conditions for practice to facilitate thoughtful collective deliberation and learning and ethical decision-making.

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