Professional decision making and the management of actual or suspected child abuse and neglect cases : an in situ tracking study

Abstract

This thesis comprises a comprehensive investigation of professional decision making in the management of actual or suspected child maltreatment cases via a six-month in situ case tracking study. Specifically, it was an attempt to highlight the realities of case management decision making, its complexity and the issues facing professional through an in-depth analysis of the factors affecting the decision making of professionals within one complete child protction network. The subject pool consisted of 11 professionals who had been identified as playing a significant role in the reporting, assessment and/or alleviation of child maltreatment in the targeted child protection network. Overall, 260 children residing in 190 families suspected or confirmed as being physically, sexually, emotionally abused or neglected were tracked through the targeted netwrk. Cases were collected by structured interview or questionnaire with the various participation professionals. The influence of child, family and socio-environmental effects (case-related factors) and aspects of the child protection systems (systemic andprofessional factors) on the various professionals' decision to substantiate child abuse and neglect, and the decision of child protection workers and police members to take statutory action were examined. This involved quantitative analysis (measures of association and the creation of statistical decision models via Multiple Regression), the descriptive mapping of interprofessional communication patterns (social network analysis) and the assessment of the realities of professional decision making via a cross-case analysis. The results provided evidence of the effect of a variety of in situ effects not traditionally identified in models of the decision making process and highlighted the important role played by non-statutory professional in the management of actural or suspected case of child maltreatment. The decisions made by these workers determined the subquent involvement of statutory services and could either enhance of diminish the likelihood of a positive case outcome. Workers involved in the case tracking were utilising the informal relationaships they had developed with other workers in the region to circumvent formal methods of communication and coordination (referral protocals and case conferences). Although this could enhance professional decision making, it was also responsible for the exclusion of some workers from the case management and professional decison making process, poor information exchange, interprofessional disputes and less than optimal case managment. The constructin of statistical decision models indicated the importance of workers' perceptions of severity when deciding to substantiate a case, and confirmed the workers' reliance on female caregivers for information and as the primary means of intervening with the family. The results of the case tracking were subsequently used to develop an Ecological Framework of Decision Making able to encompass current knowledge of the factors that influence professional decision making in the child maltreatment field. The implications of the Framework for decision making research and as an educational or training tool are discussed, as are the results for curreny child protection practtice. It is contended that the results of the tracking study and the majority of the issues identified have implications for other western child protection systems and current child protection practice.