The lived experiences of complex care of families with complex problems: A realist evaluation of Integrated Social Care

Abstract

Introduction/Background: An ongoing realist evaluation of the implementation of the program [Amsterdam Customization method] in social welfare in Amsterdam (NL), focussing on multi-problem families, revealed among others, that participating organisations within the program tend to focus on their own tasks, without shared decision making. This becomes extremely clear in the context of safety for the children: parents are not seen as partners to guarantee this safety but as causer of the problem. And this view from the perspective of one organisation seems to diminish all efforts to offer the parents help in finding ways to create a safe environment for their children. Instead parents are more or less threatened by the risk that the children will be taken away from them. The mechanism is a lack of interdisciplinary adjustment of observations and a lack of shared decision making, the outcome for the parents is fear and withdrawal from involved professionals. This is in contrast with the principles of the implemented program.
 Why a workshop? A 90 minutes workshop is a good way to share experiences with the delegates and find ways to handle a well-known problem within the implementation of integrated care programs.
 Who is it for? Participants from the area of social work as well as participants in implemented integrated care programs as such are a welcome audience to share ideas and experiences.
 What we are going to do?
 •A 15 minute 
 ointroduction on the context of the implemented program and the findings of one part of the research: client interviews [first researcher]
 oFocus on one finding: the missing collaboration between all stakeholders in the context of safety for the children in multi-problem families [first researcher]
 •Depending on the number of participants: 60 minutes discussion in one or more groups around two questions (1. do you recognise the situation [examples]; 2. What did you do / are you planning to do/ could be done to stimulate shared decision making that involves all stakeholders)
 •15 minutes report and (an attempt to) conclusions
 •10 minutes wrap up and eventually exchange of contact addresses
  
 How are you going to engage with the audience? Fitting to the concept of a workshop the meeting will be interactive, participants in the subgroups are asked to appoint a speaker to present the core of the group discussion, results of the plenary will be written down and per email shared with interested participants.
 How are you going to summarize the take home messages? We end up with lessons learned and sum these up in take home messages. Attendees are invited to write these down and take these with them.