Statutory Child Protection Research Articles

The Healthy Homes and Neighbourhoods Integrated Care Initiative

Introduction: Sydney Local Health District undertook a collaborative planning process for vulnerable families in 2013 and 2014. In late 2014 the District successfully tendered for an integrated care initiative for vulnerable families – Healthy Homes and Neighbourhoods, which was implemented in July 2015.Practice Change Implemented: The initiative involved system redesign and commitment from health, education, social care, local government, primary-care and non-Government partners. The model included: shared intake, care-coordination, family group conferencing, wrap-around delivery models, place-based service hubs, general practice engagement and support, and population-based health improvement initiatiave.Aim and Theory of Change: The intervention aims to break intergenerational cycles of disadvantage, psychological trauma, poor parenting and poor health outcomes. A complex Theory of Change (ToC) was developed, that in summary, would: 1) engage, empower and support families; and 2) develop and strengthen the service system through a collaborative co-design process.Targeted Population and Stakeholders: The initiative is intended for vulnerable families with complex health and social care needs who have one or more dependent children (unborn through to 17 years) where their complex health needs are impacting on their capacity to parent effectively and participate in their community. The Stakeholders included: the local primary health network (PHN), statutory child protection agency, housing department, schools, early childhood education and care providers, local government, and non-Government organisations working with complex families.Time Line: Implementation in July 2015, reviewed 2016 and secured recurrent funding July 2017.Highlights: The initiative has the following key features:Multiple core and non-core agencies working together over a sustained period of time (i.e. 5 years) with families with complex health and social needsAll the needs of families are in scope for the intervention, including housing, employment, income support and legal adviceUse of evidence informed integrated care methods by service partners, including family case conferencing, and “wrap around” care deliveryEncouraging families to have a “health home” for all their health needs and supporting them to move from dependency to independenceSupporting general practice providers to care for families that are often seen to be “too difficult”Development and implementation of shared assessment tools and referral criteria: Implementation of family assessment and engagement tools that can be used over the long-term to monitor the health and wellbeing of family membersTransferability: The integrated care model uses design elements that were adapted from other international projects and which can be implemented in other health and social care settings. The model may also be transferable to other vulnerable population groups including aged care.Conclusions: The development of a trusting relationship between HHAN care coordinators, service providers and their clients has been an integral component of the success of the Healthy Homes and Neighbourhoods Program.Discussion: The HHAN initiative demonstrates the benefits of integrating services with the social care, education and local government sectors to address the social determinants of health as they affect familiesLessons Learned: The development of trust between agencies, clinicians and patients is essential for the development and implantation of integrated care initiatives

Promoting Best Practice in Assessment and Intervention: The Challenges of Working in Times of Cutbacks and Change

Promoting Best Practice in Assessment and Intervention: The Challenges of Working in Times of Cutbacks and Change

Acceptability of the Winangay Kinship Carer Assessment Tool

There is an urgent need for culturally appropriate ways of assessing Aboriginal and Torres Strait Islander kinship carers for Aboriginal and Torres Strait Islander children entering into out‐of‐home care in the Australian statutory child protection system. The Winangay Aboriginal Kinship Carer Assessment Tool (the Winangay Tool) has been developed to address this need. A key factor in the success of new ways of working is the fit of the new practice within the context in which it is introduced.The aim of this study was to evaluate the social and cultural acceptability of the Winangay Tool to practitioners responsible for assessing kinship carers.‘Evaluate[s] the social and cultural acceptability of the Winangay Kinship Carer Assessment Tool to practitioners responsible for assessing kinship carers’A total of 84 practitioners completed a questionnaire prior to training and 83 practitioners completed a questionnaire on completion of training in the use of the Winangay Tool. Responses on questionnaires completed pre‐ and post‐training in the Winangay Tool suggest a high level of acceptability to practitioners. Both Aboriginal and Torres Strait Islander and non‐Aboriginal practitioners rated the Winangay Tool as culturally appropriate and acceptable overall, describing it as user‐friendly, collaborative and innovative.The favourability of the Winangay Tool to practitioners compared to their existing approach to assessment suggests that it is likely to be well endorsed and implemented by practitioners completing kinship carer assessments.Key Practitioner Messages Preserving and enhancing the cultural identity of Aboriginal and Torres Strait Islander children in care is fundamental to their wellbeing. The Winangay Tool is designed to be a culturally appropriate method of assessment of Aboriginal kinship carers. Aboriginal and non‐Aboriginal assessors rate the Winangay Tool highly on cultural acceptability and see it as an improvement on existing mainstream approaches or tools.

Intervening with Children Living with Domestic Violence: Is the System Safe?

ABSTRACTThis article examines cross-sector relationships that facilitated or impeded effective responses to women and children experiencing domestic violence. It reports on the findings of a study of 54 Australian professionals working in either statutory child protection, family law, or domestic violence and community services. Qualitative data gathered from focus groups with participants is the research base for this article. The study found that overwhelmingly the focus group participants described myriad policies and practices in the public sphere that could compound the impact of men’s violence against women in the private sphere.IMPLICATIONSComprehensive risk assessments should attend to assessing the risks posed by institutions of the state.The findings are particularly relevant to practitioners and policymakers who wish to work in socially just ways, which begin with rendering visible the coercive tactics of the state.

Practitioner Perspectives on Collaboration across Domestic Violence, Child Protection, and Family Law: Who's Minding the Gap?

ABSTRACTAustralia has two legal systems that address safety where children have been exposed to domestic violence: the state- and territory-based statutory child protection systems and the federal family law system. Numerous reports and recommendations have attempted to address the jurisdictional gap between the state and territory systems of public law and the federal system of private law that result in different approaches, which have implications for survivors of domestic violence attempting to establish safe, post-separation parenting arrangements. This article describes the findings of 5 focus groups with 54 domestic violence, child protection, and family law practitioners in both front-line and managerial positions. These focus groups explored participants’ perspectives on the opportunities for, and barriers to, collaboration for children’s safety across the three sectors in response to calls for improving service integration. While common ground from which to build collaboration was identified, there were different views about the potential role of child protection services in cases involving the family law system. This indicates the need to build common understandings of the nature and risks to children of post-separation domestic violence.IMPLICATIONSComprehensive responses to children exposed to domestic violence require the collaboration of the child protection, family law, and domestic violence services.Efforts to enhance service integration need to address both cross-jurisdictional legal barriers and to build common understandings of post-separation domestic violence.

Medical neglect at a tertiary paediatric hospital

Medical neglect is under-researched and the extent of the problem in Australia is unknown. We conducted a review of the referrals for medical neglect to the Child Protection Unit (CPU) at a tertiary children’s hospital in Sydney over a 5 years period, from 2011 to 2016, to determine what medical conditions are being referred, the reason for the medical neglect concern and whether cases are managed in line with American Academy of Pediatrics (AAP) guideline on medical neglect.61 cases of medical neglect were identified, constituting 4.1% of all referrals to the Child Protection Unit for physical abuse and neglect. There was a wide variety of medical conditions. Most were chronic medical conditions (87%). The top two medical conditions were chronic and complex multi-system disorders (37.7%) and endocrine disorders (18%). The majority of medical neglect were related to concerns that the caregivers were unwilling to follow medical advice (45.9%) or unable to provide necessary medical care (26.2%). In line with the AAP guideline on medical neglect, all cases were managed by addressing communication difficulties (100%) and resource issues were addressed in 80% of cases. A report to statutory child protection agencies was made in 50% of cases. Directly observed therapy and medical contracts were used in 30% and 26% of cases. We conclude that children with chronic medical conditions may be at risk of medical neglect. Communication difficulties were a factor in all cases. Statutory agency intervention is often required.

Social work perceptions and identity: How social workers perceive public and professional attitudes towards their vocation and discipline

INTRODUCTION: A century after Abraham Flexner’s (1915/2001) infamous speech conveyed his “dismissive attitude toward social work’s professionalism,” Gelman and González (2016) reflected that social work is again at a critical juncture. The fight for recognition of social work’s professional status has been influenced by multiple factors including negative public perceptions of the occupation. In Aotearoa New Zealand, professionalisation campaigns have been far from unifying, with diverse ideas about practice standards and accountability polarising opinions. At a time that the country is grappling with mandatory registration of social workers, this research considers the ways in which social workers perceive themselves, and the profession that they identify with.METHODS: Semi-structured interviews with 83 social workers in Aotearoa New Zealand were conducted. Participants were required to be eligible for social work registration. Interview transcripts were thematically analysed.FINDINGS: Several identity themes emerged during the analysis of the 83 interviews. The first theme relates to the ways in which statutory child protection social work has impacted on identity. The second, and perhaps predictable theme, is that many social workers in this study experienced significant professional marginalisation from their colleagues. The third theme emerged from participants’ views about the likelihood of mandatory registration of social workers impacting on their identity and the professional standing of social work.CONCLUSION: Most participants in the current study believed that mandatory social worker registration may positively influence the public’s view of social workers, other professionals, and also social workers themselves. However, many participants seemed to experience levels of self-stigma – and potentially believe they are viewed more negatively by the public than they actually are. Social workers’ perceptions of their role and profession is an area that warrants further investigation.

Conditional openness: young people define practices for successful child protection interventions

Taking the reforms of child protection legislation that have occurred since the 1980s as a backdrop, this paper considers young people’s perspectives on the factors that facilitated their engagement with child protection services and the barriers they perceived to effective service delivery. Drawing on findings from a New Zealand study of young people’s experience of multiple service use (child protection, mental health, youth justice and remedial education), the paper identifies that that rather than being ‘resistant’ or ‘hostile’ to statutory child protection intervention, young people reported a ‘conditional openness’. This conditional openness was characterised by three themes: communication; continuity and consistency; and contextual and cultural responsiveness. Interventions with these characteristics activated this conditional openness allowing effective interventions to occur. Using a series of case studies, comprising interviews and agency case file records; the paper considers the experiences of 109 young people (12–17 years) as well as those of the ‘person most knowledgeable;’ an adult nominated by young people because they knew the young person’s situation well.

Parental Participation in Statutory Child Protection Intervention in Scotland

Parental Participation in Statutory Child Protection Intervention in Scotland

Working together to identify child maltreatment: social work and acute healthcare

Purpose – The wider research literature indicates that health professionals’ ability to identify possible child maltreatment varies, and that this can lead to under-reporting of possible maltreatment to local authority (LA) statutory child protection agencies. The purpose of this paper is to understand how acute trust paediatric and LA services work together in suspected cases of child maltreatment, and what is viewed locally as good practice. Design/methodology/approach – A mixed-method approach, consisting of an online survey, qualitative case studies and good practice examples, was used to describe key features of current practice in joint working between acute trusts and LA services, and to generate insights that could help improve practice. Findings – Holistic assessment and information gathering, supported by training and expert input, were identified as being critical to a comprehensive approach to identifying maltreatment. Both in-hospital and community-based social work arrangements can be effective bases for joint working in respect of child maltreatment. Effective joint working relies on shared vision and values, and investment in, and commitment to, collaborative working. Research limitations/implications – This study covered arrangements in emergency departments (EDs) and maternity departments only, so future research could usefully look more broadly within acute care settings. Study respondents were also limited to safeguarding leads so, in future, there would be real value in exploring the experiences, practices and views of frontline practitioners. Practical implications – The study includes practical implications for hospital and social work teams working to safeguard children. Originality/value – The study highlights the characteristics of effective liaison between acute trust maternity and EDS and social work teams.

How early is early intervention and who should get it? Contested meanings in determining thresholds for intervention

The latest wave of reforms of the child protection system in Australia have been based on attempts to provide support to all families with vulnerable children, rather than increasing surveillance of ‘at risk’ families and forensic responses to incidents of maltreatment. This includes a drive to widen the remit of child protection from the statutory child protection agency and involve other government agencies such as health and education as well as the non-government sector in child protection. This paper reports on the effects of one such reform, the NSW initiative Keep Them Safe. It focuses on the classification of families as needing either early intervention or intensive support, using thematic analysis of qualitative interview data. MethodInterviews and focus groups were conducted with practitioners and managers from human service agencies (total n=115), and discussed their perceptions of the initiative and the changes it had introduced to service delivery. FindingsPractitioners discussed family needs in ways which contested the policy meanings of ‘early intervention’: whether families are conceptualised in terms of their needs or risk; whether engagement with services should be voluntary or mandated; and whether the agencies to support them should be the statutory agency or an NGO. The implications for these tensions, in terms of policy and practice, are discussed.

The Value of Family Welfare Conferencing within the Child Protection and Welfare System

The Family Welfare Conference (FWC) is a model used within the child protection and welfare services to address concerns about the needs of children and their family's ability to respond to these needs. The FWC model operates in partnership with family members, who participate in identifying both the issues of concern and potential responses to address these. The core premise of the FWC model involves greater engagement by family members in the process of responding to matters connected to their children's protection and welfare. This paper presents the findings of a research study on the value placed on the FWC model by social workers working in a statutory child protection and welfare department in the Republic of Ireland. A mixed-methods study was employed with social workers asked to complete an anonymous questionnaire and to participate in a face-to-face interview. The main findings highlight the value of the FWC as a model of relationship-based practice, with participation and partnership with family members viewed as crucial elements. The particular strengths identified in the model include the relationship that is established and developed between the FWC coordinator and the family members, the decision-making methods engaged in by families, and the increased understanding of the issues involved by virtue of participation within the FWC process. The place of the FWC within child protection and welfare services is considered in light of these findings, with an overall positive viewpoint presented.

Responding to child deaths: the work of Australia's Victorian Child Death Review Committee

The Victorian Child Death Review Committee (VCDRC) in Australia is a multidisciplinary Ministerial Advisory Committee established to review the deaths of children either currently child protection clients or known to the statutory child protection system. The Committee provides advice about each child death as well as insights into what are the surrounding patterns and issues. Key to this role is examining the contribution of the service sectors to the protection of children and the routine practices that are in place to respond to children and vulnerability. This paper provides a snapshot of the cases referred to the VCDRC and the key messages for practice drawn from them. What emerges is that often the threshold for when statutory child protection services must be involved in child and family matters can be ambiguous and that agreement about intervention, the level and nature of need or risk, and when cumulative harm and neglect require statutory responses are not always shared between agencies. It is clear that the lack of common frameworks about what constitutes child protection intervention challenges services. It is recommended that there be and used agreed definitions and frameworks to ensure shared understandings and collaborative responses across the service and legal systems.

A queueing model for the capacity planning of a multi-phase human services process

The increasing availability of data concerning service demand and service provision has enabled the application of queueing models in new domains. In this paper, we present a case study involving a queueing model of the multi-phase statutory child protection services process in the State of Victoria, Australia. The model, which has been calibrated using field data, supports the exploration of alternative scenarios of client types and loads, and of staffing levels. The model is intended as a tool for managers to examine and provide an insight into the process and enables a quantitative analysis of the process, to assist in resource analysis and capacity planning. It provides for calibration at the caseworker level, including the requirement for a caseworker to handle multiple cases simultaneously. Closed form analysis of the model, a network of processor sharing queues, is not feasible. We describe three methods that support performance analysis of the process at different levels, drawing on mathematical results from the literature and using both analytic and simulation techniques.

Enacting Firm, Fair and Friendly Practice: A Model for Strengths-Based Child Protection Relationships?

Strengths-based solution-focused approaches are gaining ground in statutory child protection work, but few studies have asked front line practitioners how they navigate the complex worker–client relationships such approaches require. This paper describes one component of a mixed-methods study in a large Canadian statutory child protection agency in which 225 workers described how they applied the ideas of strengths-based practice in their daily work. Interviews with twenty-four practitioners were analysed using an interpretive description approach. Only four interviewees appeared to successfully enact a version of strengths-based practice that closely mirrored those described by key strengths-based child protection theorists and was fully congruent with their mandated role. They described navigating a shifting balance of collaboration and authority in worker–client relationships based on transparency, impartial judgement, attentiveness to the worker–client interaction and the value that clients were fellow human beings. Their accounts extend current conceptualisations of the worker–client relationship in strengths-based child protection work and are congruent with current understandings of effective mandated relationships. They provide what may be a useful model to help workers understand and navigate relationships in which they must reconcile their own authority and expertise with genuine support for the authority and expertise of their clients.

From investigation to collaboration: Practitioner perspectives on the transition phase of parental agreements

Internationally there is a growing trend to implement alternative pathways within statutory child protection. This trend has emerged in response to burgeoning pressures on statutory child protection authorities and research highlighting the potentially negative impact of intrusive interventions on families. There is great diversity in the types of alternative pathways that have been implemented across jurisdictions. Differential response and parental agreements are two examples of alternative pathways that can be enacted for cases that warrant ongoing intervention. Whilst sharing commonalities such as providing supportive responses and working collaboratively with parents to avoid children going into out-of-home care, these two approaches have a significant difference in their implementation. Differential response allows families to be linked with supportive interventions without the prerequisite of a full child protection investigation. In contrast, in many jurisdictions, including Queensland (Australia) where this study takes place, the implementation of parental agreements occurs after the investigation has occurred. As such parents are expected to transition from being investigated to being a collaborative partner in addressing child protection concerns. In this paper, we report on a study into the use of parental agreements, known in Queensland as “Intervention with Parental Agreement” (IPA) and focus on this transition phase. Drawing on interviews with 25 practitioners we highlight the factors that impact this critical stage of IPA practice and identify factors that facilitate and inhibit a successful transition from investigation to collaboration.

Which strengths-based practice? Reconciling strengths-based practice and mandated authority in child protection work.

The recent application of strengths-based practice in child protection settings has been accompanied by evidence of inconsistent implementation and concerns that the approach is incompatible with statutory work. Few studies have moved beyond asking whether child protection workers are implementing strengths-based practice to explore why the approach is enacted as it is. This article describes a mixed methods study using an online survey and interviews to elicit from 225 statutory child protection workers in a large Canadian agency how they applied strengths-based ideas and why they did what they did. The authors found that although strengths-based practice was popular, 70 percent of participants believed that it was not always applicable to child protection work. Participants described five distinct versions of the approach, only one of which was fully congruent with their mandated role. The study suggests that the common conflation of strengths-based and solution-focused approaches ignores important differences in the conceptualization of practitioner authority and leaves practitioners attempting to implement versions ofstrengths-based practice that do not fit statutory child protection work. Only when practitioners choose solution-focused models that support their use of mandated authority is consistent implementation a reasonable expectation.

‘Changing the way we do child protection’: The implementation of Signs of Safety® within the Western Australia Department for Child Protection and Family Support

ObjectiveThis paper describes a six-year large scale implementation of the Signs of Safety practise framework in a complex statutory child protection context in Western Australia. The case study documents both the practitioner-led and organisational-led implementation journey as part of the State's child protection system reform drawing on Roger's diffusion of innovation theory and Fixsen's five stage implementation model as conceptual frameworks, and highlighting the key facilitators and barriers. MethodsThe study is a collaboration between researchers investigating the impact and use of Signs of Safety in Western Australia who contributed the theoretical perspectives and analysis; and key personnel from the Department responsible for implementation who contributed documents, manuals, records and personal accounts to form the narrative of the implementation. A naturalist, intrinsic and multiple case study design utilising semi-structured interviews was used to consult with 27 Departmental staff and practitioners. Thematic analysis was utilised to identify key themes and patterns of experiences with the Signs of Safety framework implementation. FindingsMuch can be learned from the journey of the Department and their long term commitment and systematic implementation strategy of Signs of Safety including the significance of leadership, learning and developing initiatives, effective communication, instituting continuous improvement processes and the provision of feedback for individual practitioners. Signs of Safety appealed to natural champions of systemic social work practise within the Department whose organisational culture adapted to align with the principles of the framework in building partnerships and understanding with families, being solution-focused, maintaining an open stance of inquiry and balancing strengths and safety around children whilst concurrently working to solve dangers and harm. As a learning organisation, the Department also utilised case practise implementation teams to be able to move through more successfully the different stages of implementation. In utilising Fixsen's implementation framework, the challenges and gaps to implementation strategies were also highlighted, including a problematic data system and an internal focus compromising the success of interagency collaboration. ConclusionThis discussion paper has provided an overview of the key concepts of the diffusion and implementation literature, and highlighted the importance of utilising theoretical frameworks in guiding implementation of practise models especially in complex statutory child protection contexts. Findings will be of particular interest to child welfare leaders and supporters of organisational change, providing concrete examples of implementation strategies and demonstrates the systemic benefits of a theoretical framework for guiding implementation efforts.

Private and public voices: Does family group conferencing privilege the voice of children and families in child welfare?

This article examines the use of family group conferencing in child protection and considers its ability to privilege the voice of children and families who reach the attention of statutory child protection services. The family group conference (FGC) is a process of family decision-making in child protection, originally developed in Aotearoa New Zealand, and now practised in many countries including the UK. Examining the literature and research relating to the FGC it considers whether the approach provides a genuine context of participation and partnership, or whether it has become an instrumental professionally led practice as families are charged with greater responsibilities for children at risk.

A Public Health Approach to Child Protection: Why Data Matter

In Australia, many researchers and policy makers believe that statutory child protection systems are overburdened and ineffective. The way forward, they suggest, is a public health model of child protection. A public health approach comprises four steps: (1) collecting surveillance data; (2) establishing causes and correlations; (3) developing and evaluating interventions; and (4) disseminating information about the effectiveness of intervention activities to the public health community. However, in Australia there are no reliable surveillance data. There is no information about ‘person’. Information is not collected about the characteristics of children (e.g., ethnicity) and parents (e.g., mental illness) reported to child protection services. Data are not comparable across place. This is because the states and territories have their own child protection legislation, definitions and data recording methods. Data are not comparable over time. This is because many jurisdictions have introduced new data recording systems over recent years. This paper concludes that it is essential to develop an effective child protection surveillance data system. This will ensure that services are located in areas and targeted towards populations in greatest need. It will enable large-scale evaluation of the effectiveness of prevention and intervention activities.