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Sunday, October 3, 2010

Professor Munro offers her first view of her work on the UK child protection system

Professor Munro was appointed by the UK government to review the child protection system and to consider ways to make it effective. There is an exhaustion one imagines in the UK with public inquiries following the deaths of children known to the child protection system. The British public must surely be wondering why the system cannot seem to work. Professor Munro was a good choice as she has been an insightful author regarding the challenges of the system. She has a good record of looking at the broad issues and not getting mired in the details of a specific case at the expense of the bigger picture. Thus, it is with some excitement that one starts to see the product of her inquiry.

Very quickly she identifies one of the major themes that we have seen in the literature - the over managerial-ism of the system. In my view, this has been to protect politicians and senior managers from criticism if something went wrong - the policy and procedures were followed therefore we are blameless. But as Munro notes, this is not helping children:

"A dominant theme in the criticisms of current practice is the skew in priorities that has developed between the demands of the management and inspection processes and professionals’ ability to exercise their professional judgment and act in the best interests of the child. This has led to an over-standardised system that cannot respond adequately to the varied range of children’s needs" (p.5).

Managerial-ism would have you believe that risk can be predicted, that procedures will manage all kinds of situations and that families will neatly fit into categories. In my won work, I know that there are no cookie cutter views of families. What one might expect going in is often not what is founded. Flexibility is key to case management not procedural-ism. The problems are often not clear and the data emerges slowly and unpredictably. Munro recognizes this.

Fear that there will be yet another death drives a lot of worry in cases and can skew how a case gets perceived. She states, "The problem is that the evidence
of abuse and neglect is not clearly labelled as such. The causes of injuries are often hard to ascertain; children’s distress and problematic behaviour can arise from myriad causes. Fear of missing a case is leading to too many referrals and too many families getting caught up in lengthy assessments that cause them distress but do not lead to the provision of any help. This is creating a skewed system that is paying so much attention to identifying cases of abuse and neglect that it is draining time and resource away from families" (p.6). Equally, when budgets get too tight, cases can be shunned because the resources are not there to properly investigate and open for services. How government chooses to fund child protection has a direct impact on how cases will be addressed - too much fear leads to too many cases being opened and dissipated efforts being made creating funding pressure. Too few financial resources and cases will be missed that will lead children to remain in high risk situations. The balance is hard to find.

Munro raises a particularly crucial issue that can easily be lost in the myriad of efforts to protect systems from tragedies or overspending - social work is about relationships and the need to build them in challenging environments. Rules, technical solutions, procedures do not support that work. Earlier work by Munro has found that the amount of time social workers actually spend with families is going down as they strive to meet organizational versus client needs.

If the goal of child protection is to keep families together or to reunify them wherever possible, then social workers must be able to focus on the clinical needs of families. Referring to the work of Farmer (2008), Munro states, "Farmer
illustrates this point well reporting that the highest success rate for reunifying
children with their birth families was 64% while the lowest was 10%, with the key
determinant being the skill and investment of the social work team" (p.10).

The clinical lessons explored in Britain but seen around the English speaking child protection systems have not been successfully implemented. Thus, the errors keep getting made. As Munro states, "The efforts to improve practice have not addressed all the weaknesses in practice and have tended to focus mainly on the process of case management, increasing regulation, and standardised assessment frameworks. Difficulties such as forming working relationships with families, asking challenging questions to really understand the family’s history and current situation, keeping an objective view on what is happening, and coping with the emotional demands of the work have received less attention. The biennial reviews of SCRs report recurrent problems in practice, e.g. children being invisible to professionals because the focus is on the parents, inadequate assessment of the dangers of parental problems of substance misuse, domestic violence, and mental illness, and fixed judgments not being challenged and revised" (p.12).

We must also recognize that there are some families where the risks are not going to go down and things will not get better. Holistic views of the case including the use of effective intervention strategies will highlight those families. Social workers need to be able to do good case work for that to be seen. It then also leaves room to ask if we are doing what is right for this child; for this family as opposed to asking are we doing the right procedurally prescribed action.

There also needs to be the opportunity to learn from mistakes. Thus, we need a system where people can acknowledge mistakes without fear of reprisal or job loss. Most jurisdictions do not have that making it hard for the learning to take place. Instead, we have systems where somebody needs to be blamed. We must remember that we are not talking about malpractice but about errors that will occur because of the inherent nature of the work.

Munro also notes the power of supervision in helping keep workers analyzing what is going on with a case. As she states on p. 18, "Building strong relationships with children and families with compassion is crucial to reducing maltreatment, but trust needs to be placed with care, and ‘respectful uncertainty’ towards families, and interest and curiosity in their narratives, needs to be part of the practice mindset. To work with families with compassion but retain an open and questioning mindset requires regular, challenging supervision."

Several reviews of what goes wrong on child protection have commented on the lack of a voice for the child. Munro reminds us of that and emphasizes the importance of workers building a relationship with the child and actually hearing their story so that their needs can be understood as well. While this seems obvious, managerial-ism and procedural-ism work against that.

Critics of child protection are quick to attack if a child dies. Media leap on such stories. So to do the critics leap on perceived over zealousness. One only has to look at the US blog of the NCCPR to see this. Munro notes, "The media carry two perennial forms of stories about child protection: cases where the danger has been under-estimated and cases where the danger has been overestimated.
Professionals, in particular social workers, face the possibility of censure
whatever they do: they are ‘damned if they do and damned if they don’t.’"(p.20). There are no zero harm options in child protection!

Munro is providing a thoughtful look at this very complex system. The first report gives us reason to be optimistic that she may bring the kind of view where substantive improvements are possible (assuming the political will).

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