Dissenting opinions really matter

Imagine being in a case conference and not feeling that the assembled group has considered all of the needed information. Imagine as well, that you are a junior in the room. What typically happens, is that the junior will keep quiet. They may try to explain their concerns to a trusted colleague later but their ideas are lost to the group.

The aviation industry has considered this problem as contributing to airline accidents. They have been working at creating an environment where all in the cockpit feel comfortable speaking up. The risks for a plane are a bit more obvious - if the error occurs it might crash killing many. But it is in the analysis of prior accidents that it has become clear that speaking up can save lives.

Professor Eileen Munro of the London School of Economics has pointed out in earlier writing that we should learn from other industries who have taken time to dissect how to prevent disaster. She believes that there are lessons to be learned. I agree.

For too long, however, we have relied upon the courage of a dissenting member of the group to speak up rather than encourage dissenting opinions. When that occurs, we tend to see group think - this is where the group coalesces around the opinion of the majority. In particular, the group tends to conform to the opinions of the more powerful members. This leads to errors in thinking and decision making because it assumes that the powerful member or the group has it right.

The group may, however, in seeking consensus, also filter out data that contradicts the group or power member opinions. Thus, they become selective in what data they consider rejecting data that strays from the group opinion. It leads to conformational thinking as opposed to critical thinking.

Serious case reviews and similar reviews of death and injury in child protection cases has identified this concern.

The minority opinion can often contain insights or perspectives that have not been given much consideration or analysis. These opinions can open up new perspectives or link previously unlinked data. They can also act as a way to ensure various options are considered.

It shouldn't take courage. Rather, it should be encouraged. The group leader should seek the conflicting opinions. The challenge is that it takes time - typically in short supply in high demand, high caseload environments. Yet failing to do so places people at risk.

For the minority opinion holder, there is also the use of language. Certain terms and words catch the group's attention more than others. Indicating that you have serious concerns, serious reservations, you are quite uncomfortable with the direction being taken, you think that the plan is unsafe,  are all terms that can garner the group's attention. How we say it matters as much as what we say.

By encouraging this approach, we can reduce harm to children and families.  In a previous blog I spoke about the B.C. Supreme  Court decision that held social workers liable for their decisions to place children in the care of an abusive father. The judge's decision illustrates that contradictory data did exist. This might be an example of how group think occurred and dissenting opinions were either squashed or not voiced. There are many other examples.

But it is up to managing leaders to create an environment where various points of view are welcomed. When a dissenting opinion occurs, how can it be seen as needed and explored? Management can act in a way that sees the opinion as needed or do the opposite. Thus, the quality of the supervisory environment serves to encourage or discourage the voicing of minority ideas. Otherwise, it can be very lonely to be the "other voice".

Assessing risk in child protection - but what risk?

When one thinks of assessing risk in child protection, one might automatically think about risk to a child. Is the child safe? If not, what needs to be done? Should the child be left with parents or removed? If there are immediate risks, can they be mitigated. These are all important risk questions.

However, there are two other facets of risk that are often not spoken about but can play very crucial roles in assessing risk in a family - risk to the social worker and risk to the agency. Both of these risks are by products of the outrage that occurs when a child is seriously harmed or killed while child protection is involved. There have been a myriad of high profile cases in Canada, Australia, New Zealand, the UK, Ireland, the United States and elsewhere. Here in Canada, we are awaiting the release of the Hughes Inquiry into the death of Phoenix Sinclair. It is expected to be released early in 2014. Based on prior inquiries that Justice Hughes has done in other provinces, one can expect a thorough report that will make for grim reading. It is these types of reports that are needed but also create a fear response - who wants to have the next high profile case in the media after all.

Phoenix Sinclair

For the social worker, this means that each case decision is also influenced by the risk to the social worker. What is likely to happen if this decision turns out to be riskier and problems occur? When this pressure exists within the decision making process, then there develops a tendency at self protection. This leads to more conservative decision making where getting more intrusive with a family seems like the best path.

So too for the agency or the team managers who do not want to be the next team under public scrutiny. 

Thus, the decisions around what a child needs are influenced by matters that have really nothing to do with the risks to the child.

Some attempts have been made to influence this decision making process by introducing programs such as Signs of Safety. This looks to a family's strengths that can be utilized and enhanced. The goal is to reduce the number of children living away from home. It does require that the agency take more risks that enhancement can occur. The early research tends to be promising. But it does require that the agency be able to tolerate the higher risks. Even more important, is for the politicians to be able to accept the risks.

When things go wrong, politicians have zero tolerance for errors even though errors under any program are inevitable. Child protection decision making is done in a reality of partial information that is almost constantly changing. It is politically difficult to defend the imperfections of decision making when the public is outraged.

There are also factors that child protection cannot solve particularly poverty, crime in neighbourhoods, family breakdowns and unemployment - even those increase risks. Politicians can create social policies that do reduce those risks - but cannot eliminate them.

Thus, while we want social workers to be the best they can at the work they do, no matter how well budgets are managed and case loads are kept low, there will still be errors and fatalities - albeit fewer. This is a very hard argument to sell as a politician but it is reality.

Readers might also find this comparative work between the UK and Belgium of interest

Also of interest will be this blog from Chris Mills in the UK.