Evaluations of responses to child care problems (with a high proportion of neglect cases) from social work, education and health, in a number of authori-ties across Scotland, show what many previous studies have shown – that responses are often incident driven rather than holistically child focused (Baldwin 2001, 2002; Daniel 2002; Department of Health 1995; Ogden and Baldwin 2001). Little detailed attention is given to the wider problems of income and debt, housing, social networks, health needs. Even where many services have been offered over long periods, these have often been fragmented, poorly co-ordinated, sometimes overlapping or continuing to focus on one aspect of the presenting problem even where there is little change. Comprehen-sive assessment and long-term, planned collaboration to achieve specific outcomes are only clearly achieved in a minority of cases. Yet the Scottish Exec-utive Audit and Review of Child Protection (Scottish ExecExec-utive 2002a) showed that where a single worker was able to give these aspects priority, effective work could be achieved.
These are areas where an individual professional can make a major differ-ence, achieving changes for a child, whether through their direct practice, through supervising others or making a contribution in a team. The chapters which follow will provide detailed examples of effective ways of working, from a number of different perspectives. Here we would like to draw out some of the principles which we think will help guide workers in taking a more holistic Figure 2.2 A model of family, school and neighbourhood support, based on individualized and population-wide profiling, assessment and planning
Urban and rural initatives – health, education and social work:
Universal services to respond to the changing needs of children and families:
· living in disadvantage
· vulnerable
· in need
· Early years, school, neighbourhood and family supports
· Range of childcare
· Safe, supervised play and activities
· Community safety and health initiatives
· Employment and educational opportunities
· Advocacy, income maximization
Intensive and therapeutic services for children and families:
· with complex and multiple needs
· needing a range of intensive focused provision
· where neglect and risk of harm
Easy access, non-stigmatizing, supportive, preventive, inclusive
approach, recognizing that our current systems may not be as child oriented as we would wish, but do allow reasonable scope for working for the benefit of an individual child at the same time as trying to improve conditions for all.
· Assessment of need and risk needs to be comprehensive and continuous, both population wide and individual.
· Services need to be planned on a continuum, with the ability to respond at the earliest identified point of risk or need.
· Where intensive intervention is required, it needs to take account of the range of needs and risks over time, and plan and evaluate specific objectives and changes needed.
· Specialist, intensive services need to be seen in relation to and connected with universal and mainstream support services.
· Co-ordination at all levels of service delivery and intervention needs to be systematic and supported within and across all agencies, with clear lines of accountability and responsibility for resources and tasks.
· Partnership and collaboration across professions and teams, with children and their parents, is a necessary starting point for holistic, child-centred approaches.
· Evaluation of outcomes – for individual children and for populations of children – is an essential component of case and service planning.
We believe that these points can be taken account of in every situation where a professional from health, education, social work or other related services, is concerned about the risk of neglect or other potential harm to children. They are reminders of the importance of working at all levels – looking for opportu-nities to improve individual practice and organizational systems, at the same time as seeking economic, social and cultural changes to benefit children.
Research for Practice in Child Neglect
David Gough
Introduction
The potential benefits of research in child neglect are obvious. It can provide evidence about the nature of phenomena, their extent, their cause, and the impact of strategies to change the nature or extent. Policy makers, practitioners, users of services and other individuals and groups, can add evidence to other factors to inform decision-making.
There are also many potential negative aspects of research. Research costs money, it can be mistaken in its conclusions and thus misinform decision-making; it can be used instrumentally to justify actions being taken for other maybe hidden reasons. Research can give the impression that progress is being made, that something is being done, while avoiding difficult questions and decisions. It can make people believe that there is knowledge where there is none. It can undermine professional workers who believe that there is a research evidence base that they could and should know if only they had the time and expertise to understand and utilize it. Investment in research can add to moral panics that define certain groups of people and/or behaviours as something odd and different and thus assist the social construction of social problem making in society. There is nearly always an ethical as well as financial cost of undertaking research and these costs may be higher than the final products of the research.
There is often an assumption that research is intrinsically good, but unless we are clear about the purposes that research serves, for whom or what, as well as its potential negative effects then we cannot properly assess its role and use-fulness. Users of research such as practitioners and policy makers are meant to make use of research to inform their policy and practice, but is this a realistic aim? The first section of this chapter examines the nature of academic research and the many challenges for non-academics in accessing and assessing that research and argues for systematic research synthesis to address practitioner, policy maker and service use focused reviews of evidence. The second main section of the chapter then examines whether there are other barriers to use of
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research. It proposes not a ‘research active practitioner’ model but a ‘practitio-ner as research driver’ model of practitio‘practitio-ner engagement with research.