putting analysis into assessment these power point presentations accompany the second edition of...

Putting Analysis into Assessment

These Power Point presentations accompany the second edition of Putting Analysis into Assessment. They can be used in team-development or training courses and have all been tested in practice receiving positive feedback.

Aims

To provide participants with tools to increase their skills and confidence in analysis and judgement within assessment practice

© National Children’s Bureau 2011

Objectives

To explore the policy and practice context of decision-making and judgement

To provide an opportunity to assess strengths and weaknesses in use of analysis in assessment

To introduce models and approaches will strengthen assessment practice with children in need


Presentation 1

• Introduction, background and issues


Legislative and policy context

• Framework for the Assessment of Children in Need and their Families 2000

• Adoption and Children Act 2002• Children Act 2004• Every Child Matters 2004• Children and Young Persons Act 2008• Common Assessment Framework [2006–8] • Working Together [updated 2010]• Integrated Children’s system 2009• New Govt 2010• Munro Review 2011


Why concern about analysis?

• It is clear from the studies we reviewed that the analysis of information has continued to be problematic in practice so attention needs to be focused on strengthening this crucial aspect of the assessment process’. [Turney et al 2011]

• The failure or inability to analyse, in particular, has been noted time and again in Inquiry Reports, Inspection Reports and Serious Case Reviews yet despite the repeated identification of this difficulty, and various new procedural requirements, the problem remains. [RIP-analysis and critical thinking 2010]


CHILDSafeguarding

& promoting

welfare

Assessment Framework England – conceptual framework

Health

Education

Identity

Family & SocialRelationships

Social Presentation

Emotional &Behavioural Development

Self-care Skills CH

ILD

’S D

EV

ELO

PM

EN

TAL

NE

ED

SPA

REN

TING

CA

PAC

ITY

FAMILY & ENVIRONMENTAL FACTORS

Basic Care

Emotional Warmth

Stimulation

Guidance & Boundaries

Ensuring Safety

Stability

Wider F

amily

Housing

Em

ployment

Income

Fam

ily’s

Social

Integration

Fam

ily History

& F

unctioning

Com

munity

Resources


Core theories underpinning framework

• Human needs• Developmental theories• Attachment theory• Resilience theory • Ecological perspective• Theories of parental capacity


Strengths and weaknesses of framework

Strengths• Provides common

framework that has been widely accepted [The triangle]

• Soundly based in theory and research

• Provides a holistic view of children's needs

Weaknesses• Doesn’t encourage analysis

• Reliance on systems, loss of flexibility [esp. since ICS]

• Interpretation of timescales

• Practitioners not using guidance fully


What we found during Putting analysis into assessment project

• Thorough assessments • Lack of reference to research and theory in

assessment reports• Resistance to starting assessments [ticking clock] • Lack of standardisation about length/detail in

assessments• ‘Workings out’ not shown in assessments • Children not very visible in assessments–lack of

creativity• More partnership with–focus on adult needs


Quality of analysis [messages from research]

• Assessments too static and descriptive• Accumulation of facts not woven together or analysed

to offer explanation for current situation• Too much focus on parents’ ability to carry out tasks

rather than how their own history and development affects parenting capacity

• Focus on single events or concerns rather than patterns [start again syndrome]

• Reaching conclusions too soon without different explanations being explored

• Disregarding children’s accounts• Parental co-operation dictates outcomes


Quality of analysis [cont]

• Not enough information paid to information from family, friends, neighbours

• Attention focused on most visible or pressing problem• Pressures from high status referrers leads to over–

precipitate action• Professionals think that because they have explained

something it will have been understood• If significant harm not found, often no referral to other

services• Practitioners reluctant to admit to being frightened or to

ask for help with challenging families


Presentation 2

• Analysis and Intuition: the nature of expertise


Analytical and intuitive thinking

Analytical• Formal logic• Probability theory • Decision theory• Formal instruments • Empirical research• Measure specific dimensions• Statistical equations

Intuitive• How people reason • Establishing rapport • Using empathy and

experience• Imagination• Unconscious appraisal of

competence


Intuition Strengths – weaknesses

• Fundamental • Swift• Interpersonal• Draws on knowledge and

research• Tacit – even if can’t be

articulated still valuable• Survived over time

• Implicit – defective as shared public knowledge

• Not necessarily reliable• Limited to range of own

experience and bias• Blind spots – look for

evidence to confirm assumptions

• Doesn’t acknowledge variables


Analytical reasoning Strengths – Weaknesses

• Knowledge base from empirical research – a lot done

• Resumes and critiques readily available

• Many aspects of subjects have been studied

• Helps to understand effectiveness of approaches

• Supports good decision making

• Need to justify actions – accountability

• Findings tentative – only weak causal link at times

• Can’t just read findings – need to understand context – use judgement

• Difficult to export to different populations

• Child abuse definitions change over time

• Can’t have RCTs in child protection studies


Formal Knowledge

Practice Wisdom

Emotional Wisdom

Values

Reasoning skills


Experience

Analysis

Experimentation

Reflection

Kolb’s Learning Theory


Exercise

• Choose a case that you are involved with or is familiar to you

• Plot a pathway through different points at which decisions were made [big and small]

• Can you identify elements of knowledge and skills you applied at each point?

• Would this be different depending on your length of practice experience?


Messages for Social Work

• Child Protection workers need to become more analytical and critical to improve accuracy – make reasoning, more open and accountable.

• Empathy and intuition needs to be central but practice can be improved by developing analytical skills.

• Child abuse is a phenomen shaped by social context – an understanding of cause and treatment cannot be universally applied.


Messages continued

• Evidence that actuarial tools demonstrate a higher level of accuracy than professional judgements alone and can play a part in overall case management

• Provide opportunity for consistency across agency and workers

• Help in developing clear standards• Formal methods don’t offer certainty. SWs should be

cautious about the level of accuracy they can hope to achieve.


Presentation 3

• Critical awareness and hypothesising


The process of analysis in assessment Sally Holland [2004] Child and Family Assessment in Social Work. Sage Publications

• Analysis pervades assessment from beginning• Practitioners often have difficulties in articulating

thinking• Approaches used in Social research are applicable to

gathering, organising and analysis of data• Need to be aware of impact of self on assessment

relationship• Cultural Review EXERCISE


Cultural review

• Reflexivity – A circular process of thought and action, with our thoughts and beliefs interacting with and affecting service users and their responses and experiences in turn affecting our thoughts and belief systems

• Cultural review reveals some of the unconscious processes and hidden influences on our ability to engage with families. By bringing assumptions and underlying influences on our thinking into awareness we can see them more clearly and take compensatory action


Hypothesis

• The cornerstone of analysis in assessment might be seen as the process of building hypotheses for understanding a family situation and developing these until they include a plan for a way forward [Holland]

• A hypothesis is a testable proposition


Developing hypotheses

• Human tendency to be verificationists • Need to do more than be neutral • Look for data that might disprove • Look for info that will explain and test ways of

understanding and helping [including antecedents]

• Different models within research for developing hypotheses – need to both draw from data and test data against original concerns [retroductive]


Sources of hypothesis

• Service-user explanations – listen and take seriously • Practitioners’ explanations, practice wisdom• Other professionals – specialist perspective– inter-agency working• Observations and direct work with children• Evidence-based practice, wide reading of research• Theory, having and using ideas


• Child protection services and managers need to establish the systems, ethos and context in which constant testing and revision of hypotheses and assumptions can underpin practice, as well as creating a working environment where professionals are actively encouraged to question their judgements

and to invite alternative opinion – one in which it is acceptable and safe to simply change their mind

• ‘Playing the devil’s advocate’• ‘A fresh pair of eyes’ – make use of supervision to

aid reflection[Munro 1999]

Building hypothesis


The process

• Actively seek evidence to disconfirm or challenge hypothesis – avoid simply confirming the dominant concern

• Ask yourself questions about competing goals, factors that favoured courses of action, what might happen if.....

• What factors have led to changes in view?• Be conscious of value placed on sources of

hypothesis – would you treat same info from different source differently?


Quality of analysis

Three types of bias:

• The rule of optimism

• Natural love

• Cultural relativism

[CWDC. NQSW Programme. Supervising Assessment work: Underpinning knowledge]


Discrepancy

• Informational

• Interpretive

• Interactive

• Incongruent

• Instinctual© National Children’s Bureau 2011

Discrepancy clues

Organisational clues Worker clues

Inter-agency clues Family clues


Healthy scepticism and respectful uncertainty

• CP involves working in unstable, distressing and sometimes personally threatening situations

• Evasiveness, concealment or outright dishonesty by some of the protagonists can be anticipated, if not assumed

• Repeated inquiry reports show the extraordinary lengths to which some abusive parents can go in their efforts to deceive practitioners

• Laming proposed that the concepts of ‘healthy scepticism’ and ‘respectful uncertainty’ should form the basis of relationships between social worker and families in such cases


Observation skills

• Openness and concentration• Aware of own assumptions and prejudices• Aware of the observer effect• Awareness of the environment• Suspending judgement• A structure or model for observation• Able to use and evaluate theories to analyse• Recording observations accurately • Using observations as part of assessments• Aware that collective experience will be revealed[Baldwin 1994]


Using and managing information

• Making notes• Highlighting themes [coding]• Analyse info from various sources• Key words• Be conscious of value placed on sources of hypothesis • Constantly check out views with others • Supervision critical • Consultations with other agencies• Avoid group think • Share with those being assessed


Presentation 4

• Understanding needs


Needs-led assessment – Why ?

• Inspection reports have found that it is not always clear how the services provided meet the needs of children

• Local authorities interpret and meet need differently• Deterrent prevention • Haphazard pattern of access to services – sticking

plaster approach


Part 11 Children Act 1989

Child in Need

Part 111 lays out the duty on L As to provide services to safeguard and promote the welfare of children in need. A child is in need if:

A] he is unlikely to achieve or maintain or to have the opportunity of achieving or maintaining a reasonable standard of health or development without the provision for him of services by a local authority or

B] his health or development is likely to be significantly impaired or further impaired without the provision for him of such services or

C] he is disabled


Benefits of needs-led approach

• Helps –children –parents –workers to understand what must be done and what needs to change in order to meet needs

• Helps encourage parental empathy • Helps to determine and achieve specific outcomes for children• Promotes a wider focus than only considering harm• Provides transparency• Fairness of access• Helps in placement planning • Useful in service planning as well as individual work


Definitions of resilience

• ‘Resuming its original shape after compression’ [Oxford Dictionary]

• ‘The process of, capacity for, or outcome ofsuccessful adaptation despite challenging or threatening circumstances’ [Masten et al 1990]

• ‘Normal development under difficult conditions’ [Fonagy et al 1994]


Presentation 5

• Risk and resilience


Main terms used in resilience

• Risk/Adversity: any factor or combination of factors that increases the chance of an undesirable outcome affecting a person.

• Protective factors: the circumstances that moderate the effects of risk.

• Vulnerability: a feature that renders a person more susceptible to a threat.

• Resilience: positive adaptation in the face of severe adversities.

• Coping strategies: children learn or are taught strategies that promote resilience.


Factors associated with vulnerability

• Child – age, health, development, behaviour, status, personality, attachments

• Parents – history, age, relationships, lifestyle, criminal record, substance misuse, health

• Community – lack of community cohesion, lack of support, homelessness, financial difficulties


Factors associated with resilience

• In the child themselves – innate personality traits or outlook

• The family and relationships – strong attachment or protective relationship

• The wider community – external interests or protective relationships


Why important

• Important to gain an understanding of vulnerability and resilience in children when assessing their needs [holistically]

• Resilience relates to how well children cope or are taught to cope, how much social support they have and how they deal with difficulties generally

• Will help to inform the interventions that will help children achieve better outcomes


Interventions [cont]

• Interventions to support informal networks – peers, mentors, role models

• Support and education for parents of infants

• Building supportive relationships – immediate and extended families

• School based programmes – emotional literacy and mentoring programmes

• Broad based community initiatives© National Children’s Bureau 2011

Interventions to promote resilience

Three types of approach identified:

• Risk focused: Aim to reduce or prevent risk. • Asset focused: Resources input to counteract

adversity, e.g. additional tutoring/job training etc.

• Process focused: Protect or restore systems to support positive development, e.g. work on attachment

Most effective interventions use all or a combination of the approaches above targeted at the child, family and community level


Interventions [cont]

Evidence so far suggests that in order to develop resilience we need: multifaceted programmes that consider factors across child, family and community arenas; programmes that address risks, assets and resilience processes; and targets that include the development of secure relationships and wider supportive relationships, self-esteem and mastery, and provision of positive nursery and school or community experiences.


Presentation 6

• Signs of safety


Signs of safety approach • Background and origins• Underpinning philosophy • Practice principles for partnership • Six practice elements• Interactive exercise


Background and origins

• Andrew Turnell and Steve Edwards• Early 1990s: Perth Western Australia• Collaboration with Berg and Shazer: Founders

of Solution-focused Brief Therapy (Wisconsin)• Collaboration with child protection colleagues • Could Brief therapy be used in child protection

settings?


Aims (Turnell and Edwards)

• To increase confidence of child protection workers in their own practice

• To enable them to more readily make and commit to judgements based on a balance of information regarding danger and safety

• To develop an approach that was focused on solution and safety, and field tested by social workers


Practice principles

• Respect service recipients as people worth doing business with

• Cooperate with the person not the abuse• Recognise that cooperation is possible even

where coercion is required• Recognise that all families have signs of

safety • Maintain a focus on safety


Principles (cont)

• Learn what the recipient wants• Always search for detail• Focus on creating small change• Don’t confuse case details with judgements• Offer choices• Treat the interview as a forum for change


Six practice elements

• Understand the position of each family member• Find exceptions to the maltreatment• Discover family strengths and resources• Focus on goals• Scale safety and progress• Assess willingness, confidence and capacity


Group exercise

• In your groups take the practice element you have been ascribed

• Plan and deliver a 5–7 minute presentation describing this element to your colleagues

• Give one example of where a group member has used such an approach in practice (or could do so)


Presentation 7

• Involving children


Background to involving children

• Legislation [Children Act 1989] – ascertainable wishes and feelings

• UN Convention on the Rights of the Child, articles:

12 [right to express views freely], 4 [those views to be respected])


Messages from research (Ofsted 2010, Review of SCRs

• Child not seen enough or asked about views/feelings

• Agencies didn’t listen to adults with important information to contribute who tried to speak on child’s behalf

• Parents and carers prevented professionals from seeing and listening to child

• Practitioners too focused on parents’ needs

• Agencies did not interpret findings well enough to protect child


Messages from children (Children’s Rights Director 2011)

• Less than a ¼ thought their wishes and feelings made much difference to decisions re care

• 67% thought their wishes and feelings made no difference• 50% said social workers didn’t take notice of their wishes

and feelings• On positive side, Action for Children/C4EO 2010 found C&YP

‘overwhelmingly positive’ about their social workers


Barriers for children (C4EO 2010)

• Lack of awareness that behaviour was abusive• Shame, embarrassment and self-blame• Stigma, loss of credibility, friends finding out• Fear of losing control and people taking over• Getting someone into trouble/splitting family up• Loyalty for or feeling sorry for the abuser• Access to someone to tell, not knowing where to go for help


Barriers for children (C4EO 2010) (cont)

• Concerns about confidentiality• Concerns about whether the person is competent to deal

with the issue• Fear that telling will make things worse and that abuser

will be told they have disclosed• Not being able to express oneself• Believing in self-reliance, not wishing to burden others


Barriers for professionals

• Attention diverted by vulnerable parents (Brandon and others 2008/9)

• Lack of confidence and skills

• Lack of time for direct work, planning and creativity

• Increased proceduralisation (Munro 2011)


What children want from professionalsC4E0 2010, Children’s Rights Director (for Munro) 2011

• Ask them things face to face, on their own

• Offer real choices and ensure they feel free to state their true feelings

• Choosing neutral/informal venue

• Talking and listening (including giving explanations/calm and informal)



• Professionals to keep in touch

• Help with sorting out problems and ‘getting on with the important things’

• Get C&YP involved in activities

• The following qualities: caring, understanding, knowledgeable, hard working, trustworthy and available, accessible culturally competent, positive and fun



• Offer advice/suggestions without forcing opinions• Sticking with them over time• Information and explanations – clear, honest, in

writing and verbally• Empathy and understanding about how children feel

about disclosing• Trust – helped by consistency, honesty and reliability



• Consider family relationships and don’t just talk to older siblings

“our worker would boss my mum and dad around. Not explaining, but telling them ... It was confusing to me that they weren’t in charge anymore”

• Offer a range of ways to communicate – informal, creative and accompanied by other activities

• Find out C&YP’s, preferences and specific needs, using facilitators or alternative communication where needed


Further considerations

• Importance of initial responses to children trying to share a concern. They may only try once (Prior, Lynch and Glazer 1994)

• Explain that questioning the child’s account does not indicate disbelief (Woolfson in C4EO 2010)

• Note changes in child’s behaviour, note concern and ask them about it


Factors to support communication (Jones 2006)

• Maintain neutrality, but not indifference• Manage one’s personal responses to distressing material• See the child as the expert• Convey genuine empathic concern congruent to situation• Use open-ended and unbiased approaches/allow free recall• If adult does not ask, it is unlikely the child will tell• Record the exchange in detail, content and duration• Clarify ambiguous information


Coastal Cities Study: Sally Holland 2004

• Whilst social workers used child-centred language, children were ‘minor characters’ in the narrative

• Two-dimensional descriptions of children described mainly in their responses to their parents

• Children often described with ‘detached objectivity’ (Sheridan chart language)


Coastal Cities Study (Cont)

• Social workers’ ambivalence about the worth of obtaining children’s opinions

• Children often described in relation to their progress regarding ‘developmental norms’

• In some cases, children’s views were prominent but the weight given to them variable


Examples from Coastal Cities Study: Child’s views

• ‘Elizabeth presents as whimsical and materialistic and may not be impressed by the current accommodation ... It is clear that Elizabeth has changed her mind on a number of occasions …’


Examples from Coastal Cities Study (Cont)

• ‘Paul has remained consistent in his expressed wish to have Mr Taylor return home … Paul presents as a very sensible child who I feel would not hesitate to voice any feelings of unease …’


Coastal Cities: Use of theory

• Be critical and thoughtful in our application. Powerful arguments can be made using flawed or overly narrow evidence base

• Reports referred to attachment, but only partial aspects of child’s attachment behaviour were observed, and often in emotionally charged and ‘artificial’ situations such as contact visits


Ways in which children’s voices are silenced:

• By not reporting the child’s voice when recounting their experiences

• By objectifying through use of emphasis and language

• Presupposing what the child may say

• Presenting their voices as subjective, biased and untrustworthy


Summary of suggestions for practice

• Consult children about assessment methods and work with their preferences

• Focus on what child can do and not what they can’t• Be holistic in issues explored and portrayed• Focus on ‘meanings’ for the child• Acknowledge limitations of knowledge and understanding

about the child’s views in reports


Presentation 8

• Assessing need and risk for children in chronic situations


• Difficulty in assessing cumulative and pervasive effects

• Often coexisting with parental problems

• Signs and symptoms ambiguous or significance is not recognised

• Early recognition and intervention important, but in reality often do not receive timely help


What is needed?

• Understanding of child development, impact of neglect and consequences of delay

• Can’t predict risk but can be ‘risk sensible’ – judge quality of decision-making, not decisions (Munro 2011)

• Targeted support beyond crisis points to address deep-seated problems (not closing at first signs of improvement)


Considerations of timing

• Babies under one, more likely to develop secure attachments to new, permanent carers

• First three years crucial to child’s development

• Tendency for delay/less proactive intervention for over 6-year-olds

• Vulnerability of suicide/risk-taking behaviour for neglected/emotionally abused teenagers


Considerations of timing (cont)

• Children experiencing repeated/failed attempts at reunification have the worst outcomes, with those who remain Looked After having better outcomes

• Be mindful of purpose of repeated assessments; what are the information gaps? Will they make the difference? Timescale?

Not just a safe place to fail?


What helps?• Relationships with parents; dependable, respectful, self-

aware, ‘healthy scepticism’

• Convey empathy and understanding – overwhelming processes and emotions can prevent parents from ‘hearing’

• Co-operation, not an adequate predictor of change

• Recognition of the ‘change process’


What helps?

• Be mindful of how approach affects parental motivation (MI techniques can be helpful)

• Guard against desensitisation to poor standards

• Use a range of sources, inc. baseline tools, e.g. Home Inventory and specialist tools, e.g. Alcohol Questionnaire

• Helpfulness of joint work, multiagency assessments, drawing on adult services and specialist assessments

• Critical thinking and reflective supervision


Presentation 9

• Recording and reporting


Reaching conclusions

• ‘I always feel that they're not finished. Core assessments are finished when it’s the case conference tomorrow and initial assessments are finished when you’ve contacted the GP four times, they’ve never replied and you have to move on to another one’ [Social worker in Holland 2004]


Reaching conclusions

• Reaching saturation point-drawing conclusions• Never going to be indisputable• Conclusions that look forward rather than back

[solution focused]• Flexible to changing circumstances


Reporting

• Forms not neutral• Considering the audience• Clarity about facts and opinion• Views of service users• Service user access – how might this read to young person

accessing records later?• Language use – avoid value laden language/use plain language• Ordering of points – prioritisation• Is the trail from identification of needs through to

recommendations absolutely clear?• Not just what but why


A good assessment report

• Is clear about the purpose, legal status and potential outcomes of the assessment

• Is based on a clear theoretical framework

• Is clear about context and value base

• Is collaborative with, and promotes accessibility for, service users

• Is based on the multiple sources of good information from different agencies

• Values the expertise and understanding service users bring to their situation

• Is clear about missing information

• Identifies themes and patterns about needs, risks, protective factors and strengths


putting analysis into assessment these power point presentations accompany the second edition of...

Documents

assessment of children

common assessment framework

assessment reportsresistance

assessment process

assessments children

use of analysis

analysis of information

integrated childrens