Who gets ongoing service and why? An exploration of assessment, judgments and decision making during initial assessments in child protection and welfare social work in Ireland
University College Cork
Background: Deciding whether or not to provide ongoing services following an Initial Assessment of alleged child abuse and or welfare concerns is one of the most important decisions that Social Workers make in Child Protection and Welfare. Despite this, very little is known about this practice or decisions at the conclusion of Initial Assessments or about the characteristics of children and families involved and their service needs. To fill these gaps, this thesis addresses the following issues: (i) current Irish policy for assessment and decision-making with reference to international developments; (ii) the organisational context for assessment practice; (iii) judgment and decision-making strategies that social workers use to determine eligibility for ongoing service; (iv) the characteristics of children and families who undergo Initial Assessment compared to the general population; (v) factors that are associated with the decision to provide ongoing service following an Initial Assessment; and (vi) comments on the efficacy of the current legislative and policy framework for assessment practice. Methods: Two empirical studies were informed by an extensive narrative literature review. A case study was designed to explore assessment practice in nine social work departments within a large administrative region of Tusla during the first quarter of 2016. Information collected from case file records (n=45) and interviews with SWs (n= 2 teams; n= 7 individuals) was thematically analysed to gain insight into the context for practice and into the sense-making and rationales provided for decisions. Secondly, a descriptive and analytic cross-sectional study was designed to profile children in Initial Assessments and to identify factors associated with the decision to provide ongoing service. Descriptive and multivariable analysis was applied to a complete sample of 480 children whose Initial Assessments concluded in seven social work departments in Tusla in the first quarter of 2016. That study also explored the use of the California Structured Decision Making© Family Risk Assessment (NCCD, 2017) to support decision-making. Results: The case study revealed that consistent with the literature, in situations of limited resources, a number of heuristic strategies were used to make decisions for ongoing service provision. Although social workers operate under a dual mandate of welfare and protection, in situations of high demand they prioritised caseload management over individual risk management leading to regret about judgments and decisions made in this specific practice context. The descriptive findings of the cross-sectional study revealed that families involved in Initial Assessments have greater burdens compared to the general population in addition to the specific child abuse and welfare-related difficulties investigated. The prevalence of exposures to risk factors is identified. Almost 2 in every 5 children (38.5%, n=185) remained open for ongoing service following Initial Assessment. In a multivariable model, several clinical and organizational factors were associated with ongoing service. In the analysis, the Irish model was compared to the California Structured Decision Making© Family Risk Assessment tool. The latter model would have allocated more children to ongoing service. Conclusions: The study makes many novel and important contributions to the literature. Through the originality of the study design, the research presents an in-depth exploration of the context for assessment practice and a detailed understanding of how SWs make decisions for ongoing service provision within this situated context. The findings are discussed in relation to their theoretical, practical, and research implications.
Child protection and welfare , Assessment , Judgment , Decision making , Service provision , Sequential studies , Case study , Descriptive and analytic cross-sectional study , Ireland
O'Leary, D. 2022. Who gets ongoing service and why? An exploration of assessment, judgments and decision making during initial assessments in child protection and welfare social work in Ireland. PhD Thesis, University College Cork.