Decision-making in child welfare services ...

DOI: 10.1111/cfs.12444

REVIEW

Decision‐making in child welfare services: Professional discretion versus standardized templates Inger Kristin Heggdalsvik1

|

Per Arne Rød1

|

Kåre Heggen2

1

Department of Social Science and Social Education, Western Norway University of Applied Sciences, Bergen, Norway

2

Abstract The article explores differences in the assessment and decision‐making processes, in child welfare

Department of Social Sciences and History, Volda University College, Volda, Norway

services where a standardized template is implemented and in services where it is not. Child

Correspondence Inger Kristin Heggdalsvik, Department of Social Science and Social Education, Western Norway University of Applied Sciences, Bergen, Norway. Email: [email protected]

need for intervention. In Norway, as in other European countries, there is a shortage of knowl-

welfare services in several countries use different approaches to assess children's and families' edge about decision‐making strategies. The article examines how 36 child welfare caseworkers in 6 different teams in Norway investigate, assess, and make decisions at the phase of an incoming referral. The analysed data were collected by focus group interviews. We use decision theory as a theoretical frame of reference. The analysis shows variation in the assessment procedure at different points of the process, depending on which approach was used. Despite such differences, the final decisions made were almost identical. Even though the data has its limitations because of the small number of informants, the results indicate that choice of approach is not decisive for decision‐making in the child welfare services. KEY W ORDS

child welfare, decision‐making, framework of assessments, professional discretion, standardized approach

1

|

I N T RO D U CT I O N

Norwegian Board of Health Supervision, 2014; Office of the Auditor General in Norway, 2011–2012).

In recent years, there has been an ongoing discussion in child welfare

To make assessment practices more coherent and systematized, a

services regarding risk reduction technologies versus discretion as a

template was developed by the Norwegian psychologist Kvello. This

human‐oriented judgement, drawing upon administrative systems

template is based on psychological theories and focuses on important

and different professional methods. Several countries have developed

assessment points and concepts in child welfare workers' investigation

frameworks to help practitioners in making assessments. In England,

procedures. The different sections focus on topics such as children's

the Common Assessment Framework was developed as a standard-

competence, parent's competence, risk and protecting factors, and

ized assessment tool for professionals working with children (White,

children's self‐reporting (Kvello, 2010; Kvello, 2015). The template

Hall, & Peckover, 2009). Sweden and Denmark have developed tools

has been implemented in about 60% of the Norwegian child welfare

such as BBIC and ICS (Andershed & Andershed, 2016; Deloitte

services (Vis, Storvold, Skilbred, Christiansen, & Andersen, 2014).

Consulting, 2014).

The Norwegian situation reflects important debates as in other

In Norway, child welfare workers have traditionally been given a

countries, for instance, England (Munro, 1999; Munro, 2011) and Aus-

great deal of autonomy to handle cases with professional discretion,

tralia (Gillingham, Harnett, Healy, Lynch, & Tower, 2017). Practitioners

based on training. But, this tradition has increasingly been accused of

are criticized for applying insufficient analytic reasoning in their assess-

being too arbitrary. Usually, one or a few caseworkers make assess-

ment and decision‐making (Munro, 1999). Child welfare services are

ments of incoming referrals, and final decisions of what to do are made

also facing increasing demands to implement so called evidence‐based

together with a team leader. However, reports have concluded lack of

practice (Bergmark & Lundström, 2010; Drisko & Grady, 2015). On the

systematization, shortcomings in the work procedures, and assess-

other hand, Broadhurst, Hall, Wastell, White, and Pithouse (2010)

ments characterized by arbitrariness (Andresen & Neegaard, 2012;

argue that at the heart of the human project of social work, there is

Child & Family Social Work. 2018;1–8.

wileyonlinelibrary.com/journal/cfs

© 2018 John Wiley & Sons Ltd

1

2

HEGGDALSVIK

ET AL.

a range of informal, moral rationalities concerning care, trust, kindness,

“jurisdictional claims” (Abbott, 1988). Child welfare workers handle

and respect. These aspects are difficult to systematize. Even though

challenges in the services with professional discretion because every

the caseworkers increasingly interact with a variety of technologies,

case is unique. This is described as an ideal model of social work.

the work remains relationship related.

On the other hand, a lot of research shows that this ideal model

In UK, Pithouse et al. (2012) conducted research that challenged

can be inadequate. Lipsky, as well as other researchers, document that

the view that the uncertainty of traditional discourse in child welfare

such a model often leads to random decisions and solutions

work can be more safely moderated by computer‐based technologies

(Kahneman, 2011; Kirkebøen, 2013; Lipsky, 2010). Therefore, more

for reporting and decision‐making. Gillingham's (2011) studies con-

standardized models have been developed in Norway as well as other

clude that the use of structured assessment tools in child protection

countries, such as manuals, templates, or evidence‐based methods

work over time may impair the development of expertise but that this

(Rød, 2016). In our analysis, the focus will be on the distinction

depends on the process of implementation. A New Norwegian study

between professional discretion and standardization.

(Almklov, Ulset, & Røyrvik, 2017) concludes that a standardization of

To analyse our data, we have chosen decision theory as a theoret-

child welfare work which objectifies families creates a distance

ical frame of reference. Bauman, Fluke, Dalgleish, and Homer (2014)

between families and child welfare workers and puts a focus on correct

present one way of thinking about caseworkers' job as a coordination

procedures more than the best solutions.

of a decision‐making continuum. This continuum starts at intake and

Assessment and decision‐making processes related to child wel-

ends at case closure. We have utilized Munro's prescriptive model of

fare are often described as complex and wicked problems and charac-

decision theory (Munro, 2008), a model that Bauman et al. (2014) pres-

terized by unstable factors (Devaney & Spratt, 2009). Decisions are to

ent as compatible with their decision‐making continuum. Munro's

be made on a case‐by‐case basis and in terms of values in the best

model is presented in terms of a decision tree as a framework for mak-

interest of each child. The practitioners conducting the assessments

ing decisions, an effective way to organize reasoning and to analyse

need to demonstrate accountability by reporting their work and

problems. The framework consists of the following judgements: (a)

explaining their final decisions to parents and children, and ultimately,

What decision is to be made? (b) What options are there? (c) What

in different court systems and in other forms of external scrutiny.

information is needed to help make the choice? (d) What are the likely

According to O'Sullivan (2011), a key feature of professional wisdom

consequences of each option? (e) How probable is each consequence?

is the selection, integration, and combination of different types of

(f) What are the pros and cons of each consequence? and (g) The

knowledge, which is necessary in order to make a holistic judgement

final conclusion.

based on the best combination of knowledge that the practitioner

Due to regulations in the Norwegian Child Welfare Act, we also

holds or has access to. One important question is then whether stan-

emphasized (a) the children, (b) the parents, (c) law and matters of

dardization is practised in an instrumental way or whether it stimulates

concern, (d) assessments according to risk and protective factors, and

professional discretion.

(e) statements based on caseworkers' experience.

As several child welfare services have implemented a template during the last couple of years, it is of interest to gain extended knowledge of the analytical assessments and decisions of both approaches.

3

|

METHOD

As researchers, we find it crucial to discover how the starting point of an incoming referral turns out for the children and families involved.

Our study took place in 2013. The sample consisted of six focus groups

How will practitioners assess the same vignettes in services where

with six members, a total of 36 child welfare caseworkers. They were

Kvello's template has been implemented, compared with where it is

working in three different Norwegian cities. Each service was repre-

not implemented? The main questions are the following:

sented by two focus groups. In the service in one of the cities (125,000 inhabitants), Kvello's template had already been imple-

1. How does using a standardized template compared with a more

mented—hereafter, “the template groups” (Rød & Heggdalsvik, 2014).

discretional approach influence the caseworkers' assessments in

A request was sent to two other municipalities (46,000 and 37,000

their handling of an incoming referral?

inhabitants) where Kvello's template had not been implemented—

2. Does the choice of assessment approach make a difference when it comes to the final decisions of investigation strategy?

hereafter, “the discretion groups.” Implementation means that the method and knowledge of the template is well anchored in the service. To ensure that we had study groups that were comparable, the three different services were asked to participate with informants whose work on a daily basis involved assessing new referrals and

2

|

T HE O R E T I C A L P E R S P E C T I V E

conducting investigations in the initial phase of a case. All the participants had experience from child welfare, though this varied in terms

In discussions about approaches in investigating and decision‐making

of length.

in child welfare work, a common approach has been in line with

Focus group interviews were chosen as the method of data collec-

Freidson (2001) in professional theory, where professional workers

tion. Focus group interviews take place in an artificial context com-

build their practice on a scientific knowledge‐base and certain ethical

pared with real child welfare work, but still it may give the researcher

standards but where discretion is an unavoidable element. This judge-

privileged access to in‐group conversations, which contain key profes-

ment is the basis of what Abbott describes as professionals'

sional terms and categories in the situations in which they are used.

HEGGDALSVIK

3

ET AL.

Discussions occurring within focus groups provide rich data on

To choose vignettes in which the characters and the story are

the group opinions associated with a given issue (Halkier, 2010;

credible, the content of the vignette in the present study was based

Kitzinger, 1995).

on the authors' knowledge of practice and relevant research. The case-

The interviews were conducted at the office where the case-

workers in all groups independently commented that the content in

workers did their daily work. The caseworkers were asked to assess

the presented vignettes was quite familiar to them. Findings of the

the information as if it were a regular referral. They were first pre-

study have afterwards been given in dialogue with the child welfare

sented with part one of a vignette constructed as an incoming referral

services that participated in the study.

and designed for the purpose of this study. Andershed and Andershed

To increase the data's credibility and to capture themes, and pat-

(2016) argue that vignette is the method of choice to achieve a direct

terns, the researchers worked separately with the data before coming

comparison of assessment methods in a situation as close to real life as

together and comparing our reading several times. According to Braun

possible, while keeping the potentially confounding factors constant.

and Clarke (2006), the “keyness” of a theme is not necessarily depen-

The study is descriptive in terms of investigating how professional

dent on quantifiable measures but rather on whether it captures some-

social workers would have made decisions in the real world of practice

thing important in relation to the overall research question. We

(Taylor, 2006).

categorized the text material using thematic analysis as a strategy to

The part one vignette consisted of a report given by a nurse at a

identify, analyse, and report patterns or themes within the data.

combined primary and secondary school, containing information about three siblings: Emilie aged 13, Alexander 11, and Embla 8. Their contact teachers described the three children as being tired and unable

4

|

LIMITATIONS

to concentrate. Their parents had split up 3 years earlier. Embla's contact teacher had overheard Embla telling her classmates that their mother's new cohabitant was stupid and angry. The nurse was concerned about Emilie, due to the fact that she skipped classes. On

The difference between decisions made by the use of one single case vignette in a focus group in contrast to decisions made in practice is a limitation of this study.

several occasions, Emilie had locked herself in at one of the school's toilets and once said that her mother's cohabitant was a scumbag.

5

|

RESULTS

After a short break, they were presented with Part 2 of the vignette, containing more information about the same children. This time, the caseworkers were given reports with a short summary of a first conversation with the children's mother, with the children's father

5.1 | What decision is to be made and what options are there?

and with the three children together. The new information can be sum-

The two vignettes in this study ask for assessment and decision‐mak-

marized as follows: the children's mother is a psychologist working in

ing in two different phases of an investigation. The first decision is

an educational and psychological counselling service, and she does

whether the caseworkers assess the information given in the referral

not feel that there are any problems at home. The children's father is

as children in need of support from child welfare services. Possible

a college lecturer but is on sick leave due to an accident. He is not sur-

conclusions are (a) to withdraw, (b) to investigate, or (c) to refer to

prised by the fact that the child welfare service has received a referral

another service. The caseworkers in all six groups hardly spoke about

and says he has been waiting for it to come. The children's father says

relevant statutory provisions and the child welfare act as a regulation

he is most concerned and worried about Alexander, since he has

of the right and duty to conduct investigations in this case. Only one

become so quiet lately. During the conversation with the children,

focus group, a discretion group, started the discussion by asking “Is this

where the nurse is also present, the children are quiet until Emilie

a case we are going to investigate?” which illustrates our main point of

leaves the room. Embla, then, suddenly stands up and says, “Didrik

looking at the referral in terms of the regulations in the law. All six

(mother's cohabitant) hits Mommy.” Alexander, then, immediately

groups concluded that the information given in the referral needed

grabs Embla's hand and they leave the room.

further investigation.

Then, the caseworkers were asked to discuss how they would

The Child Welfare Act gives quite clear instructions as a frame-

handle the case further. At the end of the session, the researchers

work, to be aware of where to focus one's effort. Well aware that

asked some questions to be sure they correctly understood the terms

the initial assessment of how to categorize a new referral often takes

being used.

more effort than choosing action once the assessment has been made

Our impression is that the social workers worked hard and

(Munro, 2008), we asked ourselves whether the absence of a legal

seriously. All six interviews were audio recorded. It seemed as if the

framework during the discussions was due to experience, tacit knowl-

participants quickly forgot they were being recorded. In all, there were

edge, or whether it was a coincidence. One explanation might be that

approximately 12 hr of audiotaped material. The interviews were

despite the mandate to work with the referral as they normally do, the

immediately transcribed. Excerpts from the data included in this

information was unclear. Another explanation might be the fact that

article were translated into English by the authors.

the situation was a research interview where the participants wanted

In analysing the data, we did not emphasize the social interaction

to do their best, and in that respect, the regulations laid down by law

among the informants during the interviews. This article focuses on

may prove to be self‐explanatory. The legal provisions might also be

the content of the caseworkers' assessment approach based on the

so well integrated in the procedure that they prove to be self‐evident

information given in the vignette.

in the discussion. However, what drew our attention was that the lack

4

HEGGDALSVIK

ET AL.

of statutory provisions as part of the first discussion happened in five

about the children. Although still a focus, the children were more a part

out of six groups. Otherwise, we could not find any difference

of all the different hypotheses, questions, and options that were con-

between the groups in their assessment or final decisions, because

sidered as part of the whole discussion.

they all started discussing the information they were given, and no

Another necessary piece of information expected to help make

one argued that they would withdraw the referral or transfer the chil-

the choice is assessment and decision‐making based on risk and pro-

dren to another service.

tective factors. According to O'Sullivan (2011), it is common to think of clinical judgement and actuarial methods as two broad approaches

5.2 | What information is needed to help make the choice

to assessing risk. Clinical risk assessment refers to practitioners using their knowledge to assess the degree of risk based on identified factors in a particular situation. Actuarial risk assessment refers to practi-

As researchers, we expected the caseworkers to focus their attention

tioners using predictive factors identified through actuarial research.

on the children and their caregivers when starting their assessments

The caseworkers in the template groups spoke about risk and protec-

and decision‐making. The discussions related to the parents and

tive factors through the assessment process. Quite early in the pro-

mother's cohabitant were quite similar in all six groups. Still, there were

cess, statements based on the information given in the referral were

differences in discussions of the children involved. The ratification of

made, such as, “these children are at high risk 3‐5.” This quote relates

the UN Convention on the Rights of the Child and Sections 6–9 in

directly to a specific section in the template and is quantified in terms

the Norwegian Child Welfare Act (1992) determine children's rights

of level of concern. Statements such as “We need to aim for the tem-

during proceedings as a clear framework for making assessments and

plate and count risk and protective factors, especially at the stage of

decisions in the best interests of a child. All six groups wished to

the notification report,” also clearly relate to the template. These state-

involve them in the investigation of the referral, but they differed in

ments are in accordance with actuarial risk assessment and with

how to involve them. In the template groups, the social workers

Andershed and Andershed (2016), who found that social workers

highlighted the children explicitly in their discussions. Statements such

who use a structured assessment instrument identify a greater number

as “I think it is all about us being incredibly conscious of focusing on

of risk and protective factors, as compared with social workers without

the children, what they express both in behavior and what little they

such tools.

tell us,” and from the other group, “the most important information

The template groups also referred to other systems and routines

we can get during the investigation of the referral must be from the

several times during their assessment. Tools such as “Fagtekst,” a

children,” are examples of this type of statement. They made it clear

method of writing journals, and “Acos,” a computer programme, and

that they were aware of different dimensions of assessment, including

specific routines related to work with families in terms of domestic vio-

behaviour, what the children say, and the awareness that children may

lence, were mentioned as part of the assessment. Overall, they

communicate in ways other than by speaking. The caseworkers also

displayed great self‐confidence as they worked with the assessment

emphasized involvement as involving giving clear information to the

process. A question is whether this confidence is the result of using a

children and not only asking for information. Statements such as “…

standardized template that makes it clear what to do next as part of

information to the children by telling who we are, why we are here,

the assessment process or because the social workers were experi-

what we are doing, and what we are planning to do further,” exemplify

enced and therefore confident in their work?

how strongly the caseworkers emphasized the children and their per-

Two discretion groups (same service) did not mention the terms

spectives as the main focus in the investigation. They also discussed

“risk” and “protective factors” during the whole interview. In the other

how they could get more information about the children as part of

service, both discretion groups mentioned risk and protective factors

the assessment. The caseworkers also emphasized the children's

but found it difficult to sort things out due to a lack of information.

“self‐reporting” where they write summaries based on conversations

The following statement illustrates the assessment:

with the children involved, as part of the template. The discretion groups also emphasized the importance of conversations with the children involved but not to the same extent as the template groups. These groups discussed more how to build relations with the children and different communication methods to use. Statements such as “… and eventually get to talk well with all the children so

I think, by having the first conversation, by having joint conversations, by having individual conversations and focusing on the children, and of course the mother's cohabitant, we will be more able to become aware of the risk and protective factors and sort things out.

we get a good relation to them,” are an illustration of this. In addition

This method of assessment contrasts with the one used by the

to focusing on parent–child relationships, the caseworkers spoke of

template groups. Instead of starting out with risk and protective fac-

parents as a resource for planning conversations with the children.

tors, this group will focus on these factors later, once they have started

One of the groups illustrated this by saying “… in this case we are work-

the investigation and know more about the family.

ing traditionally, so the parents can tell us how the children will be most confident when they speak with us.”

Broadhurst et al. (2010) argue that risk assessment instruments seem to reduce decision‐making options and minimize the use of dis-

A pattern that emerged in the template groups was that the case-

cretion. From the statements in one discretion group, we find that

workers spoke more directly about the children. They thought it was

the caseworkers think of risk and protective factors as information

most important to pay attention to the children, no matter what

they will gain through conversation with different members of the

options they were considering. The other groups spoke more indirectly

family. Uggerhøj (2011) argues that reliance on decision‐tools is a

HEGGDALSVIK

5

ET AL.

threat to professional discretion, because these tools objectify the

ideally should have more conversations with if we wish to get some-

families under consideration and might omit relevant differences

thing out of her, or we won't get anywhere.” is an example of this.

between families. In terms of Uggerhøj's statement, the caseworkers

Another example, can be illustrated by the following statement: “…

in the four discretion groups asked a lot of questions as a part of their

and I also think the children could be attacking the new cohabitant

assessment process. For example, “… how is the structure in the fam-

even though they are actually angry with their mother.”

ily?”, “who has what role?”, “what happens at home?”, “why?”, “how

Munro (2011) describes good professional practice as being

much?”, “how often?”, “for what reason?”, “what does he say to the chil-

informed by knowledge of the latest theory and research. In terms of

dren?”, “how does he involve the children?” These questions can be

referring to actual research, the template groups spoke about research

“interpreted” as an intent to get hold of nuances in the assessment

in terms of Kvello (2010). Apart from that, none of the focus groups

and decision‐making processes.

mentioned research (findings or articles) when discussing the referral

The caseworkers in the template groups seemed to be guided by a

towards possible consequences. One explanation might be that

certain standard of the assessment. In terms of staying focused on rel-

knowledge of child welfare and research is so well integrated that it

evant aspects, the template might be helpful for caseworkers without

was taken as self‐evident in the discussion. Another explanation

experience as well as for them with long and routinized experience.

might be that accessing the latest relevant research knowledge is

On the other hand, it challenges the awareness of nuances and

time‐consuming and both challenging and difficult for caseworkers

variations among children and families. What different caseworkers

(Drisko & Grady, 2015; Wike et al., 2014). O'Sullivan (2011) argues

stick to when doing assessments according to a standardized template,

that research‐based knowledge is most useful when relevant research

can also vary. O'Sullivan (2011) claims that one limitation of using

studies have been carried out, and the findings are assessable by

clinical risk assessment turns out to be that it is subjectively based,

practitioners who are able to integrate them with other sources of

and therefore, liable to both individual bias and errors. This means that

knowledge.

both the reliability and the validity of such assessments can be questionable. In this study, participants within the different groups expressed different viewpoints when it came to assessing risk and protective factors. Nevertheless, the patterns of assessment are

5.4

|

How probable is each consequence?

considerably different in the template groups and in the discretion

O'Sullivan (2011) points out that it is not possible to know whether a

groups.

decision has been effective until it has been implemented. Based on this fact, he makes a distinction between “a sound decision,” which

5.3

|

Possible consequences of each option

relates to the process, and “an effective decision”, which relates to the outcome. In our study, the research design did not allow us to look

Although the caseworkers with the template said, “We can make a set

at the outcome of the decisions made. A challenge is the uncertainty

up from the template as regards which area to focus on,” the case-

regarding what is the best judgement at all times in the process. On

workers in the discretion groups mentioned a wider variety of methods

the other hand, if child welfare caseworkers' were to consider all the

available to get information about the children's situation, and thereby

possible options and consequences of every decision they make, the

discuss probable consequences of each option of the different

amount of information they need to assess would be overwhelming.

methods. A statement such as “we may make a lifeline marking when

In our study, we observed a difference in the time spent on the discus-

things happened in the family and when the symptoms started to

sions in the six focus groups. Although there is variation, the two tem-

appear,” is one illustration of that.

plate groups spent more time than the other four. One discretion

Despite the fact that the methodological approach in this study is

group discussed the first part of the vignette for 20 min before they

a vignette, statements such as “What also might be interesting here is

reached their conclusion, in contrast to one of the template groups.

to try a network meeting,” illustrates how the caseworkers in one of

When starting their work, they related their question as “I think first

the discretion groups discussed and reflected about how to get the

of all we need the grounds for investigation, now I'm thinking of Acos.”

information they need to make further assessment. They show that

Also, “We can make a set‐up based on the template as regards which

in the caseworker's “toolbox,” there are several options for interpreta-

area to focus on” and “What do we pick from the template which is

tion based on cultural as well as personal understanding. As a conse-

of importance in this case? Are we going that far to control, or are

quence, there are several matters that influence the decisions to be

we going to have the first meeting with parents and children first?”

made. Several proficiencies, including analytical and emotional skills

This focus group spent 90 min discussing the same vignette. Consider-

and intuition, were challenged. In addition, personal opinions based

ing the circumstances, time is not of interest. But, it is of interest when

on experience show how caseworkers within the same service chose

it comes to accuracy in how to start assessing and making decisions

different methods based on their experience. The statement “I find

about a referral. On the one hand, the time spent might have to do

observations made at home more important than observations made

with our methodological approach, or with caseworkers being afraid

at school” illustrates this.

of doing something wrong, because they knew it was a research study.

When discussing the possible consequences of each option, the

On the other hand, when making decisions, caseworkers must exercise

template groups to a greater extent emphasized experimental knowl-

judgement in terms of how much effort they put into different deci-

edge gained from other cases they had worked with. Statements such

sions. This also includes making judgements with regard to the size

as, “And Emilie is, from the way she is described, actually a girl who we

of the task facing them (Munro, 2008).

6

5.5

HEGGDALSVIK

|

The pros and cons of each consequence

When approaching a professional decision, reflecting on how interpretations and assumptions have been made is of great value. Littell (2008) defines confirmation bias as a tendency of humans to emphasize evidence that supports one's own hypotheses while ignoring

ET AL.

decision‐making. Interestingly, in this study, the final conclusion at the end of the discussions turned out to be quite similar in all six groups; the children's caring situation needs to be further investigated, and the caseworkers need more information to decide whether and how to intervene before they can make a final decision.

evidence to the contrary. All six groups discussed several important and relevant hypotheses. But, on occasions, it seemed as if the caseworkers ended up discussing in circles. Due to the complexity of child welfare, it is difficult to think of decision‐making as having a clear beginning and a clear end. It can be appropriate here to think in terms of chains where sequences of decisions are taken over time, where one decision leads to the next. O'Sullivan (2011) gives a picture where the chain starts when a referral is made and ends when the case file closes. Links in the chain are the choices made, either as small steps or, at times, decisions in terms of major changes. In this chain of decision‐ making, it is important for caseworkers to be aware of viewpoints that do not support their arguments. Contrary argumentation is a way of safeguarding the decision‐making process by picking up on arguments that lead to another decision. In the assessment and decision‐making, we did not find patterns of contrary argumentation such as discussing the pros and cons of the different hypotheses, in any of the six focus groups. According to Munro's framework of asking what the pros and cons of each consequence are, we could not find that contrary argumentation was a routinized part of the assessment and decision‐making processes in either the template or the discretional approach.

6

|

DISCUSSION

A general challenge when making decisions is the fact that the children and families involved are unique in their character, and because of that, it is difficult to establish exact standards (Eriksen & Skivenes, 1998). Decisions made at different stages of an investigation, involve uncertainty as to whether the required information has been collected, categorized, and made as an appropriate trade‐off between risk and protective factors. In addition, caseworkers also are unique individuals and approach situations differently in terms of attitude, length of experience, and their form of cognitive processes. This study raises the question of whether it is possible to locate differences in the assessment and decision‐making processes in child welfare services where a template is implemented and in services where it is not. There is evidence that many front‐line workers are resistant to moving away from their intuitive approach (Munro, 2008). Orders are obeyed and risk assessment frameworks are completed, but confidence is retained in the front‐line workers' own intuitive reasoning. In that case, the introduction of a formal framework becomes an extra burden and not a support. A national inspection in Norway tells us that the reason why some child welfare services do not use Kvello's tem-

5.6

|

Main findings

plate is that it is too time‐consuming (Norwegian Board of Health Supervision, 2014).

The caseworkers in the discretion groups had discussions character-

Because all six groups came to similar conclusions regarding what

ized by sequences of fragmented decisions. When carrying out their

to do based on different methods, the results can be seen in relation to

assessments, they also emphasized emotions and feelings more often

the study by Bartelink, van Yperen, ten Berge, de Kwaadsteniet, and

than the caseworkers with the template. Several times, statements

Witteman (2014), who concluded that there is no convincing evidence

such as “I think that …” or “I get the feeling that …” were used during

that structured decision‐making leads to better agreement on deci-

their discussion. This way of thinking and assessing is in agreement

sions concerning child abuse and neglect. The discretion groups were

with Munro (1999), who claims that many professionals, especially

more tentative in their decision‐making, and it seemed as if they tried

social workers, rely heavily on intuitive skills in practice. Feelings, as

to avoid creating hypotheses without more information. Templates

much as knowledge, lead to a conclusion based on the caseworker's

may speed up decision‐making but not necessarily result in better deci-

emotional response, namely, that “it feels right” (Munro, 2008).

sions. Social workers might be more focused on certain information

According to the general emotion theory, emotions are our first reac-

and reach a state of certainty far too soon.

tions to affective phenomena (Ben‐Ze'ev, 2000). These might be both

The results from the present study give no overall answer as to

short‐term and longer lasting emotions. An obvious question is

which approach to decision‐making is more suitable, in terms of assur-

whether the caseworker's emotions contribute to strengthening or

ing the best interests of the child. On the contrary, they indicate that

weakening the process of decision‐making and the final conclusion

there are pros and cons to both approaches. Assessments and deci-

drawn. The caseworkers in the template groups structured their dis-

sions made with the assistance of a template seem to provide a frame-

cussion of the case according to stages of the template, and they did

work where the template governs the decision‐making process.

not mention their emotional reactions to the information they were

Another striking element of this study was how the template groups

to make decisions on.

highlighted the children throughout the whole assessment. Assess-

From Munro's summaries which claim that caseworkers put too

ment on the basis of professional discretion was characterized by

much emphasis on conspicuous and emotion‐based information

sequences of fragmented decisions, but placed importance on

(Munro, 1999), one can assume that emotions are a weakness when

nuances, in terms of differentiations among children and families. Ask-

it comes to final decision‐making. On the other hand, emotions can

ing extra questions such as why, who, what, for how long time, indi-

be seen as increasing the caseworkers' ability to understand a child

cates of how the caseworkers discussed the matter in a conscious

and a family's situation and, because of that, as contributing to better

attempt to recognize nuances and differences.

HEGGDALSVIK

7

ET AL.

The study reminds us of some of the possible vulnerability in professional discretion (Kirkebøen, 2013). It could lead to random decisions if the case is characterized by fragmented discussions, weak links to relevant research, and the influence of caseworkers' emotions (Lipsky, 2010). In that case, a template or a checklist could help the caseworkers to be aware of “where to put one's effort” in the assessment, but not a template that governs the process. The increasing preoccupation with standardized assessment tools and templates can be related to a prevailing uncertainty as to whether child welfare services' use of professional discretion leads to a better decision‐making and ensures equal treatment across municipal boundaries. Holland (2004) argues that caseworkers need to realize that the quest for the truth may be futile. Our conclusion is that a combination of standardized tools and professional discretion is needed if caseworkers are to meet the needs of families and children. The distinct contribution of our study is the potential in such a combination. A template may help the caseworker to assess all the important aspects of a case. Nevertheless, the challenge is if the template is implemented in an instrumental way, without the caseworkers' often demanding effort to understand the unique context. As O'Sullivan (2011) points out, selection, integration, and the use of different types of knowledge in order to make holistic assessments are some of the key features of a child welfare caseworker's job. These key features are a combination of the best knowledge a practitioners holds or has access to. ORCID Inger Kristin Heggdalsvik

http://orcid.org/0000-0002-7264-4257

RE FE R ENC E S Abbott, A. (1988). The systems of professions: An essay on the division of expert labor. Chicago: University of Chicago Press. Almklov, P., Ulset, G., & Røyrvik, J. (2017). Standardisation and measuring in child welfare work (Standardisering og måling i barnevernet). In T. Larsen, & E. A. Røyrvik (Eds.), The need to count (Trangen til å telle). Oslo: Scandinavian Academic Press. Andershed, A.‐K., & Andershed, H. (2016). Improving evidence‐based social work practice with youths exhibiting conduct problems through structured assessment. European Journal of Social Work 19, 1–14. Andresen, I. L., & Neegaard, C. (2012). Norwegian National Office of the Auditor's investigation of child welfare services and utilization of national measurements. (Riksrevisjonens undersøkelse om det kommunale barnevernet og bruken av statlige virkemidler). Norges Barnevern, 3, 196–205. Bartelink, C., van Yperen, T. A., ten Berge, I. J., de Kwaadsteniet, L., & Witteman, C. L. M. (2014). Agreement on child maltreatment decisions: A nonrandomized study on the effects of structured decision‐making. Child & Youth Care Forum, 43(5), 639–654. Bauman, D. J., Fluke, J. D., Dalgleish, L., & Homer, D. K. (2014). The decision‐making ecology. In A. Shlonsky, & R. Benbenishty (Eds.), From evidence to outcomes in child welfare. An international reader. Oxford University Press.. Ben‐Ze'ev, A. (2000). The subtlety of emotions. USA: Massachusetts Institute of Technology.

Broadhurst, K., Hall, C., Wastell, D., White, S., & Pithouse, A. (2010). Risk, instrumentalism and the humane project in social work: Identifying the informal logics of risk management in children's statutory services. The British Journal of Social Work, 40(4), 1046–1064. Deloitte Consulting (2014). Evaluering af ICS—Integrated children's system. Danmark: Socialstyrelsen. Devaney, J., & Spratt, T. (2009). Child abuse as a complex and wicked problem: Reflecting on policy developments in the United Kingdom in working with children and families with multiple problems. Children and Youth Services Review, 31(6), 635–641. Drisko, J. W., & Grady, M. D. (2015). Evidence‐based practice in social work: A contemporary perspective. Clinical Social Work Journal, 43(3), 274–282. Eriksen, E. O., & Skivenes, M. (1998). Correct decision‐making in child welfare. (Om å fatte riktige beslutninger i barnevernet). Tidsskrift for samfunnsforskning, 3, 352–380. Freidson, E. (2001). Professionalism. The third logic. Cambridge: Polity Press. Gillingham, P. (2011). Decision‐making tools and the development of expertise in child protection practitioners: Are we ‘just breeding workers who are good at ticking boxes’. Child & Family Social Work, 16, 412–421. Gillingham, P., Harnett, P., Healy, K., Lynch, D., & Tower, M. (2017). Decision making in child and family welfare: The role of tools and practice frameworks. Children Australia, 42(1), 49–56. Halkier, B. (2010). Focus groups (Fokus Grupper). Gyldendal Norsk Forlag AS: Oslo. Holland, S. (2004). Child and family assessment in social work practice. US: SAGE Publications Inc. Kahneman, D. (2011). Thinking fast and slow. New York: Farrar, Straus and Giroux. Kirkebøen, G. (2013). Can we trust professionals' discretion? (Kan vi stole på fagfolks skjønn?). In A. Molander, & J. C. Smeby (Eds.), Profesjonsstudier II. Oslo, Norway: Universitetsforlaget. Kitzinger, J. (1995). Introducing focus groups. British Medical Journal, 311(7000), 299–302. Kvello, Ø. (2010). Children at risk. In Harmful care situations. (Barn i risiko. Skadelige omsorgssituasjoner). Oslo, Norway: Gyldendal Norsk Forlag AS. Kvello, Ø. (2015). Children at risk. Harmful care situations (Barn i risiko. Skadelige omsorgssituasjoner) (2nd ed.). Oslo, Norway: Gyldendal Norsk Forlag AS. Lipsky, M. (2010). Street‐level bureaucracy. New York: Dilemmas of the Individual in Public Services. Russel Sage Foundation. Littell, J. H. (2008). Evidence‐based or biased? The quality of published reviews of evidence‐based practices. Children and Youth Services Review, 30(11), 1299–1317. Ministry of Children and Equality (1992) Act of 17 July 1992 No. 100 relating to Child Welfare Services (the Child Welfare Act) https://www. regjeringen.no/en/dokumenter/the‐child‐welfare‐act/id448398/ Munro, E. (1999). Common errors of reasoning in child protection work. Child Abuse & Neglect, 23(8), 745–758. Munro, E. (2008). Effective child protection. UK: SAGE. Munro, E. (2011). The Munro review of child protection: Final report. In A child‐centered system. UK: Department for Education. The Stationery Office Limited. Norwegian Board of Health Supervision. (2014). Inspection report—Municipality of Bergen (Rapport fra tilsyn med Bergen commune). Helsetilsynet.

Bergmark, A., & Lundström, T. (2010). Guided or independent? Social workers, central bureaucracy and evidence‐based practice. European Journal of Social Work, 14(3), 323–337.

Office of the Auditor General in Norway (2011–2012). Office of the Auditor General in Norway's investigation of Child Welfare Services's and the use of state measurements. (Riksrevisjonens undersøkelse om det kommunale barnevernet og bruken av statlige virkemidler)

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.

O'Sullivan, T. (2011). Decision making in social work. UK: Palgrave Macmillian.

8

Pithouse, A., Broadhurst, K., Hall, C., Peckover, S., Wastell, D., & White, S. (2012). Trust, risk and the (mis)management of contingency and discretion through new information technologies in children's services. Journal of Social Work. 12(2), 158–178. Rød, P. A. (2016). Evidence‐based social work. (Evidensbasert sosialt arbeid). In I. T. Ellingsen, I. Levin, B. Berge, & L. C. Kleppe (Eds.), (red) Sosialt arbeid. En grunnbok. Oslo: Universitetsforlaget. Rød, P. A., & Heggdalsvik, I. K. (2014). The Stavanger project—Report 1. (Stavangerprosjektet ‐ Rapport 1). Bergen, Norway

HEGGDALSVIK

ET AL.

Vis, S. A., Storvold, A., Skilbred, D. T., Christiansen, Ø., & Andersen, A. (2014). Status report on child welfare's investigations. (Statusrapport om barnevernets undersøkelsesarbeid ‐ høsten 2014) White, S., Hall, C., & Peckover, S. (2009). The descriptive tyranny of the common assessment framework: Technologies of categorization and professional practice in child welfare. The British Journal of Social Work, 39(7), 1197–1217. Wike, T., Bledsoe, S., Manuel, J., Despard, M., Johnson, L., Bellamy, J., & Killian‐Farrell, C. (2014). Evidence‐based practice in social work: Challenges and opportunities for clinicians and organizations. Clinical Social Work Journal, 42(2), 161–170.

Taylor, B. J. (2006). Factorial surveys: Using vignettes to study professional Judgement1. The British Journal of Social Work, 36(7), 1187–1207.

How to cite this article: Heggdalsvik IK, Rød PA, Heggen K. Uggerhøj, L. (2011). In K. Kildedal, L. Uggerhøj, S. Nordstoga, & S. Sagatun (Eds.), To be investigated—Norwegian and Danish parents' experiences with child welfare investigation (Å bli undersøkt ‐ norske og danske foreldres erfaringer med barnevernsundersøkelsen) I. Universitetsforlaget Oslo.

Decision‐making in child welfare services: Professional discretion versus standardized templates. Child & Family Social Work. 2018. https://doi.org/10.1111/cfs.12444