Working with Families of Children with Special Needs

Partnership and Practice

Naomi Dale

• Publisher: Routledge
• Year: 2008
• eBook ISBN:
  9781134823239
• Print ISBN:
  9780415114110
• Subtopic: History & Theory in Psychology

The importance of partnerships between professionals and the parents of children with special needs/disability is well established in childcare legislation. But is it reflected in practice?
Written for practitioners and those in training, this book recognises that forming partnerships can be a fraught process involving dissent as well as cooperation. Naomi Dale draws on case histories from her own experience to examine key partnership issues such as consent, confidentiality and diagnosis delivery. She combines up-to-date theory and research with practice to provide a wealth of suggestions and ideas for effective family work.
Working with Families of Children with Special Needs features useful exercises with each chapter, making it an excellent resource book and practice manual for multidisciplinary professionals.

Chapter 1
Conceptual frameworks for partnership work

A parent sits at home awaiting a new health visitor. She contemplates the arrival with trepidation. ‘What will she be like? Will we get on?… How will she react to my daughter?… Will she be of any help?…’ She looks across at her young daughter playing on the floor, and recalls some of the many demands and difficulties of cystic fibrosis over the last few years. Then she thinks of the future and is overwhelmed with a sudden surge of anxiety. A long road of uncertainties and worries lies ahead. The door bell rings.

A health visitor drives up to the house of a family she is visiting for the first time. She knows from the case notes that the family has a 3-year-old girl with cystic fibrosis. She feels a certain apprehension: ‘I haven’t had any experience of cystic fibrosis…. Will I appear ignorant?… I’ve heard this mother gets anxious and upset… Will she be very needy?… Do I have enough time to help her?’ Her thoughts stray to the many other competing demands of her large caseload, and she gets out of her car feeling stressed and inadequate. She walks to the front door and rings the bell.

A professional and parent come together for the first time. They bring their own worries and concerns, their own priorities and responsibilities. Somehow these have to be woven together into a relationship that works for both parties. Collaboration on the same project or issue is frequently referred to as a ‘partnership’. But how useful is the term ‘partnership’? What does it tell us about their relationship?

We start by examining the scope and limits of the term ‘partnership’ in its broadest sense, as the first step in building a case for a particular definition and conceptual model of partnership: the Negotiating Model of partnership.

RELATIONSHIPS AND PARTNERSHIPS

The Concise Oxford Dictionary defines a partner as a ‘sharer (with person, in or of thing)’. Resources, responsibilities, expertise, abilities, joint activities and power may all be shared. Risks and rewards may be apportioned. Through sharing, a goal may be reached, risks and decisions may be taken together. The route to reaching a shared objective may be easily negotiated or may arouse argument and dissent. Since the converse of sharing is ‘not sharing’, an association where there is little shared decision-making or activity is unlikely to constitute a partnership.

Partnerships can vary structurally. Some entail occasional meetings; others require recurrent meetings and extended time. They may evolve through informal encounters or formal arrangements with legally defined and ethical obligations, such as in business partnerships and professional-client relationships. Two or more persons may be involved.

The form and degree of cooperation can vary. In some partnerships, the partners work as separately as possible, only coming together to regulate the minimum shared activity necessary to prevent the partnership collapsing. In others, the partners take little or no action without consulting each other: full negotiation is needed before anything is implemented.

Each partnership has an internal power balance which will predispose the members towards a more egalitarian or more unequal relationship. One partner may take a senior role and the other a junior. One partner may have greater authority to make decisions than the other, or have greater control over resources and more resources at their disposal than the other.

The partners in a relationship may hold similar or differing interests, that is, the concerns that are seen as of greatest benefit or advantage to themselves or the party they represent. Cooperation may be more achievable between partners who share similar interests. When interests diverge, a relationship may tend to shift into conflict and eventually disintegrate.

Partnerships also differ in terms of gains and losses. In some partnerships, when one person gains the other loses. (According to games theory, a zero sum ‘game’ is one where, at the end of the game, the total wins equal the total losses.) If both partners have need of the same set of finite resources, the acquisition by one partner of the majority of the resources must limit the other to a smaller share. In other relationships, if one person gains, the other person stands to gain, or conversely, if one loses, the other stands to lose (a non-zero sum ‘game’).

We can see from the above that the term ‘partnership’ does not tell us a great deal about the extent of cooperation and reciprocity between two or more partners, except to suggest that there is some form of mutual cooperation and influence. The point to be made here is that, unless defined very specifically for the parent-professional relationship, the term can be used loosely to imply cooperation without telling us much about the extent of shared decision-making, the degree of consensus or disagreement, the power differences, and gains and losses between the partners. Apart from being uninformative, it may mislead by obscuring important differences between types of parent-professional relationships, which affect the possibilities for collaboration.

The case is persuasive for a more specific definition, but as we embark on our search we immediately face a first obstacle. It is extremely difficult to categorise professional-parent relationships into ‘types’, because each relationship is unique. Every parent and family situation has its own idiosyncrasies, and each professional has unique characteristics and ways of working and relating. The concern is not to lose the individuality and creativity of these relationships in a mechanistic and reductionist definition. Nevertheless, some common features can be identified across parent-professional relationships, which derive from the role relationship itself. The parent-professional relationship is a formal one, with each partner taking up a specified social role in relation to the other. The roles of ‘parent’ and ‘professional’ impose certain rights and duties on the incumbents of each position, to do with how that role position is constructed in society. Each position carries a set of associated norms, obligations and expected behaviours, and, as a result, each partner has expectations of how they or the other should behave together. For example, a patient expects and knows roughly how to behave with their doctor and vice versa. Consequently, there are relatively predictable patterns of behaviour and communication which are normally (or ideally) shown between parents and professionals, even though there will be individual idiosyncrasies within each relationship.

It is to these common patterns in parent-professional relationships that we turn our attention. But before looking at these, I would like to outline a few thoughts on conceptual frameworks.

Using conceptual frameworks

Descriptive and explanatory frameworks for describing role behaviours and role relationships can be referred to as conceptual frameworks or ‘models’. These intellectual frameworks are useful for distinguishing between different ‘types’ of role relationships, although in doing this, they may simplify the complexity of a relationship. Because they simplify and extract from what is going on in real life by focusing on normative role behaviour and ignoring the individuality of each person and relationship, they must be considered as ‘idealised’ and not a full picture of the reality. For example, a relationship may shift between different types of role behaviour on different occasions. But their value is in providing and explaining a pattern and permitting prediction from complex dynamics and interactions.

More specifically, ‘partnership’ models (discussed later in the chapter) provide hypothetical frameworks of how a partnership should or could work. They set out some minimum necessary prerequisites for partnership relationships, and thereby also define outer limits beyond which a partnership cannot operate. They can be used to guide and inform professional training and practice and their merits can be tested through direct practice and evaluation.

As we move forward now towards examining different parent-professional relationships it may be valuable to examine separately the ‘role partners’. Who is ‘the parent’, ‘the professional’ and ‘the child’? What are their contemporary roles? What contextual factors affect their role possibilities? How might these factors contribute to or determine the structure of the relationship and role behaviours with each other?

THE ROLE PARTNERS

The professional

The notion of the ‘professional’ role is controversial since some argue for a restricted usage of the term to refer to ‘full professionals’ in the traditional sense (e.g. doctors, lawyers, architects, university lecturers) and others argue for a wider application to ‘people workers’ (e.g. nurses, social workers, teachers; see Bennett and Hokenstad, 1973). The latter differ in their training, the nature of their acquired knowledge base, and their role and function from the so-called traditional professional (see further in Bennett and Hokenstad). But increasingly within the childcare field, the term ‘professional’ is applied to all trained, qualified persons with a responsibility for the welfare of children, and used to distinguish qualified from unqualified lay persons, such as voluntary workers, untrained childminders, or parents. It includes paediatricians, social workers, therapists, health visitors, teachers, qualified nursery staff, and others.

The professional, as implied in this book, holds a specialised body of knowledge and skills and has undertaken a period of training (often prolonged) to acquire them. This expertise distinguishes and distances the professional from the lay person and also from members of other professions. Those with a particular qualification may hold an exclusive right to practise the profession, and are permitted to control their own body of knowledge. They are responsible for delivering their specific expertise and knowledge through their professional practice. A profession may be marked by its own professional culture and code of ethics developed by its members, including a service ethic in relation...

Table of contents

• Contents
• Figures and tables
• Preface
• Acknowledgements
• Chapter 1 Conceptual frameworks for partnership work
• Chapter 2 Beginnings
• Chapter 3 The parent’s perspective
• Chapter 4 Communicating and negotiating
• Chapter 5 Frameworks for understanding the family
• Chapter 6 Working with the whole family
• Chapter 7 Assessment of family needs
• Chapter 8 Participating in developmental services
• Chapter 9 Information and control
• Chapter 10 The KIDS Family Centre: a model of service delivery
• Chapter 11 Legislation and partnership
• Chapter 12 Organisational issues
• Looking back, looking forwards
• Bibliography
• Name index
• Subject index