Child and Family Assessment in Social Work Practice

Sally Holland

• Publisher: SAGE Publications Ltd
• Year: 2010
• Print ISBN: 9781849205221, 9781849205214
• eBook ISBN: 9781446259764
• Edition: 2
• Topic: Social Sciences
• Subtopic: Social Work
• Index: Social Sciences

This thoroughly revised and updated second edition of Child and Family Assessment in Social Work Practice is an essential guide for social work students and practitioners involved in the assessment of children and their families. Focusing on ?core? assessments and guiding the reader through the complexities of conducting assessments of need and risk, the book now includes within each chapter a range of specifically-tailored exercises and focus points which encourage readers both to reflect on what they have learnt and to understand how they can apply that learning to practice.

Placing a strong emphasis on good, evidence-based, assessment practice, Sally Holland has also, for this new edition, included original research evidence from a wide range of up-to-date research studies which are relevant to today?s practice and which aim to promote a critical and reflective approach to the assessment process.

The book is divided into three parts:

- Part 1 explores different appoaches to assessment work, outlining policy changes and their implications for working with children and their families.

- Part 2 studies those involved in child and family assessments: children and their parents; and the relationship between the assessors and the assessed.

- Part 3 - a more practical guide - outlines the actual process of an assessment, illustrated by case studies, focusing on planning assessment methods, analysis, reporting and critical evaluation.

Accessibly relating theory and research to actual practice through the use of case studies, exercises, and suggestions for good practice and further reading, this book has a student-friendly structure It will be an invaluable resource for practitioners and academics across the field of social welfare, particularly for those embarking on, or already involved in, child and family assessment.

1

Introduction

Every day, thousands of children are helped, supported and in some cases have their lives saved by these staff. (Lord Laming, Hansard, 12 March 2009: Column 464)

One of the most controversial and complex areas of social work is the assessment of a child and their family when there are concerns about the child’s welfare. As Lord Laming suggests, every day child welfare workers are carrying out assessments of children’s welfare and helping to protect children and provide for their needs. From time to time misjudgements are made with tragic consequences. These cases receive far more publicity than the successful cases. Current evidence suggests that child protection work in the Western world is likely to be one of the causes for the drop in child abuse-related deaths in England, Wales and several other major developed countries (Pritchard and Williams, 2009). This book is focused on assessing children’s welfare in terms of need and protection: that challenging yet routine task carried out by social workers in all Western countries.

Areas of decision-making can include any of the following: the provision of supportive and preventative services, the likelihood of future harm, whether a child should be removed from home, if it is safe to return a child home, or if a permanent alternative placement is necessary. The discussion in this book is relevant to all levels of assessment in child welfare, although the particular focus is on in-depth assessment work where there are complex problems. This might include families with multiple and continuing support needs or following incidents of abuse or neglect. Such assessments are also used to aid decision-making about permanent placements for children. Practitioners conducting assessments of this kind may also be reporting their assessment conclusions to civil or family courts, case conferences or other key decision-making arenas.

This book has a number of central aims. First, I aim to provide a thorough discussion of child and family assessment, introducing readers to the scope of the literature on the topic, including research findings and theory. I aim to provide the opportunity for child welfare practitioners and students to critically reflect on the range of ways that assessment may be understood, and on their own assessment practice. Separate chapters discuss in detail some of the key themes that are central to assessment with children and their families, such as involving children and relationships with parents. Finally, I aim to provide a coherent vision of assessment practice that is thorough, fair to all participants and recognises the complexities of the assessment process. This latter point requires attention to values and to theoretical matters and it is these that are considered next.

Constructing assessment

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Attempted solutions to dilemmas over the correct approach to assessment have varied over the last century and on a national and local basis. One of the key concerns has been the tension between searching for assessments of measurable scientific validity and those that reflect the individually situated nature of each family’s circumstances and concerns. The first approach aims to produce assessment results that are objective, accurate and consistent, whoever is the assessor. The second approach places more emphasis on professional judgements based on an in-depth understanding.

Here, for the sake of clarity, emphasis has been placed on the differences between the two positions. In everyday policy and practice, both the writers of guidance and assessors themselves may draw from both traditions. For example, in the US, where there has been a tendency to aim for more accurate and objective assessments of risk to children, there is the facility in most assessment formats to over-ride findings if particular individual circumstances prevail (Gambrill and Shlonsky, 2000). In practice, practitioners in the US have been seen still to use much individual clinical judgement, even when using actuarial tools (English and Pecora, 1994). In England and Wales a largely qualitative approach to assessment is contained in the Framework for the Assessment of Children in Need and their Families¹ (Department of Health, 2000a). However, the guidance also encourages practitioners to use checklists and ratings scales as part of an assessment. The ways in which some social workers attempt to work with some of these tensions inherent in the nature of assessment practice are seen in Chapter 3 of this book.

The approach of this book is informed by both ‘scientific’ and ‘reflective’ approaches to assessment. For example, in Chapter 9 it is suggested that practitioners approach the analysis of assessment findings in a rigorous manner, using classic analytic techniques from qualitative social scientific research traditions. Practitioners are also encouraged to use scales and measurements where these are appropriate. Throughout the book, readers are also encouraged to reflect on the complex and contested nature of much of the information they will be working with during assessment work.

This latter understanding of assessment practice is informed by social constructionism, and this is the main theoretical underpinning of the book. Constructionism may be located within wider movements in academia; part of the post-Second World War loss of confidence in perceiving science as a march towards progress and understanding. Its main concern is with how knowledge and understanding are historically and culturally determined. Through our everyday interactions we build shared structures of understanding and these often become institutionalised and become, to us, an objective, external reality (Payne, 1999).

Examples of social constructions that are directly relevant to this book include constructions of childhood and child abuse. Changing and conflicting constructions of childhood can be identified in contemporary society, particularly around debates about the criminalisation of children (James and James, 2004). Parton (1985, 1991) has written extensively about the developing constructions of child abuse in the UK, demonstrating the practical and moral nature of much of our decision-making in this area (Parton et al., 1997). A social constructionist analysis of social problems can explore how claims about problems are made and maintained by various groups and in whose interests they serve. ‘Moral panics’ about perceived threats to sections of society are examples of speedy and extreme constructions of social problems (Payne, 1999).

Parton and O’Byrne (2000: 24–6) summarise some of the main components of social constructionism:

1. It problematises the view that we can straightforwardly observe the real nature of the world around us.
2. It understands social constructions as historically and culturally specific.
3. It pays attention to social processes and daily interactions, as this is how our knowledge of the world is formed.
4. It challenges the view that people and their environment have a discoverable real nature that can be uncovered.

Adopting this stance for assessment work has profound implications for how we understand our task. It has both positive aspects and potential drawbacks. First, it potentially broadens our understandings of some processes (such as our responses to bereavement) from being psychologically or biologically determined to being socially defined and maintained (Payne, 1999). Second, it liberates practitioners from the view that they must discover the ‘truth’ during an assessment and come to the correct solution. Instead we must listen hard to each participant’s account and value it as just that, an account, rather than assuming that our task is to judge its truth. This requires that assessors must remove themselves from the stance of ‘expert’ on other people’s lives and instead position themselves as listeners and facilitators (Parton and O’Byrne, 2000). Positive interventions such as those proposed by solution-focused and strength-based models can follow from taking such a stance. Third, maintaining an awareness that much of our knowledge is culturally constructed also brings about the potential for anti-oppressive practice by critically examining our own social constructions and attempting to form an understanding of others’. We can also reflect on the power relations in society that maintain the claims of some groups to have privileged access to the truth. Payne notes that:

we need theories which allow for the negotiation of assumptions and conceptions of the world and the purposes which we seek to undertake. (1999: 56)

There are potential drawbacks to applying social constructionism to the assessment of children and their families. Adopting a pure constructionist approach can be seen as adopting a viewpoint that there is no external, material reality. This, of course, is not a stance that practitioners dealing with experiences of child injury, neglect, poverty, domestic violence and poor housing could easily adopt. Instead, it is suggested that it is our classifications of these material realities, our experiences of them, our interests in them and the claims we make about them that are constructed (Taylor and White, 2000). A logical application of social constructionism would also imply that all constructions of the world are equally valid. Therefore, a child abuser’s view that their actions were justifiable might be equally valid to that of the child who wishes the abuse to stop. Child welfare practitioners must act, not simply reflect, and must make judgements that will sometimes value one construction of the world over another. We have both a legal and moral imperative to do this. However, by drawing on the ideas inherent in social constructionism, we may understand that we will never be making an entirely objective decision, but one that is moral, practical and political. In many family situations it will be possible for the practitioner to work alongside the family members to find a construction of their situation that will be hopeful and helpful (White, 1997; Parton and O’Byrne, 2000). In cases of denied child abuse practitioners will often need to take a more authoritative stance (Haringey LSCB, 2009) but even in these situations it has been demonstrated that parents can be engaged with constructively to promote the safety of their children (Turnell and Essex, 2006).

An evidence-based book

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Throughout this book I emphasise that assessment conclusions should be clearly evidenced. In the same way I have attempted to write a book that is clearly evidenced. I have avoided making assertions about what assessment ‘should’ or could be without rooting those statements in research. The first edition of this book drew heavily on the Coastal Cities study, my doctoral research from the late 1990s and a series of follow-up interviews following the implementation of the Assessment Framework in 2001. Most of the findings from the Coastal Cities study are still highly relevant for a second edition of the book. Indeed, the case of Baby Peter, the repercussions of which are still dominating the headlines as I prepare the second edition, tragically reflects one of the key findings from the study. This is that the relationship between the parent(s) and the social worker tends to dominate the process of assessment, a risk which can lead to the focus on the child becoming lost. Although there was in fact much concern and attention paid to Peter, the relationship with his mother appears to have caused the risk to Peter to be under-estimated and to prevent practitioners from revising their initial assessment. I have therefore retained those aspects of the Coastal Cities study that seem most relevant to today’s practice, and also incorporated new evidence from recent research, conducted by myself and by others.

The Coastal Cities study investigated how social workers carry out in-depth assessments of children where there are expressed concerns about their welfare. The research was carried out in two neighbouring cities in the UK, both located on the coast. In the larger city I examined assessments carried out by state social workers (City Social Services). These social workers carried large and varied caseloads, weighted towards child protection and children looked after by the local authority, and their assessments were part of this work. In the smaller city, I looked at the work of practitioners based in a specialist referred family centre that conducted in-depth assessments referred by the local authority (Hillside Family Centre). It was owned and managed by a large national voluntary organisation. In both sites, all social workers were qualified and had post-qualifying experience of between 2 and 16 years.

The research was conducted in three stages. In the first stage, 16 assessments were examined in depth. This stage included several in-depth interviews with each social worker at different periods of the assessment process, the observation of assessment sessions that had been previously video-taped, the reading of case records and observation of staff members in their team room. The second stage followed the initial analysis of the first 16 cases. The case files of four further cases were examined to check the validity of the initial analysis and this analysis was also critiqued by a focus group of social workers from the family centre. The third stage of the Coastal Studies research involved semi-structured interviews with ten social workers from the same two agencies in 2001, to explore with them the changes and continuities in their assessment practice since the introduction of the Department of Health/National Assembly for Wales Assessment Framework earlier that year. The 20 assessments in stages one and two involved 35 children aged from six months to 12 years and one assessment involved an unborn child. Of these cases, 15 had been referred for assessments by the family court and the other five by multi-disciplinary child protection case conferences. The cases included alleged physical abuse, sexual abuse, neglect and Munchausen’s Syndrome by Proxy. The families undergoing assessment involved heterosexual couples, lone mothers and fathers and the maltreated children and their siblings. Whenever data from the Coastal Cities study are included, I have used pseudonyms and occasionally changed some identifying features in order to protect the anonymity of the participants. A fuller explanation of the research methods is located elsewhere (Holland, 1999).

Research into practice

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The inclusion of data from this research study, and from the findings of others who have researched assessment practice, affects the tone and purpose of this book. The words and actions of the Coastal Cities social workers are not included in order that either the reader or myself may pass judgement on how well or how badly a group of practitioners have carried out assessment practice. Instead, and in the tradition of others who have carried out ethnographic research into social work (for example, Pithouse, 1998; White, 2002; Scourfield, 2003) the intention is less directive. Following Bloor’s (1997) argument, it is by providing some detailed description of how others have conducted assessment work that I hope readers may be able to reflect on their own practice, by recognising, comparing or contrasting their work with that carried out by the Coastal Cities workers and those in other research studies cited in this book. Therefore, the inclusion of the research findings is intended not only to illustrate the discussion but also to aid critical reflection. However, I am aware that readers will also want help in applying some of the research findings in action. There are suggestions for practice and exercises throughout the book, and the third part of the book provides an intentional change of tone, becoming more of a practical guide than the previous two parts.

While I am currently involved in social work through research and teaching qualifying and post-qualifying students of child and family social work, my interest in this topic originates in my own practice experience. Upon qualifying, I worked in a busy city centre children’s social work team. I carried a large and varied caseload of which ongoing assessment work was a staple part. I occasionally carried out more intensive assessments, such as those discussed in this book, usually for court hearings. I then moved on to work in a voluntary sector family centre, similar to the family centre in the Coastal Cities study, although not the same centre. There, I was part of a team for whom the core of our work was to carry out in-depth assessments of families referred by the local authority. Although the families referred often presented severe challenges concerning the abuse or neglect of their children, the work of the centre had a constructive tone. Even where assessments recommended that children be removed from their parents, or should not be returned home, relations between staff and family members frequently stayed positive. This was aided by very low caseloads, therefore each family was given time to express their views and be listened to. There was also a team ethos of respect for all who attended for assessment. It was from this background that I began to research and write about assessment practice. I therefore believe, from first-hand experience, that it is possible to carry out assessments of families, even where concerns are severe, in a positive and participatory manner. I acknowledge that this is aided by solid resources and low caseloads and that, as is discussed in Chapter 2, many practitioners in the Western world are struggling with rising and complex workloads. However, I would also argue that most of the suggestions for practice derived from research in this book are achievable in most social welfare settings as they are concerned particularly with a participatory ethos and adopting a critical and analytical app...

Table of contents

• Cover Page
• Title Page
• Copyright
• Contents
• Acknowledgements
• 1 Introduction
• Part I What is Assessment?
• Part II People in Assessments
• Part III The Assessment Process
• References
• Index