Tuesday, 29 January 2013

Decision-making: a key skill for child protection

Decision-making follows on from situation awareness. Obviously if we have misjudged a situation then our decision-making, however logical, will not result in a good safe service. So step one in any decision-making process demands an assessment of the situation.

But even if we have correctly assessed the situation things can still go wrong.  Plenty of accidents occur when professionals have correctly assessed what is happening but then select the wrong course of action.

Few would doubt that good decision-making is central to effective child protection work. And decision-making permeates the task of making a child safe. Decisions have to be made about whether to refer a particular case, whether to accept the referral, whether emergency protection action is required, whether a child should be made subject to a child protection plan, what services should be offered, whether care proceedings should be started, whether a child should be discharged from hospital, whether parents should be made subject to criminal proceedings: the list is long, if not endless.

Surprisingly there is not a vast literature about decision-making in child protection. And some rather naive assumptions have been made. One such is the idea that procedures can cover most child protection decision-making situations. On the contrary, while there is some scope for rule-based decisions in child protection, the toughest decisions are usually dependent on professional experience and frequently require creative imagination if they are to be effective. Children's best interests are not usually found in a flow-chart.

Sadly voluminous procedural manuals - which I have frequently protested about in this blog - usually result in decision-making becoming bureaucratic and cumbersome with no obvious benefits for the child.  It is wrong to pretend that complex decision-making can be reduced to simple discrete steps when this is manifestly not the case.

The psychological literature on decision-making is comprehensive and I have space here only to make a couple of points that I hope will generally be helpful.  The first is that decisions are often risky and should never be rushed unless the nature of the situation makes this unavoidable. The second is that decisions should always be reviewed before irretrievable actions are taken.  Thirdly decisions always need to be communicated to colleagues in a clear and timely way.

Some airlines use acronyms to help staff remember the stages in decision-making. The British Airways version is DODAR - diagnosis, options, decision, assign tasks, review. Although these sound simple, when applied properly they can be a real support to professionals who are making decisions in urgent and stressful situations. In particular they help ensure that no stages are overlooked.

I believe that child protection professionals can learn to be better decision-makers by examining what is known about decision-making in other fields. But the decision-making context is particularly complex in child protection, not least because it often involves several agencies both making agency-specific decisions and also participating in interagency decision-making.

Thus in the case of Baby Peter the police took a decision not to prosecute the mother. This appears to have influenced the local authority's decision not to start care proceedings. Taken together the two decisions appear to have had the overall impact of lowering the priority of the case across a range of agencies.

Sadly there is little research in this fascinating area of child protection.  I would warmly welcome a major study looking at the opportunities and challenges of decision-making in child protection, especially with a view to examining critical incidents from the perspective of organisational psychology.  Clearly there is much that could be learned from examining whether group-based decision-making processes, such as a child protection conference placing a child on a child protection plan, can be suboptimal because of the effects of 'group think'. Other danger areas might concern what Argyris [1] has called 'skilled incompetence', a phenomenon in which managers of large commercial concerns were observed playing clever games by moderating and weakening their criticisms of plans devised by chief executives. They did not want to be seen as 'yes people' but neither did they wish to dent the ego of their boss too much! Do similar kinds of games take place within and between child protection agencies?

[1] Argyris, C. "Skilled Incompetence" Harvard Business Review, 1 September 1986.