Hood, Rick

Kingston University Research Repository

Complexity and interprofessional working in child protection Rick Hood Royal Holloway, University of London Background • Integrated children’s services • The ‘expert system’ and the team around the child • Complex needs and complex cases • What is complexity?  The Children’s Trust Source: DCSF 2010: 8 The team around the child Source: DCSF 2008: 48 Disaggregating complex needs Hood, 2012 Complexity and interprofessional networks Hood, 2012 Research question What is complexity for professionals working together on complex cases? – How do they experience complexity? – How is complexity constructed in their accounts? Study design • Case-based study design • Purposive sample • Mixed qualitative methodology • Interpretative phenomenological analysis (IPA) • Critical discourse analysis (CDA) Fl h  1  19/12/10  Data Collection and Analysis CASE 1 CASE 2  Interviews  Transcribing Interviews Transcribing IPA data analysis CDA data analysis IPA data analysis CDA data analysis Findings Findings Discussion and implications  Research Protocol Flowchart Apply for ethical and R&D approval Present research to LCSB Academic review and upgrade Literature review Theoretical framework Study design and methodology NHS ethics approval  University ethics approval R&D approval  Identify initial sample of cases Negotiate access to research sites Approach potential participants Informed consent from participants and service users Write up and disseminate research Identify final sample  Fieldwork • Study site: 1 inner city children’s trust • No. of cases: 2 • No. of participants: 17 (Case 1: 10; Case 2: 7) • No. of interviews: 21 (Case 1: 12; Case 2: 9) • Two rounds of interviews (First: 14; Second: 7)   IPA Findings • Causality • Relationships • Assessment • Intervention • Risk Causality • Exploration of cause and effect – E.g. multiple problems, critical periods, linear/cyclical sequence of events  • Lack of control – E.g. volatility, surface and depth,  unwanted consequences Relationships • Dynamics of acceptance and rejection – E.g. hostility and acceptance, togetherness and separation • Managing the relationship – E.g. being open, trust and mistrust, informality, expectations • Perceptions of conflict – E.g. Being heard, hierarchy and status, fault-lines between agencies Assessment • Significance of information – E.g. access to info, ambiguity of info, context and history, getting the ‘big picture’ • Emotional resonance of the case – E.g. concern, stress, frustration • Processes of understanding and explanation – E.g. interpreting behaviour, immersion, search for diagnosis, boundaries Intervention • Balancing care and control – E.g. engagement and compliance, support, containment • Negotiating one’s contribution – E.g. role’s and remits; managing resources • Striving for progress – E.g. feeling ‘stuck’, trial and error, commitment • Functioning of the network – E.g. coordination, flexibility, withdrawal Risk • Acuteness of need – E.g. vulnerability and dangerousness, severity, divergence from norm  • Struggle for control – E.g. escalation, prevention, responsibility Conclusions • Non-linear causality and ‘double hermeneutic’  • Ambiguity and dualisms e.g. positive/negative • Organisation and self-organisation of network • Tactical or strategic intervention? • Problem of diagnosis and clinical oversight • Explicit and implicit communication • Incomplete differentiation • Relationship as resource Hood, R. (2012) ‘A critical realist model of complexity for interprofessional working’, Journal of Interprofessional Care, 26: 6-12   Contact: Rick.Hood.2009@live.rhul.ac.uk 

How professionals experience complexity and joint working in child protection

https://eprints.kingston.ac.uk/id/eprint/33503/3/Hood-R-33503.pdf

How professionals experience complexity and joint working in child protection

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