Partnership and collaboration: Rhetoric and reality

Child

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PARTNERSHIP AND COLLABORATION: RHETORIC AND REALITY TONY MORRISON Lancashire.

UK

Abstract-Multidisciplinary collaboration in child protection work in the UK is facing considerable strains resulting from major organizational changes across public welfare systems. budgetary cuts, and severe resource deficits. In parallel with this there has been a powerful impetus through new legislation to recast the management of child protection in order to involve clients far more in decision making, reduce the removal of children from families, and to redirect resources towards a more preventive approach. This paper considers the nature of effective partnerships both between clients and agencies, and between agencies in the child protection field. The need for clear defimtions of “partnership” is emphasized as well as the necessity for partnerships to be underpinned by a continuum of supportive and protective services. A framework for interagency collaboration is offered.

Key Words-Partnership,

Collaboration,

Anxiety,

Intervention,

Outcomes

INTRODUCTION CHILD PROTECTION WORK appears to have reached a watershed in the UK. Organizational

change and fragmentation combined with harsh financial cutbacks across the welfare sector mean that multiagency collaboration is facing possibly its sternest test since the importance of interagency work was first recognized. In addition, the Children Act 1989 has sought to radically recast the relationship between State and family within a “partnership” ethos by working with parents with the aim of reducing statutory intervention in cases of child abuse. However, this legislation has been enacted with little increase to the resource base. This paper considers the implications of these fundamental changes for the meaning and practice of both agency-family partnerships and interagency collaboration. It is argued that these twin axes in child protection are interdependent so that neither can exist effectively in the absence of the other. The nature of partnership practice is explored and frameworks for effective intervention services and collaboration are offered. Current debates, however, need to be understood within the context of the historical development of the UK’s child protection system. The death in 1974 of a young child (Maria Colwell) at the hands of her stepfather, and the subsequent high profile public inquiry (Colwell, 1974) exposed major shortfalls in coordination between agencies. This together with many similar high profile reports thereafter has led to the creation of a strong interagency framework based on local Area Child Protection Committees (DOWHome Office, 1991). These committees bring together senior managers from agencies to act as a strategic coordinating task group. Their responsibilities include establishing interagency procedures, coordinating multiagency training, monitoring collaborative practice, reviewing cases causing serious concern, publishing an annual report; and disseminating public information. At an operational Received for publication August 23, 1993; final revision received June 22. 1995; accepted June 26, 1995.

Reprintrequestsshould

be addressed to Tony Morrison,

625 Bury Road, Bamford,

UK. 127

Rochdale, Lancashire OLl

I

4DN,

Chdd Abuse & Neglect, Vol 20, No 2, pp. 127-140, 1996 Copyright ~3 1996 Elsewer Science Ltd Printed m the USA. All rights reserved 0145-2134/96 $15~) + .00

Pergamon

0145-2134(95)00124-7

PARTNERSHIP AND COLLABORATION: RHETORIC AND REALITY TONY MORRISON Lancashire, UK

Abstract--Multidisciplinary collaboration in child protection work in the UK is facing considerable strains resulting from major organizational changes across public welfare systems, budgetary cuts, and severe resource deficits. In parallel with this there has been a powerful impetus through new legislation to recast the management of child protection in order to involve clients far more in decision making, reduce the removal of children from families, and to redirect resources towards a more preventive approach. This paper considers the nature of effective partnerships both between clients and agencies, and between agencies in the child protection field. The need for clear definitions of "partnership" is emphasized as well as the necessity for partnerships to be underpinned by a continuum of supportive and protective services. A framework for interagency collaboration is offered.

Key Words Partnership, Collaboration, Anxiety, Intervention, Outcomes

INTRODUCTION CHILD PROTECTION WORK appears to have reached a watershed in the UK. Organizational change and fragmentation combined with harsh financial cutbacks across the welfare sector mean that multiagency collaboration is facing possibly its sternest test since the importance of interagency work was first recognized. In addition, the Children Act 1989 has sought to radically recast the relationship between State and family within a "partnership" ethos by working with parents with the aim of reducing statutory intervention in cases of child abuse. However, this legislation has been enacted with little increase to the resource base. This paper considers the implications of these fundamental changes for the meaning and practice of both agency-family partnerships and interagency collaboration. It is argued that these twin axes in child protection are interdependent so that neither can exist effectively in the absence of the other. The nature of partnership practice is explored and frameworks for effective intervention services and collaboration are offered. Current debates, however, need to be understood within the context of the historical development of the UK's child protection system. The death in 1974 of a young child (Maria Colwell) at the hands of her stepfather, and the subsequent high profile public inquiry (Colwell, 1974) exposed major shortfalls in coordination between agencies. This together with many similar high profile reports thereafter has led to the creation of a strong interagency framework based on local Area Child Protection Committees (DOH/Home Office, 1991). These committees bring together senior managers from agencies to act as a strategic coordinating task group. Their responsibilities include establishing interagency procedures, coordinating multiagency training, monitoring collaborative practice, reviewing cases causing serious concern, publishing an annual report; and disseminating public information. At an operational Received for publication August 23, 1993; final revision received June 22, 1995; accepted June 26, 1995. Reprint requests should be addressed to Tony Morrison, 625 Bury Road, Bamford, Rochdale, Lancashire OLI I 4DN, UK. 127

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level there are detailed procedures for interagency coordination, especially during the investigative and initial decision-making stages: almost all investigated cases where abuse is suspected are subject to a multiagency case conference to which parents and children, where appropriate, are invited. The names of children who are assessed as being in need of a child protection plan are placed on local child protection registers. There is no mandatory reporting system. The primary emphasis from 1974 until the late 1980s was on the duty of the State to protect abused children, without a complimentary focus on preventative and post-services. The story of inquiries during this period had been of "too little being done too late." However, the crisis in Cleveland in 1987 tapped into a possibly deeper public disquiet about overzealous intervention in the cases of large numbers of children suspected of being sexually abused. The accusation had now changed to "too much, too soon." This became in turn one of the most potent catalysts to the Children Act 1989, designed to reshape intervention philosophy in favor of the preservation and support of the family, and away from paternalistic State intervention. "Partnership" philosophy and working closely with parents was thus seen as the solution to all the deficits of the child protection process, with little account being given to the impact of increasing resource deficits on practice. However, the Act also retained much of the previous framework for investigating suspected abuse and intervening to protect children, albeit with more robust safeguards to limit what decisions social services could take without the court's sanction. Fox-Harding (1991), in her analysis of the Children Act, describes two contrasting tensions within the Act. First, increases in the State's right to intervene in family life are juxtaposed with the " n o order" principle of judicial non-intervention. Second, the Act's strong emphasis on working with parents and defense of the natural family is counter-balanced by the strengthening of children's rights. Thus, 3 years after implementation, while figures show a dramatic reduction in the numbers of emergency applications for the removal of children from home, the percentage of children on child protection registers who are looked after by social services has dropped by only 3% from 23% in 1989 before the Act to 20% in 1993, 2 years after the new legislation (DOH, 1994). Similarly, figures for numbers on child protection registers reveal that despite a substantial 30% decrease between 1991 and 1993, mainly due to the removal of one general c r i t e r i a - - " g r a v e concern," during the same period there has been an underlying increase of 23% in registrations for the other more specific criteria such as physical and sexual abuse and neglect (DOH, 1994). In other words, while gatekeeping has generally improved, there remains a fairly consistent cohort of abused children in need of alternative care and protection, and an increase in some areas of reporting. Given the philosophical tensions within the Act and the trends described above, it is perhaps not surprising that it has proved so difficult to find a consistent definition of partnership. In fact, neither the statute nor official guidance defines the term. So why is this apparently "userfriendly" and straightforward term so problematic to define and express in practice? The lay person's definition would equate the term with joint business, sharing, and equality. However, it is very clear both in statute and accompanying guidance that partnership in this context does not mean equality. The State has not abdicated its right to intervene in family life when a child is deemed to be seriously at risk of harm, particularly in cases of sexual abuse which are seen first as criminal acts. The UK has not, for instance, adopted the principle of family group conferences as in New Zealand, whose legislation is based on a more radical belief in a non-adversarial response to family difficulties. The New Zealand approach is based on an equalization of professional and community interests and a belief that the State's job is to support and resource family decisions (Marsh & Allen, 1993). Further analysis of the concept of partnership by Howe (1992) explores distinctions between notions of participation and empowerment: " T o what extent should helpfulness, empowerment, and participation be mentioned in the same breath? Is to speak of one to speak of the others? Although they develop similar characteristics, they ought not to be confused as members of

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the same species. Their evolutions are quite separate but in occupying similar ideological niches, they have assumed similar shape and form. Practice is likely to become muddled if workers are attracted merely by a concept's looks rather than by its intellectual origins. So, for example, it might be that clients experience participation as fair rather than helpful or that empowerment is a weaselword in child protection if good practice is to be characterized by honest dealings." Howe (1992) also contrasts a therapeutic definition of partnership based on a psychological contract between the parties for change, and a social justice definition based on respect, sharing, openness, clarity of roles, responsibilities, accountabilities, and involvement in decision making. A further dimension to partnership is added when its political complexion is considered as it relates to consumerism, citizenship, and handing back responsibility from the State to individuals. There are manifest difficulties if consumerist ideologies underlie partnership in child protection, given that abused children do not have the maturity or power to act as miniconsumers in order to ensure that their rights are upheld. Thus, it is vital that we are clear who it is we are in partnership with, about what, and to what end. As Adcock (1991) states, partnership is not an open-ended arrangement or an end in itself. It should be based on an assessment of the child's needs and the shared duty of both the State and parents/caregivers to promote the healthy development of children. Within that framework partnership can then be seen as a continuum of relationships between agencies and families, which range from the voluntary to the statutory. Partnership cannot be simply equated with voluntariness. Thus, "while we must search for every possible way of improving the process for parents, it will remain for some, if not many," comments Stevenson, " a nasty business, the very opposite of the cozy encounter which simplistic talks of partnership suggests" (1994). Collaboration in a Fragmenting Environment

Thus far, the meaning of partnership in terms of agency-family relationships has been explored. However, because the management of child protection requires the combined skills and resources of different agencies working together, then the quality of interagency collaboration has a direct impact on partnerships between agencies and families. Partnership is about services, sharing, information, accountability, and communication. Rather like the child whose world is mediated through the quality of relationships between the parents, so the experience of vulnerable families in the child protection process is mediated through the modelling of multidisciplinary relationships and behavior. One cannot not feel safe as an airline passenger while witnessing the crew arguing among themselves, or worse, providing conflicting accounts of what is happening and what to do when the plane is in trouble. Unfortunately, research about the definition, practice, and efficacy of collaboration paints a picture of just such confusion and conflict (Hallett & Birchall, 1992). Aitken summarizes much of the research on collaboration when he says: "Coordination is a word which is overworked, underachieved, and seldom defined" (1975). Weiss comments: "'When a coordination program is launched, the vague sense that coordination will be effective often camouflages the multiple conflicting hopes of clients, politicians, administrators, professionals, and interest groups that each cherish independently. The definitional ambiguity which makes coordination a handy political device has led to a chasm between rhetoric and operationalization'" (1981). As a result, collaborative efforts may often proceed without an appreciation of their true complexity. Hallett and Birchall (1992) summarize various definitions by suggesting that " T h e essence (of collaboration) is that the combination of skills produces an outcome which could not be achieved as effectively or efficiently, by other cooperative means." Challis, Fuller, Henwood, Klein, Plowden, Webb, Whittingham, and Whistow (1988) describe collaboration as having three elements: the organizational machinery (structures, policies, etc.); the process of working

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together both formally and informally; and the output in terms of services and benefits to abused children and their families. Collaboration therefore cannot be said to exist just because the organizational machinery is in place, or even because it is felt people are working well together. While procedures for joint working are essential, too often such aspects of the machinery of collaboration become confused with the outcomes of collaboration. The critical test is what outcomes are achieved for abused children and their families. Multiagency coordination then, while seen to be a very desirable objective has in practice proved to be difficult to achieve, due to a combination of structural, philosophical, cultural, and financial blocks. Stevenson (1989) has noted five major barriers to collaboration.

Structures and systems. Agencies with different roles, histories, cultures, powers, and priorities are expected to work together across a professional network in constant flux, comprising literally thousands of staff, sometimes across wide geographical areas, to agreed standards, under pressure and over time. Expectations about accountability, supervision, and responsibility for decision making are vastly different across disciplines. Communication. Information is power and sharing it symbolizes some ceding of autonomy. Disagreements exist both as to the content of what is to be shared and about the actual value of talking together at all. What seems essential to communicate for one may seem a breach of confidentiality or peripheral to another. Status and perceived power. Differences in contracts of employment, professional training, occupational status and power, gender, race, class, language, and public image all contribute to the real and felt power differentials within the interagency network. Working together means contact between differing emotional realities, different systems of meaning and different types of bias. Consequently, women and men, Black and White, disabled and able bodied, gay and straight, have to address differential experiences of power and powerlessness as aspects of organizational practice and learning (Vince & Martin, 1993). At its most acute, the statutory responsibility of social services for the protection of abused children is at odds with its lower status and less certain identity when compared, for instance, with other groups on whom it is dependent to carry out those responsibilities, such as doctors and lawyers (Hallett & Birchall, 1992). Professional and organizational priorities. While for social workers, pediatricians, or other child protection specialists child abuse may be a priority, for the vast majority of the network (teachers, family doctors, lawyers and criminal judges, and so on), it is often an occasional problem at most. Collaboration takes place across groups whose investment in and knowledge base about child protection is so diverse as to appear at times mutually unrecognizable. Extent to which collaboration is perceived as mutually beneficial. The fact that government policy requires agencies to collaborate is no guarantee that they will do so. There are many subtle and sometimes delinquent ways in which coordination can be undermined if the reasons for collaboration are unclear, the perceived costs of so doing outweigh the perceived benefits, or there are insufficient resources to support agencies working together. However, the pace of organizational change across public welfare combined with severe budgetary cutbacks has increased the strains on collaboration to a very precarious point. Reforming legislation in health, education, and social services has resulted in extensive decentralization and the creation of internal markets and competition which have fundamentally altered the relationships between those who purchase services and those delivering them. This fragmentation of central structures means it is no longer possible for senior managers to guarantee a response to child protection throughout their agency. The result is that collaboration

Partnership and collaboration

13I

is dangerously overdependent on the commitment and skills of individuals, rather than organizations, and too easily disrupted by their departure. On the human side, it has led to a culture of "survivalism" in which individual energies are directed inwards toward self-protection, with little spare energy left to engage with the external world of other agencies. On top of all this, the child protection system is severely overloaded. A decade ago there were some 10,000 children on child protection registers. By March 31, 1993 there were 32,500 children in a period that has seen major restraint of public expenditure (DOH, 1994). Hallett and Birchall (1992) summarize the situation when they describe the "atmosphere of chronic overstrain, unrealistic expectations of staff, desperately inadequate resources to cope with rapidly increased reportage of cases and a limited fund of skills and knowledge confronting rising expectations that abuse should always be successfully managed." Child protection work is in, or at least approaching, crisis.

THE ANXIOUS ENVIRONMENT There is, however, a further psychological link between interagency and family-agency dynamics which has a powerful impact on our ability to engage in the difficult business of partnership. This concerns the role of anxiety. Anxiety runs like a vein throughout the child protection process. It is present in the anxious or unrewarding attachment that forms the family context in which abuse may occur. It is present in the highly charged atmosphere of the parents' first encounter with professionals concerned about their child. It is present, too, within the professional system, as child abuse represents a crisis not only for the family, but also for the professional network. Finally, anxiety exists not just at the level of the individual, but also as Menzies (1970) has pointed out, as an organizational phenomenon. In the current climate of rapid change, the organizational anxiety generated in the management of risk is compounded in many organizations' by the struggle for their own survival. Menzies (1970) research on "Social Defense Systems" provides a compelling description of the organizational and human effects of managing in such an environment. She states " T h e success and viability of a social institution are intimately connected with the techniques it uses to contain anxiety. The needs of the members of the organization to use it in their struggle against anxiety leads to the development of socially structured defense mechanisms, which appear as elements in the structure, culture and mode of functioning of the organization. A social defense system develops over time as a result of collusive interaction and agreement between members of the organization in order to avoid the experience of anxiety, guilt, doubt and uncertainty which are felt to be too deep and dangerous for confrontation." Failures at an organizational level to contain anxiety appropriately can permeate all aspects of the agency's work, as well as affecting its relations with the outside world and other agencies. This is demonstrated in the Dysfunctional Learning Cycle described by Vince and Martin (1993) (Figure 1). In this environment anxiety is seen as unprofessional, a sign of weakness or not coping. As a result, uncertainty is suppressed through fight and flight mechanisms. The absence of forums where feelings and doubts can be safely expressed leads to defensiveness and a resistance to share and reflect on practice. It also undermines confidence to experiment with new practice. (This may go some way to explain why it has proved so difficult to enable staff to relinquish paternalistic practices in favor of more innovatory and participatory approaches.) Emotional defensiveness then deepens into cognitive distortion whereby the painful reality is warded off via denial of dissonant information and attitudes, offering a temporary but false sense of security. If this process worsens with more willful and sustained ignorance, it may lead eventually to total disengagement. Such systems have the appearance of being psychologically

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T. Morrison

DISENGAGEMENT AICOETY ,

WILFU~ R G H T F / L G I H T IGNORANCE( ,~ DENIAL~

DEFENSIVENESS/AVOIDANCE

Figure 1. Dysfunctional Learning Cycle. From "Inside action learning," by R. Vince and L. Martin, 1993, Management Education and Development, 24, 205-215. Copyright 1993 by Sage Publications. Reprinted with permission.

impregnable. The consequences of prolonged engagement in such a dysfunctional coping cycle are deeply damaging for all involved: families, staff, agencies, and most of all abused children. These consequences can include: 1. Depersonalization as clients cease to be individuals and become statistics; 2. Detachment and denial of feelings as the language of intervention becomes bureaucratized into packages and throughput; 3. Ritual task performance concerned only with procedural compliance; 4. Constant counter-checking, in which cases never get beyond assessment; 5. Redistributing responsibility through projection and blaming of individuals or other agencies; 6. Reframing and minimizing the true nature of concern; 7. Clinging to the familiar even when it has ceased to be functional (Menzies, 1970).

IMPACT AND OUTCOMES ON PARENTS AND CHILDREN It is not surprising in such an environment to discover then that the experience of parents and children involved in the child protection process is very mixed. A large scale research study following the careers of 73 children on Child Protection Registers by Farmer and Owen (1995) found that the large majority (70%) of parents experienced the initial impact of the child protection process (investigation and the initial case conference) as highly stressful. This was due to factors such as lack of information and consultation; the marginalization/blaming of the nonabusing parent (mainly mothers); lack of preparation for their involvement in case conferences; disputes over whether abuse had occurred, culpability, and the need for intervention; feeling out of control; and a failure to consider the needs of these parents. Jointly these factors had the unintended effect of intensifying pre-existing dynamics within families. Thus "mothers became more despondent, shouldering an increased burden of responsibility, while fathers frequently distanced themselves further from families . . . . Moreover by the end of the investigation decisions and interventions have crystallized which were likely to determine future child care outcomes" (Farmer & Owen, 1995). Despite these high levels of initial alienation, parents wanted to be more involved in decision making were able to respond to skilled and sensitive workers. These factors contributed to a

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number of positive outcomes 20 months later. In three-fifths of the parents for whom the early stages of impact had been negative, this was no longer the case by the end of the period, largely due to a change of worker. Secondly, parents appreciated workers who showed an attitude of respect, liking, and an ability to understand their point of view. This enabled sufficient common ground to be created, by incorporating goals of importance to the parents while addressing the child's needs. In many ways the childrens' experiences mirrored that of the parents, although, of course, far fewer attended case conferences due to age. Older children removed because of sexual abuse felt blamed and punished for disclosing, and experienced a loss of control. Many were very concerned about the impact on other family members, and had deep conflicts of loyalty. They particularly appreciated the presence of a familiar figure during the investigation, and regretted the exclusion of the nonabusing parent. They also wanted their feelings about responsibility understood rather than denied, and thus benefited considerably in the approximately 50% of cases in which individual counselling was offered. They also wanted to retain family links and for the worker to seek to establish a positive relationship not only with them, but with their parents. Overall at the end of 20 months, 70% of the children on Registers had been protected, while 30% suffered further abuse. Of those children who had been protected, this had been achieved by total separation from the abuser in 45% of cases, temporary separation in 29% of cases, and in the other 26% of cases while remaining at home. In 68% of cases the children had also made developmental gains, via either change of placement (50%), or direct services such as day care, or skilled worker interventions. To sum up thus far: The UK's child protection process is experiencing a number of major transitions driven partly by financial imperatives to cut costs and increase efficiency, and partly by a professional drive to reduce paternalistic approaches in favor of partnership-based practice. However, definitions and paradigms of partnership practice remain ill-defined, resources are desperately inadequate, and collaborative structures are fragmenting. In addition, professionals continue to identify a consistent cohort of abused children in need of protection outside of their immediate family. Thus, relinquishing paternalism in a hostile and anxiety-riven welfare climate with reducing resources is proving to be an uphill task. Staff remain concerned for children, and understandably wary that any failure to protect children as a result of increased risk-taking in the name of "partnership" will be punished. As Calder says, "'Partnership is loaded with possibilities but it cannot offer a quick solution to entrenched problems" (1995).

Towards Effective Partnership Practice Unfortunately, because the Child Protection process in the UK has evolved reactively in response to scandals, there has been both a lack of strategic direction at a national level about intended outcomes as well as an unhealthy separation of child protection from child welfare goals and polices. Child protection must be considered within an overall family and social policy context whose aims include combatting poverty. The UN Convention on the Rights of the Child (1989) offers such a framework. Unified by a recognition of childrens' personhood, it recognizes the significance of liberty, privacy, equality, and nurturance rights in preserving the integrity and dignity of children as individuals (Melton, 1991). Articles referring to child protection systems state the need for "effective procedures for the establishment of social programs to provide the necessary support for the child and for those who have care of the child, as well as other forms of prevention, and for identification, referral, reporting, investigation, treatment and follow-up instances of child maltreatment, and as appropriate for judicial involvement" [arts. 3(2), 6(2), 19(2)]. The Convention affirms the principle that the child's interests should be the primary consideration, and that the State bears a special duty not to harm children. Thus, child protection must be rooted in the twin principles of the paramount importance of the child, and minimal intrusion into family life.

134

T. Momson INTERVENTION CONTINUUM

An integrated approach to child welfare within which the protection of children must be a key outcome should target positive outcomes for individuals, families, and communities in both the short and the long term. Therefore, there is a need for a continuum of services which are both individually and population based (Tuck, 1995) and delivered on an interagency basis. This can only be done if there is political commitment supported by the provision of services and resources. Intervention must also be based on an appreciation of the multifaceted and interrelated causes of abuse. Environmental, socioeconomic, familial, interpersonal, physical, and psychological factors operate in a unique and dynamic manner affecting development of each child. Thus material help to compensate for poverty and disadvantage needs to be complimented by interpersonal and family help (Cohn & Daro, 1987). Intervention is required at primary, secondary, and tertiary levels.

Primary Prevention Given that child abuse is ingrained in the ways in which society construes childhood, communities are organized, and families are structured (Donnelly, 1991), primary prevention must be seen as an integral part of child protection and not as a luxury to be added if there are resources. Four areas require attention (Daro, 1988). 1. There is a need for public education to increase knowledge about the nature, extent, and effects of abuse, to reduce societal tolerance to it, and to offer models of positive parenting. 2. Social policy needs to be coordinated and targeted at supporting families and reducing poverty. As Donnelly (1991 ) has commented: " T h e cycle of poverty with its family disintegration and chronic violence counteracts current prevention strategies." 3. Family support services must be designed to target both communities and identified high risk groups. These services aim to compensate for disadvantage, relieve stress, and prevent serious child rearing problems. As Gibbons, Thorpe, and Wilkinson (1990) remind us, " w e need to recognize that the bulk of social care is provided by ordinary people, usually women, and within families, often at great personal cost. Such informal networks are often fragile and it is when they give way that statutory services become involved. To prevent such breakdowns, work should be directed towards identifying and strengthening the natural sources of help within communities." Empowerment strategies must seek to build on clients' existing resources and networks. 4. Child empowerment programs are needed to provide all children with the knowledge, specific cognitive and social skills, strategies, and networks to help avoid abuse.

Secondary Intervention Intensive parent enhancement programs have been shown to be effective with high-risk families in producing long-term educational material and relationship improvements for both children and parents (Daro, 1988). Progress in screening for the high-risk families (Browne, Stratton, & Davies, 1988) can assist in targeting these services. To be effective, programs need to offer a mix of educative, supportive, and therapeutic services on an intensive basis over periods of between 1 and 3 years. Short-term family support programs, sometimes only of a few weeks duration, cannot act as a substitute.

Tertiary. Intervention Intervention once abuse has occurred requires close coordination between agencies to ensure the safety of the child. However, while protection is the priority, this must not be to the

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exclusion of post-abuse work aimed at preventing further abuse and helping children to recover from harm. It is at this point that the concept and practice of partnership faces the greatest strains. We should recall that partnership in this context does not imply equality, but does demand fair play, accountability, information, and involvement in decision making, especially where statutory intervention is invoked (Howe, 1992). The aims of tertiary intervention are thus: 1. Ensure a coordinated multiagency response to reports of abuse, and the management of substantiated cases; 2. Establish healthy gatekeeping to avoid the inappropriate inclusion of children in child protection processes, while recognizing that initial reports may be very poor indicators of risk and that without investigating concerns and sharing information children can go unprotected; 3. Provide a post-abuse service that includes work to change damaging patterns of family interaction; to improve child management skills; to empower nonabusing caregivers; reparative work with children; and abuse specific work for perpetrators; 4. Provide a substitute and secure family environment for those children who cannot return to their family. The importance of therapeutic services for abused children is underlined by Rutter's work (1985) on the cognitive effects of trauma. Rutter's work on resilience in children stresses the significance of the pre- and post-trauma environment in mediating the effects of trauma. Outcomes for children are related to a chain of interacting life events which either act as protective and buffering factors, or conversely, which may be harmful and increase vulnerability. Emphasizing the particular damage that abuse inflicts on the child's cognitive processes in terms of a loss of trust and control in both self and others, Rutter (1985) stresses the crucial importance of children being able to appraise and process their painful experiences, attach meaning, and integrate them in order to avoid becoming developmentally stuck. This particular aspect of reparative work is stressed here because work on feelings and behaviors too often overlooks the crucial role played by cognitive processes in mediating the aftereffects of trauma.

INTERAGENCY COLLABORATION It has been argued that partnership with families cannot be considered separately from partnership practice between and within agencies. Child protection services cannot be strategically planned, or delivered by single agencies. Deficits in collaboration undermine the experience of partnership for families. Front line staff are powerfully affected by agency cultures and management styles that are increasingly behaviorist and interventionist. Many staff lack a basic sense of trust and confidence in their own agency without which their ability to work empathically and skillfully with dysfunctional family dynamics is very impaired. Thus the front line of partnership, where workers seek to engage with families, may too often be an interaction between two parties neither of whom feel understood, valued, respected, prepared, or supported. Under such circumstances the likelihood of dangerous retreats into minimization, paternalism, or collusion is all the more. If partnership is to become a reality, it must be ingrained and modelled within organizational structures, cultures, and working relationships which seek to reward collaboration rather than competition. At the heart of this vision is a concept of healthy, rather than " s a f e " organizational and interagency processes. It involves a commitment to the learning organization, in which

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renewal rather than maintenance or survival is the driving force. Vince and Martin (1993) describe such an environment in their Functional Learning Cycle (Figure 2). In this culture anxiety is seen as normative, allowing for the expression of healthy uncertainty and difference, where "mistakes" are opportunities for learning, not punishment. Risks are taken and innovations are attempted. The real dilemmas in child protection work are openly acknowledged and struggled with, from which unexpected or creative resolution may come; in consequence of which staff are empowered to tackle further demands. To put it more crudely, this is an agency culture in which thinking and feeling, and not just " d o i n g " are legitimized. In terms of interagency collaboration this culture can conceptualize as a series of building blocks. 10. Staff care 9. Quality assurance 8. Supervision 7. Provision 6. Training 5. Policies and procedures 4. Philosophy of intervention 3. Collaborative structures, leadership 2. Mandate for collaboration. 1. Recognition and definition.

Recognition and Definition. There must be a shared recognition of the need for collaboration, and shared definitions of the meaning of partnership and interagency collaboration in the context of child protection work. Partnership is working with parents/caregivers and their networks to enable them to carry out the responsibility shared by both the State and parents/ caregivers to promote the welfare of children. It is not about equal power, but about working together toward a common goal (Tunnard & Ryan, 1991). It involves attitudes, skills, policies, decision making, services, accountability, and openness. It seeks to build on existing strategies of families, acknowledge power differences, and to work positively with difference (Boushel & Lebacq, 1992).

AN:~E'IV INSIGHT RESOLUTION

UNCERTAINTY

J

STRUGGLE~

PJSK~PJMENT

Figure 2. Functional Learning Cycle. From "Inside action learning," by R. Vince and L. Martin, 1993, Management Education and Development, 24, 205-215. Copyright 1993 by Sage Publications. Reprinted with permission.

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Mandate. Government must provide both the mandate and framework for collaboration. Unless this is specified, some agencies will continue to opt out. Collaboration across government is also vital. Multidisciplinary work that relies on the cooperation of individuals is not enough. What is required is interagency work in which organizations work together. Structures. Formal structures at both national and regional levels are required to underpin collaboration. In the UK, the system of Area Child Protection Committees at a local authority level have provided a crucial mechanism for the development of interagency policy, planning, training, and monitoring, as well as for case management coordination. However, formal administrative linkages are fragile unless they are embedded in a network of effective informal relationships. Thus, there is a need for complimentary informal local networking structures through which issues that cannot be tackled at the formal levels can be processed (McFarlane & Morrison, 1994). These include clarifying local roles, developing trust, sharing anxieties, conflict resolution, and identifying resources and needs. Too often, without such networks, negative experiences of the formal structures such as case conferences go uncorrected, undermining future cooperation. Philosophy of intervention. Attention to role and structure will be of limited effect if there is no shared value base or clarity about the aims of collaborative intervention. In a climate of rapid change, attention to values and rationale is easily lost. But neither legislation nor interagency procedures can work if they are interpreted differentially by different groups according to their own value system about child abuse. Any discussion of intervention philosophy must consider the balance that is to be struck between preventative and protective approaches, and between care and control. The place of prosecution and the degree to which abuse is to be seen as a crime are crucial elements in this debate. Failure to make clear the real issues of power and authority implicit in child protection work will leave the professional community with an ambivalent and ambiguous mandate. Again, government has a central role in establishing a coherent philosophy of intervention linked to broad national child protection objectives. Policies and procedures. Once underlying principles are established, agency and interagency procedures are essential. Staff must know what is expected by their own agency in terms of working with other agencies as well as what they can expect from other agencies. Such procedures need to be clear, credible, congruent, resourced, monitored, and owned at a senior interagency level. Role clarity is a prerequisite of multiagency working. Families should also be informed about agency policies, standards, and means of redress. Training. Multiagency training is potentially one of the most powerful catalysts for collaboration. Certainly in the UK, government funding for such training has had an immense impact on the quality and extent of interagency work. However, such training cannot be a substitute for in-house training, where the ethos and practice of collaboration needs to be implanted from the earliest stages of professional development. Multiagency training needs to be owned by management and located within a explicit framework of interagency structures and policies. Finally, this form of training must attend not only to knowledge and skills, but also to values, especially around discrimination, perceptions, roles, feelings, and conflict resolution. Provision. The nature and range of intervention required has been discussed earlier. Without post-abuse services there is a real danger that child protection will be seen as a system that can identify and label problems, but cannot assist in resolving them. Such systems run the danger of professionals, courts, and families opting out altogether. As Challis and colleagues (1988) have observed, collaboration exists not merely when the machinery is in place, but when it is in place, working jointly, and delivering concrete outputs to children and families.

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Supervision. It would be hard to overstate the importance of supervision in the management of child protection. Deficits in supervision have been a persistent theme in child abuse inquiries. Once poor practice escapes supervisory scrutiny in the initial stages of case management, the evidence is that it is extremely difficult to remedy (DOH, 1991). While the concept of supervision is mainly associated with the social work profession, all those involved in child abuse would surely recognize the need for structured opportunities to reflect on practice, judgements, feelings, and prejudices. Indeed anti-discriminatory practice will make little progress without such forums. Management support systems for all agencies dealing with child abuse should have a structure for such reflection. Worryingly, however, the trend away from professional toward general management has eroded the quality and availability of supervision. The quality of child protection work will never improve unless agencies understand and invest in supervision (Morrison, 1993). Quality assurance. Given public concerns about the management of child abuse, clear standards and quality assurance processes are required now more than ever. This means minimum standards, complaints, and appeals procedures. Mediation facilities are also required, to reduce the adversarial nature of user-agency and some interagency relationships, and it has been suggested that the creation of a childrens' ombudsman might be one way of achieving this. Child protection systems must demonstrate publicly an ability and determination to be self regulating. Staff care. The Orkney Inquiry made explicit reference to the problem of stress in working with abuse. It stated: "Generally employers are not sufficiently alert to the problem of stress. Too often admitting stress can be seen as sign of admitting failure or weakness" (Clyde, 1992). If collaboration is in part designed to share anxiety, then it follows that staff care should be a proper concern, not just at an individual agency level, but also at an interagency level. This means far more than the provision of staff counselling. It starts from the premise that managers need to provide a comprehensive infrastructure for practice, which means paying serious attention to all of the building blocks described above. Staff care exists when organizations attend to their staff' s needs for identity, esteem, efficacy, meaning, belonging, and growth. Without this, staff will not be able to go on day after day listening and responding to the pain, disruption, grief, loss, and violence that is child abuse. Their partnerships with clients may then become partial engagements focused on following procedures, rapid turnover, and personal survival while avoiding the emotional realities and meanings of the children and families with whom they work.

CONCLUSION Partnership and collaboration are complex concepts which demand the re-evaluation of old attitudes and the courage to change. They are not a recipe for a conflict-free child protection process. They are, however, the signposts to the next stage in confronting the profound challenge that child abuse represents to the nature of society. They ask it once again what price the good society will pay for its children. Child abuse not only harms individuals, but also undermines their capacity to participate in society by attacking the basic sense of trust in oneself, without which a democratically autonomous person cannot exist (Bross, 1991). As Brandt Steele (1987) has repeatedly commented, we take for granted the enormous investment needed to prepare an engineer, accountant, doctor, or scientist. Yet we have still to recognize the committed and sophisticated effort required to create a competent, caring, trustworthy, ordinary, but very human citizen for today's world.

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