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Background: Multi-professional approach to child protection decision making is widely promoted by service organisations, although the conditions for this to be effective are little known., Objective: This systematic narrative literature review explored empirical evidence on the implementation of multi-professional child protection decision making in community settings. Of particular interest were the contextual conditions upon which joint working is build (inputs), aspects of interactional functioning (mediators), and the results of working together (outputs)., Participants and Setting: Five electronic bibliographic databases were selected for the search. The review was restricted to articles published in peer-reviewed journals, in the English language for ten years, from 1st January 2010 to 31st December 2019. Of the 6934 studies retrieved, 30 studies undertaken in six countries were included., Methods: The systematic approach to literature reviewing utilised was 'Systematic Narrative Review'. This approach starts with clearly formulated questions, employs systematic, explicit, and replicable processes for searching the literature to retrieve research, retains quality appraisal limited to publications in peer-reviewed journals, and uses a narrative synthesis., Results: The analysis outlined key building blocks that form the structure for collaborative decision making and identified cognitive, relational, and behavioural interactional properties that occur when making decisions together. Limitations of the published literature hinder the ability of making robust inferences about outcomes of collaborative decision-making practice., Conclusion: The article discusses the next steps for research and implications for policy and practice for promoting useful multi-professional working in child protection decision making in the community., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Healthcare professionals working at community-based services have a crucial position in raising concerns about possible child maltreatment. Yet, barriers exist to healthcare professionals adhering to mandatory reporting rules and regulations., Objective: The current study investigated the various forms by which healthcare professionals working in community services manage mandatory reporting, their reasoning and experience with formal requirements. The study has utilized the decision-making-ecology model as a conceptual framework., Participants and Setting: The study was carried out in the largest district of the largest health-management organization in Israel, across fourteen sites located at seven cities. Eighteen healthcare professionals of various occupational groups participated in in-depth semi-structured interviews., Results: The results reveal that out of the of 52 recent cases that have been suspected for possible child maltreatment, only 58 % were reported as legally required. Yet, about half were reported in delay. Practitioners were more likely to report after additional evidence accumulated and increased the level of suspicion or after failing to manage the issue by other means of support. The analysis identified multiple factors that combined to impact the decision-making regarding reporting. Those were clustered around the individual case, healthcare professional, organizational setting, and external context., Conclusions: Our results emphasize the importance of workplace-environmental conditions in promoting optimal reporting behaviors, including working in multi-disciplinary teams, availability of rapid expert consultation, provision of emotional-support, and reciprocal exchange of information with child-protection-services., (Copyright © 2019. Published by Elsevier Ltd.)

This qualitative research was designed to evaluate the extent to which a national reform in Israeli child protection decision making committees was achieving its aim to strengthen professional judgment through introducing a new standard tools package into practice. Twenty-one case studies of families referred to the committee were investigated and followed up after six months. Data were collected through interviews with social workers, field observations of the committees' discussions and document review. Using a systems approach as a conceptual framework, everyday practice was studied within its organizational context. A key finding of the research was a very limited utilization of the tools in practice. Evidence showed no advanced performance in the few cases where the tools were used, and that when they were used they mainly operated to record customary practice. Follow up data provided limited evidence of improvement in the safety and well-being of vulnerable children. The analysis revealed several systemic factors that interfered with the tools being fully and successfully implemented, including pressure of workloads, practitioners' inadequate skills, limited professional support, and an organizational culture that discouraged sound practice. The research directs attention to the organizational changes needed in order to enhance the provision of effective help for children and families., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

'Risk' has become a central concept for social work practice in countries with more developed social welfare systems. As argued by Hazel Kemshall and colleagues, 'risk' has often replaced 'need' as the main driver for social work interventions as societies seek to avoid harm to citizens. This shift of focus raises a tension between care (support for the individual or family in their own right) and control (seeking to prevent harm to themselves, each other or other citizens). This article considers some of the key developments in the 25 years since the above article, including the development of risk communication; the growing familiarity with both likelihood and severity concepts of risk; the assessment of risk as part of organisational arrangements to manage risk; and theoretical developments linking social work assessment, 'working with risk' and decision-making. In the first part of the article, we explore the care versus control boundary through focussing, in turn, on child and family social work, adult care services, mental health social work and criminal justice social work, and their respective developments. We then further extend two key foci regarding assessment and care planning as well as the use of professional knowledge at the care and control boundary. Our analysis of these developments points towards more nuanced approaches to managing risk and making decisions at these sometimes contentious boundaries. [ABSTRACT FROM AUTHOR]

The aim of this systematic narrative literature review is to explore empirical evidence as to how a multiprofessional approach to child protection decision making is implemented in hospitals settings. Child protection cases where there is a suspicious serious injury suspected sexual abuse or serious neglect are often investigated in hospital, involving a number of relevant professions. Five electronic bibliographic databases were used for the search. To be included in the review studies had to be published in a peer-reviewed journal, report on empirical research, be available full text in English, and have used an identifiable research design. The search was restricted to 10 years, from January 1, 2010, to December 31, 2019, and retrieved 6,934 studies. The review includes 26 studies undertaken in 10 countries. In all the hospital-based settings studied, child protection decision-making tasks were assigned to a designated multiprofessional team. However, there was remarkable diversity in models of team structure, regulation of workflow, structured procedures, and standardized tools through which practice was carried out. Research focused on evaluating the teams' effectiveness in fulfilling their duties which were, first and foremost, the identification of possible child maltreatment. The analysis identifies various systemic approaches and quality improvement methods to promote effective team-based decision-making processes in hospitals. The interactional aspect of collaborative team-based practice was generally missing from the published research. This article discusses next steps for the development of practice, policy, and research to enhance useful multiprofessional child protection team working in hospitals. [ABSTRACT FROM AUTHOR]

This study investigated how physicians, nurses, and social workers in community health care services make judgements about possible child maltreatment in ambiguous situations. We examined the influences of social biases (i.e., perceptions linking ethnicity, gender, and family socioeconomic status to child maltreatment) and belonging to distinctive occupational groups (i.e., physicians, nurses, and social workers) on professionals' assessment of suspected child maltreatment, intention to consult with others, and reporting. We used an experimental survey design including vignettes presenting a child's history inspired by real‐life clinical cases. Data were collected from 397 health care professionals—170 physicians, 179 nurses, and 48 social workers—employed at community health care clinics in northern Israel. Findings show that the child's gender and family socioeconomic status had significant effects on assessment of possible child maltreatment. Also, professionals' occupational group had significant effects on assessment of child maltreatment and intention to pursue consultation. Another key finding was the significant effects of judgements about child maltreatment assessment, consultation, and reporting on one another. The study reinforces efforts to improve health care professionals' management of suspected child maltreatment that include the development of clinical decision support systems that use routinely collected electronic medical record data. [ABSTRACT FROM AUTHOR]

Skills of the 'information age' need to be applied to social work. Conceptual and practical aspects of using online bibliographic databases to identify research were explored using multi-professional decision-making in child protection as a case study. Five databases (Social Science Citation Index, Scopus, Medline, Social Work Abstracts and Cochrane Central Register of Controlled Trials) were searched for relevant studies, retrieving 6,934 records of which fifty-eight studies were identified as relevant. The usefulness of specific search terms and the process of learning from the terminology of previous searches are illustrated, as well as the value of software to manage retrieved studies. Scopus had the highest sensitivity (retrieving the highest number of relevant articles) and retrieved the most articles not retrieved by any other database (exclusiveness). All databases had low precision on this topic, despite extensive efforts in selecting search terms. Cumulative knowledge about search strategies and empirical comparison of database utility helps to increase the efficiency of systematic literature searching. Such endeavours encourage and support professionals to use the best available evidence to inform practice and policy. [ABSTRACT FROM AUTHOR]

This study investigated child protection decision-making practices of healthcare-professionals in community-health-services. We examined the effect of heuristics in professional judgments regarding suspected maltreatment, as affected by the child's ethnicity, gender, and family socioeconomic-status, as well as the healthcare-worker's workload-stress, and personal and professional background. Furthermore, we examined how these variables influence judgments regarding suspected maltreatment and intentions to consult and report child-maltreatment. We used an experimental survey design including vignettes manipulating the child's characteristics. Data was collected from 412 professionals employed at various community-health-service-clinics of the largest health-management organization in northern Israel. Findings show that all subjective factors have a significant effect on suspected child-maltreatment assessment, which appears as a significant predictor of later decisions regarding consultation and reporting. This study lends support to prior research indicating that healthcare-professionals' decisions may incorporate biases, and suggests how the effects of these biases' are mediated through a sequence of decisions. Recommendations focus on providing regular consultation opportunities for practitioners. [ABSTRACT FROM AUTHOR]

This article examines the provision of legal advocacy for parents as a means to promote partnership working in child protection. It is situated in the context of formal decision-making committees in Israel and provides first indications of what happens when lawyers intervene on parents' behalf. Data were collected using an online survey sent to the chairs of these committees. Altogether, seventy-seven chairs around the country who had experienced at least one discussion in which parents had legal representation participated in the study. The analysis uncovered the broad range of functions performed by lawyers before, during and after the discussions, and the ways they influenced decision making. A surprising finding was the key role lawyers had in providing parents with emotional support. Generally, chairs voiced a positive attitude towards legal advocacy for parents, believing it both helpful and just. The study implications are discussed in terms of systemic working arrangements required for effective advocacy, including a coherent code of practice, well-defined preparation and professional training for all parties. Finally, methodological benchmarks for future research are presented. [ABSTRACT FROM AUTHOR]

Abstract Based on the premise that functional, multi-professional work in the child protection process is crucial to the delivery of effective service, this article reports on a qualitative study carried out to evaluate inter-agency and multi-disciplinary practice in Israeli decision-making committees. The investigation was directed by the systems approach and looked at practice in the context of the work environment. It examined the cases of 21 families referred to the committees of one of seven social services departments, with follow-up after six months. Data collection involved observations of the discussions and interviews with social workers. According to the findings, school representatives were the only professionals outside of the social service system to participate in the committees, and the committee chairs and senior social workers were dominant in making intervention decisions. Indication of groupthink bias was also found. The follow-up data revealed partial implementation of intervention plans and limited improvement in the children's condition. The analysis identified several systemic sources of difficulty towards achieving meaningful interagency working, including a lack of legislation and departmental organizational conditions. The study advocates an alternative, fresh, whole system approach to the delivery of services for vulnerable children and families. Highlights • Limitations to multi-professional work were found in Israeli child protection decision making committees. • Indication of groupthink bias was also found. • Follow-up data revealed partial implementation of intervention plans and limited improvement in children's condition. • The analysis identified several systemic sources of difficulty towards achieving meaningful interagency working. [ABSTRACT FROM AUTHOR]

This research was set out to examine the extent to which a national reform in the Israeli child protection decision-making framework of formal committees is achieving its aim for strengthening partnership with parents. The research employed a qualitative method of inquiry and a case-study design. The cases of twenty-one families brought before the committees were investigated and followed up after six months. Data were collected through interviews with social workers and parents and observations of the committees' discussions. A systems approach was undertaken as a conceptual frame- work in order to study practice within its organisational context. Based on the relatively small sample, the key finding is a very limited realisation of partnership with parents in terms of allowing them power to influence decisions. This is suggested to have come in the way of improving outcomes for children and families. Evidence showed that mechanisms of coercion and control were used in the discussions in order to enforce agreements. The analysis identified several systemic factors that were obstacles to good partnership working, including: heavy caseloads, lack of time for building relationships, insufficient skills in communicating effectively with parents and paternalistic organisational culture. Implications are discussed in terms of whole-organisational changes. [ABSTRACT FROM AUTHOR]

A national reform of child protection practice in Israel includes the ambition of strengthening children's participation in intervention decisions carried out in formal committees, called planning, intervention and evaluation committees. A qualitative study was conducted of how well this was being achieved by following 21 case studies of families referred to the committees over 6 months. Data were collected from interviews with social workers, field observations of the committees and a document review. A systems approach was undertaken as a conceptual framework in order to allow a whole‐organizational understanding of what is happening in the field, and why. The key finding was a very limited realization of the reform's aim. Only seven children attended the committees, and they had little influence on decisions, which appears to have made them less co‐operative in implementing them. Those who did not attend rarely had their views conveyed to the committee by their social workers. The reform's lack of success is explained by being ill suited to the organizational working environment and culture. The analysis identified a number of systemic factors influencing the failure to give greater priority to children's views, including lack of skill and time, organizational messages about practice priorities and paternalistic ideology. [ABSTRACT FROM AUTHOR]