Multi-professional work in child protection decision-making: An Israeli case study

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 multidisciplinary 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.

Qualitative process evaluation from a complex systems perspective: A systematic review and framework for public health evaluators

“…A range of public health topics were represented in the sample, including social work [ 43 – 45 ], school health [ 41 , 46 – 50 ], workplace health [ 51 , 52 ], sexual health [ 48 , 53 , 54 ], health equity policy [ 55 , 56 ], urban planning [ 57 , 58 ], substance use [ 53 , 56 , 59 – 61 ], child development [ 62 ], public–private partnerships [ 63 ], community empowerment and transformation [ 42 , 64 ], and violence prevention [ 65 ]. The studies were conducted in 13 countries, which included 9 high-income and 4 middle-income settings: Australia [ 51 , 52 , 57 , 65 ], Brazil [ 55 ], Chile [ 62 ], El Salvador [ 54 ], Finland [ 56 ], India [ 62 ], Israel [ 43 , 44 ], the Netherlands [ 46 , 47 , 58 ], New Zealand [ 50 ], South Africa [ 48 , 62 ], Sweden [ 59 ], the United Kingdom [ 42 , 49 , 60 , 61 , 63 , 64 , 41 ], and the United States […”

“…Some studies ( n = 3), for example, defined a case based on geographical boundaries, and each case represented a geographical locality [ 42 , 60 , 61 , 64 ]. Other case study examples included individual families [ 43 , 44 ] or schools [ 41 ] or the specific application of a policy [ 56 ].…”

“…For example, speaking to a range of different actors within the system, through interviews (semi-structured, in-depth, or narrative) and focus groups [ 41 – 65 ], was used to assess different perspectives about an intervention, relationships, and theories of change within the broader system and to make sense of system trajectories. Documentary review and analysis were also relatively common, being used in 7 studies [ 41 , 43 , 44 , 46 , 47 , 50 , 62 – 64 ], and a range of documents were reviewed including media reports, community plans, evaluation documents, and case reports. Documents were used to understand intervention development and implementation and to generate data at different levels within systems, for example, with some evaluators choosing to review national-level documentation and subsequently conduct regional or local-level interviews [ 41 ].…”

“…Knai and colleagues integrated data from several evaluative strands including impact and process evaluations [ 63 ]. Five studies reported accompanying outcome evaluations, but those results were not presented alongside the process evaluation reports [ 43 , 44 , 46 , 47 , 59 , 64 ]. Three studies presented outcome data alongside their process evaluations [ 50 – 52 , 60 , 61 ].…”

“…The process evaluations in this literature base varied in terms of the stage of evaluation planning and conduct in which they drew on complex systems thinking concepts and frameworks. Although the reporting was not always clear, 14 evaluation teams used some facets of systems thinking and complexity science when planning and designing their evaluations [41][42][43][44][45][46][47]49,[51][52][53]57,58,[60][61][62]64,65], which ranged from asking systems-oriented research questions to informing the sampling strategy (e.g., a conscious effort to sample different elements or from different levels within the system) and data collection tools (i.e., interview topic guides). Other evaluators used complex systems concepts, theories, or frameworks solely to structure their analyses [48,50,[54][55][56]59,63].…”