The everyday risk work of Dutch child‐healthcare professionals: inferring ‘safe’ and ‘good’ parenting through trust, as mediated by a lens of gender and class

Abstract

Amidst intensifying policy concerns with children's wellbeing and development, healthcare professionals are required not only to assess risk of abuse and neglect, but to manage risk of 'poor parenting' more broadly. Drawing on 15 in-depth interviews and non-participant observations of 61 professional-family interactions, across four preventative public health services for children in the Netherlands, we explored how professionals accomplished such risk work amid intractable uncertainties. Building inferences from brief encounters with families, professionals gauged the extent to which they trusted parents to care 'appropriately'. This trust developed most readily with parents experienced as 'familiar' by the largely middle-class female professionals. Harnessing Schutzian phenomenology, we analyse the related manifestations of social structure within the interactionaldynamics and lifeworlds of risk assessment. We argue that social structures of gender, class and ethnicity can be seen as influential both through the differing potential for 'we-relationships' to be formed and via the generalising and stereotyped knowledge applied in their absence.

Special Issue: Complexity, Routines, and Reflexivity in Professional Work

“…We then introduce a model of three key features of risk work and the tensions which emerge as they are combined in practice (see Figure 1), alongside an understanding of processes by which these tensions may become more explicit or remain latent within everyday working experiences and practices. Our arguments are grounded in an extensive review of related literatures (Gale, Thomas, Thwaites, Greenfield, & Brown, 2016), our own recent empirical studies (see, for example, chapter 5 of Brown & Calnan, 2012;Gale, Dowswell, Greenfield, & Marshall, 2017;Gale, Kenyon, MacArthur, Jolly, & Hope, 2018, Veltkamp & Brown, 2017 and pilot work to test our emerging theory, and are presented alongside a reworking of key features of post-phenomenological social theory. The final section points to some further possibilities for extending this model and lines of research in relation to two fundamental questions: first, how is risk work practically and pragmatically accomplished amid the residual uncertainties, which emerge when handling risk?…”

“…We use intervention here in a broad sense as, while this may involve concrete actions such as undertaking emergency pre-emptive surgery or sectioning a serviceuser amid a psychotic episode, intervening may alternatively involve communicating, advising and educating about (probabilistic) links between behaviours and outcomes, or a (para)professional may merely be assessing risk (collecting and interpreting information) as the potential basis of future intervention (for example, as a health visitor or paediatrician meeting a vulnerable family, Veltkamp & Brown, 2017).…”

“…These consequences will play out in opening up or limiting the possibilities for working and interacting with these individuals or groups in the future, particularly regarding the quality of communication which will be possible. Child health care professionals, for example, are aware that their intervention (communicating/advising) at a particular moment may have implications for whether a family remains "in view" or breaks off contact from the service (Veltkamp & Brown, 2017). The style and content of communication will, therefore, have important consequences for practitioners' ability to grasp the complex dynamics of risk factors facing a particular family in the future.…”

Outing the Elephants: Exploring a New Paradigm for Child Protection Social Work

“…Messages of disrespect or coercion are conveyed insidiously across boundaries of class and ethnicity. Veltkamp & Brown's (2017) qualitative study of the 'every day risk work' of Dutch child healthcare professionals found that similarities, or 'proximal' relationships', in terms of class and gender supported the development of 'we relationships' -where "common lived experiences and correspondingly shared stocks of knowledge facilitate familiarity and shared understanding" (p.1300). In other words, it is easier for middle class professionals to form trusting relationships with middle class clients.…”

The relevance of risk work theory to practice: the case of statutory social work and the risk of radicalisation in the UK

“…Some decisions in social work are straightforward-there is little doubt or uncertainty about whether a child with injuries inflicted by a parent or guardian requires state intervention. However, other more future-oriented decisions about child safety are less certain, while the stakes remain just as high (Veltkamp & Brown, 2017). Here children's futures are uncertain and professionals' everyday decisions are made on a balance of risks-they are undertaking 'risk work'.…”