Module 1: A Systemic Approach to Risk Assessment and Safety Planning
Aim of this Module:
To establish a framework for risk assessment and safety planning that is based upon a general theory of systemic social work practice.
Professional Social Work involves constantly working with risk. In the context of Child Safeguarding, the assessment process is not only about the potential risk of harm to children but the assessment of an adult care giver's propensity to commit a harmful act or to maltreat a child. Risk means different things to different people, including professionals. Whether it is describing something as simple as an individual’s attitude to a financial situation or as complex as an organisation’s approach to everyday health and safety issues, risk is something that we come into contact with on a daily basis.
Activity
Reflect upon what you understand by the term "risk"? You might consider this in relation to both your personal life (risk and opportunities, the kinds of risk decisions you take every day for yourself, your family or others) as well as your professional, working life. Make a note of your thoughts and joint the discussion in Moodle to consider further what risk means to us professionally (you will need your Moodle Username and Password to log in to the forum).
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Preventative Risk Assessment |
Often carries out before an intervention takes place and will likely influence decisions about whether or not to intervene. Often Involves making judgements on the basis of limited information about the potential for harm occurring, how and when to intervene. Tend to use indicative factors to inform judgement or make predicitions e.g. scales based upon research and statistics. |
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Investigative Risk Assessment |
Often this is an initial assessment of a specific situation that has been raised as a concern. Most organisations have procedural guidelines forresponding to such concerns Whether the concern is in relation to a child in need or in relation to a child that is suffering or likely to suffer significant harm, a risk assessment must be undertaken. |
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Continuation Risk Assessment |
This involves (re)assessments at regular intervals in situations where there has been an identified risk. These assessments are most often about risk reduction rather than risk elimination. |
Balancing the risks of intervention against the risks of non-intervention e.g. the decision to step up or step down requires evaluation of the situation in light of the original concerns; acknowledgement that changes have occurred; assessment of whether these changes influence the situation for better or worse or have no impact one way or the other.
(Corby B., Millar M. Young L. Parental participation in child protection work: Rethinking the rhetoric. British Journal of Social Work. 1996;26:475–492.)
You can download the "Pathways to Harm, Pathways to Protection: a triennial analysis of serious case reviews 2011 to 2014" report HERE
Click HERE to visit the Risk Assessment and Management Page in the Knowledge Bank for some useful definitions
Objectives:
Define risk assessment in terms of perceived hazard, likelihood and impact.
Establish fundamental principles of risk assessment and key terminology.
Understand concepts of vulnerability and resilience (balancing strengths and needs)
Critically compare and contrast different models and approaches.
Identify when and why to undertake a riskassessment.
Learn how to assess the quality of an assessment.
Use the assessment to develop an effective, evidence based safety plan using SMART principles.
Learn how to prioritise interventions in terms of level of intervention, required effort, resources and urgency.
Identify when to review an assessment and plan.
A Systemic Approach to Risk Assessment and Management
Systems Theory has become the dominant theoretical perspective in modern social work. At its most basic level it is a theory that one thing effects another - nothing happens in a vacuum and circumstances are always changing.
A system is an entity made up of components that combine to make a complex whole in accordance with some underlying set of rules.
A system might be defined as the relationships among components which are enduring over time and in terms of their pattern of interactions.
Social workers are concerned with human social systems and, in this course, the implications for risk identification, risk assessment and risk management.
A systemic Social Work and Safety Planning model examines the ways in which people interact with their family environments; non-kin environments; community; regional, national or even international environments.
People are micro systems in their own right, meaning an individual person is a complex biological system that influences its development, physical ability and limitations, cognition, gender, awareness of the environment and so on.
That system is also influenced by environmental factors that can include the physical environment, other individuals, groups, communities, society, and government…lots of different interacting systems.
We can conceptualise these systems according to four different levels, rather like a set of Russian Dolls – the tiniest doll, representing the individual and their immediate family can be termed “The Micro System”; the individual sits inside the larger doll, which might be referred to as the "Mezzo System" (representing a small group such as extended family, community family). The next doll up is the "Exosystem:" Containing environmental elements that have a profound influence on a child's development, even though that child is not directly involved directly with them.Finally, the Exosystem System sits inside the biggest doll – the “Macro System”.
We might also consider a fifth system, the "Chronosystem" which represents fluctuations and changes over time.
People are actors living out their lives according to their own need, desires, pressures, achievements and objectives. We also have to face and deal with our own limitations as professionals. We are, at any given time influenced by our circumstances, histories, culture, gender, physical and cognitive skills and abilities and our genetic inheritance and our social, cultural and ethnic heritage; ee are influenced by our past life experiences and the way in which we were brought up. As the German Philosopher Martin Heidegger put it, we are all “bearing the weight of the past”. Nevertheless, we are also influenced by our hopes, future plans and ambitions and perception of opportunity or impediments to those hopes and ambitions.
So we cannot do much to change that which we have inherited or has been given or done to us but we live and act in the present. In the course of every day living we become absorbed in ambiguity, curiosity and inquiry, and interaction with others. At the same time we look to the future in the short, medium and long term according to our aspirations, objectives, desires, insecurities and anxieties.
Thus we are, as individuals, constantly influenced by our past experiences and present circumstances that generate trends or pressures to move us forward in a particular direction into the future.
In social work with families, the child is an individual system comprising biology, physical and cognitive development, gender and formative experiences.
The child is also a subsystem of their family, school, community, society as are their parents, the nuclear family unit, the extended family unit…and so on.
It is easy to see that systems operate within systems, interact with and effect other systems and it is these interactions that are the concern of Systems Theory. Systemic analysis can not only enable social workers to alleviate problematic conditions but prevent them: This model encourages practitioners to understand the world in terms of organised complexity that needs to be understood as a whole in order to grasp problems accurately and intervene effectively.
READING: Click HERE to download the article "Child Protection and Safeguarding in England: Changing and Competing Conceptions of Risk and Their Implications for Social Work" (Nigel Parton 2010)
BEST PRACTICE IN RISK ASSESSMENT AND MANAGEMENT Best Practice involves making decisions based upon knowledge of the research evidence, knowledge of the the child, their family and context, knowledge of the child and family's own experiences, and professional judgement
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Fundamentals |
Basic Ideas in Risk Management |
Working With Children and Their Families |
Individual Practice and Team Working |
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Positive risk management as part of a carefully constructed plan is a requred competence for all practitioners |
Risk management involves developing flexible strategies aimed at preventing any negative event from occurring or, if this is not possible, minimising the harm caused. |
All practitioners nust be capable of demonstrating sensitivity and competence in relation to race, faith, age, gender, disability and sexual orientation when undertaking risk assessments. |
Risk management and safety plans should be developed in collaboration with other professionals and agencies in an open democratic and transparent culture that embraces reflective practice. |
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Risk Management should be conducted in a spirit of collaboration and based on a relationship between the family and professionals that is as trusting as is possible. |
Risk management should take into account that risk can be both general and specific, and that good management can reduce and prevent harm. |
Risk management must always be based upon awareness of the capacity for levels of risk to change over time, and recognition that each familyrequires a consistent and individualised approach. |
All practitioners involved in risk management should receive relevant training, which shouold be updated every three years. |
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Risk assessment must recognise a family's strengths such as resilience and protective characteristics as well as deficits and risk of harm. |
Knowledge and understanding of relevant legislation is an important component of risk management including civil and criminal law. |
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A safety plan is only as good as the time and effort put into communicating its findings to others |
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Risk Management requires an organisational strategy as well as efforts by the individual practitioner |
The risk management plan should include a summary of all risks identified, formulations of the situations in which identified risks may occur, and actions to be taken by practitioners and the service user in response to crisis. |
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Risk assessment is integral to deciding on the most approapriate level of risk management and the right kind of intervention for children and their families |
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Source: Adapted from Best Practice in Managing Risk (Department of Health June 2007)
Approaches to Risk Assessment...
Unstructured Professional Judgement
Historically, risk assessment tended to be anecdotal and inconsistent, based only on an unstructured approach wherein information that was obtained during an assessment was considered. However, this information was not collected systematically, and any informatin considered relevant was not entered into the formulation of risk in any consistent or formalised way often relying on the knowledge and experience of the practitioner. Nevertheless, this approach is still better than mere chance.
The Actuarial Approach
This approach focuses on Static Risk Factors primarily that have been shown to be statistically associated with increased risk in large samples of people. A formulaic approach is usually used: an overall score is calculated as an indicator or presumed risk over a specific period of time. Such tools can be extremely helpful but need to be used with caution: errors are likely to occur if actuarial tools are used to predict risk rather than manage it.They should only be used as a part of an overall risk assessment.
What might be considered a refinement of the actuarial model for risk assessment in child safeguarding is the Predictive Modelling approach. It is statistically based drawing on vast amounts of administrative data. In the video below Emily Putnam-Hornstein PhD describes the development of a Predictive Risk Modelling Tool for safegurding.
Structured Professional Judgement (SPJ)
The SPJ approach involves the practitioner making judgement about risk by combining an assessment of defined factors derived from research; professional experience and knowledge of the child and their family; and the family's own view of their experience
Such approaches use information gathered through subjective clinical interviewing and assessments over a period of time. These will be based on previous social, environmental, behavioural and personality factors that have resulted in harmful behaviour(s) in the past.
Assessments may also consider personality traits, mental illness, as well as biological, social and psychological factors that are related to child maltreatment. These are known as stable dynamic factors.
Clinical assessments and those obtained through professional judgement are not thought as accurate a predictive tool as actuarial assessments in that they rely more on personal judgement, which can be subject of bias, rather than hard statistical evidence. This could result in over-prediction, falsely predicting recidivism (Hagen, 1997; Steadman, 1987; Hood etal, 2002). Clinical risk assessments are also used primarily for the prevention rather than prediction of child abuse and neglect.
When Judgement is Unstructured...
Risk management and safety planning in child safeguarding should be structured and consistent: it needs to be explicit to the client family and should involve the family's priorities. Decisions about safety should not be based simply upon the largely unstructured professional approach which is vulnerable to personal biases and may miss the presence or absence of important protective factors such as resilience, resources and the views of the family and other professionals. Such biases can lead to poor judgements where the risk is over or under estimated. This is especially true if the judgement is made by a practitioner working alone rather than within a multi-disciplinary safety network or team working together. It is also important to note that if it is not clear that an individual or family's risk is being assessed, the principle of engagement is broken.
RESOURCE: Download the Systematic Review of of models of analysing significant harm by Jane Barlow, Joanne D Fisher, David Jones HERE.
Activity
Try to find out the following information:
1. Does your organisation carry out actuarial risk assessments?
2.Are the results recorded as a risk classification or as a percentage?
3.How are they then used and reviewed?
Make a note of what you find, where and how you found and any reflections. Add the day, date and time that you did this activity and file it in your CPD portfolio.
Reflective Activity
Reflect upon your own work and setting. Make a list of the Pros and Cons in the use of Unstructured Professional Judgement Approaches, Actuarial Approaches and Structured Professional Judgement Approaches. File your list with the day, date and time that you made it and add it to your CPD Portfolio as an activity of this course.
CONCLUSION
Although actuarial assessments are sometimes viewed as the more commonly used and more reliable single assessment method, there are important limitations that have to be taken into account. The combined use of Structured Professional Judgement with actuarial assessments is recommended. Such a holistic approach to risk assessment is a technique which is most likely to enhance both the predictive accuracy and usefulness of risk assessments of child abuse and neglect.