By Jenny Krutzinna and Marit Skivenes (University of Bergen, Norway)

Child and Family Social Work, volume 26, issue 1, pages 50 – 60

Review written by Dr David Wilkins

What question does this study focus on?

This paper reports on a study from England, Germany and Norway, in which the authors looked at how mothers’ parenting capacity was assessed, understood and justified in relation to the removal of new-born babies. 

How did they study it?

The data consists of written court judgements from the three countries, made in relation to new-born babies. In total, the paper includes 117 such cases – 27 from Germany, 76 from Norway and 14 from England. The authors looked at these written judgements and sought to analyse the information and justifications they contained relevant to the final decision. They also interviewed a small number of judges (or other court decision-makers) to help ensure that their analyses were reasonable. Using the court judgements, they i) mapped the characteristics of the cases, ii) identified discussions of parents and parenting capacity, iii) coded them for parent-related risk factors and iv) looked for discrepancies and took steps to ensure their analysis was reliable. They focused only on mothers, and not fathers, due to their “relative importance with regards to newborns and the widespread absence of fathers [from the court cases]” (p. 53). 

What did they find?

Many of the mothers were very young, with nearly-half (41%) being aged 21 or less. Nineteen of the mothers had a previous child already in care, and over one-third (36%) had a history of child protection involvement of their own. One hundred of the cases (86%) resulted in the removal of the new-born baby. A mean average of more than three ‘risk factors’ were identified in each case (3.6 in England, 3.3 in Germany, 5.6 in Norway). These included a lack of empathy for the child (in 60.7% of cases), poor parenting competency (59%), mental illness (58.1%), abuse in childhood (53%), lack of compliance (50.4%), denial of problems (47%), substance misuse (28.2%) and learning disability (28.2%). A number of ‘risk-reducing factors’ were also identified, including willingness to engage with services (58.1%), competence in some areas (24.8%) and recognition of problems (23.1%). The court judgements overall contained more information about risk factors, than risk-reducing factors, and there were clear differences between the countries in relation to which factors were most often and rarely mentioned. The judgements often lacked an attempt to balance between the risk-increasing versus the risk-reducing factors when justifying the decision. 

What are the implications?

It may be that in most, if not all, of these cases, the risk to the new-born was so high, that a balanced consideration of risk-reducing factors was impossible or irrelevant. It is also the case that because the baby was new-born, the decision was made necessarily on the basis of predicted future harm, rather than an evidenced-based assessment of actual parenting capacity. Nonetheless, the authors do invite practitioners to consider the importance of risk-reducing factors and the interplay between parenting problems and social support measures that are or could be provided. Of course, in the short-term there may be little option but to prioritise child-safety – whether the same applies to longer-term planning, or indeed when the child is older, may be less obvious.  

Review written by

Dr David Wilkins

By Thomas Mackrill and Idamarie Leth Svendsen 

Child and Adolescent Social Work Journal, doi: 10.1007/s10560-020-00734-9

Review written by Dr David Wilkins

What question does this study focus on? 

This paper reports on a study from Denmark, in which one service implemented the use of routine outcome measurement. Such measurements are often used in counselling services but are much less common in social work.  

In this case, social workers were asked to gather two types of feedback every time they met with a family member. At the beginning of each session, the worker completed an Outcome Rating Scale, to monitor well-being, and at the end of each session, a Session Rating Scale, to obtain feedback on how the meeting went. You can watch a short 1-minute video of how these scales were used in practice here (the video is in Danish but has English subtitle).   

How did they study it? 

The study ran for two years. The researchers observed training and supervision sessions and helped develop a manual for implementing the new approach. They also interviewed social workers and managers about the perceived benefits and challenges of measuring outcomes in this way.   

What did they find? 

They found that social workers were more used to thinking of themselves as case managers, rather than considering how their interactions with the family could be an important mechanism for facilitating change. By obtaining regular feedback, workers become more aware of their practice, of their strengths and their areas for improvement. Workers also found they were having more conversations with family members about whether things were getting better for the child or not.  

Some workers worried that by asking parents directly and more often about their views, this could undermine their statutory authority. Some were also concerned that if the outcome measures showed things were not getting better for the child, this would reflect poorly on them and on the wider service. Workers also felt that the outcome measures were too simplistic to accurately measure the complexity of family life, and that they could detract from a focus on risk and on structural problems such as poverty.  

What are the implications? 

These findings show the potential benefits of implementing routine outcome monitoring in social work, and some of the challenges. The study also shows how making these kinds of ‘simple’ changes is not always straight-forward and can have unintended consequences too.  

Review written by

Dr David Wilkins