Child protection and public health: nurses' responsibilities

Background. Health care workers have been recognized as having a key role in the protection and care of Scotland's children, particularly in respect of identification and detection of child abuse. Nurses, especially health visitors, are often the first professionals to suspect that child abuse has taken place. While previous research has found that health visitors have primarily perceived their role as that of providing support and advice to vulnerable families, there are pressures on them to fulfil a more narrow surveillance role. Concurrent with a lack of clarity about the role of health visitors in child protection, there has been increasing recognition that other nurses can also make an important contribution, including those who do not work directly with children.

Aims. The aim of the study was to explore nurses' understanding of their professional responsibilities in relation to child protection, and the potential for nurses to be involved in the protection of children from abuse.

Methods. A qualitative interview-based design was used, and 99 nurses working in an National Health Service trust in a Scottish city were interviewed, either individually or in groups, about their professional involvements in child protection issues. Interview data were subjected to thematic analysis.

Findings. There was lack of consensus among interviewees about the nursing remit in child protection issues, particularly with respect to the extent to which nurses should actively seek to detect cases of child abuse. An emphasis on identification and detection was not easily accepted by many nurses, and was perceived by some to be a change from their more traditional role of supporting families, as well as being potentially in conflict with some public health responsibilities.

Conclusion. In spite of the perception of some nurses that there is a sharp divide between child protection work and public health interventions, many of the child protection roles identified by nurses, such as supporting families, parenting education and service development, are clearly within the ambit of contemporary notions of public health. Furthermore, it is clear that there is a role in child protection for a much wider group of nurses than health visitors.

Making a difference in child protection: towards an effective education for teachers

The purpose of this paper is to examine recent research about teachers' participation in the child protection system with a view to developing guidelines for effective child protection training. In relation to the conference themes, this paper offers multiple intersections, whether as an example of policy development impacting on the education of teachers, as one of professional practice which has implications for the ongoing education of the teaching workforce, or as a teacher education initiative, per se.

Including teachers as 'real' partners in child protection

Simultaneous downsizing of child protection services and increasing numbers of child abuse notifications often result in many notifications remaining un-investigated. One possible solution to this problem is to extend the capacity of the child protection system by delegating some of the tasks commonly undertaken by child protection workers to allied professionals. One such group of allied professionals is teachers. In the past, teachers have been recognised for their unique role in notifying suspicions of abuse, however, education professionals are often overlooked for their potential to contribute more than they currently do to child protection. In this paper we suggest that teachers can be included as 'real' and credible partners in the child protection process in a way not previously considered possible.

Clinical supervision in child protection for community nurses

Community nurses have been recognized as having a key role in the protection and care of children, particularly in relation to the identification and detection of child abuse. In order to fulfill this role in a competent manner, they need to have access to appropriate supervision. The aim of this paper is to explore community nurses' and health care managers' understanding and experience of clinical supervision in child protection. The findings presented here were collected as part of a larger study commissioned by the Greater Glasgow Primary Health Care National Health Service (NHS) Trust. Ninety-nine nurses and nursing managers were interviewed, either individually or in groups, about their professional involvement in child protection issues and support for their involvement in child protection work, as well as their current knowledge and perceived training needs. The interview data was subjected to a thematic analysis. A lack of consensus was found among nurses and managers in Glasgow as to what constitutes clinical supervision and a good deal of variation in nurses' experiences of clinical supervision in the field of child protection. The historical difficulties with regard to supervision were attributed to several aspects of nursing culture. However, both nurses and managers emphasized the need for formal, regular, systematic supervision for all nurses regardless of their specific role with regard to child protection.

Educating teachers in child protection : lessons from research

This paper examines research about child protection preparation of teachers. Such research indicates that the nature of the training required to "do the public good" would differ markedly from that which is currently on offer in most teacher education courses. Whilst teachers have the potential to operate as frontline respondents in combating child abuse, the limitations of their training create a situation in which they are "worried, lacking in confidence and stressed about their ability to comply with mandatory reporting legislation" (Bluett, 2002). The consequences to the community are substantial: not only are there disincentives for teachers to participate in child protection roles and the increased likelihood of poor quality reporting, but children subjected to abuse may be unable to access protective services via the school system. The paper distills the findings of recent studies to identify design parameters for effective teacher preparation in child protection. The paper concludes that a program informed by research has the potential to produce enhanced outcomes for children, teachers and the broader community.

Child protection, risk assessment and blame ideology

In this article we use qualitative data drawn from a sample of child protection cases 10 demonstrate holV the process of al1ributing blame to parents and carers for child maltreatment is a sign!ficanr influence 011 decisionmaking,
sometimes to the detriment of assessing the flltllre safety of children. We foctls on two cases which both demonstrate how the process of apportioning blame can lead to decisions which might not be considered 10 be in the best interests of the children concerned. We conceptualise blame as an 'ideology' with its roots in the discourse of the 'risk society', pelpetuated and sustained by the technology of risk assessment. The concept of blame ideology is offered as an addition to theOlY which seeks 10 explain the influences on decision making in child protection practice.

Exploring the possibilities of an expanded practice repertoire in child protection

Summary: This article discusses research that explored an alternative to proceduralized child protection practice informed by the risk paradigm, by expanding the repertoire available to practitioners through combining features of the risk paradigm with social constructionism. This approach incorporates three dimensions: theories of knowledge and power, related professional roles, and practice skills. In this article, we discuss and critically evaluate only the first dimension: theories of knowledge and power. Through dialogue facilitated by semi-structured questions, we explored practitioners' perspectives about the relevance and appropriateness of the alternative approach for practice.

Findings: The practitioners' participation and feedback offer insights into complex connections between `theory' and `practice' with the practitioner as a positioned subject and mediator of practical meanings of formal concepts.

Applications: 1) Recognition of each practitioner's interpretation of formal concepts and how they are applied in actual practice, even within shared organizational contexts. 2) The importance of dialogue to expand the range of possibilities that maintain openness to ongoing learning. 3) The value of theoretical pluralism that may offer greater opportunities for professional discretion, rather than single self-contained approaches that may constrain effective and ethical practice.

Domestic violence and child protection : partnerships and collaboration

The interface between the child protection and domestic violence sectors is often problematic, in that the two sectors operate relatively independently, with little integration. However, it is widely recognised that these sectors need to work more closely to enhance both women's and children's safety. This paper explores the processes needed for the child protection and domestic violence sectors to develop collaborative partnerships that lead to the provision of higher-quality responses to both women and children. Drawing on collaboration theory, a number of barriers to the development of successful partnerships are described, and applied to initiatives that seek to develop integrated approaches between child protection and domestic violence services. It is concluded that there is much scope for the two sectors to work closely together, but that the development of integrated responses involving both child protection and domestic violence services will take a significant commitment, level of determination, and stamina from both parties.

Chronic child maltreatment in an Australian statutory child protection sample

The prevalence, course and predictors of chronic child maltreatment were investigated. The majority of children referred experienced chronic child maltreatment. The characteristics of families and maltreatment were more similar than different for chronic and isolated child maltreatment. The type of response provided by child protection services differentiated chronic and isolated maltreatment.

Professional response and attitudes toward female-perpetrated child sexual abuse : a study of psychologists, probationary psychologists and child protection workers

Previous studies have suggested that lay people and professionals both tend to deny or minimise female-perpetrated sexual abuse of children. However, such abuse has been shown to have negative impacts on the victims. This study investigated whether professionals who might work with victims or perpetrators of childhood sexual abuse show a bias in processing scenarios and making decisions when confronted such abuse. A sample of 231 psychiatrists, psychologists, probationary psychologists and child protection workers responded to variations in vignettes in which women and men offended against children, and completed a questionnaire assessing attitudes to women's sexually abusive/offending behaviour toward children. All professional groups regarded cases involving female perpetrators of child sexual abuse as serious and deserving of professional attention. However, while there were some differences between groups, female perpetrators were more likely than male perpetrators to be considered leniently, suggesting that minimisation of female-perpetrated sexual abuse of children may persist in the professional arena. As a result, both female perpetrators of sexual abuse and their victims may go untreated, and in the case of perpetrators, their behaviour may go unsanctioned. Training for professionals to enhance their understanding of the seriousness of sexual abuse perpetrated by women is indicated.

Child protection practitioners and decision-making tools : observations and reflections from the front line

Decision-making tools, particularly risk-assessment tools, have been implemented by governments around the world, perhaps most notably in the field of child protection, though little attention has been paid to how practitioners use them. This article presents the findings from ethnographic research that explored how child protection practitioners in the Department of Child Safety, Queensland, Australia, used four Structured Decision Making tools developed by the Children's Research Centre in Wisconsin in their daily practice in the intake and investigation stages of a case. The findings that the tools were not being used as intended by their designers and, in fact, tended to undermine the development of expertise by child protection workers has profound implications for the future development of technological approaches to child protection and, more broadly, human services practice.

Locating child protection in preservice teacher education

A recent report delivered by the Australian Centre for Child Protection has highlighted the need for empirical evidence of effective pedagogies for supporting teaching and learning of child protection content in Australian teacher education programs (Arnold & Maio-Taddeo, 2007). This paper advances this call by presenting case study accounts of different approaches to teaching child protection content in University-based teacher education programs across three Australian States. These different cases provide a basis for understanding existing strategies as an important precursor to improving practice. Although preschool, primary and secondary schools have been involved in efforts to protect children from abuse and neglect since the 1970s, teacher education programs, including preservice and inservice programs, have been slow to align their work with child protection agendas. This paper opens a long-overdue discussion about the extent and nature of child protection content in teacher education and proposes strategies for translating research into practice.