childrens services beauty & the beast of inter-agency working sheena bolland dr john henning...
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CHILDREN’S SERVICES
Beauty & Beauty & The BeastThe Beast
Of Inter-agency Working
Sheena Bolland
Dr John Henning Brodersen
CHILDREN’S SERVICES
Today’s Programme
• Introduction• Service Development• Theory / Culture of multi-agency work
The Beast• The positives and negatives of multi-agency working• Interface with different cultures management perspective supervision
The Beauty• Best of each culture
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The C.A.S.T team
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GPs, Paediatricians, Teachers, School Nurses, Youth Justice Workers, Health Visitors, Social Workers, Voluntary Agencies etc
Tier 1
Individual Professionals Trainedin Children and Young People’s Mental Healtheg Psychiatrists, Psychologists, Therapists etc
Specialist Multi-disciplinary Teams
Tier 2
Tier 3
Very specialist
services, incl. children away from
home
Tier 4
The 4-tier model for CAMHS
Primary Mental Health Workers etc
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Objectives Of The Service
• To establish a multi-agency service working across the Tiers
• To reduce the waiting times & improve access to CAHMS specialist services
• To support children at risk of exclusion & reduce school exclusions
• To ensure families of children using the Tier 2 service has access to appropriate family support workers
• To reduce the “risk” for children
• To continually develop services for families in the Medway area
• To provide a consultation service for professionals in Medway
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ServiceDevelopment
Manager
SSA
ClinicalPsychologist
P/TPaediatrician
Senior PractionerPMHW
Chatham
Primary MentalHealth Worker
Gillingham
Primary MentalHealth Worker
Rochester
Primary MentalHealth Worker
Sexual Inappropriate Behaviour
Behaviour Support Worker
Gillingham & Chatham
Behaviour Support Worker
Strood & Chatham
Connexions PA13-19 years
Medway
P/TCounsellor
Sessional FamilySupport Workers
Team Structure
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Clinica
l Govern
ance
PSA 2
CAHMS MAPPINGEDUCA
TIONNational Service Framework
WKMHTWKMHT
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What can theory do to help us create more cohesive multi-agency teams?
Helps us reflect on what goes on between team members and between agencies.
Help inform us in how to improve working practice, in an evidence based manner with good accountability for decision making.
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Social Construction of Reality and Culture
Knowledge is not universally ‘true’ but depends on the culture.
Traditions and what is viewed as common sense are culturally determined.
e.g. nodding yes and no reversed in Bulgaria.
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Coordinated Management of Meaning (CMM) Pearce & Chronin (1980)
•Culture
•Episode
•Speech Act
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Government
Social services
Health services
Education
Private and voluntary organisations
Socio –culturalcontext
Cultural MapCultural Map
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Clinical Psychology
Counselling
General nursing
Health visitor
Social work
Teaching
British Psychological Society
General Medical Council
Royal College of Nursing
Professional contextProfessional context
UKCP
BACP
Primary mental health workers
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Attachment Theory (Bowlby, 1979).
Family Scripts (Byng-hall, 1995).
Narrative Approaches (White, 1995).
Roles (Belbin, 1981).
Structural Issues (Minuchin, 1974).
Theories used in this presentation
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The Beasts of inter-agency working
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Where is your team currently in terms of its development?
e.g. Forming, Norming, Storming,
Performing (Tuckman, 1973).
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•Permeability
•Coalitions•Capturing •Role reversal•Dysfunctional discipline
Beasts in interagency teams
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Group processes than inhibit team cohesion
Team Splitting and allocation of roles (Belbin, 1981).
Conformity seen as a higher priority than evidence based decision making (Harris, 1999).
Group think- under stress ,or dominant leader, consensus overrides looking at alternative courses of action.
Group polarization, more extreme decision making than in isolation.
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Responsibility held by a manager means they cannot admit ignorance or dispensability resulting in poor decision making (Harris, 1999).
Team cohesion has an influential role in the management process (Henning Brodersen, 2004).
Colleagues seen as an important source of support versus making decisions very difficult (Henning Brodersen, 2004).
Group processes than inhibit team cohesion
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•Ability to access a diversity of perspectives.
•Reduce the likelihood of clients falling into gaps in service provision.
•Reduced conformity to professional/ organisational shackles.
•Ability to form more informed beliefs about the strengths of other organisations.
•Increased flexibility in matching internal resources to external demands.
Beauty of Interagency working
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Please draw a current map of your organisational, or professional cultures.
You can circle any alliances or coalitions.
Post exercise reflection
How would the map created by other
agency members differ?
How would you like the map to look in the future?
What would be the first step towards this aim?
Exercise
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Building clear structures.
Communication.
Groups and meetings.
Lines of accountability.
Feedback loops (Campbell, 2001).
Whole Team Training (Henning Brodersen, 2004).
What can we do to enhance the beauty of interagency working?
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