Management development programme for leaders of 0-19 integrated early intervention teams Learning Module, Part 1

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Carole BrooksAssociate, Research in Practice

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Learning objectives

• Learn about leading an evidence-informed team;• Explore the theory underpinning integrated practice;• Consider the emotional responses to change and

ways to deal with them effectively;• Introduce tools to support supervision practice;• Consider methods for promoting emotional

resilience in the workplace and in individuals;• Explore ways to support analysis and critical

thinking in assessment.

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AgendaTime Session

9:45 Welcome and introductions

10:05 Leading evidence-informed teams and leading change

11:30 Break

11:45 Delivering effective supervision

13:00 Lunch

13:45 Promoting reflective relationship-based practice and emotional resilience

15:00 Break

15:15 Supporting analysis and critical thinking in assessments

16:30 Close

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Leading evidence-informed teams

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What is evidence-informed practice?Decisions about how to best meet the needs of service users are informed by:1. the best available research evidence and data

about what’s effective2. practice expertise (built up through learning from

operational experiences)3. views of service users themselves (expectations,

preferences, the impact of their problems, their views on interventions)

Making sure these are considered alongside other factors in making practice judgements and policy decisions.

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The evidence ‘trio’

Printed version – page 4 of delegate pack

Professional identity

Safer decisions

Better services

Improved outcomes

Better resource allocation

Political and social confidenc

e

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‘Push’ factors

• clear expectations of professionals who work with CYP

• greater scrutiny of decisions (e.g. courts, inspection, performance assessment, media)

• government pressure to tackle enduring problems (e.g. ‘high cost, high harm’ families)

• integrated working with other disciplines and professions – what knowledge does your organisation ‘bring to the party’?

• evidence-informed commissioning

• more likely to achieve the outcomes we’re seeking for CYP and their families if we know more about what’s likely to work best

• it’s at the heart of CPD

• supports transparency in decision-making of the organisation and gives us the opportunity to explain to families how decisions are made

• it equips us to make cases for greater investment

‘Pull’ factors

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Focussing on the right things

Out of your control

In your control

budget cuts

thresholds

strategic org issues

supervision

quality of assessments

transfer of learningpolicy changes

reaction to change

team functioning

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Getting the best from your integrated team

Integrated Team

Different professions Greater experience More knowledge Bigger evidence base Varying viewpoints and

insights to child/family• Different processes &

systems• Common goal = the

child and family

Approaches to supporting evidence-informed practice

‘Research-based practitioner’ model

‘Embedded research’ model

‘Organisational Excellence’ model

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What does an evidence-informed team look like?

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Using evidence in decision-making

Awareness Self-knowledge Proportionate Defensible UnderstandableEffectiveSkills– curiosity– open-mindedness – the ability to hypothesise– observation skills– problem solving skills– ability to synthesise and

evaluate information from a range of sources

– creativity

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Barriers and enablers

In your groups spend 5 minutes discussing what prevents you from using evidence in decision-making and what might be done to improve this.

Then spend 5 minutes lookingat what is in place which helps you to use evidence when making decisions.

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Making good decisions

In order to make good decisions:

• Self-awareness

• Analysis and intuition

• Know your preferences

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De Bono’s thinking styles (1985)

Everyone has a preferred thinking style and this affects the approach we take to making decisions.

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Group exerciseOn your tables, use the Decision-making hats tool to consider different thinking styles. Each choose a hat and discuss an issue from that perspective.

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Integrated practice

Rather than blurring boundaries, the establishment of clear boundaries is essential for successful inter-professional working. Clearly defined boundaries establish an exploratory space in which team members can tap into and use team skills, thus harnessing the diversity of the team.

(Rushmer & Pallis, 2002)

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Theories of integrated practice

Three useful theories:

1. Wenger’s ‘communities of practice’

2. Engestrom’s ‘activity theory’

3. ‘Change theory’

Wenger: Communities of PracticeThe extent of joined-up working can be measured using these three constructs:

1. mutual engagement – co-participation, doing things together

2. joint enterprise – shared accountability, sharing responsibility for joint practice

3. shared repertoire – shared approaches such as tools, language and actions

(Wenger, 1998)

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Engeström: ‘activity theory’

‘Expansive learning cycles’ (Engeström, 2001) occur in the workplace when teams come together with different knowledge, expertise and histories to pursue a common goal. In order to effect change, they must work through processes of articulating differences, exploring alternatives, modelling solutions, examining an agreed model and implementing activities.

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Engeström: ‘activity theory’

(After Engeström, 2000)

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Change theory

Change works better when:• there is effective leadership; • we are trained and supported during the

period of change; • the change is consistent with our own

values and attitudes.

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Attitudes to change

A survey of children’s professionals experiencing change classified them as follows:• Enthusiasts – fully committed to the change

process • Optimists – feel positive about the change, but

need evidence to be fully convinced• Pessimists – feel negatively about the change

agenda • Unsure/don’t knows – a group who are unable to

actively identify the nature of the change

(Frost, 2007)

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Five TIPS for promoting integrated practiceThe Leeds-based TIPS project heard from professionals and service-users and suggested that the following five themes emerge as key themes in integrated working:

Theme 1: CommunicationRegular and clear communication within teams which includes the dissemination of the scope and limitations of the professional roles and context of team members through ongoing social networking.

Theme 2: Assertive leadershipLeadership needs to establish a strong, shared value base that enables the team to act promptly and effectively, feeling secure in an ethos that promotes flattened hierarchies and a no blame culture.

(Brock et al., 2009)

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Five TIPS for promoting integrated practice

Theme 3: A supportive cultureThe understanding of a team philosophy and vision which is continually generated through the building of relationships that share practice and values, mutual respect and empathy towards each other and the needs of the service user.

Theme 4: Individual qualitiesEach member of the team should sustain personal confidence in professional identity to ensure commitment to emotional and political ownership and investment in the shared values.

Theme 5: Organisational issuesA balanced team structure that incorporates people from different agencies and professional backgrounds and inclusively involves all staff fully is most likely to be effective. 

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Supporting teams through change

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How practitioners feel about change

• Excited• Enthusiastic• Positive• Hopeful• Challenged

• Uncertain• Confused• Anxious• Overwhelmed• Frustrated

Taken from RiPfA’s Change Cards: www.changecards.org

How practitioners feel about change

Excited

“It’s working!”

Enthusiastic

“It’s the right thing

to do.”

Positive

“It’s really rewarding.”

Hopeful

“I hope it will work.”

Challenged

“I’m not ready for

this.”

See pages 5-6 of your delegate pack

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How practitioners feel about change

Uncertain

“I’m not convinced.”

Confused

“It’s allunknown.”

Anxious

“I feel alone sometimes.”

Overwhelmed

“It’s just too much.”

Frustrated

“I keep hitting barriers.”

See pages 5-6 of your delegate pack

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Reflecting on your current positionFirst, reflect on where the following are at (what emotion):a) your team b) your servicec) your department / agency

Then, in pairs, think of a staff member in a negative emotion place and think what you can do to bring them into one of the more positive emotions.

See page 7 of your delegate pack

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RiP resources and tools

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Break

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Delivering effective supervision

“Apparently, you’re well liked by your team members. That troubles me.”

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Importance of supervision

• Supervision was a major factor in staff retention.(Webb and Carpenter, 2011; Carpenter et al., 2012)

• The perception of supervisor support, as well as support from peers at work, predicted intention to remain employed - while low supervisor support and low co-worker support were significantly related to the intention to leave.

(Dickinson and Perry, 2002)

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What is good supervision?

What are the key elements of good supervision?

What makes a good supervisor?

What doesn’t work in supervision?

See page 8 of your delegate pack

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Key elements of supervision

• Opportunity for reflection

• Opportunity to be challenged

• Opportunity to test out ideas

• Empowering the supervisee

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What works in supervision?

• “A secure professional relationship where the supervisor takes the time to understand and assess the supervisee’s strengths and weaknesses.”

(Morrison & Wonnicott, 2010)

• “Giving and receiving of critical constructive feedback can create an atmosphere of learning, self-improvement and strong sense of security while contributing to organisational objectives.”

(Hafford-Letchfield et al, 2008 in Bourne and Hafford Letchfield, 2008)

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The right type of supervision

• Common features: line management, case discussion and CPD.

• Supervision that spends too long on administrative practices and risk management, or is authoritarian in approach, may be counter-productive (Beddoe, 2010).

• Should have time, and a safe environment, to reflect and learn both from their own experiences and from wider research messages.

• Can express stresses openly without fear of judgment.

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Qualities of a good supervisor

What service-users want:

• Knows what they are doing• Can work towards a goal• Is honest and realistic

about what can be achieved

• Can recognise progress and pitfalls

• Can be trusted

What supervisees want:

• Good working professional knowledge of the field

• Skills in coordinating work• Setting limits and

manageable goals• Monitoring progress for front

line workers• Creating a climate of belief

and trust(Kadushin, 2002)

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Tool for practice: Individual Supervision Tool Uses the 4 parts of Kolb’s learning cycle (1976):

See page 9 of your delegate pack

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Tool for practice: Individual Supervision Tool

Aims to:• Encourage effective problem-solving skills and

critical reflection• Foster enhanced case discussion and self-reflection• Build relationship between supervisor and

supervisee• Can also be used in personal development reviews,

and appraisals

Definitions of group supervision• Group supervision is a negotiated process whereby members

come together in an agreed format to reflect on their work by pooling their skills, experience and knowledge in order to improve both individual and group capacities (Morrison, 2001)

• Group supervision involves the use of a group setting to implement part or all of the responsibilities of supervision (Brown & Bourne, 1996)

• Group supervision is the regular meeting of a group of supervisees (a) with a designated supervisor or supervisors, (b) to monitor the quality of their work, and (c) to further their understanding of themselves as clinicians, of the clients with whom they work, and of service delivery in general. These supervisees are aided in achieving these goals by their supervisor(s) and by their feedback from and interactions with each other (Bernard & Goodyear, 2009)

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Benefits of group/team supervision

• Encourages group reflection• Encourages critical practice amongst peers• Encourages individual professional development• Promotes peer support• Promotes better shared understanding of practice

in a team• Encourages the team to

support one another by exploring practice in case scenarios

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Cyclical Model for group supervision

Contract: Ground rules, boundaries, accountability, expectations, relationship

Focus: Issues, objectives, presentation,

approach, priorities

Space: Collaboration, investigation, challenge, containment, affirmation

Bridge: Consolidation, information giving, goal setting, action planning,

client perspective

Review: Feedback, grounding, evaluation,

assessment, re-contracting

(Page and Wosket, 2001)

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Tools for practice: Team Supervision Tool Also based on Kolb’s learning cycle (1976), this tool encourages practitioners to:1. share their experience of a case or situation2. reflect upon it in a group with others’ reflections3. learn from this dialogue and critical analysis4. then take this learning into practice

Note: a degree of discipline may be required to ensure that the team attend to each stage of the cycle in order, and do not skip ahead to planning actions before the issue has been reflected upon, for example.

See page 12 of your delegate pack

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Tools for practice: Audit Tool for Managers • Enables managers to explore where there may be

gaps in their service which may contribute to poor emotional resilience.

• Adapted from the Health and Safety Executive (2009) who identified various behaviours to reduce stress at work.

• Useful for managers to assess whether they currently exhibit the behaviours necessary to promote emotional resilience and, therefore, offer effective services.

See page 14 of your delegate pack

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Tools to support practitioner development

The Decision Tree

See page 16 of your delegate pack

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Tools to support practitioner development

The Problem Tree

See page 17 of your delegate pack

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LUNCH

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Promoting relationship-based practice and emotional resilience

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Supervision as a tool for promoting resilience

“Supervision is a professional conversation which should promote learning and reflective practice. Any professional should always be able to have access to a manager to talk through their concerns and judgements affecting the welfare of a child.”

(DfE, 2012)

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What is emotional resilience?“A set of conditions that allow individual adaption to different forms of adversity at different points in the life course.” (Chapman, 2001)

“Resilience can be defined as the capacity to rebound from adversity stronger and more resourceful.”(Walsh, 2006)

“The potential to exhibit resourcefulness by using available internal and external resources in response to different contextual and developmental challenges.”(Pooley and Cohen, 2010)

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Building a healthy workplace network

• Understanding the impact the organisation has on the individuals both within it, and served by it, is crucial to beginning to build resilience within the workplace.,

• Understanding your motivation to be part of an

organisation supports mindfulness at work.

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How can managers promote emotional resilience in their workplace?

• What is the purpose of your organisation?• What does it need from its employees to be able to

function?• What does it need from its service-users to be able

to function?• How do these requirements become distorted or

maladaptive?• How do we use emotional resilience to bring them

back into balance?

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A resilient individual?

(Grant & Kinman, 2012)

• Self-efficacy and self esteem

• Enthusiasm, optimism and hope

• Openness to experience• Positive self-concept and a

strong sense of identity• High degree of autonomy• Self-awareness and

emotional literacy• Critical thinking skills• Ability to set limits• Well-developed social skills

and social confidence• Flexibility and adaptability

• Ability to identify and draw on internal and external resources

• Successful adaptation to change• Persistence in the face of

challenges, setbacks and adversity

• Sense of purpose • Ability to learn from experience• Orientation towards the future• Sense of humour

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7 learnable skills of resilience

1. Emotional awareness or regulation2. Impulse control3. Optimism4. Causal analysis5. Empathy6. Self-efficacy7. Reaching out (taking appropriate risk)

(Reivich, 2005)

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Relationship-based reflective practice

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“…skills in forming relationships, using intuitive reasoning and emotions, and using knowledge of theories and empirical research, are equally important components in effective social work…”

(Munro, 2011: 44)

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Promoting RBP with families

Theoretical roots and ideas:• Rests on the fusion of psychosocial, psychodynamic

and systemic approaches• The past affects the present and we do not always

realise its impact• Attachment theory, holding and containment are

central to understanding and helping vulnerable people with troubled pasts

• An awareness of unconscious processes and defence mechanisms is crucial in forming effective relationships

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Promoting RBP with familiesCore principles:• Recognises the complexity of human behaviour and

relationships: people are not rational beings• Understands anxiety as a natural response to

distress and uncertainty and manages it within an attachment framework

• Acknowledges social welfare practice as complex, unpredictable and full of uncertainty

• Emphasises use of self and the role of intuition• Recognises that establishing meaningful

professional relationships is the key to engagement

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Promoting RBP with families

‘Recognition theory’• Recognises parents as individuals with own desires

& needs, achievements and abilities• Recognises parents’ role in wider society• Encourages self-belief and a positive identity • Avoids the shame, anger and indignation that

people feel if not recognised for who they are• Promotes a ‘give & take’, reciprocal approach • Acknowledges parents as an end in themselves, not

just in relation to protecting their children

(Turney, 2012)

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How organisations can support RBP / engagement with families

• Case audit• Supervision• Learning cultures

(Burton, 2009)

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RBP in supervision

How do the core principles of RBP with families relate to the supervisor-supervisee relationship?

Are there any overlaps?

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Promoting RBP in your teams

“There is a concern that the tradition of deliberate, reflective social work practice is being put in danger because of an over-emphasis on process and targets, resulting in a loss of confidence amongst social workers. Regular, high quality, organised supervision is critical, as are routine opportunities for peer learning and discussion. Currently not enough time is dedicated to this and individuals are carrying too much personal responsibility with no outlet for the sometimes severe emotional and psychological stresses that staff involved in child protection often face.”

(Laming, 2009: 30)

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RiP resources and tools

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Supporting analysis and critical thinking in assessment

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Reflective point

What does a sound analytical assessment look like?

Take 5 minutes to discuss in pairs.

Write a list of key qualities you should be looking out for in good assessments.

See page 18 of your delegate pack

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Break

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Sound analytical assessments

• Understanding of family history and context

• Specific about individual child’s needs and family’s needs

• Clear, evidence-informed prediction on likely impact on child if identified needs are not met

• States why assessment is being done and what it hopes to achieve

• Includes evidence to support the decision

• Clear statements about what practitioner thinks should happen

• Logical, focused, concise, jargon-free

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Auditing your team’s assessments

Using the list of characteristics of a good assessment, think about your team’s current assessment practice.

What are their strengths (individual and group)?

Where could improvements be made?

What could you do to support them?

See page 19 of your delegate pack

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The 5 Anchor Principles

• Help practitioners to analyse throughout assessment process

• Can be used to appraise the quality of assessments in your team

• Can also be applied to supervision – provide a key framework for supervisors to use when talking to practitioners about their assessments

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The 5 Anchor Principles

1. What is the assessment for?2. What is the story?3. What does the story mean?4. What needs to happen?5. How will we know we’re making

progress?

See page 20 of your delegate pack

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Applying the Anchor Principles

Read the Danny Case Study and consider:

1. What is the assessment for?

2. What is the story?

3. What does the story mean?

4. What needs to happen?

5. How will we know we’re

making progress?

See page 21 of your delegate pack

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Recommendations for supervisors

• Conduct an audit of your practice as a supervisor

• Record informal supervision as well as more formal structures

• Conduct an audit of your team’s assessments

• Develop group supervision sessions

• Encourage supervisees to be more creative with their responses to child’s needs

• Use the anchor principles as a framework for case discussion

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RiP resources and tools

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Revisiting today’s learning objectives…• Learn about leading an evidence-informed team;• Explore the theory underpinning integrated practice;• Consider the emotional responses to change and

ways to deal with them effectively;• Introduce tools to support supervision practice;• Consider methods for promoting emotional

resilience in the workplace and in individuals;• Explore ways to support analysis and critical

thinking in assessment.

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Use the Kolb individual or team supervision practice tool in supervisionORUse the anchor principles whilst working through one of your cases in supervision

Come prepared to feedback about your experience(s).

See page 24 of your delegate pack

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Stop, Start, Sustain exerciseConsider the key research messages from today. What do you feel needs to stop happening, start happening and continue to happen (‘sustain’) in your organisation, in order for practice to better reflect each of these messages?

See page 25 of your delegate pack

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Evaluation forms

Please complete your evaluation form – on both sides!

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THANK YOU

See you at PART TWO:Weds 19 November 2014