Vicki Welch

Contested views of expertise in children’s care and permanence proceedings

Abstract In this article, we consider different perspectives on who is best able to provide relevant and helpful expertise in public law cases where the long-term care of children is under consideration. Opinions vary and sometimes conflict on the respective importance of legal, child development, and lay understandings. These opinions relate to views on rights, appropriate procedures, decision-making processes, and the effects of decisions on children. Firstly, we summarise literature relevant to the knowledge and skills of three key groups of decision-makers within the Scottish child care system: legal professionals, child care professionals and lay decision-makers, and outline literature about guardians ad litem and their counterparts. We then discuss issues of expertise emerging from a study exploring the reasons for, and impact of, the appointment of safeguarders (who, in Scotland, perform a similar role to guardians). We conclude that there may be an increasing tendency for disagreement and a lack of clarity about who brings the most relevant and helpful expertise to hearings; this may have negative effects for children.

Talking back to 'family', 'family troubles', and 'the looked-after child'

‘Looked after’ is a term used in the UK to describe children who are the subject of ‘alternative care’ arrangements (i.e. in the care of a statutory authority), most often away from their birth parents. Within this potentially stigmatising context, this article presents a reanalysis of data from semi-structured interviews with 17 participants during three recent small-scale studies in Scotland. Juhila’s concept of ‘talking back’ to potentially stigmatising categories informs this analysis that explores participants’ understanding of, and responses to, three categorisations: the ‘family’, ‘family troubles’, and ‘the looked-after child’. Participants were young people with experience of home supervision, birth mothers of adopted children, or kinship carers. The analysis finds clear examples of ‘talking back’ to all three categories, including through a process that linked categories, such that accepting aspects of one potentially stigmatised identity helped to explain membership of another. This suggests a potential refinement of Juhila’s model. ‘Looked after’ was widely understood, but the term was seldom used by participants. There was evidence that participants ‘talked back’ to the idea of looked-after child by problematising its appropriateness in their circumstances, including home supervision and kinship care. In their discussions with researchers, these participants privileged biological understandings of ‘family’, affirming enduring links despite troubles and separations. The article concludes by identifying briefly some implications for policy and practice.

Randomisation before consent: avoiding delay to time-critical intervention and ensuring informed consent

Abstract Obtaining informed consent can be challenging in stressful and urgent circumstances. One example is when potential participants have recently had their child removed into care; intervention is urgent and mandatory whereas participation in associated research is voluntary. Using a nested qualitative study, we examined experiences of consent processes in a randomised controlled trial of a family assessment and intervention service for maltreated young children. Some potential participants found it difficult to use information; some believed consenting might influence the return of their child. In response to these ethical challenges, we propose reversing the typical process of securing consent, so that randomisation to an intervention occurs before inviting potential participants to consider the trial. This will avoid delays, delineate research from intervention, and make it easier to consider information. We suggest that this innovation could be useful in trials across service areas that incorporate urgent and complex interventions.

Partnership approaches to the evaluation of complex policy initiatives: qualitative research as key to building effective relationships

We argue that major health and social care policy initiatives are not too complex for randomised controlled trial (RCT) methodology and illustrate this using the example of the Best Services Trial (BeST?): a RCT of an infant mental health intervention for maltreated children. We suggest that qualitative research, as a core part of the trial process from conception and development through to implementation and evaluation, is crucial in building, understanding and strengthening the partnership required to drive such a complex trial. Data pertinent to trial implementation demonstrate the iterative nature of the process whereby stakeholders are consulted and their views influence the conduct of the trial. Here we reflect on the bi-directional relationship between qualitative data collection and partnership-working in a trial. For very complex trials to be possible, significant resource needs to be available for the qualitative component. Key Practitioner Message: • Qualitative research is key to understanding, building and strengthening partnership approaches to researching complex interventions; • Qualitative research is vital to supporting randomised controlled trials involving multiple sectors; • Qualitative research provides essential explanatory power to outcome data in research.