Assessing, Consulting, Reporting Heuristics in Professional Decision-Making Regarding Suspected Child Maltreatment in Community Healthcare Services

Enosh, Guy; Alfandari, Ravit; Nouman, Hani; Dolev, Lilach; Dascal-Weichhendler, Hagit

doi:10.1177/1077559520937351

Cited by 16 publications

(16 citation statements)

References 55 publications

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“…This table is meant to be an estimate of national trends for both Indigenous-specific and general population trends in Canadian samples, as accurate prevalence estimates of ACEs within national populations are challenging to provide. Reporting can be influenced by individual disclosure or reporting bias (Calheiros et al, 2020; Enosh et al, 2021), the presence and structure of health and child welfare agencies, policies, and providers (Cooley & Jackson, 2020; Livingston et al, 2021), type of maltreatment (Livingston et al, 2021), and seasonality (Shields et al, 2021), in addition to the ability to collect and document reports in a consistent manner within a regionally specific database (Fallon et al, 2010; Leeb & Fluke, 2015; Smith et al, 2017). Although this table is not directly comparable to the method used by Finkelhor (2020), it does describe national data related to family violence and mental health difficulties for Indigenous people in Canada.…”

Section: Recent Population-level Ace Datamentioning

confidence: 99%

Adverse childhood experiences (ACEs) are increasing in indigenous populations in Canada: Now what?

Lund¹,

Mushquash²

2022

Canadian Psychology / Psychologie canadienne

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Although recent literature completed in the United States shows that individual exposure to adverse childhood experiences (ACEs) is generally declining on a national level, analyses have not yet determined how these trends are experienced within diverse demographics, specifically related to race, gender, and socioeconomic status. Further description of how ACEs are experienced within marginalized groups can inform broader policy and preventative interventions. This narrative review explored the national data related to ACEs and subsequent health outcomes among Indigenous peoples in Canada in order to consider population-level trends. In Canada, Indigenous communities continue to confront experiences of intergenerational trauma and family disruptions due to histories of residential schools and overrepresentation in both child welfare and criminal justice systems. This review of national data indicated that, overall, ACEs are increasing within Indigenous populations, and Indigenous peoples experience ACEs more frequently than non-Indigenous peoples. It is possible that the well-documented health disparities within Indigenous populations are partially related to increased exposure to ACEs and are mediated by intergenerational traumas. Potential policy and treatment implications to inform broader public health approaches of ACE prevention and treatment are discussed. Public Significance StatementThe current findings suggest that, within publicly available population-health data, exposure to ACEs may be increasing among Indigenous families in Canada despite national trends suggesting such exposure is decreasing among general populations. Culturally relevant interventions that can both prevent and mitigate the effects of ACEs among Indigenous communities are required.

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Section: Recent Population-level Ace Datamentioning

confidence: 99%

Adverse childhood experiences (ACEs) are increasing in indigenous populations in Canada: Now what?

Lund¹,

Mushquash²

2022

Canadian Psychology / Psychologie canadienne

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“…Nonetheless, there are also concerns about assessment of probable CM being influenced by personal perceptions including subjective interpretations of observed parental behavior Kim et al, 2017) and social group biases that link minority groups and lower socioeconomic status with CM (Benbenishty et al, 2014;Higginbotham et al, 2014;Jud et al, 2010). The latter pattern was frequently found in individual professional's isolated judgments in health care settings (Enosh et al, 2020).…”

Section: Diagnosis Of CM By Multiprofessional Teamsmentioning

confidence: 99%

Processes of Multiprofessional Child Protection Decision Making in Hospital Settings: Systematic Narrative Review

Alfandari

Taylor

2021

Trauma, Violence, & Abuse

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The aim of this systematic narrative literature review is to explore empirical evidence as to how a multiprofessional approach to child protection decision making is implemented in hospitals settings. Child protection cases where there is a suspicious serious injury suspected sexual abuse or serious neglect are often investigated in hospital, involving a number of relevant professions. Five electronic bibliographic databases were used for the search. To be included in the review studies had to be published in a peer-reviewed journal, report on empirical research, be available full text in English, and have used an identifiable research design. The search was restricted to 10 years, from January 1, 2010, to December 31, 2019, and retrieved 6,934 studies. The review includes 26 studies undertaken in 10 countries. In all the hospital-based settings studied, child protection decision-making tasks were assigned to a designated multiprofessional team. However, there was remarkable diversity in models of team structure, regulation of workflow, structured procedures, and standardized tools through which practice was carried out. Research focused on evaluating the teams’ effectiveness in fulfilling their duties which were, first and foremost, the identification of possible child maltreatment. The analysis identifies various systemic approaches and quality improvement methods to promote effective team-based decision-making processes in hospitals. The interactional aspect of collaborative team-based practice was generally missing from the published research. This article discusses next steps for the development of practice, policy, and research to enhance useful multiprofessional child protection team working in hospitals.

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“…In order to investigate this, a series of experimental design studies were conducted in Israel with case workers (N = 105), community health professionals (N = 412), and members of planning and decision committees (equivalent to family case-conferences), consisting mostly of social workers (N = 290, in 50 committees across the country). Life-like vignettes (originally drawn from actual case records) were manipulated in order to assess the possible biasing effects on professional decision-making of factors, such as client’s ethnic identity, socioeconomic status [ 12 , 26 ], religiosity [ 27 ], or gender [ 28 ]. Overall, each of these client characteristics was found to affect workers’ professional decision-making, especially in cases of higher ambiguity.…”

Section: Client Factors and Decision-makingmentioning

confidence: 99%

“…Similarly, a quantitative standardized vignette-based study regarding the assessment of risk and mandatory reporting conducted in Israel with 412 healthcare professionals found perceived workload stress had a significant influence on assessment and decision making. While the burden of actual workload may be open to contest, whether it is reasonable, too heavy, or a bargaining position in union negotiations, there are indications that perceived workload stress, as measured by questions such as “How often does your job leave you with little time to get things done?” “How often do you have to do more work than you can do well?”, increases the tendency of healthcare professionals to assess risk as higher [ 26 ].…”

Section: Professional Experience Factors and Decision-makingmentioning

confidence: 99%

An Ecological Model for High-Risk Professional Decision-Making in Mental Health: International Perspectives

Regehr

Enosh

Bosk

2021

IJERPH

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Mental health professionals are frequently presented with situations in which they must assess the risk that a client will cause harm to themselves or others. Troublingly, however, predictions of risk are remarkably inaccurate even when made by those who are highly skilled and highly trained. Consequently, many jurisdictions have moved to impose standardized decision-making tools aimed at improving outcomes. Using a decision-making ecology framework, this conceptual paper presents research on professional decision-making in situations of risk, using qualitative, survey, and experimental designs conducted in three countries. Results reveal that while risk assessment tools focus on client factors that contribute to the risk of harm to self or others, the nature of professional decision-making is far more complex. That is, the manner in which professionals interpret and describe features of the client and their situation, is influenced by the worker’s own personal and professional experiences, and the organizational and societal context in which they are located. Although part of the rationale of standardized approaches is to reduce complexity, our collective work demonstrates that the power of personal and social processes to shape decision-making often overwhelm the intention to simplify and standardize. Implications for policy and practice are discussed.

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Assessing, Consulting, Reporting Heuristics in Professional Decision-Making Regarding Suspected Child Maltreatment in Community Healthcare Services

Cited by 16 publications

References 55 publications

Adverse childhood experiences (ACEs) are increasing in indigenous populations in Canada: Now what?

Adverse childhood experiences (ACEs) are increasing in indigenous populations in Canada: Now what?

Processes of Multiprofessional Child Protection Decision Making in Hospital Settings: Systematic Narrative Review

An Ecological Model for High-Risk Professional Decision-Making in Mental Health: International Perspectives

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