On Structured Decision Making® Implementation in the Voluntary Nongovernment Early Intervention Sector of New South Wales

December 18, 2013 | Cara Langley, Practice Specialist, Wesley Mission

In preparation for this blog, I asked questions of our local offices.

In preparation for this blog, I asked questions of our local offices. “What impact is the Structured Decision Making^® system having on your work with children and families?” “What does the SDM^® system look like inside family homes?” “How do the assessments fit with best practice and with you?” Our Brighter Futures (BF) program in the New South Wales Sydney Metropolitan West area has taken a significant step in adopting SDM assessments for non-statutory, voluntary early intervention (EI) work with high- to very high-risk children and their families. In 2012, our EI program was moved to one step below statutory government child protection. This move brought with it a number of challenges—staff were to undertake work with an increased focus on child safety, welfare, and well-being concerns, a “definition shift” around what EI was/is and the risk and complexity levels in families engaged with EI and staff support and development (e.g., What tools do we need to support this work and what additional support do staff require?). However, the biggest question of all was, “What will this mean for children and families?” Staff asked: “Will children miss out?” and “Will deficit-based ‘big stick’ practice replace our relational strengths-based work?” As with any change, our people had a number of questions.

The need to move toward assessment and case management tools that greater supported our tailored case management approach had been known by managers for a while. Following the Service Provision Guideline program changes, what had once been a whisper became a very audible conversation both within individual BF agencies and across the state. Six BF agencies chose to adopt the SDM model, and for the first time, individual BF agencies across New South Wales banded together to collaboratively research, select, train, and implement assessments tailored to our context that would also parallel statutory child protection language and tools. The benefits of this collaborative interagency approach were outstanding. With the NCCD Children’s Research Center’s (CRC) support and guidance, the consortium of agencies planned together, provided interagency training, shared wisdom and knowledge, addressed policy and practice issues, and mirrored the implementation process across each of the six service provider sites.

I knew from our scheduled weekly implementation meetings with team leaders and program managers that the Sydney Metropolitan West SDM implementation had, for the most part, incorporated the structures and strategies they needed—both for support and to identify and resolve issues quickly. The keys to this rollout were solid training; ongoing consultation with CRC for technical questions whilst also leaning on CRC’s previous implementation experience, and clear implementation plans, strategies, and support mechanisms developed in consultation with all team leaders (our key people). We faced some teething problems around policy alignment and practical issues, but staff indicated that to date, they generally felt supported in the change, and the overall sense was that the SDM system was providing what they needed. I was still keen to hear the feedback straight from the frontline. I was particularly keen to hear how the SDM safety assessment (and safety planning) implementation was going—a first for a voluntary nongovernment EI service in Australia. I took to the floor.

The answers were diverse, as honest answers should be. For some, the clear and concise assessments were the draw card: “It’s clear about what we need to work on together to support the children being safe. It links directly with my case plan and the family knows what it is that I am worried about and why. They can either choose to work on these things or not. They have choice. It’s still voluntary … and they know exactly why I am there.” For others, the evidenced-based check-in was the greatest asset: “The tooling is an objective external measure that I can test my instinct against … It’s a reference point—it’s not just what I think, but there is [an assessment] with evidence behind it that is also suggesting that there may be a problem.”

The best answer of the day, however, was yet to come. I sought out a caseworker, quietly sitting at the back of the office. She had been much quieter than the others. I asked her directly what she thought and she replied, “I think we’re having conversations that we didn’t have before.” So simple and yet so key. The caseworker went on to explain that she was talking to families about their strengths and the concerns in a way that she had not before. The assessments supported clarity for her. She understood the issues, and this enabled her to relax into a conversation with families without being nervous about what she needed to address or how to explain it. She explained to me that there was a higher level of purposeful team leader and caseworker discussion about issues, assessment, and case plans and that this had supported clearer conversations with families about case direction and options. She was inspired by the practice conversations that were now taking place around her: How do we engage the children? How do we work within families where there is active domestic violence? What does an effective safety plan look like and what timeframes should we consider for this? This caseworker saw caseworkers actively engaging with children and children responding with their ideas and thoughts. She explained that families are curious about the assessments and tools but still happy to participate—“we’re not ‘losing’ families”—and that for her, clear conversations with children and families meant clearer assessments, clearer case plans, clearer reviews, and better outcomes for children. Music to my ears!

In relaying these responses, I am not suggesting that we are “there.” The change and implementation journey is still in its infancy. Some staff are still anxious for those families that do not meet our threshold of high to very high risk. There are concerns that such targeted and clear conversations, whilst strengths based, may still scare off families that we may have been able to engage over a longer period of time with a less direct approach. There are concerns that the balance of relational work and direction may become skewed (with direction being prioritized). So there are still plenty of conversations and learning to be had. At this point, however, I feel confident in our ability to work through all of these issues, particularly now that on every level we seem to be “having conversations that we didn’t have before.”

Cara Langley is the Wesley Mission (Lead Agency) Brighter Futures practice specialist for the Sydney Metropolitan West area of New South Wales. Cara has been working with vulnerable children and families in a variety of settings since 1994, including local government children’s services (mainstream and special needs), state government statutory child protection and out-of-home care in New South Wales and Victoria, and the Brighter Futures program (non-government sector). Her work has included frontline delivery, program management, and practice specialization roles. Her present role involves working alongside 13 nongovernment agencies partnering in Brighter Futures EI program delivery.