Using Risk to Support Positive Outcomes

July 25, 2016 | Doug Smith, Program Associate


Historically, my understanding of the word “risk” has been limited to the context of its everyday use: “This might be a risky move”; “You’re taking a risk with that one”; “You might be putting yourself at risk by doing that.” I never gave the term much more thought, at least not intentionally.

Two months ago, I began my work as a program associate for NCCD. At that time, I started hearing the word “risk” being used in a different and very particular way. I was intrigued, as it sounded different from the way I had been accustomed to hearing it in my everyday exchanges. Suddenly, I was hearing “risk” used to describe a classification method to inform decision making within social service systems—specifically within child welfare, juvenile justice, and adult protection settings.

At first, this concept was tough for me to grasp; how could we classify families based on a set of factors which may or may not be in their control? Furthermore, how can this classification inform critical decisions within the lifespans of their involvement with these social service systems? This concept didn’t become fully clear to me until I was asked to think about it within an entirely different setting altogether.

My sister recently gave birth to two wonderful twin boys. She has three other children and was absolutely ecstatic to add two more bundles of joy to her family. The twin pregnancy, however, was treated very differently than her other three pregnancies. After learning she was pregnant with twins, my sister was immediately informed that her pregnancy was “high risk,” and therefore different precautions needed to be taken to ensure both she and the babies remained healthy and safe. As a result, she had more frequent contacts with physicians as well as different types of tests, ultrasounds, and procedures, and was given modified instructions for how long she could work and when she would need bed rest.

This change in service delivery was due to the fact that she had a high-risk pregnancy. “High risk” did not mean she had done anything wrong; it simply meant that because of the presence of known risk factors, future complications were more likely to occur.

Applying this same logic to families involved in social service systems, “risk,” as it is used within the Structured Decision Making® (SDM) model, suddenly became crystal clear to me. The presence of risk factors that more strongly correlate with certain undesirable outcomes means that by providing families with additional services and support, agencies can hopefully mitigate some of those potential “complications.”

My sister’s high-risk pregnancy ended with two healthy babies and one happy, healthy mother, in part due to the increased and specialized services and support she received. The underlying concept of the likelihood of future complications in a high-risk pregnancy is the same concept as the likelihood of future undesirable outcomes as they pertain to individuals and families within our social service systems. By identifying those high-risk families, we can provide them with the services and support they need to avoid negative outcomes, just like my sister and her newborn twin boys avoided potential future complications throughout the pregnancy and the birth.

After making this connection, I finally felt like I had a grasp on understanding risk within the SDM® system. Now, as I find myself training the concept of risk within the SDM system around the world, my twin nephews continue to help others to understand this concept, just as they helped me.