Risks, rights and the role of the state: Grounded professional judgement

[Introduction]

The Research in Practice and Research in Practice for Adults podcast, supporting evidence-informed practice for children, adults and families.

[What is Grounded Professional Judgement?]

Dez: Welcome to the Research in Practice podcast. I'm here today with Danielle Turney of the University of Bristol. Excellent to have you here Danielle, thank you. Now, we're going to talk about the rather, sort of, nebulous notion of grounded professional judgement, which is a term that you've coined in fact. Do you want to tell us a little bit about that?

Danielle: Yes, of course. It came about through a piece of work I was doing with a Norwegian colleague, a social worker called Vibeke Samsonsen, who was also completing a PhD at the time and spent some time in England looking at assessment practice and drawing a comparison between the processes and approaches in Norway and in England. She and I got talking about assessment practice and decided it would be interesting to write something together, which we did. One of the issues that we focussed on in the paper was the notion of professional judgement and trying to understand where it fitted in understanding assessment practices in our two systems. Norway's system being very different from England in that we have an assessment framework that was introduced some years back, which had as we know the assessment triangle, which we still, I think widely use. We have had a system that has become particularly, again aligned with the introduction of the integrated children's system, a system that has become quite proceduralised, quite formalised and quite bureaucratic. By contrast, Norway has no assessment framework and no particular structure beyond, there's some very limited guidance in their legislation about what should happen but it's very minimal. So, we've got these, sort of, two not-, I mean England's system could be more extreme, especially like we're on a continuum but we're towards different ends of the continuum, and at the same time as we had the Munro report, which was saying we need to move away from rule-governed proceduralised compliance culture towards a more open-minded, reflective, thoughtful thinking process. Norway is saying unfettered professional judgement means you get, sort of, random decisions here and there, there's no consistency, actually, maybe we need a bit more structure.

Danielle: So, these two things, sort of, came together whilst she was doing her PhD and were very much the subject of our conversations. So, professional judgement seemed, to both of us, to be a very key notion for how our different systems viewed the world with the system in England appearing to be trying to close down options for discretionary thinking but the Norwegian system perhaps putting it at the other end of the scale where professional judgement was almost unchallengeable, or that was how one could characterise it, that professionals made professional judgements and that was what they drew on. That was the basis on which things happened, and the risk of that of course is that it becomes unchallengeable. I can say, 'Well, in my professional judgement, this is the right thing to do,' how are you going to challenge that? So, actually trying to look at some of those tensions and we basically came to the view that neither of our systems had the answer and that probably the answer lays somewhere in the middle, but that's another conversation for another day. What we did try and explore, was why we'd got these very different approaches in our different countries and how the frameworks for thinking were different. One of the ways in which we tried to think that through was in terms of how do we understand the notion of child abuse and child protection and what social work's about. You know, the notion of tame problems and wicked problems? You see tame problems being ones that even if they're difficult to frame, are amenable to solutions or to strategies for addressing them. Wicked problems being the much more diffuse ones where often there isn't a right answer or indeed an answer.

What we wondered was whether our different systems had actually understood child protection on the one hand almost as a tame problem in England and actually as a wicked problem in the Norwegian system. So, the English response has been to try and sort of shutting down the room for manoeuvre saying, 'Here's what we need to do, if we do this then we will be moving in the right direction,' and the Norwegian system going rather more towards the end of the spectrum as I've said before where they relied much more on the judgement and professional thinking of practitioners.

Dez: I've heard that argument certainly, and perhaps it was even more true a few years ago, I think Munro was a really influential point in terms of social work in this country but I've certainly heard the argument that we are applying tame solutions or mechanistic solutions to problems which are sometimes organic and complex rather than just complicated. You know, building a jet engine being a good example of complicated but if you follow the blueprint and have the parts you will eventually build a jet engine. As opposed to a family system, which is highly complex. So, I've certainly heard that argument. I suppose I'm curious in your highlighting, and I should that some of our other podcasts have focussed on risk and rights, and you're highlighting to me that if in England, we had taken the approach of just highly mechanistic and tame and proceduralised and there was little room for professional judgement, you could see how people's rights might sometimes be undermined there. So, the right to challenge your professional's assessment of you, if you're following or are at point three of the procedure now it has to go to conference, that can all start to feel quite oppressive.

Danielle: Though, arguably professional judgement that can't be challenged is equally open to abuse.

Dez: And that's so important. We talk, I think, certainly in this country almost universally we tend to talk about professional judgement as being one, a good thing and two, a thing we'd like more of, you know, we need to enable it and empower it and I think I'm right in saying that the very recent consultation that came out from working together seemed to suggest that even management oversight might be less significant than we thought in terms of professional judgement, and that's a really important- you could place values in situations where their rights are diluted or overlooked or undermined because professional judgement becomes incontrovertible.

Danielle: On what grounds can you challenge it? I guess that's where this notion of grounded professional judgement came in because we were trying to explore what happens in that space where professional judgement takes place. I suppose it's trying to move away from like a black box, you know, where you feed information in here, something happens in this little bubble of professional judgement and out pops a decision, and actually, what we were trying to do I think, was explore what happens in that black box or that bubble however you want to think about it, to say, what goes on? What are some of the challenges that professional judgement might face? We know a lot more now about, for example, some of the challenges of good thinking in relation to the literature on heuristics and biases. We can understand that there are all sorts of pitfalls to good thinking and we can think about what supports better thinking but it's actually, just trying to shed some light on the processes and what would allow us to make judgements, and social work has to make judgements. We try not to be judgemental but push comes to shove, social work is about making decisions, decisions depend on certain judgements that you've made about what's going on or what might be going on or how you might respond. So, professional judgement I think is absolutely essential and rather than trying to organise it out of the system, which I think is what perhaps we were trying to do or the system was trying to do previously, as you say, Munro brought the notion back in that we need to be able to think, we need to be able to reflect, we need to be able to use people's knowledge and experience well and support them to use it better, but that actually provokes a whole new set of conversations about, well, so what it is?

Danielle: How would we know if we were doing it? What does it look like, and how do other people have access to it? Because it's not just somebody sitting in a corner having big thinks, it's got to be accessible and scrutinisable, if that's a word, and open to challenge, transparent. So, hence, the idea of a grounded professional judgement rather than one that was just floating in the ether. That's where that sort of thinking came from.

Dez: You've made it not at all nebulous that's fantastic, I really understand what you're getting at.

Danielle: So, the argument we've put forward is that it has two key aspects to think about, and here I apologise because the language is not necessarily that comfortable, but we were talking about how people know things, and what they know, and in a sense what warrant they have for knowing it. So, ideas about knowledge get put under this lovely heading of epistemology, and I have to own up to being quite fond of that but recognise it's not on everyone's top list of things to talk about. What we're trying to talk about here is two forms of epistemological understanding. So, and this is in the literature already but what we've to do is bring these notions together, epistemic accountability, and epistemic responsibility. So, the notion of accountability is not new to social work. We know that there are all sorts of mechanisms in place to try and promote accountability that we have to be accountable for what we do and how we do it and so on. We can think about that in two if you like, two dimensions, structural accountability. So, that is looking at ways in which we can perhaps, going back to my idea about tame problems, ways of structuring things so that we reduce the amount of leeway there is for making decisions for exercising discretion, we use law, policy, procedural frameworks, to provide a structural accountability framework. So, that's one dimension of accountability. The other dimension or another dimension of accountability is what has been referred to as epistemic accountability, which is a kind of thinking that goes into addressing wicked problems. What that's talking about is how we can effectively improve the conditions for and the quality of reasoning and that's in a sense the objective of what epistemic accountability is.

Dez: Okay.

[What Grounded Professional Judgement looks like in practice]

Danielle: So, how do we do that? Well, there may be ways of using, for example, formal education systems, social work education systems to develop good reasoning skills, to support people to develop reflective skills, the sorts of thinking skills that you and I talked about on other occasions. Support systems such as supervision being in place to enable people to think and reflect and be challenged in their thinking. So, those are notions about helping people to think about or focus on what we know and how we know it. So, that's the sort of epistemic element and the accountability structures that support that. Does that make sense?

Dez Holmes: Yes.

Danielle: So, that's one element, but by doing that we need to also think about what is it that's being talked about here. The notion of epistemic responsibility is talking about how we show in our reasoning particular characteristics that are important to justify what we're saying or to provide a warrant for us coming to the view we have. The three that have been cited as particularly relevant, and I think have great application to social work are notions of coherence, good reasoning and good reasons, and goodness of fit with available evidence. So, if we're thinking about how those two together, the notion of epistemic accountability and epistemic responsibility come together.

Dez: Which we're short-handing as the conditions for good reasoning and sort of showing your workings out.

Danielle: Yes.

Dez: You know, responsible, transparent.

Danielle: Yes, so grounded professional judgement in practice is about using epistemically responsible processes of critical thinking and reflection on an individual basis. To show how analyses meet those criteria of coherence, good reasons and goodness of fit with the available evidence.

Dez: I can understand the latter two very clearly if I'm putting myself in the position of a parent or a child who needed social work intervention. Fit with the evidence makes good sense and good reasoning and good reasons. What do you mean by coherence though?

Danielle: Actually being able to give an account that links together in a coherent way.

Dez: So, not leaping from one strand of thought mistrials, developmental outcomes are not being met, to another that may or may not be connected like down to a particular socio-economic position but having a coherent, connected set of thinking.

Danielle: And part of that is being able to show what you know and why you know it, and how you know it, and the flipside of that is therefore also being able to show what you don't know and where there are disconnects of things that are not yet clear. So, I think it's about again, transparency, not being afraid to say we know this but we don't know that, and this is how we might go about exploring whether this is a relevant gap to fill, and providing a framework within which that kind of thinking is allowed. So, grounded professional judgement in practice has a particular need for an organisational context that will allow thinking that is not constrained by fear, by a need for compliance or blame, anxiety about blame. If you are going to say we know this but we don't know that, is that going to put you in a position where you're going to be told off?

Dez: Well, of course, that's so important because if we understand and certainly I was going to argue this but that practitioners are in part role modelling for those we serve, for these adults and children we serve, being able to say, being brave enough to say, 'I actually don't know this, I'm not sure, I haven't got this, I think I've made a mistake, I think I don't understand this, I think I might need support in X,' that is exactly what we require. I mean, our entirely early help system is predicated on that families will be brave enough to say, 'I'm not okay, can I have some help, please?' The very least we can do is make sure out practitioners are able to demonstrate the same kind of courage, bravery and resilience.

Danielle: And if we're making decisions that are going to have a profound impact on family's lives, that actually we have to be able to show how we've arrived at those decisions, and in a sense, be able to take somebody else on that journey of thinking with us. Then, we're open to challenge, because if I say, 'Okay, here's my take on the available evidence, here's the story that I think-,' and I don't mean story in a fictitious way, I mean the narrative that I think explains this situation effectively. So, I've got a coherent narrative here, 'I think it fits with the evidence in these and these ways and these are my reasons why I'm drawing these conclusions,' and I've set that out for you as my supervisor or as a parent I'm working with or as another professional or a court, somebody can say, 'Actually, no, how did you get from there to there?' 'Well, I look at that, you know, as an external person, I look at that evidence, I've actually joined these dots, and they're different from the ones you've joined, what sense do you make of that?' And clearly, it could become very adversarial or in an organisational culture that is about learning and engaging with complexity, ideally, your supervisor or colleague will be saying, 'Yes, but,' and that's a conversation that you are then enabled to have and if you actually have a made, if you like, an illegal jump, in your thinking or you've joined dots that don't belong together, somebody else saying, 'Hang on a minute,' devil's advocate position might be the difference between a good decision and a bad decision. I think, actually, that's a responsibility we have to take on and this kind of thinking framework allows, and again if you've done the work.

Danielle: It's not just saying anything goes, and so if it's my professional judgement it's not challengeable, but it is saying I'm going to do the work that allows me to make the best judgement I can at this time and here's how I got there.

Dez: So, that point about absolute transparency, I think is key. I was reminded as you spoke of, I had a conversation which you were involved in with your colleague Beth Tarleton around working with parents with a learning disability or difficulty and so many of those parents, not understanding what the child protection intervention was about or how they got there or what it involved, and somebody at the Bright Spots research that again your colleagues in Bristol have been heavily involved in.

Danielle: Busy lot.

Dez: You are a busy bunch, aren't you? The Bright Spots work, which is a really fantastic bit of research looking at exploring with children in care and young people in care, what they think, and a really quite concerning proportion of those children saying, 'I might be alright in care,' there was actually very positive messages about being in care, 'But I don't know how I got here, I don't know why I'm here.' We know from a care-experienced adult, one of the great concerns they continue to raise is, 'When I finally got my hands on my case files, that was the first time I saw how you'd made the decisions about me.' So, showing our workings out in real-time, which I think is what you're advocating for here, it's about our professional values and it's a moral issue. It's not simply about professional standards.

Danielle: I think it's all of those things and actually, it's yes, a way of thinking about the work you do and the relationships you've made that allows you to think more open-mindedly, more generously, but always with the idea that it could be other.

Dez: Yes.

[Hunches and uncertainty]

Danielle: I think we have to make decisions often in very, very difficult circumstances. Social workers don't have full evidence, don't have full information in many situations, they're making decisions in complex, painful, contested, messy situations. So, I think this is a way of saying if we can actually follow our thinking through, and it puts quite a lot of pressure back on you as an individual to say, 'Why do I think that? What am I basing it on?' Actually, sometimes we have to acknowledge that we're basing our view on something pretty flimsy that will not stand up. So, we've got to be honest enough and robust enough to sometimes say, 'To be honest, that was not grounded.'

Dez: That was a hunch.

Danielle: 'That was a hunch.' Hunches, I don't have a problem with hunches, I've said before, you know, intuition is a great place to start probably a bad place to finish. If it starts you thinking, great, but for me then the question is, so what? What are you basing that on? Where is that going? What are the implications? It's hard work and it's throwing you back on your own thinking processes and we all need a bit of space and support with that sometimes. Somebody who says, 'I can see where you're going with that, have you thought about this?'

Dez: Yes.

Danielle: 'I don't see where you're going with that, have you thought about that?' That to me is a part of this framework of thinking that I think we were trying to present in that paper.

Dez: That makes really good sense. What often struck me, we did a lot of work around supervision, reflective practice and we draw heavily on your work of course, and a comment that a manager made in a session I was involved in and it stayed with me for many years, because I think it was just absolutely pitch-perfect. It was a group of supervisors and team managers and they were talking about how do you elicit that sort of thinking? Thinking about thinking. They weren't using the term grounded professional judgement, I don't think you'd quite got it out into circulation at this point, and they were talking about how you can really force hypotheses rather than encourage testing of them. So, when you say to a member of your team, why do you think that? You will get a whole litany of reasons why I'm right. So, if you ask me, 'Well, why do you think that Dez? What's underpinning your hunch?' I'll find you lots and lots of proof about why I'm right. Of course, and that's a very human response. Whereas, if you ask me, just a tiny simple change in language, if you ask me, 'What would you need to see or hear to change your mind?' All of a sudden, you're placing me not in an oppressive way, you know, in a generous way, you're placing me in a position where I have to think about my thinking. I have to contend with the idea that my mind could be changed and that's not a bad thing, that's a thoroughly good and useful thing.

Danielle: And I think that connects with ideas of respectful uncertainty and so on, that Laming used. Curiosity is a great friend of good thinking, in my view and actually, encouraging people to continue to be curious both about the circumstances they encounter but also their own thinking about them, I appreciate that might sound a bit regressive and sort of self-referential and I'm not trying to suggest that social workers again are just going to sit there gazing intently at their own navels, but actually, trying to think you are making critical decisions, sometimes life-changing, certainly influential, impactful decisions, I think you have a key professional responsibility to make your thinking the best it can be in an uncertain and imperfect world.

Dez: Thank you very much. You've really given, and this is always the case with your work, if I call you meta it's a compliment. It won't sound like it by the look on your face but encouraging us to think about thinking, reflect about reflecting, be curious about curiosity, you know, there's these reflexive layers to what you're asking us to do.

Danielle: Because in the end, you have to make a decision.

Dez: Yes. Absolutely. I'm most stricken and I'd like us to return to this perhaps in another interview about the conditions. You've touched on supervision, learning cultures, and making it safe to make mistakes, to challenge your thinking. I'd like to come back to that please and give it its own space for an interview if that's okay?

Danielle: My pleasure.

Dez: Thank you very much indeed, Danielle Turney.

Danielle: You're welcome.

[Outro]

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