This incident came to mind recently when listening to discussions about demands for new medical treatments. It seems that health trusts are being pressured by desperately ill people to prescribe drugs that offer promising results but which have not been 'licensed' by the medical authorities. This led me to ask, 'What is the equivalent to licensing in children's services?'
There are naturally difficulties in comparing medical treatments with child care but it is still possible for anyone to 'invent' childcare practice and implement it without external approval. Childcare history is littered with unjustified practices, from the abusive Pindown regime to the less obtrusive but zealous denial of footwear or TV. Things that should help struggle to have any influence; training is insufficiently consistent and professional associations are weak. Standards and inspection are obviously important but they tend to set minimum levels and emphasise what not to do. Moreover, much of their focus is probably irrelevant to children's long-term needs.
The problem is exacerbated by the dearth of validated childcare interventions. Codes of Practice and 'What Works' recommendations abound but they can easily be discredited. In the past three years, 71 articles have been published in Adoption & Fostering. Nineteen of these are general discussions and 48 empirical studies. The other four comprise clinicians and therapists describing what they believe works for the children they see. It is good that these professionals disseminate their work but as editor I am reliant on peer reviewers to distinguish the skilled practitioner from the crackpot. While these articles offer coherent responses to children's needs and rational explanations of irrational behaviour, I remain nervous of the lack of proof. Hence the careful evaluation of the Fostering Changes programme in this edition is an especially welcome attempt to establish validated practice.
Another way forward is to consider the conceptual framework that underpins children's services, in particular the concept of a 'service'. Fostering and adoption are often described in these terms. But no child needs fostering or adoption as such; what they have are needs which, at the present time, we think are best met by activities labelled fostering and adoption. What matters is what happens in these contexts, not what they are called or how they are administered. A more fruitful focus, therefore, is to perceive services as a 'technology or mechanism for alleviating people's problems' or as 'the activity intended to meet a child's needs and so achieve desired outcomes'.
The advantage of this perspective is that it emphasises what is actually done. It also clarifies the role of specific practice in meeting specific needs, and so highlights any mismatch. It may be that practices we dislike produce later benefits. As Jane Austen wrote, 'it is very worthwhile to be tormented for two or three years of one's life for the sake of being able to read for the rest of it'. But whatever our preferences, we should never, in the plethora of care detail, lose sight of the reasons for what we do to children who have to live away from home and its ability to meet their needs.
Roger Bullock is Commissioning Editor of Adoption & Fostering and a Fellow, Centre for Social Policy, Warren House Group at Darlington
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|Publication:||Adoption & Fostering|
|Date:||Sep 22, 2006|
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