Seductive Strategies and Multi-Professional Mayhem in Health and Social Care Research with Children and Young People

1. Seductive strategies and multi-professional mayhem. Health and social care research with children and young people Tony Long Professor of Child and Family Health October 2008

2. The drive for multi-disciplinary approaches to everything

3. Policy documents – especially from 2000: (The NHS Plan, Health service for all the talents, Working & learning together (DH), Benchmarking academic & practitioner standards (QAA), etc Find a university which isn’t pursuing IPL! Major issue for validation of programmes and evaluation of schools, faculties HEIs Research studies to identify the way forward Meme “…units of cultural transmission which propagate themselves in the meme pool by leaping from brain to brain by a process which, in the broadest sense, can be called imitation.” Dawkins R (1976) The selfish gene (p192) Oxford University Press Uncritical promotion of multi-disciplinary working

4. …sounding seductive, but failing to deliver… Inter-professional learning in the health care professions: • often demanded • labour-intensive • sometimes enjoyed • hardly mainstream • evidence of outcome lacking CNO Chris Beasley

5. Values for integrated working with children and young people http://nmc-uk.org/aArticle.aspx?ArticleID=2344 Children's practitioners value the contribution that a range of colleagues make to children and young people’s lives, and they form effective relationships across the children's workforce. Their integrated practice is based on a willingness to bring their own expertise to bear on the pursuit of shared goals, and a respect for the expertise of others.

6. Getting it wrong:1. Language (for effective working)

7. “Professional and occupational groups” “Competent bodies” SpReg, SSLT, RSW, FSW, StSW “The College” What does “clinical practice” mean to a social worker? Terrible Terminology

8. Additionality • The output of additionalizing? • Resources over and above the standard quota.

9. When do social work students first learn to say “pop”? • “Pop along to the office...” • “Pop it in the post, then.” • “I’ll pop in to see how you’re getting on…”

10. “If there’s anything…”

11. Getting it wrong:2. Perspective – shared goals

12. That means… Service user involvement Hard evidence Insight and understanding Appropriate methods Local relevance Generalisability We’re all answering a question • “I want a strong, rigorous, worthwhile study.” (But is it the same question?)

13. Write a section for me on… Think what the key questions will be… Do you have the reference for that? Ethics approval Great (but different) Expectations

14. Getting it wrong:3. (not so) Common Knowledge

15. “Can’t we just count the midwives in with the nurses? Who needs to be at the table? Long T, Davis C, Johnson M. Murphy M, Race D, Shardlow S (2006) Standards for education and training for interagency working in child protection in the UK: implications for nurses, midwives and health visitors. Nurse Education Today 26 (1) 11-22.

16. BHLP CAF Development of the collaborative agenda TAF 4 Mandates Leads Children’s Trust Local Strategic Partnership LAA SMT Cultural Change (External Consultancy) Operational Management Group Springboard Team Respect Action Area Family Intervention Project Locality Teams Children’s Trust The way forward for collaborative services Rapidly moving agendas… …and associated terminology Ravey M, Long T, Murphy M, Fallon D (2008) Evaluation of Blackpool Council Springboard Project. University of Salford

17. Research with YP is (un)ethical • What ethics committee? • The risk of exploitation • Physical and other dangers • Vulnerable individuals • Vulnerable groups • Sensitive topics Long T, Fallon D (2007) Ethics approval, guarantees of quality, and the meddlesome editor. Journal of Clinical Nursing 16 (8) 1398-1404.

18. Vulnerable people, sensitive topics • MRC, RCPCH guidelines – only if the research couldn’t be done on adults. Joan Livesley (safety in hospitals) Who else can tell the young person’s story? • Substance misusing families – they’ll never talk to you. Michael Murphy Privileged Access Interviewers • Sensitive topics – Debbie Fallon (teenagers accessing emergency contraception) – Who decides that the topic is sensitive, and who makes it sensitive? Murphy M (2006) The Childs View: The highs and lows of Family Life Bolton ACPC/Bolton DAT Fallon D (2006) To raise dream and ambition – a rhetorical analysis of the teenage pregnancy strategy. Nursing Inquiry 13 (3)186-193

19. Getting it right1. Clarity of purpose

20. The nature of health & social care practice with young people Ability to understand complex multi-faceted reality of life/care/health Different research skills …and access Purpose of a multidisciplinary YP research team CYP@Salford

21. Getting it right2. Ensuring shared values

22. Partnership working Inclusiveness Rigorous and useful Ethical research Innovative & flexible Agreed values

23. Research with YP is essential • Improvement of specific services • Non-exclusion agenda – right to benefit • They have things to say and… • They want to be heard • … and to make a difference • Whose voice is to be heard?

24. Mol an oige agus tiocfaidh siad Praise the young and they will flourish. Listen to the young and they will flourish.

25. Getting it right3. Playing to our strengths

26. Working at Effectiveness • Picking the right team for the occasion • Sustained commitment to joint working (the squad) • Working on communication • Working to strengths and being pragmatic • Understanding the potential. Being ready to emphasise it Long T, Fallon D, Devitt P, Oak E, Murphy M, Dugdill L (2008) A community health needs evaluation to improve uptake of services at a children’s centre in a deprived and geographically isolated town. Journal of Children’s and Young People’s Nursing 2 (3) 108-114.

27. Avoid exploitation (but who decides when it becomes exploitation?) Protect from danger (but allow some risk) Hear the voice (but who chooses the issues?) Respect autonomy (but what are the limits?) Luke Calum Indi Jack Creating a balance for YP by maximising the team’s attributes

28. It may all seem too good to be true… “To every human problem there is a neat and easy solution – and it’s wrong.” H L Mencken

29. Multidisciplinary research with YP is too diffic u l t !

30. Multidisciplinary research with YP is too difficult! • Many problems • No easy answers • …and the answers keep changing • That’s life! Get on with it.

31. The way forward (if we choose it) • Sensitivity. Awareness of selves as well as young people. • Flexibility…mixed with creativity. • Listening & learning • Being prepared to be wrong • …but

32. Daring to be right!

33. Seductive strategies and multi-professional mayhem. Health and social care research with children and young people Tony Long t.long@salford.ac.uk CYP@salford.ac.uk