Interagency Practice and Outcomes for Adolescents in Addiction and Social Services

1. Interagency Practice and Outcomes for Adolescents in Addiction and Social Services Presenters; Robert O’Driscoll & Miriam Keogh Research Team; Liam McCarthy (AC), Trisha Mc Shane (SW), Helena Horgan Khan (SW) Barry Corkery (AC) Keith Duff (SW) Wednesday, 10 September 2014

2. Presentation overview Aims of the research and a description of the research process Show you some interesting data from interviews and workshops Connect this to our preliminary findings Articulate an emerging theory

3. http://www.ted.com/talks/terry_moore_how_to_tie_your_shoes.html#.TrOA0dv97-U.mailtohttp://www.ted.com/talks/terry_moore_how_to_tie_your_shoes.html#.TrOA0dv97-U.mailto We all like to think the way we do it is the right way

4. The aim of the research is; • To enhance the outcomes for adolescent service users who are concurrently open to addiction and social services. • To transform the interagency and inter-disciplinary practice of practitioners working with this client-group • To advance the recommendations of the Ryan Report (2009) • To assess the methodological potential of CHAT and DWR to contribute to the enhancement of professional practice

5. Young Person Interviews Young Person Interviews Professional Interviews Professional Interviews Change Laboratory 1 (Focus Group) Change Laboratory 1 (Focus Group) Change Laboratory 2 (Focus Group) Change Laboratory 2 (Focus Group) Change Laboratory 4 (Focus Group) Change Laboratory 3 (Focus Group) Data Evolution

6. Cultural Historical Activity Theory

7. Client Inclusion • “I have a fairly clear idea of what people do, I don’t think that’s true for our young people or our clients. I think that we often don’t explain our services as well as we should, you just presume that they know it and you just move onto the next topic”. • “We’re just not being listened to, like, what we need, the social workers think they know everything but everyone is different, like”.

8. Interagency tasking • “I’ll be honest about ourselves anyway, I'm not going to speak about any other agency, but we do bad mouth other agencies from time to time, you know in discussion” • “ Ye call them case conferences, we call ours allocation meetings. We discuss new cases as they come in. We discuss them in our own bubble…. And nobody from outside of that bubble is allowed in. So we come away what we are going to do with this young person based on our bubble”

9. Interagency tasking • “We had a conversation about a referral and I remember saying that we didn’t have a formal interagency policy drawn up with your agency. Regardless, in the interests of the client and if the client is the centre of our focus we would just go through any obstacles that arise. It actually worked out well.”

10. Assessment “there are so many variables to be taken into consideration when doing an assessment, so I think in the very first place, the assessment of young people is probably the most important thing, not just looking at their use, and I am concerned that, in my experience of some young people in the past it was a tick box exercise”

11. Competencies • “but there isn’t actually a huge emphasis on me developing myself in terms of, you know, how I engage with other agencies or how I engage with other families” • “I think spaces that are provided for people to take their hats off and just say, “Look, this is where it’s at with me”, do you know what I mean? More opportunity for that to kind of actually happen in a real way, so whether that’s kind of done through you know, maybe … practitioner forums … where people can come and sit and just kind of put out their practice issues”

12. What are we finding? • Our research participants indicated that more was needed for effective interagency working • We have the legislation, policy, best practice guidelines and infrastructure • We know what facilitates and inhibits interagency practice (Buckley 1997, 2003b) • Trust and understanding each others values and ways of working, good communication and confidentiality are important factors

13. What changed? • Rules around blaming other agencies or practitioners for problems with cases • Revisiting -introduction of a pre-assessment and referral forms • Interagency training aiming to align system wide change in practices • More contact between agencies and individual practitioners

14. What else • Planned interagency visits • A practitioner tool for monitoring personal practice in interagency activity

15. What do our findings suggest • CHAT as a lens for systemically analysing work practices has been useful to develop SW and AT practice • Centrality of the client and family for effective interagency work to take place • DWR worked as a neutral reflective space to discuss practice facilitates practice development

16. Limitations and directions for future research • Timeframe • Further DWR workshops to consolidate changes to practice

17. Contact details • Arbour House Research Team; Robert O’Driscoll & Liam McCarthy, Barry Corkery • 021-4968933 liam.mccarthy@hse.ie • North Lee Research Team; Miriam Keogh, Helena Horgan Khan, Keith Duff, Trisha Mc Shane • 021-4927000 miriam.keogh@hse.ie