A constructivist grounded theory study of the decision-making processes of professionals in a children’s service, mixed multi-disciplinary assessment team

Robbins, Eva (2016) A constructivist grounded theory study of the decision-making processes of professionals in a children’s service, mixed multi-disciplinary assessment team. Professional Doctorate thesis, Tavistock and Portman NHS Foundation Trust / University of Essex. Full text available

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Since 2003, Children’s Services have sought to promote more consolidated work by professionals of different disciplinary backgrounds who might otherwise follow independent forms of practice. This is believed to enhance efficacy and reduce inequality in providing for vulnerable children (Boddy, Potts, & Statham, 2006; DCSF, 2003). Evidence that this improves child outcomes is mixed, however. Professionals may have difficulties working together effectively, for example Anning, Cottrell, Frost, Green, & Robinson (2006) and Sloper (2004). This research presents a qualitative study into the decision-making processes of a Children’s Services multi-disciplinary team (MDT) of educational, health and social care professionals. The study explores which aspects of the MDT strengthen and undermine collaborative work, and how this influences child assessment outcomes. The study was exploratory, using Constructivist Grounded Theory (CGT) analysis of the recorded discussions of professionals concerning six preschool child cases. All six children were referred with neurodevelopment difficulties. The transcripts revealed a fragmentary MDT with a singular, medical model approach to practice, which in this particular situation, averted collaborative working. The established context for the operation of decision-making was in the professionals’ referral system, whereby a Child Assessment ‘pathway’ functioned. Decision-making comprised System routines, Weighing-up significance, Expediency including Centralisation and Convenience, Continuation of Function, and Avoidance of Difficulty/Unpleasantness. Use of the Autism Diagnostic Observation Schedule (ADOS) cut-off score to diagnose autism spectrum disorders (ASD) was an outcome of the decision-making process. Discussions revealed that once such decisions were made, they remained unchanged. Psychoanalytically informed concepts (Hollway, 2011) were used in analyses. This enabled a framework of understanding for professionals’ work, as well as for promoting organisational development and change.

Item Type: Thesis (Professional Doctorate)
Additional Information: Thesis submitted in partial fulfilment of the requirements of the Doctorate in Child and Educational Psychology awarded by the Tavistock and Portman NHS Foundation Trust in collaboration with the University of Essex
Uncontrolled Keywords: Professional Doctorate in Child and Educational Psychology, Decision, Making, Multi, Disciplinary
Subjects: Families > Fathers
Health and Medical Sciences > National Health Service
Learning & Education > Educational Psychology
Learning & Education > Learning & Education in Psychology
Social Welfare > Social Work
Department/People: Children, Young Adult and Family Services
URI: https://repository.tavistockandportman.ac.uk/id/eprint/1290

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