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Current issues in child protection policy and practice : Informing the NT Department of Health and Community Services child protection review



Current issues in child protection policy and practice : Informing the NT Department of Health and Community Services child protection review

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Adam M. Tomison.


Tomison, Adam M; National Child Protection Clearing House (Australia)


E-Publications; E-Books; PublicationNT




Made available via the Publications (Legal Deposit) Act 2004 (NT).


Date:2004-02; Cover title. Written for the Northern Territory Department of Health and Community Services.

Table of contents

Child protection and family support services -- Developments in child protection practice -- Responding to child abuse and neglect in Indigenous and rural-remote communities -- Evidence-based practice in child protection – How do we better inform practice -- Conclusion: child protection and family support in the 21st Century.




Child abuse -- Australia -- Prevention

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National Child Protection Clearing House

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v, 89 ; 30 cm.

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Check within Publication or with content Publisher.

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Northern Territory Department of Health and Community Services 71 CURRENT ISSUES IN CHILD PROTECTION POLICY AND PRACTICE Does the current western approach to child protection work? How do we know? What is good practice in child protection? In this section, the aim is to explore the means by which evidence-based practice may be embraced to better inform practice. Evidence-based practice can be defined as: the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individuals (Sackett, Richardson, Rosenberg & Haynes 1997:2). More specifically, it involves: integrating individual practice expertise with the best available external evidence from systematic research as well as considering the values and expectations of clients (Gambrill 1999:346). The 1960s heralded not only the modern rediscovery of child abuse via Kempe and colleagues work on the battered child syndrome (Kempe et al. 1962), but also the first empirical (or experimental) tests of the effectiveness of health and welfare programs. This heralded the dawn of the program evaluation era, and with it, the expectation that public sector programs should be able to objectively and scientifically demonstrate program success and client satisfaction (Rist 1997). This shift has eventuated partly as a consequence of a growing focus on demonstrating service costeffectiveness and cost efficiency (Rees 1994; Cooper 1997), and ongoing concerns regarding the social cost of poorly performing programs (Weiss 1988; Stevens 1999). The validity of the latter has been demonstrated with respect to child abuse and neglect, by the continuing toll of child maltreatment deaths (Stevens 1999), high rates of re-abuse and repeated child maltreatment reports to statutory child protection services, and the continuing high incidence of child maltreatment in the community. Curtis (1997) argues that it is the the seductive appeal of absolute certainty thought to result from the use of quantitative, economically-focused performance criteria that has led to the domination of scientific or experimental evaluation methods, an appeal that has been strengthened by the absence of other viable alternatives. Thus, in the 1990s, following a trend evident across a variety of fields including medicine, welfare, and education, there was a growing shift to adopting an evidence-based approach to child protection practice. Based on the view that formal rationality of practice based on scientific methods can produce a more effective and economically accountable means of social service (Webb 2001:60), the intention is to make policy and practice decisions informed by a critical appraisal of the best evidence available rather than merely accepting famous ideas just because they are famous (Sheldon 2001:803). SIMPLY THE BEST? RANDOMISED CONTROL TRIALS Empirical evaluation can be defined as involving the conduct of a true experiment (Fink & McCloskey 1990). This requires pre- and post-test comparisons of matched control (no treatment) and experimental (treatment) samples. Overall, the intention is to evaluate with large sample sizes over time, enhancing the potential for future replication. Of all experimental approaches, it is randomised control trials (RCTs) that are considered to be the gold standard or best practice research (Fink & McCloskey 1990; Smith 1999). Such designs involve the random allocation of participants to either an experimental group or a control group, enabling the researcher to overcome a variety of potential sources of bias and provide the best chance of determining an unbiased estimate of the effect of participation in a particular program (Chalk & King 1998). Unfortunately, many have taken evidence-based practice to mean: that practice should be based upon the evidence of randomised control trials alone, and that all other practice is either not evidence-based or of a lower quality ... This narrow approach, whilst not one envisaged by the original proponents of evidence-based medicine (Sackett et al. 1996), is a common misunderstanding of the paradigm (Ramchandani, Joughin & Zwi 2001:60). EVIDENCE-BASED PRACTICE IN CHILD PROTECTION: HOW DO WE BETTER INFORM PRACTICE?

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