Cooperation Who benefits the most Camilla Blomqvist

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Cooperation Who benefits the most?- Camilla
Blomqvist

• PhD thesis in social work
• Qualitative and quantitative study
• Finished by 2009

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Aim

• How co-operate child psychiatry, social services
  and school when all organizations are involved
  with the child?
• How does the process look like to be a
  co-operating case?
• Is the child perspective similar or different in
  the different organizations?

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Method

• Observations in consultations
• Observations and interviews in cases
• Survey

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Distribution of survey answers
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Who answered the survey?

• 1 in 5 were men
• Most men were from School services and Child
  Psychiatry
• It was more common that women had worked at least
  6 years than men (38 vs 25).
• The average for job experience was a little more
  than 8 years.
• The majority of personnel with more than 15 years
  of experience worked in Child Psychiatry and at
  school.

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Who is cooperating?

• Joint cooperation Child Psychiatry/School/Social
  services
• 41 participate 1-4 times/month (frequent
  cooperation),
• 40 less than once quarterly.
• The remainder every other or every third month.
• Half of those who frequently cooperate have at
  least 10 cooperative cases per year. (many cases
  few meetings or few cases many meetings)

• Child Psychiatry cooperates more often than
  school and social services

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Who cooperates?

• Frequent cooperation is most common among
  personnel with 6-15 years of job experience.

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How does cooperation take place?

• Telephone and mail is more common than meetings.
• Meetings often include the parents. This is more
  common for Child Psychiatry.
• Meetings that include the parents and children
  are most common for Social services.

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Thoughts on cooperation

• Every other person from Child Psychiatry/Social
  services feels that he/she has good or very good
  cooperation with school services.
• A little more than 1 in 3 from Child
  Psychiatry/School services feel that he/she has
  good or very good cooperation with social
  services.
• 1 in 4 from Social/School services feels that
  he/she has good or very good cooperation with
  Child Psychiatry services.

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Differences in cooperation all

• Perception/Experience of cooperation with Social
  services and Child Psychiatry changes positively
  once one has experience of it.
• The perception of cooperation with School
  services is not dependant upon experience.
• Differences are amplified those who cooperate
  within School and Social services (70) are more
  familiar with the UNs Childrens rights than
  those within Child Psychiatry are (24).

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What influences the development of cooperation
between organizations
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The best for the child

• All organizations are familiar with the UNs
  Childrens rights act. Social and school services
  are more familiar than Child Psychiatry.
• Assessments regarding what is best for a child is
  done for each individual case Social services
  more than the others
• Organizations reach consensus together regarding
  what is best for a child.
• Social services most often decides what is best
  for a child when their is disagreement.
• 1 in 6 do not discuss what is best for a child
  in their organizations. This is equally common in
  all organizations.

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Consultations at Child Psychiatry

• Participated in 42 treatment/diagnosis
  consultations.
• Listened to 269 patient histories

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Partial results from consultations

• The majority of cases were brought up by the
  parents.
• Cooperation was initiated by referral or
  invitation.
• In 4 of 10 cases cooperation was started.
• The idea with cooperation was benefits for Child
  Psychiatry or for Child Psychiatry and the family.

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• Focus shifts between children, parents, and
  which contributions Child Psychiatry can make.
• The case officers preconceptions characterize
  the childs history and influences efforts.
• Ambiguous between assessment/treatment.

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Eight cases

• From treatment consultation/treatment at Child
  Psychiatry
• All the children had problems in school as well
  as previous contact with Child Psychiatry and
  social services.
• 7 out of 8 children had had long-term contact.
• 7 out of 8 were boys.
• Children between 10 and 17 years old.
• 2 of the children lived with their original
  families.
• Many resources have been given to the families.

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Partial results of cases

• Families were moved around between organizations
• Personnel change
• Ambiguity
• Little room for the childs best
• Disagreement
• Exposure
• For both the family and personnel
• Time
• Long time to gather oneself

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What was the final result of cooperation in the
cases?

• Better cooperation between organizations
• Treatment process begins together
• Slow change no change?
• Disagreement among organizations

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Conclusions organizational level

• Internal organization complicates things
• Assignments and boundaries
• Skepticism for the assessments of other
  organizations
• Discussions about costs
• Confidentiality
• The efforts of the organizations and the
  children's needs
• Time
• Problems in 1st grade are not solved in 9th grade
  
• Seasonally controlled organization
• Simultaneous work

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Conclusions concrete practical level

• For whom are we cooperating?
• Personnel?
• Child?
• Parents?
• Inter-professional cooperation internally and
  externally
• Different professions different explanation
  theories?
• Fun to work together.
• Difficulties describing the causes of problems.
• Teachers are important for children.
• Lack of clarity in their work efforts.
• Power
• Parents and children feel they are overrun
• Personnel also feel they are overrun

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The cooperation of organizations and the UNs
child rights act how does it work?

• The child becomes an object.
• It takes time for the childs story to be heard.
• The childs exposure
• In individual meetings
• In the agreements of organizations
• In difficulties obtaining help

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Things to think about

• How would cooperation be affected with one
  authority instead of three?
• How would the personnels efforts be affected
  if they talked with and not about the family?
• Would there be a difference if the childs
  story was heard earlier?
• What would happen if cooperation started
  earlier?
• Would it make a difference if the childs needs
  controlled organizational efforts instead of the
  resources of the organization?