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Donna M. PencePractice Improvement Consultant
Pence-Wilson Training & Consulting, Inc
Critical Thinking: Decision-Making in Child
Maltreatment Investigations
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Content Alert
Learning Objectives
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Key decision points in child maltreatment investigations
Styles of decision-making
Errors in Decision-making
Influence of personal and professional biases on decision-making
Benefits of MDT case staffing and supervisor consultation on decision-making
Importance of thinking about your critical thinking skills
Basic Components
of the Investigative
ProcessChild Maltreatment Investigation Components
Cross Reporting & Coordination
w/ Other Investigative
Agency
Reviewing History & Gathering
Background Information
Investigative Planning
Child
Interviewing
Adult Interviewing
Evidence Identification &
Collection: Medical/
Physical/Verbal
Critical Thinking- Evaluation of
Information & Evidence
Consultation & Decision-Making
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Community thinks we have one of these…
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Reality, we seem to be behind this
ball when it comes to child
fatalities.
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“I felt personal as well as professional responsibility
to get it right. This all contributes to anxiety.
The reality is, if you make a wrong decision lots of
people, particularly children will suffer.”
Social Worker
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“…most disasters are caused by the
result of a sequence of smaller events…”
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Critical Thinking
Critical thinking is the intellectually disciplined process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and/or evaluating information gathered from, or generated by, observation, experience, reflection, reasoning, or communication, as a guide to belief and action. In its exemplary form, it is based on universal intellectual values that transcend subject matter divisions: clarity, accuracy, precision, consistency, relevance, sound evidence, good reasons, depth, breadth, and fairness. The Critical Thinking Community http://www.criticalthinking.org
Two Components of Critical Thinking
The habit, based on intellectual commitment, of using those skills to guide behavior.
A set of information and belief generating and processing skills
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A well cultivated critical thinker: raises vital questions and problems, formulating them clearly and precisely; gathers and assesses relevant information, using abstract ideas to interpret it effectively comes to well-reasoned conclusions and solutions, testing them against relevant criteria and standards; thinks openmindedly within alternative systems of thought, recognizing and assessing, as need be, their assumptions, implications, and practical consequences; and communicates effectively with others in figuring out solutions to complex problems.
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We want investigators to
try to reason things out on the basis of evidence
and good reasons.
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Categorical Thinking
Go down a listChoosing between various
categoriesEach question narrows the choice
Fails to grasp the importance of context
Fails to recognize that actions are mediated by circumstances that change over time and place
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Decision-Making
Complexity = increased chance of something
going wrong!
Information Gathering
Application of Rules or Criteria that is applied
Discussion Feedback
Decision/Professional Judgment Reassessment
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Steps in Decision Making
DECISIONAL BALANCE
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Wild and Wonderful Whites of West
VirginiaActivity
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Decision-Making Errors
Jumping to conclusions
Entering into power strugglewith client
Accepting parentalwithdrawal/“closure”
Sticking to the same case plan
(Reder, Duncan & Gray, 1993)
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Are we asking the right questions?
Are we correctly understanding the information?
What are the criteria we use to inform our response?
Misinterpretation or misdiagnosis of risk
Initial Report
Who, What, When Where, Why, How
Considerations in Documentation
Evaluating the source of information
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Gathering, Documenting
and Evaluation
Information
Interview Protocols
A good investigation requires an orderly, structured procedure in the gathering of sufficient information to determine if maltreatment took place and to develop a coherent investigative plan.
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Partial information is a key factor
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Jurassic Park School
of Investigation(and Decision-
Making)
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Do we take the time needed to adequately analyze, interpret, and
reflect on the information we have?
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Near Misses:
Something could have gone wrong but have been prevented
Something did go wrong but no serious harm was caused
“Near Misses”
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The prioritization of cases
Professionals not having an accurate or full picture of what is happening
Decisions made by other teams and agencies
Many near misses occurring during the referral and
investigation stages are due to:
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Preconditions - The Dirty Dozen
1. Lack of Communication
2. Complacency
3. Lack of Knowledge
4. Distraction
5. Lack of Teamwork
6. Fatigue
7. Lack of Resources
8. Pressure
9. Lack of Assertiveness
10. Stress
11. Lack of Awareness
12. Norms
• Set the person up to make the active error• Are often a combination of more than one of the
Dirty Dozen
Preconditions
To a Human Error
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Decision-Making Models
Models help us to reduce the complexity of a situation by enabling us the suppress most of it and concentrate on what is most important.
Models do not define what or how we should think; they are the result of an active thought process.
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Strategies
Investigative PlanQuestioning PlanInterviewing Plan
The Importance of “Framing” in Interviewing
“If they can get you asking the wrong questions, they don’t have to worry about
the answers.”
Thomas Pincheon
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Can I explain what I did, how I did it,
when in the process I did it, what
policies, procedures, research, best
practices support what I did (or did
not do?
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BiasThe hidden 4 letter word…
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Three Critical Concepts
Confirmatory Bias Reasonable Alternative Hypothesis Source Monitoring
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“Neuroscientists have shown
biases in thinking are built into the
very way the brain processes
information…the reasoning areas of the brain virtually shut down when confronted with
dissonant information.”
Tavris & Aronson, 2007
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“I will look at any
additional evidence
to confirm the opinion
to which I have
already come.”
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The more important the decision, the greater the need to reduce dissonance by overemphasizing the correctness of the decision.
Once we make a decision, we feel we must justify and rationalize it, even if we don’t really have strong empirical support for it.
Why we don’t accept our
decisions being questioning…
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Reasonable Alternative Hypothesis
Other explanation for statements, injuries, behaviors which should be
evaluated by the investigator during the investigative process.
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Source Monitoring Determining how the
information being provided was acquired by the person sharing it. Did they experience it, see it, hear it? Were they told about it, saw something suspicious and have drawn conclusion based on that?
Source Confusion Confusing an event that
happened and the details . Other people provided details, time delay, telling and retelling, embellishing.
Source Monitoring
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Investigator and Organizational Issues
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Optimism BiasNegativity Bias
Previous History BiasPrejudices/ Stereotype
Biases of Memory
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The Rockman
“You see what you want to see and you hear what you want to hear.”
“The Point”, 1972
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Belief Systems Can…
• Skew Perceptionso “See what we want to see and hear what we want to hear.”
• Influence Clinical Judgment o Confirmatory bias Professional Personal
• Subvert Accurate Documentationo “Good facts” and “Bad facts”
• Affect Decision-Makingo Viability, Credibility, Logic, Optimism-Pessimism, Attribution of Responsibility, Weight to Evidence and
Expert Opinion (Munro, 1999)
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The Challenge of Challenging
Beliefs
(Munro, 1999)
Confirmatory Bias Trap
Case Theory
Question Design/
Evidence Collection
Interpretation of Evidence/ Answers to Questions
Quality Consultatio
n?
Confirm
Theory
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Case Planning
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“GOOD FACTS”
Those pieces of information or evidence which support my working hypothesis
“BAD FACTS”
Those pieces of information or evidence which do not support my working hypothesis or directly refute it.
Lawyers way of looking at
“facts”
Identify Reasonable Case Theories
Trauma/ Culturally-
Informed Case Planning
Question Design/ Evidence Collection
to Explore All Reasonable
Theories
Interpretation of Evidence/ Answers to
Questions
Validate Most Reasonable Theory
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Theory disproved
Theory disproved
New Theory developed
Determine Action/s
MDTConsultation w/
Supervisor, peers, MDT,
experts
Theorydiscarded
OUR MIND PROCESSES…
SATISFICING•Selection of the first identified alternative that appears good enough.
AVAILABILITY
•Ease by which previous examples come to mind. Recent & vivid events easy to recall.
FRAMING• The
presentation of information influences its interpretation. Implies information is understood within a context.
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Minimum Sufficient Level of Information
Experience
Knowledge & Experience
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MDT Case Staffing
Supervisory Consultation
Peer Consultation
“Expert” Consultation
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Truth Evaluation
Denial or Admission
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Decision many of us make frequently as we are confronted with our behaviors or beliefs.
What is it we’re being asked about?What has been our past experience/s?Who is doing the questioning?Can I convince you you’re wrong?How guilty am I feeling?
They’re telling me the truth. I know because…
Its sounds plausible It fits my experience They wouldn’t lie about something like
this Their body language didn’t indicate
deception Their story has been consistent I’ve worked with them before and I
know them
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Secondary Traumatic Stress (STS) and Decision-making
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Sources of Secondary Trauma
in Child Welfare
The death of a child or adult on the worker’s caseload
Investigating a vicious abuse or neglect report
Frequent/chronic exposure to emotional and detailed accounts by children of traumatic events
Photographic images of horrific injury or scenes of a recent serious injury or death
Helping support grieving family members following a child abuse death, including siblings of a deceased child
Concerns about the continued funding and adequacy of resources for their agency
Concerns about being publicly scapegoated for a tragic outcome when they did not have the means or authority to intervene effectively
Source: Osofsky, J. D., Putnam, F. W., & Lederman, C. (2008). How to maintain emotional health when working with trauma. Juvenile and Family Court Journal, 59(4), 91-102
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Fear
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Safety and Trauma
Have problems controllin
g their reactions
to perceived threats
Be hyperaw
are of potential threats
Have difficulty trusting
others to protect them
Have valid fears
about their own safety or
the safety of loved
ones
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Looking at the totality of the information and evidence gathered during the investigation, can you determine:
Was this child abused or neglected?
Who was responsible?
What evidence is there to support our decision?
Substantiation –Validation
Evaluation Of Evidence
Ignorance of Significance Don’t know what is relevant
Don’t collect or document in timely manner Too much stuff, so little relevance
Ignoring Context Misinterpretation of evidence
Verification / Confirmatory Bias “You see what you want to see and hear what you
want to hear.” The Point, 1971 “Jurassic Park” School Of Investigation
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Families who “withdraw” and avoid professional attention, intervention and surveillance.
Dale, 2005
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Multiple Incidents Progression/ Transitional
Behaviors Richness of Details/
Idiosyncratic Details Sexual Knowledge Secrecy Experiential Perspective/
Sensory Details Internal Logic, Consistency,
Feasibility Pressure/ Coercion/
Enticement Family Dynamics/ Outside
Influences
Analyzing the Child’s Statement:
CSA
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•A critical attitude to all evidence is needed•Always check information and remember “facts” can be inaccurate
•Investigators often rely on people’s testimony rather than written records for information•Always check statements against existing records
•When focusing on biological caretaker pay attention to their new relationships •This includes both men & women. How much time are they with the child?
•Avoid “start again syndrome”•When a family is transient and the caseworker approaches the case as new or simply fails to find the prior history
•Past history, written records, abstract theory and research findings tend to be under-used compared with the current, often emotionally charged, factual information gained in interviews
Munro, 1999
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“Good decisions do not guarantee good outcomes.”Munro, 2010
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Children need our Skills, Knowledge, CooperationAnd Caring to help them
grow
Let’s do it right!