Practitioner's Guide - Professional Curiosity

Introduction

This Practitioner's Guide has been produced by Perth and Kinross Child Protection Committee (CPC) in partnership with practitioners from NHS Tayside and Children and Families Social Work.

This guide aims to provide all practitioners working directly or indirectly with children, young people and their families in Perth and Kinross, with clear practice guidance on how to be professionally curious and use this approach in the course of their work.

We have also created a video version of the guide (see below) and a 7 Minute Briefing (Word doc, 510 KB) summarising the key points practitioners need to be aware of to help them be professionally curious.

Context

All unborn babies, babies, children and young people have the right to be cared for and to grow up in a safe environment, in which their rights are respected, and their needs are met.  Sadly, some children and young people are subjected to abuse, neglect and/or exploitation during their childhoods by parents or caregivers which can cause them emotional, psychological and/or physical harm, including death. For this reason, it is important that all practitioners working with children, young people and families understand the need for them to be professionally curious. This is reinforced by successive Learning Reviews which have found that an absence of curiosity from professionals may have contributed to a failure to adequately protect children and young people from harm.

What do we mean by professional curiosity?

Professional curiosity is best described as an approach or a mindset which involves actively seeking to understand what is going on in a given situation, through keeping an open mind and asking questions to ensure that a full picture is being obtained.  It has been described as simply 'healthy scepticism' or more informally, as 'professional nosiness'. It is closely linked to the concept of 'respectful uncertainty', a term used by Lord Laming in 2003 in the inquiry report into the death of Victoria Climbie. Lord Laming characterised 'respectful uncertainty' as bringing a pair of 'fresh eyes' to consider the case.  Lord Laming emphasised the importance of professionals playing their own devil's advocate to really test their assessments of children's situations.

Whilst professional curiosity has long been a working concept in children's services, it equally applies to adult services and those working with vulnerable adults and / or adults at risk of harm. 

What does professional curiosity look like in practice?

Professional curiosity is a combination of

• looking
• listening
• asking direct questions
• checking out, and
• reflecting on information received. 

A key part of professional curiosity is making sure that we look to verify or triangulate information that we are given or receive about what might be happening in a child or young person's life. It means not taking things at face value and seeking to always look beyond the obvious. There are many reasons that people may seek to hide the truth, including fear and shame, and so it is important that when people tell us things that do not seem to match with the other pieces of information we hold, that we ask questions to deepen our understanding of the situation.

Being curious and open minded about what has happened or may have happened, helps us to enquire further about what is going on. Most of the time, workers are not present when things occur within families and we can therefore ask about them from a position of genuinely not knowing what has happened, stressing that we want to understand.

Being professionally curious means:

• Asking open, honest and respectful questions
• Listening closely to what is being said and, just as importantly, noticing what may not be being said.
• Using observation skills - for example, what do we notice in the presentation of the person? Does the person's verbal and body language match? What does the physical environment tell us about what has occurred?
• Taking time to think things through and asking ourselves what other explanations there might be for what has happened.
• Using informal and formal supervision and discussion with peers to check out situations and our thoughts around them. Bringing another worker for a visit, to have an extra pair of eyes on a situation, can be very helpful.
• Thinking the 'unthinkable' - sadly, Significant Case and Learning Reviews have illustrated the lengths to which abusive adults will go to hide their behaviour towards children in their care. This is why we must always be prepared to consider the worst possibility in child protection situations.

What gets in the way of professional curiosity?

Practitioners work within complex and dynamic environments, within schools, hospital, clinics and people's own homes.  These are environments in which our attention is drawn in many directions at the same time and this can be barrier to truly seeing what may be happening.

Here are a number of other factors which can prevent us from being able to be professionally curious:

Fear

When practitioners encounter overt hostility or intimidation from a parent, carer or family member, their fear may prevent them from asking further questions or challenging appropriately. In these situations, practitioners must seek support from their line manager to ensure that the questions that need to be asked, can be asked. We must always ask ourselves how the child or young person in the home must feel if we, as adults, feel scared or intimidated.  

Another strategy which can make practitioners feel scared or frozen is when a parent, carer or family member threatens to complain about them or repeatedly questions and undermines their confidence as a professional. This may be particularly the case for early career practitioners and support should be sought from supervisors to address this.

Feeling reassured or overly optimistic

When parents or carers are sympathetic individuals, practitioners can feel reassured by their words or by what seems to be a lack of ill intention in their actions. Practitioners can find it more difficult to challenge people who seem nice and accommodating rather than those who do not.

This can be described as disguised non-compliance in which practitioners are kept at bay through the person agreeing with them and promising they will do what is asked of them but rarely doing so. People in the helping professions can tend towards the 'rule of optimism' in which they are over-optimistic about outcomes for children, young people and families, sometimes in the face of mounting evidence to the contrary.

This is where trying to be open-minded is important - it may be that the explanation given is true, but what if it is not?

Getting diverted or distracted

Family homes or office visits with children can be loud and busy with practitioners' attention drawn in many directions. This can make it hard to focus on the purpose of the interaction and ensuring that it is achieved. Sometimes parents or carers may use this to avoid discussion about the issues of concern.  Some parents or carers can appear to be in a near constant state of crisis with an immediate issue that needs attention which can divert practitioners from the purpose of the planned visit.  It is important first and foremost to recognise that these patterns of behaviour are occurring, name them and consider how to best address these behaviours.

Avoidance

Families who do not engage with meetings or allow home visits present particular problems in terms of professional curiosity as avoidance can be very effective in preventing assessment. Persistent avoidance from a family when there are significant concerns for a child or young person must be escalated and opportunities made for multi-agency information sharing and planning.

As practitioners, it is important to recognise that we can also be avoidant because our days can be very busy and taking time to ask additional questions can be difficult to fit in.  Practitioners are people with our own lives and circumstances which can sometimes affect our emotional ability to engage. Staying alert to this possibility and seeking support where and when we need it to manage these kinds of feelings is essential.

'Start Again' syndrome

This is where practitioners can tend to respond to each incident, or event, or new risk discretely and in isolation, rather than assessing the new information holistically within the context of the history of the child or young person. This is where chronologies are valuable tools alongside supervision and reflection on the situation in its entirety to help avoid this happening.   Learning Reviews have regularly emphasised the importance of chronologies in child protection work.

Normalisation/Becoming inured

As practitioners, we may regularly see things that are outwith the normal range for most people, such as homes in very poor conditions and/or children being subjected to severe neglect. This may cause us to become inured to what we have been exposed to and start to see these things as being within the 'normal' range. Unfortunately, practitioners can then cease to recognise the impact on the child or young person or the risks that chronic neglect, for example, can have on every area of a child or young person's physical and mental health and their development.  It is important then, that, as practitioners, we take stock of how our tolerance may have become maladaptive through checking things out with peers, asking a colleague from another agency to accompany us on a visit and pushing ourselves to consider the situation with fresh eyes.

Confirmation bias

This is when we unconsciously look for evidence that supports or confirms our pre-held views.  We do this by unconsciously filtering out pieces of information that do not support our view and emphasising the importance of those that do.  Actively keeping an open mind, using supervision and supports to think through whether we may be falling into this trap, can be helpful to counter it.

'Knowing but not Knowing'

This is about having a sense that something is not right but not knowing exactly what, so it is difficult to grasp the problem and take action. This is underpinned by intuition and gut feeling. Supervision and reflection can be useful in these scenarios to discuss where these feelings are coming from and begin to look at what further information is needed. Feeling comfortable to explore these uncertain feelings is conducive to helping us understand what is causing these feelings and whether they can be substantiated.

Managing Uncertainty

As practitioners, we may face accounts of situations which are contradictory, disclosures which may be vague, or which may be clear but are later retracted and be left with concerns which are impossible to substantiate.  It is important in these scenarios that we recognise the uncertainty about what has happened rather than give in to the temptation to discount concerns which cannot be fully proven. This can be as simple as acknowledging the concerns about the incident and that it is not possible to conclude either way what has happened.

Being aware of the issues that may affect our ability to be professionally curious is the first step to using this approach in our work.  Always try to ask yourself if anything is getting in the way of you genuinely understanding what is going on within a child, adult or family's situation. Seek support from your manager and peers to think through and test out your thoughts and assessment of a situation.

Courageous Conversations

Professionals have to discuss challenging topics with children, young people and their families but this doesn't mean that it is easy.  It is quite normal to feel anxious or worried when we need to tell someone something difficult or challenge them about something that has happened.  Courageous conversations are a way of addressing disputes, raising concerns, challenging behaviours and/or giving information that may not be well-received.

The following are some tips on how to have courageous conversations with children, young people and their families:

Plan in advance

• Ensure there is time to cover the essential elements of the conversation

Communicate respectfully and clearly

• Keep the agenda focused on the topics that need to be discussed, use plain language and, at all times, be as clear as possible.

Be prepared

• Have evidence to back up what you are saying and ensure your decision-making is justifiable and transparent
• Apply professional judgement and adopt a common-sense approach.
• Be prepared with alternative suggestions to open up a solution-focused conversation
• Acknowledge difference in opinion and offer support such as independent advocacy or complaint procedures if appropriate.

Interpersonal skills

• Have courage and focus on the needs of the child, young person or family member
• Remain non-confrontational and allow people to have their say.
• Acknowledge feelings as they arise. Show empathy and compassion.
• Consider your body language, tone of voice and content of speech. 

Closing the conversation

• Summarise the discussion and show that you have heard and listened to what the person has told you, whether you agree with their view or not. Check that you have understood correctly.
• End the conversation by being clear about the next steps and what each of you is expected to do.

Reflective Practice, Supervision and Support

It is widely known that times leading up to a courageous conversation and after, can cause professionals some anxiety, feelings of stress and feelings of uncertainty. You may benefit from planning for a courageous conversation with a colleague and also from planning a debrief afterwards if you anticipate it being particularly difficult.

Professionals need to ensure that they share their concerns with colleagues and line managers. Creating space and allowing time for reflection, can enhance personal and professional development, help to process challenging experiences and learn from them, and can have a positive impact on your emotional health and wellbeing.

Practitioners in social work services benefit from regular supervision on a 4-weekly basis with their line manager. This is important protected time which should be prioritised and planned for by both parties.  Other agencies do not have supervision in the same way but have regular one to one meetings, or the capacity to seek expert advice through a dedicated team, such as the Specialist Child Protection Nurse Advisors within NHS Tayside.  Making use of the opportunities available to you to think through what is happening and checking out your judgments and assessments is vital to undertaking child protection work effectively.