2. CHILDRENS SERVICES Beauty & The Beast Of Inter-agency Working Sheena Bolland Dr John Henning Brodersen

3. CHILDRENS SERVICES Todays Programme Introduction Service Development Theory / Culture of multi-agency work The Beast The positives and negatives of multi-agency working Interface with different cultures management perspective supervision The Beauty Best of each culture

4. CHILDRENS SERVICES The C.A.S.T team

5. CHILDRENS SERVICES GPs, Paediatricians, Teachers, School Nurses, Youth Justice Workers, Health Visitors, Social Workers, Voluntary Agencies etc Tier 1 Individual Professionals Trained in Children and Young Peoples Mental Health eg Psychiatrists, Psychologists, Therapists etc Specialist Multi-disciplinary Teams Tier 2 Tier 3 Very specialist services, incl. children away from home Tier 4 The 4-tier model for CAMHS Primary Mental Health Workers etc

6. CHILDRENS SERVICES Objectives Of The Service To establish a multi-agency service working across the Tiers To reduce the waiting times & improve access to CAHMS specialist services To support children at risk of exclusion & reduce school exclusions To ensure families of children using the Tier 2 service has access to appropriate family support workers To reduce the risk for children To continually develop services for families in the Medway area To provide a consultation service for professionals in Medway

7. CHILDRENS SERVICES Service Development Manager SSA Clinical Psychologist P/T Paediatrician Senior Practioner PMHW Chatham Primary Mental Health Worker Gillingham Primary Mental Health Worker Rochester Primary Mental Health Worker Sexual Inappropriate Behaviour Behaviour Support Worker Gillingham & Chatham Behaviour Support Worker Strood & Chatham Connexions PA 13-19 years Medway P/T Counsellor Sessional Family Support Workers Team Structure

8. CHILDRENS SERVICES Clinical Governance PSA 2 CAHMS MAPPING EDUCA TION National Service Framework WKMHT

9. CHILDRENS SERVICES What can theory do to help us create more cohesive multi-agency teams? Helps us reflect on what goes on between team members and between agencies. Help inform us in how to improve working practice, in an evidence based manner with good accountability for decision making.

10. CHILDRENS SERVICES Social Construction of Reality and Culture Knowledge is not universally true but depends on the culture. Traditions and what is viewed as common sense are culturally determined. e.g. nodding yes and no reversed in Bulgaria.

11. CHILDRENS SERVICES Coordinated Management of Meaning (CMM) Pearce & Chronin (1980) Culture Episode Speech Act

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14. Attachment Theory (Bowlby, 1979). Family Scripts (Byng-hall, 1995). Narrative Approaches (White, 1995). Roles (Belbin, 1981). Structural Issues (Minuchin, 1974). Theories used in this presentation

15. CHILDRENS SERVICES The Beasts of inter-agency working

16. CHILDRENS SERVICES Where is your team currently in terms of its development? e.g. Forming, Norming, Storming, Performing (Tuckman, 1973).

17. CHILDRENS SERVICES Permeability Coalitions Capturing Role reversal Dysfunctional discipline Beasts in interagency teams

18. CHILDRENS SERVICES Group processes than inhibit team cohesion Team Splitting and allocation of roles (Belbin, 1981). Conformity seen as a higher priority than evidence based decision making (Harris, 1999). Group think- under stress,or dominant leader, consensus overrides looking at alternative courses of action. Group polarization, more extreme decision making than in isolation.

19. CHILDRENS SERVICES Responsibility held by a manager means they cannot admit ignorance or dispensability resulting in poor decision making (Harris, 1999). Team cohesion has an influential role in the management process (Henning Brodersen, 2004). Colleagues seen as an important source of support versus making decisions very difficult (Henning Brodersen, 2004). Group processes than inhibit team cohesion

20. CHILDRENS SERVICES Ability to access a diversity of perspectives. Reduce the likelihood of clients falling into gaps in service provision. Reduced conformity to professional/ organisational shackles. Ability to form more informed beliefs about the strengths of other organisations. Increased flexibility in matching internal resources to external demands. Beauty of Interagency working

21. CHILDRENS SERVICES Please draw a current map of your organisational, or professional cultures. You can circle any alliances or coalitions. Post exercise reflection How would the map created by other agency members differ? How would you like the map to look in the future? What would be the first step towards this aim? Exercise

22. CHILDRENS SERVICES Building clear structures. Communication. Groups and meetings. Lines of accountability. Feedback loops (Campbell, 2001). Whole Team Training (Henning Brodersen, 2004). What can we do to enhance the beauty of interagency working?

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