The Road to Relational (Part 1)

To talk about relational care sounds a bit odd.  After all, what is care if not relational? As it turns out, in some contexts – out of home care and child protection for example – the experience can be anything but relational pretty much for everyone involved but especially for those about whom these systems should care most..

But it doesn’t have to be like that.

That’s the starting point for these brief reflections spurred by two recent discussions convened by the Centre for Relational Care.

One was convened by the Centre to develop its own thinking and planning. The other was a roundtable co-convened by the Centre and the Association of Childrens’ Welfare Agencies (ACWA) and including contributions from the former Governor General David Hurley and the NSW Minister for Families and Communities Kate Washington.

That discussion zeroed in on practical things people and organisations could start doing without (waiting for anyone’s permission) to remove barriers, improve confidence and infuse new ways of working with a relational approach to care. Call them NPR moves – No Permission Required

Both conversations brought together those with lived experience of child protection and out-of-home care systems and. thinkers, leaders and practitioners from the NGO sector, from government and universities.  The point of both sessions was the same – to make the practice, culture and character of relational care intrinsic to the way these services are designed and experienced.

Beneath all of the discussion and sharing of experience, often distressing and emotionally charged, four things struck me.  These fours things need to be dealt with on the “road to relational”, the frustrating, messy but ultimately inevitable journey to put the human back into human services.

[And a quick word at the start: there’s no doubt that few people working in these complex systems at the moment strive to be any less than fully human. No-one (I hope) gets up in the morning and determines that a good day will be a day to deliberately dial down human. But sometimes that seems unavoidable, inevitable in fact.  But it doesn’t have to be. It’s a case often, as Peter Drucker once noted, of good people trapped in bad systems.  What we need to think about are the conditions that hold current systems in place and then work steadily, together, to change those conditions.]

So what are these four things?

Risk

How we define and calibrate risk is too narrow and limited.  How we understand what risk is and how it plays out in many human services contexts has to be recalibrated. That’s true for many of our public services but that’s a bigger discussion for another time.

Safety                         

Closely related to risk, our understanding of safety and how it is provided and experienced needs to change.  Some of the current safety “settings” are not  well-tuned for the contexts in which they play out.  In areas like out of home care and child protection especially, the mantra is all about keeping kids safe. Too often that is palpably not happening.

Accountability       

As they are in other public policy and service domains, many of the available accountability mechanisms and practices tend to fall into a common trap, best defined in the mantra “hitting the target but missing the point.”  It’s not that accountability isn’t happening at all.  It is.  But too often the accountability game is checking off requirements and process which miss the things – love, trust, confidence – we should be learning about and improving.

Time

And finally, the road to relational in human services is hijacked (can you hijack a road?) by different conceptions of time. Time-bound transactional services – which is what most public services are – responding to the cadence of politics and public administration find it hard to accommodate relational services, almost definitionally time-unbound, that take their cue primarily from the life rhythms and needs of service users and “clients” – or more plainly in this context, of the children and young people and their families.

Let’s have a look at each of them.

We need to talk about risk

It’s often the case in public policy that risk is defined from the perspective of the system and the people and institutions who lead and control it rather than in terms of the people whom those systems ostensibly serve.

So when issues of risk are discussed, it’s usually defined as a function of the interests and anxieties of system owners and controllers, largely politicians and bureaucrats, but NGOs and their teams too.

The risk discussions seem often to obsess on lowering risks for them – no nasty surprises, reducing the threat of losing power and control, minimising crises or mistakes for which they will be publicly berated.  That’s probably not so unreasonable or irrational.  It’s just that it’s terribly unhelpful and, at its worse, deeply corrupting of the underlying ethic of care on which the entire enterprise rests.

So the risk discussion gets to be about avoiding the front page story in the newspapers or more likely these days the risk of a social media-driven storm of criticism and anger.

There are three ways we need to re-calibrate the discussion about risk in the human services space, especially in areas like child protection and out of home care.

The first is that the dimension of risk for young people and families at the heart of these systems has to be given more weight.  In fact, the predominant perspective for any discussion should be about how to minimise their risks.

And what are those risks?  Risk of being trapped in recursive and reinforcing loops of low trust, harmful interventions and relative lack of power that hold people in conditions that betray any sense of hope and agency.

And, as well and perhaps even more importantly, what about the risks of “relational deprivation”?

What’s the cost and harm of the persistent, structural absence of relationships that mean something to the children (and it would be just as pertinent a question in aged care, disability services, early childhood education and care for example)?)

If the developmental evidence explains the central importance for children and young people of meaningful connection and persistent, safe relationships with adults, one of the risk factors that should loom large is what happens if systems and practices deny those connections?  Isn’t the risk of young people being denied those relationships the single biggest risk of poorly performing “protection” systems?  And if it was being properly weighed, wouldn’t it be even more prominent as a spur to the shift from a child protection to a child connection system?

The second way risk needs to be recalibrated is as one of the factors that define how the role and performance of system owners, leaders and funders – primarily Ministers and their senior bureaucrats, but NGOs and philanthropists too – are expected to behave and be held accountable.

At least as a balance (antidote?) to the storm of transactional and procedural risks to which we hold them to account, shouldn’t the risk of relational deprivation, for example, loom much larger on their risk register?  And when those in the system and the broader community want to know how they’ve performed, isn’t it a reasonable expectation that these more human definitions of risk rate much more consequentially than they seem to at the moment?

The third dimension of risk that needs to be recalibrated speaks to the serious misalignment between rising expectations for system owners and leaders to adopt a more agile and experimental approach to innovation (to “test, learn and grow”).

That’s hard to do if, at the same time, there is an expectation you will avoid doing anything that might fail or not work perfectly first time and which might expose Ministers and others to the risk of public criticism.

The psychologists call it cognitive dissonance, the painful process of trying to square the circle between two imperatives that are mutually exclusive.  Be innovative, try new things, work with people to push the boundaries in search of new and better ways to do the work but don’t make any mistakes and be sure to define the end point before you start.

As we keep discovering, those two things don’t sit well together. And the effort to hold that impossible equation together is itself a significant risk to people and to the system’s integrity and chances of positive, lasting impact.

A working principle that might emerge here could be along the lines of:

The primary focus has to be reducing risks for the young people involved including the risk of the sustained and structural absence in their lives of meaningful connections to, and relationships with other adults who are reliably and consistently in their lives over time.

Safe from what, safety for whom?

A child protection system claims it wants to keep children (and families) safe but often leaves those children and families feeling anything but safe.

Is it possible that decisions are being taken and modes of working and intervening are being sanctioned to keep the system safe?  Safe from criticism, safe from unexpected incidents that will draw public anger, safe from any loss of control?

It’s probably true in many other service contexts.  Think of the effort that goes into keeping children safe at school or, more pertinently at the moment, in early childhood education and care centres.  Or the enormous efforts that hospitals invest make to improve patient safety.

It’s churlish to suggest that’s all about the hospitals or the safety of the system. Of course somewhere in the mix will be a genuine concern for the safety of patients. Presumably in the best of all possible worlds, what’s good for genuine patient safety and what’s required to keep hospitals safe (to take that example) are if not exactly the same then highly aligned.  In our context, the argument I heard many times is that making children, young people and families the centre of the safety discussion will make the system safer too.

Anyway, the point here is that the idea of safety as a cardinal virtue of human service systems, especially in complex and vulnerable domains like child protection, needs to be more closely interrogated and tested.

A working principle here might be something like:

The central concern should be the true safety of the children or young people involved, which means their psychological, physical and emotional safety; that has to be the yardstick against which interventions, decisions and actions/behaviour by all other players needs to be measured.

END PART 1 [the final section of this short piece will be published in Part 2]