How collective interactions and institutional logics influence permanency planning in child protection in Quebec

Abstract

Background

In the Canadian province of Quebec, placing children in foster care is an exceptional measure whose ultimate goal is family reunification. When child-protection workers decide that reunification is unlikely, they must design permanency plans that ensure continuity of care and stable relationships for the child. Most studies of this important decision-making process have focused on individual practitioners as if they acted alone. This process is collective, interactive, and influenced by various contextual elements.

Objective

The objective of this exploratory study was to examine the collective, interactive aspects of the decision-making process involved in permanency planning.

Participants and setting

The participants were key players involved in child-protection decisions at an Integrated University Health and Social Services Centre (CIUSSS).

Methods

The theoretical approach of this study combines Giddens's structuration theory with ethnomethodology. Data were collected through interviews with 16 key players and nine months of observing advisory-committee meetings.

Results

In making permanent placement decisions, the participants must engage in extensive interactions with one another. They must also apply various institutional (clinical, legal, and managerial) logics with differing goals and differing operational frameworks, the tensions among which make the process more complex and challenging.

Conclusions

Our findings highlight the complexity of making permanent placement decisions and the importance of interaction and collaboration in this process. These findings suggest that management of this process should focus not on holding practitioners accountable and penalizing them for mistakes, but rather on providing adequate conditions for practice to facilitate thoughtful collective deliberation and learning and ethical decision-making.

Introduction

In determining when to place children in foster care and when to keep them with their families, child-protection workers must make many difficult decisions that will permanently affect the future of the children and their families alike. According to the literature, clinically speaking, one of the most critical decisions is whether to remove children from their family settings and place them elsewhere (Pösö & Laakso, 2014). The placement process involves at least two different kinds of decisions. The first kind occurs when children are removed from their family settings to protect them from present or imminent dangers. (In Quebec such placements are initially time-limited, with family reunification as the preferred outcome.) The second kind of decision involves determining whether to return placed children to their families or to develop plans to place them permanently in alternative living environments.

Previous studies have mostly focused on the first decision, emergency decision-making process, by which children are removed from their family where they face imminent risks. Such emergency decisions must be made very quickly, with very little information, in situations where children are in danger (Stokes & Schmidt, 2012)⁠. Some other studies, such as Chateauneuf et al. (2020), have focused on the decision-making process surrounding the choice of foster settings after a placement. In contrast, very few studies have examined the second decision-making process (Johnson, 2001; Mackieson et al., 2019; Montambault & Roy-Demers, 2006; Smith & Wells-Wilbon, 2011)—permanency planning, which consists in determining whether children will be returned to their families and what alternative living environments they will be placed in permanently otherwise—even though this process is a universal part of child-protection practice. Moreover, knowledge about the factors that influence decisions in this specific situation is hard to come by, because the definition of permanency varies from one context to another. The permanency options most often discussed are reunification, adoption, and tutorship (Hélie et al., 2017), with the first two receiving the most attention from researchers (Esposito et al., 2014; Goemans et al., 2016).

In Quebec, a permanency plan is a long-term measure designed to ensure children's stability and continuity of care (MSSS, 2016). The process by which a plan is developed to place a child in an alternative living environment permanently has several distinctive features. First, unlike the emergency decision-making process, the permanent placement process involves predicting positive and negative consequences that will have a lasting impact on children and their families over the longer term. Second, permanent placement decisions are made after children have been removed from their homes and so do not face any imminent risks to their safety and development. By then, the professionals concerned have usually learned more about a given dangerous situation and the changes to be made by the family, their difficulties, needs, and motivation. The alternative permanent placement decision usually comes after a period in which the child-protection workers have delivered a wide range of services and therefore have a basis on which to judge the feasibility of reunification. Compared with the emergency decision-making process, this process thus involves subtler reasoning and more negotiations among the various actors involved. However, the literature seems to be more interested in the individual who makes the decisions and much less interested in the dynamic interactions among the various actors and the collective, negotiated nature of the decision-making process (Pösö & Laakso, 2014).

The goal of this exploratory study was to understand the complexity of the decision-making process by which plans are made to place children ages 0 to 5 in alternative permanent living environments rather than reunify them with their parents. The first reason why we were particularly interested in this age range is that it constitutes one of the most critical stages of child development (Lloyd & Barth, 2011). The second reason was that in Quebec, children who are in this age range at the initial placement are less likely to return to live with their natural families than older children are (Esposito et al., 2014). The third reason was that a wider choice of permanent placement options is available for children in this age group (For example, adoption is rarely used as a permanent option for older children in Quebec (Drapeau et al., 2015).

The current article attempts to understand the interactive and collective nature of the decision-making process in permanency planning, and how the actors involved in this process must deal with various underlying elements, specifically three institutional logics (clinical, legal, and managerial) with differing goals and differing operational frameworks.