Effect of Exposure to Client-Aggression on Professional Decision-Making in Child Protection System

Background: Client violence towards social workers has been a growing concern both for service-providers and researchers over the past years. Although research efforts have been made to understand the causes of such aggression and its effects on the workers, little has been made to examine the effects of such exposure on professional decision-making processes. One of the most important junctions of the child-protection system in Israel are the Planning, Intervention and Evaluation Committees (PIECs), interdisciplinary committees that makes crucial, life-changing decisions regarding children at risk. Indeed, extant research has indicated that Child Protection Officers are at high risk of being victimized by clients. 

Using a factorial experimental design, this study examined whether the worker's past exposure to violence by the client is related to current decision-making regarding children-at-risk.

Methods: The sample consisted of 290 participants in 50 PIECs in the Israeli child-protection system. The committees were sampled in order to maximize variance. We used an experimental-design within a cross-sectional survey-framework in three phases: (1) scheduling a committee; (2) surveying all the invitees using an on-line personal questionnaire; and (3) observing the committee discussions using an observation tool and a committee-level questionnaire. Both questionnaires used the same series of vignettes, describing a child at risk and his/her family, based on real life cases. The vignettes were randomly manipulated according to three factors: 1) child gender (boy/girl); 2) religiosity of the family (ultra-orthodox/secular); and 3) the level of detailed case information (full-information/missing-information re child, missing-information re family). Responses, both on the personal and on the committee levels included decisions regarding: 1) Assessed level of risk to the child; 2) placement recommendation; and 3) recommendation to involve a child-protection-officer (CPO). Personal level survey included  background variables and the Client-Violence-Questionnaire (CVQ). We controlled for socio-demographic variables in both personal and committee questionnaires. Regression analyses were carried at the case level, controlling statistically within worker and committee clustering, using robust standard errors within a generalized-estimating-equations (GEE) model.

Results: Most participants (89%) experienced some kind of client's violence during their professional life, and 76% over the last three months. Comparatively, social workers experienced more violence then the other professionals. Exposure to client violence has an effect on both personal-level and committee decisions. For instance, exposure to verbal violence decreased the probability of high-risk assessment in personal-level decisions, but increased the probability for a recommendation for a CPO's involvement. Property violence decreased probability of any decision on: 1.child-risk-assessment; 2.recommendation for out-of-home-placement; and 3.recommendation for CPO's involvement. Threats increased the probability of a recommendation by the committee for out-of-home placement.

Implications: The results indicates a high prevalence of exposure to client's violence of professionals who are involved in decision making for children at risk. The results also suggest that  exposure to client violence has an effect on both personal and team  professional judgment. These vexing outcomes will be discussed within the framework of reasoned versus heuristic decision-making processes, on the one hand, and exposure to client violence, on the other.