Informed Choice from Theory into Practice
Presented on Tuesday 2 March 2010
Working in an Informed Choice Framework
Gwen Carr, Alys Young
Today
- Look at the origins of why IC became:
- a policy issue
- an approach for families
- a challenge for practitioners
- and a headache for researchers! - Work experientially through an informed choice framework together
- Consider in-depth
- a range of underpinning issues
- and their implications for service delivery and practice
- from a range of perspectives
Families and choice
- Enduring experience - choice and decision-making
- Intensified by being in unfamiliar territory
- Imposed set of relevancies
- Complexity of deafness
Emergence of IC agenda
- Quality and nature of information
- Equitable access to range of possibilities
- Questioning of expert model (not expertise per se) - participation and rights
- More pressing issue much earlier
- Better choices for better outcomes?
Aims of the Project
- To undertake research which deepends understanding in the context of deaf children and families
- To produce guidance for prefessionals - theory and practical support
- To produce empowering guidance for parents
Problem - what do we mean by informed choice?
- Definitions resultant from what it is not
- Restricted in scope (only communication)
- Simplistic in focus (information production)
- Treated as a 'belief' or an 'outcome' not a process
- Over-contextualised in the context of deafness
- Are we in danger of creating a 'problem' we did not know we had by virtue of inventing a 'solution'?
Process
- Literature review
- Consultation
- Product development
- Trialling
Evidence from Sites
- 3 areas - Different geography (urban and rural), structures, demographics
- Multi-agency partnership and strategic consultations
- Parent consultations
Focus of data collection
- What was understood by informed choice
- Examples of how experienced, where not experienced
- Barriers and facilitators of informed choice as way of practice (strategic, organisational, front line)
- Consultation on how 'guidance should be provided'
Information, knowledge and understanding
- Key relationship is between understanding and choice
- Risks, benefits, consequences
Availability
- Provision that is possible versus provision actually available
- Avoiding partiality or bias
- If not available, could/should it be?
And if so, how?
Access to availability
- Diverse barriers to access
- Supporting access to choice just as important as offering it
Parents vary in their ability to make informed choices
- Confidence, skills, experience
- Empowering confidence is crucial
Informed choice in Families' terms
- Belief systems
- Cultures
- Social circumstances
Does informed choice mean we offer the same to everyone?
- Not just equality in what is offered
- Routes to informed choice require different approaches
Are all issues open to informed choice?
- Complex considerations and ethical dilemmas
- Rights and responsibilities
- Preference versus need
Individual choices and the effects on others' choices
- In the context of limited resources/skills
- Tension - individual versus wider
- Consequences
Parents as experts
- Not static
- Development and promotion
Informed choice is an active process
- Evolving framework
- Choices reconsidered over time
Equality of resourcing
- Flexible response to resources
- Resource-led versus needs-led provision
- Equal opportunity may require unequal resource allocation
Operational constraints
- The real world - staff, resources, training, skills
- 'Out-of-the-box' thinking, creative partnerships
Resource strategy/philosophy
- Strategic commitment and implications of value
- Leadership and influence
Training
- Oils the weels of informed choice
- Translating theory into practice: a 'menu' approach (Hunt, R & Carr, G)