Expertise in Child Protection
(Originally published March 2019)
Gary Klein is a cognitive psychologist best known for his naturalistic studies of expert decision makers in various professions. In Sources of Power: How People Make Decisions (1998), Klein discusses studies of firefighters, pilots, submarine commanders, nurses and chess masters engaged in high stakes decision making under time constraints. Klein found that experts in these professions (as identified by their peers) did not engage in systematic rational thinking characterized by deliberation regarding the pros and cons of different courses of action either under time pressures or when they had time to consider options. Experts, Klein asserts, “did not seem to be making any decisions at all if a decision results from actively comparing two or more options in a process of comparative evaluation.” Rather, “their experience let them see a situation, even a non-routine one, as an example of a prototype, so they knew the typical course of action right away. Their experience let them identify a reasonable action as the first one they considered, so they did not bother thinking of others. … We now call this strategy recognition primed decision making.”
Klein acknowledges that there are occasions when experts are required to engage in deliberation regarding next steps. He asserts, “Usually, these are times when experience is inadequate and logical thinking is a substitute for recognizing a situation as typical.” Furthermore, “deliberating about options makes lots of sense for novices, who have to think their way through a situation.” Experts can depend on intuition in a way that is often disastrous for novices who lack the experience to safely trust their instincts, Klein maintains.
One of the most controversial features of Klein’s view of expertise is his insistence that experts depend on intuition rather than analytical methods to recognize “key patterns that indicate the dynamics of the situation.” For several years, Klein engaged in an exemplary civil debate with Daniel Kahneman, the author of Thinking Fast and Slow (2010), whose studies demonstrate the vulnerability of intuition to a wide range of heuristic biases, for example, confirmation bias and halo effect. Kahneman is also a strong proponent of actuarial assessment tools for which Klein has a low regard. Surprisingly, after much discussion, Klein and Kahneman were able to agree on the conditions in which intuition can be a source of expertise rather than bias and a premature jumping to conclusions:
An environment that is sufficiently regular to be predictable
An opportunity to learn these regularities through prolonged practice (Thinking Fast and Slow, p. 240)
For example, Kahneman estimates that chess players must play chess for 10,000 hours (several hours per day for 5-6 years) to have any chance of becoming a chess master. Obviously, a great deal of experience in a profession is necessary - but not sufficient - to become an expert.
Differences between Experts and Non-Experts
Large differences in approach and skill level between novices and experts are to be expected, but what about differences between competent practitioners and experts? According to Klein, “This is one way to distinguish true experts from people who pretend to be experts. The pretenders have mastered many procedures and tricks of the trade; their actions are smooth. They show many of the characteristics of expertise. However, if they are pushed outside the standard patterns, they cannot improvise. They lack a sense of the dynamics of the situation. They have trouble explaining how the current state of affairs came about and how it will play out.”
Consider the following case example:
Gerald, age 8, comes to school with bruises on both of his upper arms, a circular bruise on his neck, and a black eye. The child tells the school counselor that his mother’s boyfriend grabbed his arms, punched him and tried to choke him because “he doesn’t like me,” but then denies to the CPS investigator that the boyfriend hit or choked him. The teacher and principal inform the CPS caseworker that Gerald came to school a week ago in girl’s clothing and with lipstick on his face. The boyfriend denies to the CPS caseworker that he hit, grabbed or choked the boy, but admits forcing Gerald to wear one of his sister’s blouses to school and to smearing lipstick on the child’s face as a punishment for “crying like a little girl” when he was sent away from the dinner table for misbehavior.
An inexperienced caseworker should be able to recognize indicators of physical abuse in this case; but may be uncertain what to do next after the child’s denial that the boyfriend inflicted the bruises. An experienced caseworker will hopefully insist that Gerald be physically examined by a physician; though medical exams are often not done when a child lacks a serious injury. The caseworker will interview anyone who lives in the home and extended family members regarding how Gerald is treated by his mother and boyfriend, as well as checking for standard risk factors or safety threats. The caseworker will also review the family’s CPS history and criminal history. The caseworker may inquire with the school regarding the child’s developmental status and academic performance. The caseworker will interview the mother separately from the boyfriend to determine if she has concerns regarding her boyfriend’s disciplinary practices. An experienced caseworker will zero in on the mother’s protective capacities. If the mother and boyfriend are receptive, the caseworker will refer them to an agency funded parenting program, absent additional evidence of child abuse or neglect.
An expert practitioner will do everything the experienced caseworker does; and will want to know more - much more - regarding the events that led to Gerald appearing at school in female clothing. The CPS expert will consider the possibility that Gerald is a rejected or scapegoated child who is being demeaned and humiliated by one or both of his caregivers. The caseworker will re-interview the child regarding other bizarre or unusual punishments he has experienced. The expert will do these things because emotional abuse of a child is an indicator of risk in and of itself, and because rejection, humiliation, scapegoating and other types of emotional abuse compound the harm done by physical abuse and will often have longer lasting effects than physical injuries. If the caseworker discovers any other demeaning or humiliating punishments, including denial of food or water, combined with harsh physical punishment of this child, she/he will consider the possibility that Gerald is being tortured.
An expert CPS practitioner will place more emphasis on the emotional milieu in which child maltreatment occurs than less skilled experienced practitioners; but the differences between competence and expertise in child protection go deeper than the amount of interest in emotional maltreatment. In the past few decades, CPS caseworkers have been trained to identify and target risk factors and safety threats abstracted from the family relationships in which they occur. As a result, competent practitioners can usually concretely and accurately identify risk factors and safety threats on assessment tools and in court documents. They do not receive the same training in understanding the relationships among family members in which these threats and risk factors occur, and often have little or no understanding of the dynamics in families that lead to serious or chronic child maltreatment.
Experts view patterns of child maltreatment as embedded in family relationships; and will be able to recognize family dynamics that lead to child maltreatment. For example, a CPS expert will not conflate standard cases of excessive punishment of a child with abuse of a scapegoated child, or with torture or with a misguided attempt at education. “Abused child” means next to nothing; excessive discipline, scapegoating, torture, misguided attempts at education are types of abuse with different dynamics. Experts will immediately recognize these differences; competent practitioners may not, given the deficiencies of current assessment tools, practice models and training programs.
Recognition and Knowledge
As a rule, experts are more knowledgeable than non-experts, but contrary to what some readers may think, conceptual knowledge and expertise are different. The main indicator of practice expertise is quick pattern recognition combined with a skilled response to a wide array of situations and events. It is possible to be extremely knowledgeable regarding child maltreatment and lack practice expertise. It is arguably true that experts are more likely to study their profession (for example by reading research articles) than less expert practitioners, but knowledge must be converted into skilled responses to standard situations and events to qualify as expertise.
An expert should be able to recognize common phenomena in child welfare practice such as relapse, ambivalence regarding reunification, self- sabotage, the combination of denial and lying from behavioral indicators, chronic neglect and chronic maltreatment and be ready with a skilled response. Experts will also realize that curiosity is much more effective than moralistic judgment in carrying out assessments and connecting families to services.
Practice skills must be constantly sharpened through use. Any child welfare manager or retired person who was once an outstanding CPS caseworker; but has not done casework or supervised line work for years is likely to have lost their edge. Expertise in child protection, like many other skill sets, must be exercised to remain at a high level, i.e., “use it or lose it.”
Thinking about Thinking
Gary Klein asserts that experts’ exceptional abilities to recognize patterns and improvise responses as needed are accompanied by the capacity to critique themselves; he maintains that “experts can think about their own thinking to change their strategies.” I am not as sanguine as Klein regarding the willingness of experts to critique themselves and admit error, especially when expertise has led to social recognition and other rewards over a long period of time. Experts, like all decision makers, are vulnerable to error; expertise is not a bullet proof shield against grievous mistakes. Experts who are overconfident or arrogant invite comeuppance which is usually not long in arriving.
A main source of error for decision makers of all skill levels is confirmation bias, i.e., looking for evidence that confirms one’s views and ignoring or minimizing information that conflicts with one’s opinions. Harry Bosch, Michael Connelly’s famous fictional homicide detective, describes confirmation bias as being “in the tunnel.” The person whose mind is made up has a strong tendency to see what he/she wants to see and disregard the rest. No one, regardless of IQ or degree of self-awareness, can overcome confirmation bias on their own. Experts, like practitioners with less developed skills, must work in a social environment that allows their views to be challenged, and which requires a rational response to criticism, regardless of one’s organizational position. Critical thinking is not like playing solitaire; quite the opposite.
Both competent practitioners and experts will be able to quickly assess the amount and types of information required to make important decisions, whereas novices are vulnerable to a main characteristic of Daniel Kahneman’s System 1, i.e., automatic thinking, “What You See Is All There Is (WYSATI).” According to Kahneman, System 1 automatic thinking “is radically indifferent to the quantity and quality of information.” Jumping to conclusions without adequate information is more likely to occur in child welfare when caseworkers have not had enough experience to assess the adequacy of evidence. Furthermore, postponing judgment when intuition has delivered a quick answer is uncomfortable. Novices must learn to tolerate uncertainty until they know enough to act.
Can Good Judgment Be Taught?
There are occasions when every decision maker, regardless of expertise, must face the limits of their knowledge and skills, and carefully deliberate regarding next steps. Decisive: How to Make Better Choices in Life and Work (2013), by Chip Heath and Dan Heath, contains excellent advice regarding how to improve decision making skills. Their advice is contained in an acronym, WRAP:
W - Widen your options; avoid either-or choices when making crucial decisions, e.g., place a child or don’t place.
R – Reality test your assumptions; seek to overcome confirmation bias; listen to other points of view; seek direct experience rather than depending on written material or verbal descriptions.
A – Attain Distance before Deciding, especially distance from the influence of short-term emotion such as strong likes or dislikes of the parties involved in the decision or whose lives the decision effects.
P – Prepare to be wrong; ask experts for base rates of common events such as CPS re-report or re-entry into care, but discount experts’ predictions of the future; set a “trip wire” for recognizing when a course of action is not working. Don’t dig in and “double down” on bad decisions.
How to Identify Expertise
Gary Klein believes that the key indicator of expertise is the ability to improvise effectively when scripts and normal procedures aren’t working.
The capacity of experts to improvise as needed is impressive, but there is another criterion I use: experts at the top of their game make difficult tasks look easy. Extraordinary expertise looks and feels effortless, so much so that some lesser level of skill in the activity may be required to fully appreciate the expert’s achievement and to understand how much hard work and dedication was required to develop the skills in question. It is a thrilling experience to perform at a high level of skill in a profession. Child protection and child welfare are no different in this regard than other professions. These jobs can be performed in extraordinarily skillful ways, but not without years of hard work, dedication and study. The payoff for exceptional expertise in child welfare is worth the effort.
Bowdry, C., Towards a Treatment- Relevant Typology of Child Abuse Families (1990). Child Welfare, vol. 69, #4, pp. 333-40.