Tag Archives: book review

Book review – “Challenging the Politics of Early Intervention: Who’s ‘Saving’ Children and Why”, by Val Gillies, Rosalind Edwards and Nicola Horsley.

I received a copy of this book from the publisher (Policy Press) in return for a fair and considered review. I approach this book from the perspective of a current practitioner (in health services), but with an academic/research background.

This is an excellent review of the underlying politics and interests underlying the prevailing social investment model of early intervention for children in the UK, and it is particularly excellent and thorough in dismantling the ‘Emperor’s New Clothes’ fetishisation of poorly interpreted neuroscience which forms the basis of much policy and current practice in early intervention. The historical roots of this approach provided fascinating background to what has become a largely cross-party consensus (though for differing reasons, depending on one’s political hue) that individual work with children and their primary caregiver (primarily the mother) is prioritised over the improvement of the social and material conditions in which children and their families live. The outlining of the various interest groups involved (political, business, philanthrocapitalist, and certain practitioner groups), as well as their problematic co-opting of poorly- (or over-) interpreted brain science, laid bare the underlying (not always entirely philanthropic) motivations for the development of this consensus, and paved the way for a blistering – and very timely – exposure of the overal social investment consensus as effacing gender, race and class factors impacting on children’s development. Further insights from practitioners highlighted indeed how, as the authors state on p.119, “Practitioners work in contexts where there is little internal questioning about the general endeavour of early intervention”, but instead accept the over-simplistic and poorly interpreted brain studies as a foundational evidence base and theoretical justification for their practice – a situation which arguably also applies to the policy makers and managers charged with developing and implementing these practices.

Whilst the book is specific to the UK context, in fact it is primarily England-focused, with just a couple of mentions of other policy initiatives (primarily the Named Person, currently contested and undergoing revision in the light of significant opposition and legal challenge) in Scotland. I would have liked to have seen a little more from parts of the UK other than England, whilst recognising that the underlying points and background apply to early intervention policy across the UK nations. Another concern echoes a previous Amazon reviewer*, which is that whilst this is an excellently argued and thorough academic critique of the current situation in policy, and in fact it does indeed end with a call for a collective rather than individualised response to social harm, moving away from an all-encompassing prioritisation of “risk” (a call with which I entirely agree), nevertheless as a practitioner I found I was looking for some practical suggestions of what to do in cases where individual responses and involvement with individual families is entirely justified, and required quickly. There may well be scope for further work in this area, if the authors are able to link with practitioners, academics, policy makers and service managers who share their concerns and misgivings. I would also have liked to have seen more input from professional bodies, as the bulk of those participating in the case study and interview part of the book were from the voluntary or non-statutory sector (it was unclear whether the FNP nurses interviewed were working within or outwith the NHS, although earlier the book had identified the decoupling of the FNP service from other statutory services in England). Perspectives from groups such as the Institute of Health Visiting, or other social work bodies, for example, would have been interesting and may have added a further layer of nuance to the authors’ arguments.

Overall though this has provided me with an immense amount upon which to reflect as a practitioner, and I recommend it wholeheartedly. It would be ideal not only for students of social policy and health/social work management, but also would offer valuable insights to practitioner training courses (social work, teaching, health visiting, etc).

Thank you very much to Policy Press for this opportunity!

* Simon Haworth on 29 September 2017 included in his amazon review the following, with which I absolutely agree: “One potential criticism is that, perceptive and value-based as the book is, it does at times seem to move too far way from the dilemma-laden nature of frontline practice, where difficult and emotive decisions do need to be made to protect children, even when it is evident that the system has failed the family.”

Book Review: “Using Research in Practice”

Some time ago I was fortunate enough to benefit from the largesse of the British Journal of Nursing in a twitter giveaway (you can follow the BJN on twitter @BJNursing). The book I received was “Using Research in Practice: It Sounds Good, But Will It Work?” by Jaqui Hewitt-Taylor. I loved the premise of the book – it is aimed not at researchers per se, but at practitioners who need to appraise research in order to think about its relevance and application to their clinical practice. This is, I think, a very useful aim: I remember as a student nurse doing my research module, and struggling to find sources which explained in simple language what research was actually all about. Later, after I qualified, I picked up a bit more about appraising the suitability (or otherwise) of research claims, particularly thanks to a group of district nurses I worked with who (I later discovered, from a friend who managed medical reps) had a bit of a reputation for grilling medical reps and giving them a hard time when they visited and plied us with sandwiches and free samples and tried to get us to buy their wound dressings. However, I must admit before starting my PhD to being really quite vague about the ‘nuts and bolts’ of clinical research, and it is here that I think this book has much to offer.

The book is in three sections, “What is research, and why should it be used?” which outlines the benefits of research and the basic definitions, paradigms, ethical issues and methods/methodologies, followed by part 2, “Is the research any good?” This largest section discusses finding and appraising research generally, before more specific chapters on different types of research (quantitative, qualitative, mixed methods, and summaries of evidence). The final section looks at “Putting research into practice”, including making decisions about incorporating research findings into practice, and the practicalities of managing change.

The substantive chapters on appraising research were all easy to read, and set out in a way which I found very helpful for the non-researching practitioner. Each chapter starts with a brief scenario, which outlines a practice-based dilemma requiring some appraisal of research evidence. The bulk of the chapter then outlines the principles of the particular type of research under discussion, and includes consideration of methods, methodology, sampling and analysis. Crucially this includes discussion of the relevance of the particular type of research to the research question in the scenario, and this is in my view a particular strength of the book, which I think is accessible and easy to follow. The chapters end with worked examples, with another scenario and discussions of two papers which may or may not be relevant and appropriate to the requirements of the practice dilemma. As a student and relatively newly-qualified nurse I am certain that I would have really appreciated a source like this to help me make sense of all the clinical research that we were expected to understand and assimilate with minimal research training.

My area of interest/expertise is in qualitative research, so that is the section I turned to first, and I was pleased to find no howlers but material with which I was in general agreement, which boosted my confidence in the credibility and authority of the author. After this I turned to the chapter on quantitative research (where I am on much shakier ground!) and there I found simple and easy to understand explanations which I greatly appreciated (although I do wonder if I found them thus because I have read more research over the years and have a greater understanding of general principles of research so was not approaching it from a zero-knowledge base). I am sure though that as a qualitative researcher currently working in an area where there is a lot of quantitative research of which I need at least a basic working grasp, I will be returning to this chapter more than once!

There were a few minor irritants about the book; a few spelling/punctuation errors which should have been spotted by the editor, particularly in the opening chapter, and most annoying for me, a number of passages where the author explains her point using chatty anecdotes about things such as a holiday in South America, niggles the editor might have with the author, and something to do with ice cream (if any of my OU students read this they will no doubt recognise this criticism; I do not expect an informal chatty style from students so I certainly don’t want to see it in published academic authors! Although I do realise this probably says more about me than about the author!). The substantive chapters, where points were explained using clinical examples and scenarios, were so well done, relevant and easy to follow that the excessively chatty and anecdotal style in those more personal examples seemed out of place and unnecessary.

I did feel that the latter chapters, whilst of interest to student practitioners, would be of most use to those already qualified and in post, in more of a position to effect change in the practice setting. However the book as a whole is to be welcomed as a useful addition not only for practitioners but also students to help ‘demystify’ research and hopefully encourage them that research is a vital part of practice rather than yet another additional burden.