The objectives of this study are two-fold: (a) to delineate the factors that guide Ontario social workers’ decision-making when rendering judgments on the mandatory reporting of child maltreatment and (b) to understand how social workers maintain the therapeutic alliance with children and families following the decision to report suspected child maltreatment. The study is informed by two distinct bodies of literature: the decision-making theoretical literature within the fields of medicine, psychology, social work, and marriage and family therapy and the therapeutic alliance theoretical literature. Harnessing the advantages of online survey technology, the study surveyed registered members (n = 480) of the Ontario Association of Social Workers who provide direct service to children and families. Participants responded to prepared vignettes of suspected child maltreatment followed by Likert-scale questions (strongly agree to strongly disagree) and open-ended questions on strategies to maintain the alliance. Open-ended questions allowed respondents to offer further commentary regarding their opinions on mandatory reporting and on maintaining the therapeutic alliance. These comments added a rich source of information to the quantitative data. Multiple logistic regression analyses showed that social workers’ ethical responsibility to the College of Social Workers and Social Service Workers, their legal responsibility to the provincial mandatory reporting laws of Ontario, and consultation with peers or eliciting direction from a supervisor comprised the main factors in their decision-making around reporting suspected child maltreatment to the Children’s Aid Society. Qualitative analyses showed that social workers employ a plethora of strategies to repair the alliance following a disclosure of child maltreatment including reporting strategies, information strategies, affect regulation strategies, advocacy strategies, and resource strategies. The major limitation of the research design was the use of vignette research, which in proscribed circumstances may not reflect what the social worker does in actual practice. Design features that compensate for this limitation include (1) use of a 5-point Likert-item response of strongly agree to strongly disagree to allow respondents a range of responses; and (2) use of open-ended questions to allow respondents the opportunity to express their opinions on the issues.

The objectives of this study are two-fold: (a) to delineate the factors that guide Ontario social workers’ decision-making when rendering judgments on the mandatory reporting of child maltreatment and (b) to understand how social workers maintain the therapeutic alliance with children and families following the decision to report suspected child maltreatment. The study is informed by two distinct bodies of literature: the decision-making theoretical literature within the fields of medicine, psychology, social work, and marriage and family therapy and the therapeutic alliance theoretical literature. Harnessing the advantages of online survey technology, the study surveyed registered members (n = 480) of the Ontario Association of Social Workers who provide direct service to children and families. Participants responded to prepared vignettes of suspected child maltreatment followed by Likert-scale questions (strongly agree to strongly disagree) and open-ended questions on strategies to maintain the alliance. Open-ended questions allowed respondents to offer further commentary regarding their opinions on mandatory reporting and on maintaining the therapeutic alliance. These comments added a rich source of information to the quantitative data. Multiple logistic regression analyses showed that social workers’ ethical responsibility to the College of Social Workers and Social Service Workers, their legal responsibility to the provincial mandatory reporting laws of Ontario, and consultation with peers or eliciting direction from a supervisor comprised the main factors in their decision-making around reporting suspected child maltreatment to the Children’s Aid Society. Qualitative analyses showed that social workers employ a plethora of strategies to repair the alliance following a disclosure of child maltreatment including reporting strategies, information strategies, affect regulation strategies, advocacy strategies, and resource strategies. The major limitation of the research design was the use of vignette research, which in proscribed circumstances may not reflect what the social worker does in actual practice. Design features that compensate for this limitation include (1) use of a 5-point Likert-item response of strongly agree to strongly disagree to allow respondents a range of responses; and (2) use of open-ended questions to allow respondents the opportunity to express their opinions on the issues.

I föreliggande kvalitativa studie var syftet att undersöka hur förskolepersonal upplever och resonerar i anmälningsprocesser samt vilka aspekter de anser vara främjande respektive hindrande för arbetet i dessa. Studiens empiriska material har samlats in genom fokusgruppsintervjuer och individuella intervjuer. Det övergripande resultatet visar att förskolepersonal upplever anmälningsprocesser som komplexa då de måste förhålla sig till omständigheter på såväl en mikro- som en mezzo- och makronivå. Omständigheterna utgörs bland annat av individuella roller och rollkonflikter, gruppdiskussioner och hänsynstagande till kollegor samt rådande samhällsnormer. Det är också den upplevda komplexiteten i anmälningsprocesserna som gör att förskolepersonal resonerar huruvida en anmälan ska göras eller inte. Detta resultat stämmer väl överens med tidigare forskning gjord på området men är något som inte överensstämmer med lagstiftarens intentioner. Resultatet visar vidare på att förskolepersonal anser det som främjande med stöd och rådgivning från kollegor och andra professioner för att få hjälp med arbetet i anmälningsprocesserna. / The aim of this qualitative essay is to study how pre-school staff experience and reason in mandatory reporting processes and which aspects they consider important for their work in these processes. The empirical data was collected from focus group interviews and individual interviews. The overall result indicates that pre-school staff experience mandatory reporting processes as complex since they have to relate to circumstances at both micro, mezzo and macro levels. Among some other aspects these circumstances constitutes individual roles and role conflicts, group discussions and existing social norms. It’s also the experienced complexity that make pre-school staff reason about whether to report or not. This result corresponds with previous research but unfortunately badly corresponds with the intentions of the legislator. Further on, the result show that pre-school staff finds it meaningful to get support and counseling from colleagues and other professions to gain help when working in mandatory reporting processes.

This thesis examines the strategic and potentially legitimising nature of voluntary environmental reporting. First, the thesis examines the relationship between emission levels on the National Pollutant Inventory and the quantity of total voluntary environmental disclosures, voluntary emission disclosures and positive voluntary environmental disclosures in annual reports. Second, an examination of changes in the quantity of disclosures discussing compliance with the National Pollutant Inventory and/or disclosures concerning pollution emissions is undertaken. Taking into consideration the findings relating to the strategic nature of voluntary disclosures, the thesis then examines the potential of such disclosures to impact upon the usefulness of mandatory annual report disclosure requirements. This is undertaken by investigating whether significant differences exist between environmental disclosure practices in the voluntary sections of annual reports for corporations reporting non-compliance, and those not reporting non-compliance, in the directors' report pursuant with the requirements of s. 299(1)(f) of the Corporations Law. The findings suggest that, for the sample corporations, a change in environmental regulation may have been an impetus for changes in voluntary environmental disclosure practices in annual reports. Disclosures are identified as being discretionary, and potentially reactive to changes in environmental regulation, with a significant increase in the quantity of voluntary disclosures relating to the National Pollutant Inventory and in the number of corporations making voluntary emission disclosures during the period. Hence, voluntary disclosures, although discretionary, may provide some indication of the corporation's actual environmental activities and provides some support for industry arguments to maintain a voluntary environmental disclosure system. A comparison of the quantity and nature of voluntary disclosures for corporations required to report non-compliance with, and those reporting no non-compliance with, environmental regulations in the directors' report found no significant differences in disclosure practices between the two groups; that is, in contrast to the findings of previous research, those reporting non-compliance had no higher propensity for either greater quantities of voluntary environmental disclosures or positive voluntary environmental disclosures. The findings suggest that the limitations faced by s. 299(1)(f) in its early years may have resulted in it not being perceived as a legitimacy threat by the sample corporations or as a lesser threat than others such as the NPI. Therefore, questions remain as to whether the section is able to produce the outcomes proposed at its inception. Overall, taking into consideration the discretionary nature of voluntary environmental disclosures, and the limitations of s. 299(1)(f), concern remains as to the quality of the Australian annual report environmental reporting system and the potential for the existence of voluntary environmental disclosures in the annual report to reduce the usefulness of a mandatory disclosure system to users. These findings suggest a need for further research into the effect of both mandatory and voluntary environmental disclosures on users' perceptions of corporate environmental performance.

<p>Abstract</p><p>In 1998 the Swedish legislation was sharpened, and active educationalists were legally bound to report any suspicion of child maltreatment. Nevertheless, there are a number of unrecorded cases of maltreated children, and research reveals that less than half of these children are reported to social services (Olsson, 2001). The purpose of the present study was to illustrate the problems with the mandatory reports in schools, as well as to study how educationalists proceed when they suspect that a child is maltreated. The method consisted of semi-structured interviews with five educationalists. The results revealed complex problems regarding educationalists mandatory reports. The procedures and routines varied and seem to be dependent on the educationalists, schools, and situations. The results also exposed the lack of official support in form of policy procedure manuals. Conclusion was that educationalists defined maltreated children in different ways, and in addition educationalists were not aware of the full significance of the mandatory reporting, even though they were aware of that they had a duty to report.</p>

Abstract In 1998 the Swedish legislation was sharpened, and active educationalists were legally bound to report any suspicion of child maltreatment. Nevertheless, there are a number of unrecorded cases of maltreated children, and research reveals that less than half of these children are reported to social services (Olsson, 2001). The purpose of the present study was to illustrate the problems with the mandatory reports in schools, as well as to study how educationalists proceed when they suspect that a child is maltreated. The method consisted of semi-structured interviews with five educationalists. The results revealed complex problems regarding educationalists mandatory reports. The procedures and routines varied and seem to be dependent on the educationalists, schools, and situations. The results also exposed the lack of official support in form of policy procedure manuals. Conclusion was that educationalists defined maltreated children in different ways, and in addition educationalists were not aware of the full significance of the mandatory reporting, even though they were aware of that they had a duty to report.

Sverige har en lagstadgad anmälningsplikt som är obligatorisk för alla som i sitt arbete kommer i kontakt med barn. Lagen är tydlig med att alla misstänka missförhållanden skall anmälas. Forskning visar att anmälningsplikten inte alltid fungerar och att det bara är en liten del av de barn som riskerar att fara illa som kommer till socialtjänstens kännedom. Vidare forskning visar att få anmälningar kommer från hälso- och sjukvården. Syftet var att beskriva sjuksköterskans erfarenheter i mötet med barn som far illa eller riskerar att fara illa. Litteraturstudien genomfördes med kvalitativ design och sökningar har gjorts i CINAHL, MEDLINE och PsycINFO. Åtta artiklar ansågs relevanta. Under analysen framkom tre teman: en emotionell utmaning, att känna sig begränsad och att våga agera. Resultatet visar att sjuksköterskan blir berörd i mötet med barn som far illa. Vidare beskriver sjuksköterskan osäkerhet, bristande kunskap och brister i organisationen. Sjuksköterskans professionella trygghet beskrivs utifrån kunskap och förvärvad erfarenhet. Det är angeläget att sjuksköterskans yrkeskompetens upprätthålls samt att det finns stöd att tillgå för att utveckla omvårdnaden kring barn som far illa. / In Sweden, everyone who comes in contact with children through their work has a statutory obligation to report child abuse. The law clearly states that any suspected child abuse must be reported. Research shows that the reporting does not always work. Only a small proportion of the children who might be victims of abuse come to the knowledge of Social Services. Further research shows that few notifications come from individuals within the health care system. The aim of this literature review was to describe nurses’ experiences of encounters with chil-dren who are victims of abuse or who are at risk of being abused. A qualitative design was used. CINAHL, MEDLINE and PsycINFO were used to select the articles, eight of which met the selection criteria. During the analysis, three themes emerged: An Emotional Challenge, Feeling Limited, and Daring to Act. The results show that the nurses are emotionally affected by their contact with abused children. The nurses also describe feelings of insecurity, a lack of knowledge, and organizational deficiencies. The nurses’ professional security is described as stemming from knowledge and experience. It is very important that the nurses’ professional competence is maintained and that there is support available in order to develop the care of abused children.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2007. / Härtill 4 uppsatser.

Sammanfattning   Bakgrund Skolsköterskan träffar alla barn under skolgången vid minst tre planerade tillfällen för hälsobesök. Tillsammans med andra professioner i skolan har skolsköterskan möjlighet att identifiera barn som far illa och har lagstadgad anmälningsplikt. Vid misstanke om samt anmälan av barn som far illa finns det risk för att skolsköterskor utsätts för stress och kan uppleva olika etiska dilemman. Detta gör det angeläget att ta reda på deras erfarenheter inom området. Syfte Att beskriva skolsköterskors erfarenheter av etiska dilemman vid misstanke om att barn far illa samt anmälan därav. Metod Studien genomfördes i två kommuner i sydsverige. Materialet samlades in vid elva intervjuer med skolsköterskor och analyserades med kvalitativ manifest innehållsanalys. Resultat De etiska dilemman som skolsköterskorna upplevde kategoriserades i fyra kategorier och elva underkategorier. Att bygga upp och bevara förtroendefulla relationer med barnen och föräldrarna var viktigt för skolsköterskorna. Viljan att göra rätt upplevdes som en svår uppgift eftersom det innebar att identifiera barn som far illa, att göra sin plikt, men även att göra nytta och inte skada. Skolsköterskorna kunde känna sig ensamma och utsatta i sin profession samt i behov av stöd, både från kollegor men även från andra professioner. De saknade återkoppling från socialtjänsten och önskade att de hade ett bättre samarbete. Slutsats Skolsköterskorna upplevde etiska dilemman i mötet med barn som far illa samt vid lagstadgad anmälan. Handledning, stöd under hela processen samt bättre samarbete med socialtjänsten skulle kunna leda till fler anmälningar. Utbildning samt standardiserade bedömningsinstrument bör kunna medföra att fler barn som far illa identifieras.   Nyckelord Skolsköterskor, barn som far illa, etiska dilemman, anmälningsskyldighet / Abstract Background The school nurse sees all children at least three times during their school years in connection to planned health visits. Together with other school professionals the nurse has the possibility to identify maltreated children and is obligated by law to report it. Suspecting and reporting child maltreatment might implicate an exposure to stress and dealing with various ethical dilemmas. It is therefore important to investigate the school nurses’ experiences concerning this issue. Aim To describe the school nurses’ experiences of ethical dilemmas when suspecting and reporting child maltreatment. Method The study was conducted in two counties in southern Sweden. Data was collected by interviewing eleven school nurses and analyzed by using a qualitative manifest content analysis. Results The ethical dilemmas experienced by the school nurses were categorized in four categories and eleven subcategories. Building and maintaining trustful relationships with the children and their parents was important for the school nurses. The wish to do right was experienced as difficult since it meant to identify maltreated children, to report it, and at the same do good and do no harm. The school nurses felt alone and vulnerable in this situation and needed support both from colleagues and other professionals. They lacked feedback from the child protection services and were yearning for a better collaboration. Conclusion The school nurses experienced ethical dilemmas when meeting maltreated children and being obligated to report it. Supervision, support during the process and a better teamwork with the child protection services may increase the reporting rate. Education and standard assessment instruments might increase the number of identified maltreated children.   Keywords School nurses, child maltreatment, ethical dilemmas, mandatory reporting

Bakgrund: Distriktssköterskor som arbetar inom barnhälsovården möter i sitt arbete de flesta familjerna ute i samhället och har möjlighet att komma i kontakt med barn som far illa. Misstankar att barn far illa måste anmälas till socialtjänsten. Anmälan om misstankar kan leda till etiska dilemman där rättvisa, att göra gott och inte skada skapar konflikter. Syfte: Syftet med studien var att inom BHV belysa sjuksköterskors erfarenheter  av anmälningsplikten till socialtjänsten, vid misstankar om barn som far illa. Metod: Studien genomfördes utifrån en kvalitativ ansats. Sex distriktssköterskor inom barnhälsovården deltog vid semistrukturerade intervjuer. Data analyserades med kvalitativ innehållsanalys på manifest nivå. Resultat: Studiens resultat presenteras i fyra huvudkategorier och elva underkategorier. Relation till föräldrarna: Sjuksköterskorna ansåg att det är viktigt att vara ärlig och informera föräldrarna om sin oro vilket oftast  ledde  till ett bra samarbete. Relationen till föräldrarna kan bli sämre efter en anmälan och då finns risk att ingen ser barnets bästa. Ibland kan empati för föräldrarna göra att en anmälan blir svår. Kontakt med socialtjänsten: Hälften av sjuksköterskorna ansåg att de hade en bra samverkan med socialtjänsten. Ofta och anonymt kontaktade sjuksköterskorna socialtjänsten för att rådfråga för att få hjälp och stöd vid misstankar. Återkoppling från socialtjänsten har blivit bättre efter en lagändring 2013. Kunskap om anmälningsplikten: Samtliga sjuksköterskor hade kunskap om anmälningsplikten, dess rutiner och var man kan finna riktlinjer. Känslomässigt förhållningssätt: Sjuksköterskorna upplevde blandade känslor vid en anmälan. Vid misstankar övervägde de noga om de skulle göra en anmälan eller inte. Ibland var det svårt att göra en anmälan eftersom det finns olika åsikter om vad fara illa innebär, beroende på kunskap och personliga erfarenheter.   Slutsats: Det förekommer att sjuksköterskor underlåter att anmäla misstankar till socialtjänsten. Sjuksköterskors plikt att anmäla är ett etiskt dilemma vilket skapar osäkerhet och oro, och förknippas med bland annat erfarenhet, känslomässigt förhållningssätt och kunskap. För att underlätta processen av en anmälan är en bra samverkan med familjerna och socialtjänsten, diskussioner om innebörden av att fara illa och stöd i övervägningsfasen nödvändigt. / Background: Districtnurses which are working in pediatric health care encounter most of the families in the community and have the probability to come in contact with child abuse. Suspicions of child abuse must be reported to social services. The requirement to report cases of suspected child abuse can lead to ethical dilemmas in which justice, to do good and not harm creates conflicts.   Aim: The aim of this research was to describe the districtnurses' experience of the obligation to report to social services, in cases of suspected child abuse. Method: The research was based on a qualitative methodology. Six districtnurses working in primary health care participated in semi-structured interviews. Data were analyzed using qualitative content analysis. Results: The results of the research are presented in four main categories and eleven subcategories. Relationship to parents: The districtnurses felt that it is important to be honest and inform parents about their concerns, which often led to a good cooperation. The relationship to the parents can be worse after a report of suspected child abuse, which can result in that no one can see the child´s best. Empathy for the parents sometimes makes it difficult to report suspected child abuse. Contact with social services: Fifty percent of the districtnurses felt that they had  good relationships and  interactions with the social services. Frequently in cases of suspected child abuse districtnurses anonymously contact social services for support and help. Feedback from the social services is better after the law changed 2013.  Emotional attitudes: The districtnurses experienced mixed emotions when reporting a case of suspected child abuse, they carefully considered whether or not to report. Depending on knowledge and personal experiences sometimes  reporting was difficult because of different opinions about what constitutes child abuse.  Knowledge of the reporting obligation: All the districtnurses had knowledge of the mandatory reporting, its procedures and where one could find guidelines.   Conclusion: It happens that districtnurses do not report suspicions to social services. Districtnurses' duty to report is an ethical dilemma, which creates uncertainty and anxiety, and is associated with for example experience, emotional attitudes and knowledge. To facilitate the process of reporting is a good interaction with the families and the social services, discussions about the meaning of child abuse and support under the decissionmaking phase necessary.