The challenge of implementation in complex, adaptive child welfare systems: A realist synthesis of signs of safety

• Published in: Children and youth services review 2023-07, Vol.150, p.106992, Article 106992
• Main Authors: Caffrey, Louise, Browne, Freda
• Format: Article
• Language: English
• Subjects: Child protection; Complex adaptive systems; Implementation; Signs of safety
• ISSN: 0190-7409; 1873-7765
• DOI: 10.1016/j.childyouth.2023.106992

•Multi-layered implementation conditions enable or disable Signs of Safety mechanisms.•Misperceptions of goals easily occur; organisations should monitor staff ‘sense making’.•Enacting Signs of Safety requires good critical thinking and interpersonal skills.•Group supervision is required to identify and address misperceptions and share responsibility.•Leadership should be explicitly aligned with Signs of Safety goals and closely connected to practice. Implementing a new initiative in any complex system is known to be deeply challenging and children’s services are no exception in this regard. Yet understanding implementation is important to support service planning as well as to avoid inappropriate (de)commissioning. Complexity-informed Realist methods are well established, especially in health sciences research, but have seen little uptake in social work, despite calls to embrace the approach. This paper utilises a Realist Synthesis to understand and evaluate how interactions between children’s services interventions and the context they are introduced into can influence implementation and outcomes. We present six emerging programme theories on how the interacting effects of reasoning and resources in varying conditions affect implementation of a popular framework for child protection social work, Signs of Safety. Our findings demonstrate that interactions at multiple systemic levels affect implementation and provide practical guidance to inform service development and delivery. Further, we contribute testable Realist Context-Mechanism-Outcome configurations (CMOCs) and discuss how these can form the basis for a Realist Evaluation.