While multiagency and multidisciplinary teams have been demonstrated to improve client outcomes, reduce duplication and increase service effect, they can also be daunting for victim/survivors, compromise confidentiality and at times, be a source of conflict between agency staff.
“I really like the idea of a case management/advocacy approach where a young person has one local ‘go to’ person who coordinates the services they receive and also links them in with other services, and finds information to questions as needed. I think what services sometimes forget is the importance of stable, face-to-face support, especially for young people who have experienced trauma and damage in their families. It is important to have a human connection and not just be palmed off between various professionals.” Hannah Baker p 243
The advocate has a number of potential roles in relation to multiagency and multidisciplinary collaboration and coordination with the main areas being:
- Development and maintenance of multidisciplinary and multiagency teams and collaboration
- Ensuring that teams are primarily client focused rather than forensic or other task focused
- Provide information sessions on things like local services, local trends or innovative programs in other jurisdictions
- Represent client wishes or provide support for the client to present directly to the multidisciplinary team
- Ensure the client is kept updated with decisions and discussion from multidisciplinary teams
- Provide case tracking
- Provide and facilitate service provision even if cases don’t proceed to court
While there are great benefits to sharing information, client confidentiality is not only a human right but also a legal right. Advocates should discuss with clients if multidisciplinary and/or multiagency meetings are the best ways to progress issues. If the advocate is representing the client at a team meeting, specific areas for discussion should be agreed beforehand and a time limited, specific release of information signed by the client prior to the meeting.
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Different professionals and agencies have different confidentiality and information requirements. All team members should be aware of these and advocates can play a role in facilitating this sharing of this and resolving how information is shared. Because rules and procedures around information sharing can be complex, it’s useful to look for examples in your jurisdiction of protocols and practices. For example, the Northern Territory Office of Children and Families have developed Information Sharing Guidelines along with Resources and training to implement these guidelines.
It’s very likely there are interagency protocols which include your agency. A series of state by state agency protocols are provided Mapping health sector and interagency protocols on sexual assault ACSSA Issues No. 2 March 2005. This is now somewhat dated and advocates should inquire as to what protocols, memorandum of understandings and agreements are currently in effect.
Click here or the picture for (2001) Response to sexual assault: Interagency guidelines for responding to adult victims of sexual assault.
These guidelines have been developed by an interagency group including representatives from Queensland Health, the Queensland Police Service, Office of the Director of Public Prosecutions, Department of Families, Office for Women, Department of Aboriginal and Torres Strait Islander Policy, Office of the Adult Guardian and Legal Aid Queensland. The guidelines are intended to provide a best practice framework for responding to adult victims, with a particular focus on victims of recent assault.
- Identify key local agencies and stakeholders who would benefit from interagency collaboration
- Review current interagency and multidisciplinary partnerships and collaborative arrangements
- Aim to be clear on other agencies and discipline’s primary goals and roles regarding work with victims/survivors of sexual violence
- Look for common objectives and benefits of collaborative partnerships
- Work with own supervisory staff to be clear on the benefits of specific collaboration for: your clients; your agency; and other agencies
- Meet with key stakeholders to review current working relationships, identify current and other collaborative goals and develop plans for enhanced collaboration
- Implement plans and meet to review outcomes. Use action learning methods to for ongoing review, planning and action steps, and celebrate successes
Much of the work of front line sexual violence advocates involves;
- Individual advocacy (advocating for and/or protecting the rights of victim/survivors)
- Self advocacy (facilitating victim/survivors to advocate for themselves)
The above may involve advocating for and with victim/survivors at multiagency and multidisciplinary levels.
Systems advocacy refers to advocating to change “the system” and to promote a cause.
- Internal advocacy occurs within an organisation or institution and aims to build organisational and political support for changes in policies, services, funding, or priorities that will benefit staff, the organisation, consumers, or the wider community: from Public Health Advocacy Institute of Western Australia (2010) Internal Advocacy Factsheet (great tips on do’s and don’ts).
- Most system’s advocacy for front-line workers will be on this level and likely to involve developing or modifying procedures, policies and issues relating to multidisciplinary teams. The best process to identify and progress internal advocacy issues is through a well-functioning multidisciplinary team. The team works as a whole with philosophical and procedural frameworks which strongly support procedural review and collective action to facilitate change.
- The role of the advocate is to work with the group to develop/enhance the functioning of multiagency groups.
- External ‘System’s advocacy’ occurs at a political, state or national policy and sometimes at a legislative level (the latter is also called ‘Legislative advocacy’ – to change laws as distinct from Legal Advocacy – advocating for existing legal rights.)
While this level of system’s advocacy is likely to be outside or on the edge of role boundaries, it may be possible to progress system’s advocacy issues through multidisciplinary teams. However, because some multidisciplinary team members may be limited in their ability to engage in external system’s advocacy, having a clearly identified number of alternative channels such as the Children’s Commissioner, the Royal Commission into Institutional Responses to Child Sexual Abuse, Law Reform Commissions or similar should be known In both internal and external system’s advocacy, supervisory staff should at the least be consulted and if the issue is to be progressed, most likely will be directly involved.
Critical success factors
Relationship, Relationship, Relationship. The ability to get along and resolve conflict in a constructive way is usually the most important determinant of the success or failure of multidisciplinary teams. See below for a reminder of some useful relationship building strategies.
- Click here for Standard 16 – Facilitate interagency support and coordination, from “Advocacy Standards for working with Children, Young People and Adults who have Experienced Sexual Violence” Parkerville Children and Youth Care (Australian).
- Click here (middle of page) for summary view of above standard.
- Click here for Work in partnership with agencies to address sexual violence National Occupational Standards (UK)
- Click here for Standards For Accredited Members – Standard 1 – Multidisciplinary Team (PDF)