Kommunen som arena for tverrfaglig tidlig innsats for barn og familier – et dialogisk og refleksivt aksjonsforskningsprosjekt

This research project is conducted in a municipal department for children and families in Rana municipality, and explores the application of a dialogical and reflexive approach to practitioners? understanding and development of an interdisciplinary intervention for pregnant women and families with infant children. The research is part of the Research Council of Norway's public sector PhD scheme. In 2014, during municipal reorganization, the midwifery and primary health nurses, family services, and child protection services were combined into a single organization. An early intervention was planned, and the interdisciplinary development of this effort is the hub of the research project. At the start of the research project, it emerged that the developmental work with early intervention was about to be halted. The aim of the research project was to develop knowledge that could identify, illustrate and provide accounts for the barriers to interdisciplinary development of an early intervention for pregnant mothers and families of infant children in the municipality. An additional, positive aim was to develop knowledge about results when this same approach is used in the development of new practice. The research project was conducted using dialogical and reflexive action research. This form of action research is located within a systemic and social constructionist epistemological perspective based on relational, dialogical-reflexive conversations. In the study, 11 co-workers and their four leaders from the different services participated, and the entire department of 65 employees participated at specific points during the research period. Through dialogic-reflexive conversations the varied practice realities of the different co-workers, services and managers have been clarified. What emerges is the different understandings between the individual services, their use of different terminology, and their conceptual framework in relation to early intervention. These are found to exist side-by-side in the practice field and are based on the different societal tasks of each service. These societal tasks are based in turn on different ideologies and approaches to work in and with families; it emerges that this diversity contributes to conflict in the practice field. Furthermore, developmental initiatives by management without co-worker participation is inexpedient. Also, to draw service focus in a new direction in an interdisciplinary field can lead to relocation of co-workers, and make conflicts that complicates development and change. The challenges involved here deserve the name «Wicked problems», in that simple solutions are not available. Here the dialogical-reflexive process contributed to restart developmental collaboration, and to the realization of several changes. During the research, it appeared as though the interdisciplinary development encountered challenges that were difficult to understand. In the final section of the study the focus is on the discrepancy between the ideas and knowledge operant in the specific field of practice about the significance of dialogue for the development of children and adults, and the societal requirements for practice in the form of laws, guidelines and intervention statements. A further issue is whether these state requirements contribute to conflict and hinder development of the practice field. The research clarifies that the term early intervention, and what it should contain in municipal practice, appears to be diffuse. Here the employees focus on lack of work focusing on parenthood, and at the same time there is disagreement and uncertainty of what such work should contain. In addition, it emerges that both state and municipal regulations are made top-down. It can be challenging if state authorities decide implementation of an effort no one quite knows what is, or should be, the municipal management decide implementation of the same effort, if employees then are to develop an effort they do not know the content of, they disagree about, and have little impact on. This together can bring an early intervention to a halt. This study communicates systematic reflection over the understanding of an interdisciplinary practice field of the challenges of early intervention development. In addition, knowledge about how a dialogical and reflexive developmental process can proceed in a complex field of practice is developed.At a time in which innovation in the public sector is desired and required, this is important knowledge for the practice field, municipal management, and the state authorities to have. At the same time, the findings presented in the latter part of the thesis contribute evidence of the need for more research on municipal developmental work with children and families. In an academic context, research on practice is desirable but challenging. The research design, research process, and results of the study will provide contributions in this regard.

Avhandlingen formidler en systematisk refleksjon over et kommunalt tverrfaglig praksisfelts forståelse av utfordringer med utvikling av en tidlig innsats for gravide og spedbarnsfamilier. I tillegg formidles kunnskap om hvordan et dialogisk og refleksivt utviklingsarbeid kan foregå i et sammensatt praksisfelt. I ei tid der innovasjon i offentlig sektor er ønskelig og påkrevd er dette viktig kunnskap for praksisfeltet, for kommunal ledelse og for statlige myndigheter. Samtidig er funnene i siste del av avhandlingen med på å tilsi at det er behov for videre utforskning av kommunalt utviklingssamarbeid med fokus på barn og familier. I akademisk sammenheng er praksisforskning ønskelig, men utfordrende. Her vil denne avhandlingens oppsett og gjennomføring kunne være et viktig bidrag i så måte. En ønsket effekt er at dette skal implisere forvaltningens planlegging og utvikling av dette feltet, slik at kommunalt arbeid overfor barn og familier utformes etter framtidens behov.

Formålet med prosjektet er å utvikle et forsknings- og utviklingsbasert arbeid for å skape kvalitetsforbedring og bedre samhandling i kommunens tilbud til barn og foreldre. Dette skal skje ved aksjonsforskning, og ved å skape et innovasjonsteam bestående av ansatte og ledere i Rana kommune, Nord Universitet, og RKBU Nord UiT - SKO-studien. Forskeren vil initiere en prosess der kommunen definerer utviklingsmål som arbeides med parallelt med forskningsarbeidet. Den metodiske tilnærming knyttes til aksjonsforskning og samarbeidsdrevet innovasjon. En aksjonsforskende tilnærming kjennetegnes av at praktikernes spørsmål leder prosessen, der handlinger iverksettes, følges systematisk og reflekteres over i samarbeid mellom praktiker og forsker. Gjennom å utforske praksis, kan en forstå den bedre og slik få utvidete muligheter til å utvikle og endre den (Schmuck, 2006, Selener, 1997). Aksjonsforskningen er en dynamisk prosess i møtet mellom praktikere og forskere i praksisfeltet, der begge parter bidrar til kunnskapsutvikling og praksisutvikling. I denne prosessen er det åpenhet i forhold til metoder, verktøy og løsninger. Det skapes møteplasser for refleksjon og analyse, der det også er muligheter for å diskutere ulike opplevelser og oppfatninger ut fra så vel teorier som erfaringer. Det handler om å ta utgangspunkt i praktikernes spørsmål, og utvikle og forandre virksomheten med utgangspunkt i lokale praksiserfaringer, hvor en tar i bruk forskningsmetoder for å løse praktiske utfordringer (Eikeland 2015). Kunnskap om hvordan forandring kommer i stand, og hva som skjer under arbeidets gang str sentralt. Prosjektet trekker veksler på kunnskap om samarbeidsdrevet innovasjon (Aagaard mfl red, 2014). Med innovasjon forstås det at det utvikles nye ideer og realisere dem slik at de gir merverdi for samfunnet. Innovasjon kan være kjent eller ny viten som kombineres på en ny måte eller brukes i en ny sammenheng.