Decision making is becoming an increasingly central feature of social work practice, yet there is limited research on the topic. Experimental methods of investigating decision making tend to be constrained by practical and ethical difficulties, whilst questions about validity and generalizability surround ethnographic and other descriptive methods. It is argued here that the factorial survey addresses these methodological difficulties as a research design to study the way that professionals make decisions in real life. In this research design, true-to-life vignettes (case scenarios or paper cases) are presented to social workers or other staff to make a judgement about a familiar type of scenario. The randomized factors within the vignettes, combined with the randomization of the selection of vignettes for each decision maker, give the factorial survey a unique capability to investigate the effect of multiple factors in complex decisions, unlike the more common factorial experiment. The method is explained, and prospects and issues for the development of this research design to study professional judgement within social work are discussed. The factorial survey has potential as a method for rigorous study of the impact of client, family and context factors on decisions by social work and social care staff.

In order to further research on decision-making in social work, a richer theoretical underpinning of models of decision-making is required. There has been significant theoretical advance in other disciplines from which we might learn and develop supportive theoretical constructs. This article outlines some major theoretical approaches to modelling individual judgement including expected utility, fuzzy set theory, signal detection, heuristics and biases, judgement analysis and bounded rationality models. Models are drawn from diverse fields such as computing, economics, psychology and operations research and are illustrated with social work examples. The models are sequenced from those that are more prescriptive (based on mathematical models of how a rational person should act) through to those that are more descriptive (creating models from studies of how people make decisions in real life). Implications are drawn out for future research on judgement and decision-making in social work. It is time for research on social work decision-making to be taken to a new level by creating and adapting models to inform empirical studies. This will require interdisciplinary collaboration and clarity in selecting, adapting and creating models appropriate to the complex environment of social work decision-making.

Risk management systems and structures are developing rapidly within UK health and personal social services. However, the risk management strategies of organizations need to take into account the conceptual frameworks used by professionals. This grounded theory study used data from nineteen focus groups and nine semi-structured interviews (ninety-nine staff in total) to explore perspectives on risk and decision-making regarding the long-term care of older people. Focus group participants and interviewees comprised social workers, care managers, consultant geriatricians, general medical practitioners, community nurses, occupational therapists, home care managers and hospital discharge support staff. Social work and health care professionals conceptualized risk and its management according to six paradigms that appeared to be in a state of reciprocal tension: (i) Identifying and Meeting Needs; (ii) Minimizing Situational Hazards; (iii) Protecting this Individual and Others; (iv) Balancing Benefits and Harms; (v) Accounting for Resources and Priorities; and (vi) Wariness of Lurking Conflicts. The effective translation into practice of risk management strategies needs to address the complex and often contradictory issues facing health and social services professionals.

There is increasing attention to decision making in social work as we become more concerned about ‘risk’ and the most effective design of assessment tools to aid professional judgement. In order to develop practice, a better conceptual understanding is required of the cognitive processes in making these judgements. This paper explores the potential use of heuristic (small-scale, ‘rule-of-thumb’) models of cognitive judgement in social work, recognising that human beings (including social work professionals) cannot simultaneously process large numbers of factors with associated statistical weightings. This paper discusses heuristic models of professional judgement based on a proposed concept of psycho-social rationality. Such heuristic models would take account of the psycho-social environment in which the decision is being made as well as of the cognitive processes of the decision maker. The potential application to professional judgement in social work is discussed with reference to examples of various types of social work decision. Potential issues in developing and adopting this theoretical approach in practice are raised—including legal dimensions and potential bias—and the implications for social work research are discussed.

Patient and public involvement is widely accepted as good practice in dementia research contributing substantial benefits to research quality. Reports detailing involvement of individuals with dementia as co-researchers, more specifically in analysis of findings are lacking. This paper reports an exercise involving individuals with dementia as co-researchers in a qualitative analysis. Data was from anonymised extracts of interviews with people with dementia who had participated in a multistage study on risk communication in dementia care, relating to concepts and communication of risk. Co-researchers were involved in deriving meaning from the data, identifying and connecting themes. The analysis process is described, reflections on the exercise provided and impact discussed. The session improved overall research quality by enhancing validity of the findings through application of multiple perspectives while also generating sub-themes for exploration in subsequent interviews. Development of guidance for involving individuals with dementia in analysis of research findings is needed.

Care at home is fundamental to community care policy, but the simultaneous growth of health and safety regulation has implications for home care services because of the duty of employers towards home care workers. This grounded theory study set in Northern Ireland used data from 19 focus groups and nine semi-structured interviews with a range of health and social services professionals and managers to explore perspectives on planning long term care for older people. Home care workers faced a wide range of hazards in the homes of clients, who themselves were faced with adapting their living habits due to their changing health and care needs and ‘risks.’ Creative approaches were used to ensure the health and safety of home care workers and simultaneously to meet the choices of clients. Staff experienced feelings of conflict when they judged it necessary to impose their way of providing home care and thus impose their values on clients to create a safe working environment. There was variation between and within organizations in terms of the staff focus on client needs or on their employer responsibility towards home care workers. The planning of home care services must take account of both the choices of clients and the hazards facing home care staff.