Dr Robbie Duschinsky, of Cambridge’s Primary Care Unit at the School of Clinical Medicine, mobilised international colleagues to ensure draft NICE guidelines that had the potential to impact on the experiences and outcomes of children suspected of being the victims of maltreatment were revised to reflect the most robust and up-to-date evidence.
Dr Duschinsky is a social scientist whose research integrates approaches from psychology, sociology, history and philosophy. He leads the Applied Social Science Research Group and since 2014 has held a New Investigator Award from the Wellcome Trust for research into debates about infant attachment and maltreatment, and the significance of attachment relationships for child health and wellbeing. The research also examines the practical implications of these debates for clinicians and social welfare practitioners.
In 2015, the National Collaborating Centre for Mental Health released the NICE-commissioned Clinical guidelines for attachment in children and young people who are adopted from care, in care or at high risk of going into care draft for consultation. The National Institute for Health and Care Excellence (NICE) is an independent organisation which develops national guidance to enable health and social care professionals to provide high quality care based on the best evidence. Their guidance would impact upon the care of vulnerable individuals across the country.
Dr Duschinsky, who monitored relevant consultations, carefully reviewed the guidelines. While they were an excellent synthesis of the available evidence, he pinpointed specific issues in how in the guidelines characterised the infant disorganised attachment classification. Critically, the guidelines advised on how this classification could be translated into clinical practice and assessments. This included a proposal which appeared to suggest that children suspected of experiencing maltreatment should be screened by clinicians using assessment for disorganised attachment. Dr Duschinsky and his colleagues were concerned as the evidence did not suggest this, and the guidelines might misdirect clinicians and social workers.
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