Study Review

Family Group Conferencing

A Family Group Conference (FGC) is a decision-making meeting in which a child's wider family network comes together to plan around meeting the needs of the child/ren

Outcome Overall
effectiveness

This rating shows how effective the intervention is at achieving the evaluated outcome.

Click here for information about how effectiveness ratings are applied.

 Strength of
evidence

This rating shows how confident we can be about a finding, based on how the research was designed and carried out.
Children and young people entering out-of-home care Overall effectiveness: mixed (maximum 2) Strength of evidence : 1 (maximum 3)
Children and young people re-entering out-of-home care Overall effectiveness: mixed (maximum 2) Strength of evidence : 0 (maximum 3)
Reunification with the family after being in out-of-home care Overall effectiveness: mixed (maximum 2) Strength of evidence : 0 (maximum 3)
Families’ perception of empowerment in parenting situations Overall effectiveness: mixed (maximum 2) Strength of evidence : 1 (maximum 3)
Family satisfaction with the family group meeting service Overall effectiveness: mixed (maximum 2) Strength of evidence : 0 (maximum 3)

Headline points

  • This summary comes from the original systematic review: Nurmatov, B.U., Foster, C., Bezeczky, Z., Owen, J., El-Banna, A., Mann, M., Petrou, S., Kemp, A., Scourfield, J., Forrester, D., & Turley, R. (2020). Impact of shared decision-making family meetings on children’s out-of-home care, family empowerment and satisfaction: A systematic review
  • This summary focuses on meetings aimed at improving shared-decision making with families. In the UK, these meetings are often referred to as Family Group Conferences (FGCs). Therefore, we use FGC throughout
  • The evidence regarding the effectiveness of shared decision-making is inconclusive. All five of the primary outcomes assessed were rated as having a low to very low strength of evidence
  • However, the results could be interpreted in a positive direction of effectiveness of shared decision-making for prevention of out-of-home care
  • This summary of 32 sources included only two studies from the UK
  • Family participation is a fundamental principle in children’s social care and more work is needed to improve the quality consistency of the services that are designed to achieve this
  • Further research is needed to provide a stronger evidence base for shared decision-making services

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What is this?

This systematic review focuses on meetings aimed at improving shared decision-making with families. In the UK, we call shared decision-making family meetings Family Group Conferences, based on the model which was first used in New Zealand in the 1980s. However, there are many international variations of this model with slightly different names e.g. Family Group Meeting. Yet, while there are subtle variations, all include an organised meeting designed to enable the family and its wider social network (extended family and other significant adults such as friends or neighbours), to work closely with professionals when planning and making decisions around the needs of the child/ren.

How is it meant to work?

FGCs involve the wider family in decision-making thereby fostering motivation for further collaboration with professionals. The model is also theorised to make people who are connected to the family more aware of the difficulties they’re facing; this could allow families to draw on necessary resources from wider family and social networks. These factors could in turn promote the safety of the child whilst keeping them at home.

The core tenet behind this model is the belief that children and families should be at the centre of decision-making about their lives. This is based on the premise that families are more likely to share sensitive information and develop a stronger social network, enhancing the quality of plans, increasing engagement and reducing the need for professional involvement.

What are the evaluated outcomes?

  • Children and young people entering out-of-home care
  • Children and young people re-entering out-of-home care
  • Reunification with the family after being in in out-of-home care
  • Families’ perception of empowerment in parenting situations
  • Family satisfaction with the Family Group Meeting service

What are the evaluated outcomes?

  • Children and young people entering out-of-home care
  • Children and young people re-entering out-of-home care
  • Reunification with the family after being in out-of-home care
  • Families’ perception of empowerment in parenting situations
  • Family satisfaction with the family group meeting service

How effective is it?

Children and young people entering out-of-home care
Overall, FGC/shared decision making meetings had a mixed effect on children and young people entering out-of-home care, which means that the results do not clearly support or reject the role of FGC meetings in achieving this outcome. This is based on low strength evidence, meaning there were only one or two acceptable quality studies included in the review. The number of young people and children who entered out-of-home care was assessed in 20 studies with a total of 620, 711 participants.

Children and young people re-entering out-of-home care
Overall, FGC/shared decision making meetings had a mixed effect on children and young people re-entering out-of-home care, which means that the results do not clearly support or reject the role of FGC meetings in achieving this outcome. This is based on very low strength evidence, meaning there were no acceptable quality studies included in the review. The number of young people and children who re-entered out-of-home care was assessed in three studies with 932 participants.

Reunification with the family after being in in out-of-home care
Overall, FGC/shared decision making meetings had a mixed effect on reunification with the family, which means that the results do not clearly support or reject the role of FGC meetings in achieving this outcome. This is based on very low strength evidence, meaning there were no acceptable quality studies included in the review. The number of children and young people that reunified with parents or guardians following a period in care was examined in 13 studies involving a total of 88, 405 participants.

Families’ perception of empowerment in parenting situations
Overall, FGC/shared decision making meetings had a mixed effect on family perception of empowerment in parenting situations. Three studies found no effect but one study found a small effect. However, based on the balance of evidence, the review authors conclude that there is no overall effect on empowerment. This is based on low strength evidence, which means there were one or two acceptable quality studies included in the review. The family’s perception of empowerment in parenting situations was assessed in four studies with a total of 2415 participants.

Family satisfaction with the family group meeting service
Overall, FGC/shared decision making meetings had a mixed effect on family perception of empowerment in parenting situations, which means that the results do not clearly support or reject the role of FGC meetings in achieving this outcome. This is based on very low strength evidence, which means there were no acceptable quality studies included in the review. The family’s satisfaction with the family group meeting service was assessed in four studies with a total of 1509 participants.

In summary the effectiveness of all five outcomes
Given the limitations and low quality of studies, the evidence regarding the effectiveness of shared decision-making is inconclusive. All of the primary outcomes were rated as having a low to very low strength of evidence. Variation in service design, target population and study methodology meant that a meta-analysis was not possible.

Where has it been studied?

Most studies were conducted in the USA (n=24) with the remaining studies from the Netherlands (n=6), the UK (n=2), Canada (n=1), and Sweden (n=1)

Who does it work for?

  • Where age was reported, most studies included children from 0 to 18 years. Based on 19 studies, the average age ranged from 2 to 10 years.
  • Ethnicity data was reported in 22 of the studies. In five studies over 50% of the sample were ‘White’  and in four studies over 50% were ‘African American’. One study focused exclusively on native Hawai’ians and other Pacific Islander families.

When, where and how does it work?

  • A rapid realist review identified three high level and interconnected mechanisms as crucial to the effectiveness of shared decision-making meetings. These are: collaboration and engagement, building trust and reducing shame, and enabling participation in decisions.
  • It’s clear we need a better understanding of whether FGCs deliver in a UK context. As part of the DfE funded Supporting Families: Investing in Practice programme, WWCSC are supporting 24 local authorities to introduce Family Group Conferencing at pre-proceedings while conducting rigorous research into the effects.

What are the costs and benefits?

Seven studies evaluated cost and although there was no strong evidence to support the cost effectiveness of shared decision-making meetings, there were positive indications for cost savings due to the low cost of implementation

How is it implemented?

From Leeds: ‘Although there is no legal requirement to use FGCs in England and Wales, they are now being offered to families in the majority of local authorities on a range of child welfare issues including:

  • Safeguarding children likely to suffer harm;
  • Permanence planning when a child cannot live at home or leaves care;
  • Contact arrangements;
  • Youth offending, anti-social behaviour and truanting’.
  • There is significant variation in terms of how meetings are delivered and implemented.
  • Eleven services reported including the typical four-step structure of a shared decision-making meeting: referral, preparation, conference and the implementation.
  • ‘Private family time’ was reported to feature in 23 of the included studies.
  • Another implementation factor is whether shared decision-making meetings should be delivered as a standalone service or part of a wider structure.
  • One study included an element of shared decision-making meetings as part of a wider substance misuse service, which aimed to keep children at home safely while another study included a team meeting element as part of a wider service to maintain foster and kinship families.
  • Of the nine studies that reported location, meetings were generally held in a neutral family friendly setting, such as a community centre.
  • Other core features often seen in Family Group Conferencing include: neutral facilitators, and an effective follow up or review.

Who can deliver it?

  • Where they were identified, the personnel delivering the programme varied greatly.
  • These included facilitators, social workers, caseworkers, youth care workers, counsellors, some of which were described to be independent or trained.

 

What are the training and supervision requirements?

The Family Rights Group deliver three day family group conference training for new coordinators –  based in London with dates for 2020. This is a course for those with some knowledge of family group conferencing and child care planning processes who wish to increase their understanding and necessary skills to coordinate a family group conference.

What supports good implementation

Case study

Leeds City Council implemented its Family Valued model in 2015 and its evaluation was published in 2017. This whole-system change involved expansion of its Family Group Conferencing service, as well as training in restorative practice across Children’s Services and partner agencies.

The new FGC/ICPC pathway was carefully developed with a wide range of stakeholders and led by the Local Safeguarding Children Board (LSCB) following permission from the Minister to work outside statutory requirements. A multi-agency reference group oversaw the innovation. There were no targets for the use of the prototype, rather a set of principles for families for whom it would be suitable.

The findings show that of 54 families interviewed who had  participated in an FGC :

  • 100% felt involved in the process
  • 100% felt their values had been respected
  • 99% felt their FGC had helped address their problems
  • 91% felt the services they were offered were appropriate to their needs

The evaluation of this model made a number of recommendations for local authorities considering restorative practice, including:

  • The way in which FGCs are introduced to families is of central importance. There needs to be wider organisational awareness of and support for FGCs from senior management and beyond, so that those outside of the FGC service encourage and engage with their use.
  • A restorative approach to domestic violence involves working with perpetrators within a whole family approach that keeps mothers and children safe. FGCs are one element of this, but they, and wider provision, including social work, require a highly skilled workforce supported to work effectively with men (the primary group of offenders). A multi-agency approach, with wide and ongoing stakeholder engagement, is required

In summary...

  • Family Group Conferences are offered to families in a large number of local authorities in the UK on a range of child welfare issues
  • However the evidence regarding the effectiveness of shared decision-making meetings is inconclusive. Further, all of the primary outcomes included in this summary were rated as having a low to very low level of evidence
  • In terms of application to a UK context only two studies included in this review were conducted in the UK
  • There is significant variation in how meetings are delivered and implemented. Family participation is a fundamental principle in child welfare services and more work is needed to improve the quality consistency of the services that are designed to achieve this
  • Further research is required to provide a stronger evidence base for shared decision-making services in the UK. WWCSC are supporting 24 local authorities to introduce Family Group Conferencing at pre-proceedings while conducting rigorous research into the effects

Further resources

This summary comes from an original systematic review called:

Impact of shared decision-making family meetings on children’s out-of-home care, family empowerment and satisfaction: A systematic review. (Nurmatov, B.U., Foster, C., Bezeczky, Z., Owen, J., El-Banna, A., Mann, M., Petrou, S., Kemp, A., Scourfield, J., Forrester, D. and Turley, R.) Published 2020.