We reviewed the international evidence on the outcomes of shared decision-making family meetings. These meetings aim to improve family members’ involvement in decisions about children at risk, compared with a traditional child protection case conference.
We set out to review all studies that had (1) a comparison group – e.g. comparing families who had taken part in shared decision-making family meetings with families who had received usual services; and (2) quantitative outcomes measures for children being in care, family satisfaction with services or parental empowerment, as well as cost-effectiveness.
How we went about it
We did a systematic search for all eligible studies, decided which were to be included in the review using pre-set criteria, and then summarised the results.
The international evidence from 33 studies shows a mixed and inconclusive picture. For children being in care, when all the outcomes are combined (i.e. care entry, re-entry and re-unification) the evidence leans in a positive direction, but the more robust studies did not show evidence of effectiveness. For satisfaction and empowerment, the evidence was mixed. The evidence was still mixed when the various different approaches were separated out – e.g. family group conferences only. There was no evidence that shared decision-making family meetings increased the risk of subsequent child protection referral. A sub-set of studies found that shared decision-making meetings could be cost-saving for services by reducing care entry and time spent in care.
Family participation should be considered a basic right in child protection. Shared decision-making family meetings are designed to achieve this, but the evidence about their effectiveness is inconclusive. It may be that these participative meetings are not uniformly delivered well or that they are not part of a wider cultural change towards better involvement of family members.
A randomised controlled trial of family group conferences in England is being run by Coram