Family Group Decision-Making for Children at Risk of Child Maltreatment

Description of Problem

Family Group Decision-Making (FGDM) has been used extensively in North America, the UK, Australia, and New Zealand and is, in many jurisdictions, considered ‘best practice' in terms of engaging families where child maltreatment is suspected or confirmed. However, there are few outcome studies the employ rigorous research methods to ascertain outcomes of interest, including recurrence of maltreatment and decreases in child placement. Of the studies that do exist, findings are relatively mixed with some studies suggesting improvement and others suggesting the opposite.

Objectives

To assess the effectiveness of the formal use of FGDM in terms of child safety, permanence (of childs living situation), child and family well-being, and client satisfaction with the decision-making process. Research Questions

Methods

Systematic review methods conforming to Cochrane and Campbell Collaboration standards were used to locate, review, and synthesize published and unpublished studies of FGDM including Family Group Conferencing (FGC), the Family Unity Meeting (FUM) model, Team Decision Making, Family Team Meetings, and Family Team Conferencing).

Description of Studies

Studies were eligible for this review if they: 1) used random assignment to create treatment and comparison or control groups; or 2) used parallel cohort designs in which groups were assessed at the same points in time (i.e., quasi-experimental designs that include groups assessed at the same time as opposed to a historical cohort).

Description of Participants

Children and young people aged 0-18 years who were the subject of a child maltreatment investigation,.

Data Collection

Extensive searches of the literature were conducted, including published and unpublished studies, and also including hand searches of relevant journals and queries to experts in the field.

Outcomes

Prevention of child maltreatment recurrence and increasing family permanence and Placement Stability as measured by reports of maltreatment recurrence, entry to out-of-home care, establishment of legal permanence, placement stability, and client satisfaction.

Analytical/Statistical Approach

Metaanalysis and narrative synthesis

Results

Fifteen databases were searched yielding 1741 studies. After initial and secondary screening by at least two readers per article, the final sample contained 6 studies (two randomized and four nonrandomized) that met the inclusion criteria.

Summary

Children receiving FGDM as delivered in these studies tended to have more maltreatment recurrences and more placements in out-of-home care than children who did not receive FGDM. Families receiving FGDM tended to receive more services and expressed greater satisfaction with these services than families receiving usual care.

Conclusions and Implications

FGDM, on its own, does not appear to reduce child maltreatment recurrence or stays in out of home care. Nonetheless, it does appear to have potential as a family engagement tool. Future studies should investigate the use of FGDM coupled with an array of effective service options.