Increasing Adherence to Team Decisionmaking through Improved Family Participation

Background and Purpose:

Team Decisionmaking (TDM) is the team approach strategy for making the best decisions regarding the removal of a child from their home, reunification, or adoption due to safety concerns (Crampton, Usher, Wildfire, Webster, & Cuccaro-Alamin, 2011). In the TDM meeting, attendance of all participants related to the child removal issues is encouraged in order to hear their voices for the best decision. Specifically, attendance of family members is required to ensure that their experiences are reflected and to reach the best possible decision outcome (Wildfire, Rideout, & Crampton, 2010). While previous TDM research demonstrates positive relationships between greater meeting attendance and positive outcomes (Wildfire, Rideout, & Crampton, 2010; Crampton et al., 2011), little is known about the relationship between family attendance and adherence to TDM practices. In general, research in the area of child welfare family engagement has not examined how central adherence to team meetings is to these approaches (Gunderson, Cahn, & Wirth, 2003; Litchfield, Gatowski, & Dobbin, 2003). This study aims to investigate how family attendance in TDM meetings may affect adherence to TDM practices.

Methods:

The research team developed and pilot tested a new assessment system (32-item self-report questionnaires) designed to measure adherence to TDM practices. The data were collected from 101 TDM meetings that took place at the Division of Children and Family Services (DCFS). A total of 395 questionnaires and 52 meeting recordings were obtained. Expert coders performed observational coding of adherence to TDM practices for the 52 recorded meetings. Coder reliability was established using double coding of 25% of the collected sample, and met standards for “excellent” according to the criteria set by Cicchetti (1994) (MICC = .75). Using the highly-reliable coder data, Spearman bivariate correlations were computed to examine the relationship between the family attendance rate and adherence to TDM.

Results:

Higher family attendance rate was correlated with greater adherence to TDM practices. Specifically, the study results indicate that the more family members attend the meeting, the more actively facilitators encourage participants’ discussions regarding safety concerns (r = .315), family strengths and supports (r = .334), the family’s needs and concerns (r = .349), and evaluation of each idea (r=.313). In addition, facilitators’ use of white boards to record the meeting process, and summarization of team decisions occurred more extensively when there was a higher ratio of family members to staff in the meeting. In summary, greater attendance of family members improved adherence to TDM practices.

Conclusions and Implications:

In this study, family attendance was associated with greater adherence to key meeting practices related to family engagement and ensuring understanding of the TDM meeting process, and to overall meeting structure. Our findings suggest that greater attendance of family members at meetings may improve TDM meeting adherence, ultimately improving the decision outcomes for children and family involved with the child welfare system. Therefore, greater efforts should be made toward encouraging active participation of family members in TDM meetings.