Family group conferences and the improvement of family centred decision making
- issue: Issue 1 / 2009
- authors: Peter Marsh
- keywords: United Kingdom, development, family, group, partnership, practice, evidence-based, social work
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Background. This chapter reviews the development, implementation and outcomes of Family Group Conferences, a form of decision making for vulnerable children and young people which places the family at the heart of the process. The Conferences are a radical model of decision making that was first introduced in New Zealand. They involve an independent co-ordinator gathering family and professionals together in a Conference which provides private family time, and seeks overall agreement on plans to protect vulnerable children (Ashley, 2006).
Family Group Conferences: the potential. Evaluations of Family Group Conferences have been very positive, and have shown that:
- it is possible to conduct the Conferences in a very wide range of circumstances,
- it is possible to get a substantial number of family members to attend Conferences even in very fraught circumstances,
- all areas of child welfare can be covered by the model, and it is appropriate for a range of other problems as well,
- once a Conference is held then around 90 percent do agree a plan to protect and support children that is acceptable to professionals,
- families find the Conferences stressful, but they are generally very positive about them (Marsh and Crow, 1999; Crampton, 2006).
The Conferences are now in use in at least 16 countries throughout the world, with many different communities using the model (Merkel-Hoguin, 2003; Nixon et al, 2005). However the introduction of such a radical model has proved difficult, and despite the positive evaluations and the avowed support of the great majority of social workers there is a relatively low rate of referral even in heavily promoted projects (Marsh and Crow, 1989; Sundell et al, 2001) and the practice remains relatively marginal within mainstream services (Brown, 2003).
It is often the case that positive evaluations and positive views about principles do not necessarily translate easily into widespread use and adoption of a particular intervention. This appears to be notably the case with Family Group Conferences, and the reasons for the exceptional difficulties may lie in particular elements of the partnership based approach of the Conferences. Analysing these will provide lessons for improving use of evidence-based developments in general, and in particular for improving those that stress the partnership between social workers and services users as a key element of practice.
A number of issues are likely to lie behind this lack of connection between evaluation and adoption, within the context of the overall difficulties concerning implementation of new practice.
The similarity principle: confusion of concepts and words? A number of the actions, and concepts, within Family Group Conferences look like other types of practice, leading to potential confusion regarding the model, and a capacity to think that much of it is already being done, because it 'looks like' or 'sounds like' something else. It may well be, to alter an old English saying, that 'similarity breeds contempt'.
The DATA syndrome: because we believe in it we do it? The introduction of partnership based approaches in the UK showed how social workers could confuse their belief in a principle with the actions that were associated with that principle, thus enabling them to think, when faced with new partnership ideas, that they 'Do All That Already' (Marsh, 1986). The DATA syndrome in conjunction with the similarity principle will reinforce the strength of the third problem, 'the rulebook culture'.
The rulebook culture: are guidelines and procedures a substitute for practice development within the social work profession? If the development of practice is given relatively low status within social work, and the relative lack of literature and research that directly addresses practice development suggests this might be the case, then there is less knowledge of implementation techniques, and more likelihood of practice being driven by procedure and agency rulebook. In many Western societies a growing managerialism within professional practice will also promote this culture, thus providing a final boost to the rulebook approach and the problems of implementing new practice.
Implementation of evidence-based partnership practice in child welfare. These issues mean that we need to consider a number of key factors in connection with the introduction of new models of practice within social work.
Standards and boundaries; defining the space for professional and user autonomy while maintaining programme fidelity. With any new programme issues of programme fidelity are important, but in the complex cases being tackled by Family Group Conferences, and where the model deliberately encourages some differences in approach (for example to reflect family cultures), there needs to be very careful consideration of how to ensure that the model in practice maintains key elements, while allowing appropriate flexibility.
Principles and action: revealing the link, or lack of it. Where underlying principles of a new model fit well with those commonly held by a professional group it is important to examine the inter-connection of those principles and actions actually undertaken in practice (Newton and Marsh, 1993).
Integrating the science: building in the science in a partnership manner. There are sound arguments for thinking that science needs to be more deeply embedded in the practice of social work, not just as the product of research but as part of the process of social work itself (Marsh, 2007). Adopting this approach, would probably provide a better climate for the introduction of well evaluated models, but more crucially it would lead to the production of evidence that was closely connected to practice and more relevant and applicable.
Recommendations. There is now an international evidence base for Family Group Conferences, but the fact that there is such a gap between the positive evidence and relative lack of practice in this area should lead us to think about key issues in the introduction of evidence-based practice, and to work hard at providing solutions for the gap between what we know and what we do.
First, we need to be much clearer as to what the particular key elements of any effective intervention programme are, so that we can examine and support programme fidelity, and also allow practitioners and service users appropriate creativity within any particular effective approach. We need to ask the question: 'what are the minimum requirements that the science suggests for this programme?'
Secondly, we need to make sure that issues of principles and of values are considered in our evaluation work. This should be at the level of outcomes (for instance we should work hard on what a 'decent' and 'respectful' outcome might look like, and not just examine outcomes that indicate problem reduction), and at the level of match with existing practice views so that we can look at the fit, or lack of fit, between existing values the practical actions of social workers and service users.
Thirdly, we need to develop an approach to social work that emphasises science as process, not just product. Pre-registration courses need to teach research methods, and the history of research. Service users need accessible research and to engage directly in research. Social work academics need to engage with practice, and to maintain a good dialogue with both practitioners and service users.
The strong evidence coming from the evaluation of family group conferences over the last twenty years is that without these fundamental changes the implementation of evidence based practice in social work will continue to be a very difficult affair.
Ashley, C. (Ed.). (2006). The Family Group Conference Toolkit - a practical guide for setting up and running an FGC service. London: Family Rights Group.
Crampton, D. (2007). Research Review: Family group decision-making: a promising practice in need of more programme theory and research. Child and Family Social Work, 12(2), 202-209.
Marsh, P. (2007). Developing an enquiring social work practice: Practitioners, researchers and users as scientific partners. Utrecht, Netherlands: Bohn Stafleu van Loghum.
Marsh, P. & Crow, G. (1998). Family Group Conferences in Child Welfare. Oxford: Blackwell Science.
Contact: Prof. Peter Marsh, Dean of Social Sciences, University of Sheffield, England. E-mail: email@example.com.