This project or publication was produced before or during the merger of What Works for Children’s Social Care (WWCSC) and the Early Intervention Foundation (EIF).
A review of international evidence across 33 studies found mixed and inconclusive evidence on how shared decision-making family meetings may impact outcomes, although the evidence leans in a positive direction when considering all outcomes together.
Shared decision-making family meetings are meetings which aim to better involve family members in decisions about children at risk, empowering them to contribute to the decisions that are made, compared with a traditional child protection case conference. We reviewed the international evidence on these meetings, looking at outcomes.
Our aim was to review all studies where the ‘treatment’ group had been compared to 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 where there were quantitative outcomes measures for children being in care, family satisfaction with services or parental empowerment, as well as cost-effectiveness.
We looked at 33 studies. These were chosen by first running a systematic search for all eligible studies, and then using pre-set criteria to select those to include. Our report summarises the findings of this collection of international evidence.
We found a mixed and inconclusive picture. For children in care, when all the outcomes are combined (i.e. care entry, re-entry and re-unification) the evidence leans in a positive direction. However we did not find evidence of effectiveness from the most robust studies.
For the outcomes of satisfaction and empowerment, the evidence was mixed. The evidence was still mixed when the various different approaches were separated out – e.g. when looking at 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.
As a next step, a randomised controlled trial of family group conferences in England was run by Coram. Read the report: https://foundations.org.uk/our-work/publications/family-group-conferencing-at-pre-proceedings-stage/
Rated 1: Set up and delivery is low cost, equivalent to an estimated unit cost of less than £100.
Rated 2: Set up and delivery is medium-low cost, equivalent to an estimated unit cost of £100–£499.
Rated 3: Set up and delivery is medium cost, equivalent to an estimated unit cost of £500–£999.
Rated 4: Set up and delivery is medium-high cost, equivalent to an estimated unit cost of £1,000–£2,000.
Rating 5: Set up and delivery is high cost. Equivalent to an estimated unit cost of more than £2,000.
Set up and delivery cost is not applicable, not available, or has not been calculated.
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Supporting children’s mental health and wellbeing: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
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Rated 2: Has preliminary evidence of improving a child outcome from a quantitative impact study, but there is not yet evidence of causal impact.
Rated 2+: Meets the level 2 rating and the best available evidence is based on a study which is more rigorous than a level 2 standard but does not meet the level 3 standard.
Rated 3: Has evidence of a short-term positive impact from at least one rigorous study.
Rated 3+: Meets the level 3 rating and has evidence from other studies with a comparison group at level 2 or higher.
Rated 4: Has evidence of a long-term positive impact through at least two rigorous studies.
Rated 4+: Meets the level 4 rating and has at least a third study contributing to the Level 4 rating, with at least one of the studies conducted independently of the intervention provider.
Rating has a *: The evidence base includes mixed findings i.e., studies suggesting positive impact alongside studies, which on balance, indicate no effect or negative impact.
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