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Program Profile: Family Group Conferencing in Child Welfare (Netherlands)

Evidence Rating: No Effects - One study No Effects - One study

Date: This profile was posted on February 25, 2020

Program Summary

This program used a decision-making model to help families involved in the child welfare system to create a care plan. The program is rated No Effects. There were no statistically significant differences found in child safety, child maltreatment, length of welfare involvement, or imposed supervision orders. The treatment group reported a statistically significant higher level of perceived social support; however, the treatment group also had a higher percentage of out-of-home placements.

This program’s rating is based on evidence that includes at least one high-quality randomized controlled trial.

Program Description

Program Goals/Target Population
Family Group Conferencing (FGC) (known as Eigen Kracht-conferentie in Dutch) was a decision-making model for families involved in the child welfare system in the Netherlands, which aimed to encourage the involvement of family members in the design of their care plan (Dijkstra et al. 2018). Families, along with others in their social network (such as extended family, neighbors, or friends) made a care plan to help solve the problems related to their involvement in the child welfare system. The premise of FGC was that parents had the right to be involved in decisions regarding their children and make these decisions themselves. The ultimate goal of FGC was to enhance child safety, to reduce professional service use and the duration of child welfare involvement. FGC also sought to improve parental empowerment and social support for parents.

Program Components
The FGC model consisted of four phases: 1) the referral phase, 2) the preparation or activation phase, 3) the actual conference, and 4) the implementation phase. In the referral phase, the child welfare worker assigned to the family introduced them to the concept of FGC and gave them an opportunity to organize a conference with their extended network. An independent FGC coordinator from the Program Bureau (Eigen Kracht Centrale in Dutch), who was unaffiliated with the child welfare agency, was matched with the family during this phase. During the preparation phase, the FGC coordinator visited with the family and their extended network to prepare them for the conference if they chose to continue with the process.

The actual conference consisted of 1) an information portion where professionals explained information on needs and care options for the family, 2) a deliberation portion where the family privately developed a care plan, and 3) a presentation portion where the family presented the care plan to the FGC coordinator and related professionals. After the care plan was approved, the family and network moved into the implementation phase to carry out the plan. The FGC coordinator monitored the implementation and the progress of the family during this phase to ensure that all agreements were carried out (Dijkstra et al. 2018; Asscher et al. 2014).

Additional Information: Negative Program Effects
An outcome evaluation (described below in Evaluation Methodology and Outcomes) compared families randomized to FGC with families who received care as usual. The results showed that children in the families who participated in the FGC intervention were more likely to receive out-of-home placements, compared with children in the control group families. Approximately 9 percent of intervention group families experienced out-of-home placements, compared with 1.3 percent of control group families. This difference was statistically significant (Dijkstra et al. 2018).

Evaluation Outcomes

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Study 1
Child Safety Scores
Dijkstra and colleagues (2018) found that there was no statistically significant difference between the Family Group Conferencing treatment group and care-as-usual control group in child safety scores.

Out-of-Home Placement
Children in the treatment group families were more likely to receive out-of-home placements, compared with children in the control group families. Approximately 9 percent of intervention group families experienced out-of-home placements, compared with 1.3 percent of control group families. This difference was statistically significant.

Risk of Child Maltreatment
There was no statistically significant difference found between the treatment and control groups in risk of child maltreatment.

Duration of Child Welfare Involvement
There was no statistically significant difference found between the treatment and control groups in duration of child welfare involvement.

Imposed Supervision Orders
There was no statistically significant difference found between the treatment and control groups in imposed supervision orders.

Parental Empowerment
There was no statistically significant difference found between the treatment and control groups in parental empowerment.

Number of Different Social Supports
There was no statistically significant difference found between the treatment and control groups in the number of different social supports.

Perceived Social Support
Families in the treatment group reported a higher level of perceived social support than families in the control group. This difference was statistically significant.
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Evaluation Methodology

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Study 1
Dijkstra and colleagues (2018) conducted a randomized controlled trial in Amsterdam, in the Netherlands, to determine the effectiveness of Family Group Conferencing (FGC). Families were determined to be eligible for the study if they were referred to a child welfare agency between January and December of 2014. Families that participated had been referred to a child welfare agency for a range of reasons, including child maltreatment, alcohol and drug abuse, mental health problems, high-conflict divorce, and childhood behavior issues.

A total of 346 families were randomly assigned to either 1) the treatment group where they received FGC, or 2) the control group where they received care as usual. Eighteen families were excluded following the random assignment because they did not belong to the target group determined by the child welfare agency, or because FGC was not offered. The final sample consisted of 328 families, with 229 families in the FGC group and 99 families in the control group. There were 529 children in the study sample with a mean age of 10 years. Approximately half of the families (53.4 percent) were from a non-Western background, and 46.6 percent were from a Western background. A majority of the participating families (75.9 percent) were broken or newly formed, and 24.1 percent were intact. A majority of the parents (77.4 percent) also had a low level of education, meaning they had completed only lower levels of secondary education. The remaining 22.6 percent were considered more highly educated. Nearly half of the participating families (48.8 percent) were referred to the child welfare agency due to a parent-related issue. The other reasons for referral were child-specific issues (24.1 percent) or family-related issues (27.1 percent). There were no statistically significant differences between groups in any of the background characteristics.

All families involved received Intensive Family Case Management (IFCM), the standard procedure for families involved in the child welfare agency. IFCM was a supervision and case management method designed for engaging and motivating high-risk youth and families with a wide range of problems. Families assigned to the control group only received IFCM, and families assigned to the treatment group received both IFCM and FGC. Family and child welfare worker reports were collected at five different periods: immediately after referral (T1), and 1 month (T2), 3 months (T3), 6 months (T4), and 12 months (T5) following the formation of a care plan.

During these assessments, the study authors measured outcomes that included child safety, risk of child maltreatment, out-of-home placement, supervision orders, duration of child welfare involvement, parental empowerment, and social support. Child safety was measured as part of a child welfare worker’s regular risk assessment, scored on a 10-point scale. This outcome was measured at all timepoints. Risk of child maltreatment was measured by the child welfare worker completing the risk assessment scale of the Actuarial Risk Assessment Instrument Youth Protection. This scale consisted of 23 items rated on a 2-point scale. This outcome was also measured at all timepoints. Out-of-home placements and supervision orders were extracted from case files and were measured at T1 and T5. Duration of child welfare involvement was taken from case files and measured in number of days. Parental empowerment was measured by a subscale of the Family Empowerment Scale (FES), which consists of rating 12 items on a 5-point Likert scale. This measure was completed by the parents to assess their perception of empowerment in parenting situations; it took place at T1, T3, T4, and T5. Social support was measured by both the number of support sources and perceived social support. The number of different social support sources was assessed by the Parental Support Questionnaire, on which the parents indicated all the sources they felt supported by, from a list of 15 resources. Perceived social support was measured by the Interpersonal Support Evaluation List (ISEL–short form), which consisted of rating 12 items on a 4-point Likert scale. This outcome was measured at T1, T4, and T5.

The authors conducted separate repeated measures of analyses of variance (ANOVAs) to examine differences among the groups at each timepoint and the effectiveness of FGC in terms of the various outcomes. ANOVAs were conducted for outcome measures such as duration of child welfare involvement, social support, and parental empowerment. Logistic regression analyses were performed to examine child maltreatment at each timepoint, as well as new out-of-home placements and supervision orders. The study authors conducted subgroup analyses to determine which families were most likely to benefit from FGC.
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Cost

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There is no cost information available for this program.
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Other Information (Including Subgroup Findings)

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Dijkstra and colleagues (2018) conducted subgroup analyses to determine which families would benefit most from Family Group Conferencing (FGC). They looked at ethnicity, family situation, education level of parents, parental intellectual disability, and referral reasons. However, the analyses showed that these familial factors had no statistically significant effects on the outcomes.
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Evidence-Base (Studies Reviewed)

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These sources were used in the development of the program profile:

Study 1
Dijkstra, Sharon, Jessica J. Asscher, Maja Dekovic, Geert Jan J. M. Stams, and Hanneke E. Creemers. 2018. “A Randomized Controlled Trial on the Effectiveness of Family Group Conferencing in Child Welfare: Effectiveness, Moderators, and Level of FGC Completion.” Child Maltreatment 24(2):137–51.
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Additional References

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These sources were used in the development of the program profile:

Asscher, Jessica J., Sharon Dijkstra, Geert Jan J. M. Stams, Maja Dekovic, and Hanneke E. Creemers. 2014. “Family Group Conferencing in Youth Care: Characteristics of the Decision Making Model, Implementation and Effectiveness of the Family Group (FG) Plans.” BMC Public Health 14:1–9.

Merkel-Holguin, Lisa. 2004. “Sharing Power with the People: Family Group Conferencing as a Democratic Experiment.” Journal of Society and Social Welfare 31:155.
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Program Snapshot

Age: 5 - 15

Gender: Both

Race/Ethnicity: White, Other

Geography: Urban

Setting (Delivery): Home, Other Community Setting

Program Type: Family Therapy, Wraparound/Case Management, Children Exposed to Violence

Targeted Population: Children Exposed to Violence, Families

Current Program Status: Not Active