Background: Capturing the scale of child maltreatment is difficult, but few wouldargue that it is anything less than a global problem which can affect victims’ healthand wellbeing throughout their life. Systems of detection, investigation and inter-vention for maltreated children are the subject of continued review and debate.Objectives: To assess the effectiveness of the formal use of family group decisionmaking (FGDM) in terms of child safety, permanence (of child's living situation), child and family wellbeing, and client satisfaction with the decisionmaking process. Search Methods: Both published and unpublished manuscripts were considered eligible for this review. Library staff from Scholarly Information (Brownless Biomedical Library)University of Melbourne, conducted 14 systematic bibliographic searches. Reviewers also checked the reference lists of all relevant articles obtained, and reference lists from previously published reviews. Researchers also handsearched 10 relevant journals. Selection Criteria: Study samples of children and young people, aged 0–18 years, who have been the subject of a child maltreatment investigation, were eligible for this review. Studies had to have used random assignment to create treatment and control groups; or,parallel cohorts in which groups were assessed at the same point in time. Any form ofFGDM, used in the course of a child maltreatment investigation or service, was considered an eligible intervention if it involved: a concerted effort to convene family, extended family, and community members; and professionals; and involved a planned meeting with the intention of working collaboratively to develop a plan for the safetywellbeing of children; with a focus on familycentred decisionmaking.Data Collection and Analysis: Two review authors independently extracted the necessary data from each study report, using the software application Covidence. Covi-dence highlighted discrepancies between data extracted by separate reviewers, further analysis was conducted until a consensus was reached on what data were to be included in the review. Two authors also independently conducted analyses of study bias. Main Results: Eighteen eligible study reports were found, providing findings from15 studies, involving 18 study samples. Four were randomised controlled trials(RCTs; N = 941) the remainder employed quasiexperimental designs with parallel cohorts. Three of the quasiexperimental studies used prospective evaluations of non-randomly assigned comparison groups (N = 4,368); the rest analysed preexisting survey data, child protection case files or court data (N = 91,786). The total number of children studied was 97,095. The longest postintervention followup period w as 3 years. Only four studies were conducted outside the United States; two in Canada and one in Sweden and one in the Netherlands. The review authors judged there to be a moderate or high risk of bias, in most of the bias categories considered. Only one study referenced a study protocol. Eleven of the fifteen studies were found to have a high likelihood of selection bias (73%). Baseline imbalance bias was deemed to be unlikely in just two studies, and highly likely in nine (60%). Confounding variables were judged to be highly likely in four studies (27%), and contamination bias was judged highly likely in five studies (33%). Researcher allegiance was rated as a high risk in three studies (20%)where the authors argued for the benefits of FGDM within the article, but without supporting references to an appropriate evidence base. Bias from differential diagnostic activity, and funding source bias, were less evident across the evidence reviewed. This review combines findings for eight FGDM outcome measures. Findings from RCTs were available for four outcomes, but none of these, combined in metaanalysis or otherwise, were statistically significant. Combining findings from the quasiexperiment al studies provided one statistically significant finding, for the reunification of families, favouring FGDM. Ten effect sizes, from nine quasiexperimental studies, were synthesised to examine effects on the reunification of children with their family or the effect on maintaining inhome care; in short, the effect FGDM has on keeping families together. There was a high level of heterogeneity between the studies (I2=92%). The overall effect, based on the combination of these studies was positive, small, but statistically significant: odds ratio (OR), 1.69 (confidence interval [CI], 1.03, 2.78). Holinshead's(2017) RCT also measured the maintenance on inhomecareandreportedasimilarresult: OR, 1.54 (CI, −0.19, 0.66) not statistically significant. The overall effect for continued maltreatment from metaanalysis of five quasiexperimental studies, favoured the FGDM group, but was not statistically significant: OR, 0.73 (CI, 0.48, 1.11).The overall combined effect for continued maltreatment, reported in RCTs, favoured the control group. But it was not statistically significant: OR, 1.29 (CI, 0.85, 1.98). Five effect sizes, from nonrandomised studies, were synthesised to examine the effect of FGDM on the number of kinship placements. The overall positive effect based on the combination of these studies was negligible: OR, 1.31 (CI, 0.94, 1.82). Metaanalysis was not possible with other outcomes. FGDM's role in expediting case processing and case closures was investigated in six studies, three of which reported findings favouring FGDM, and three which favoured the comparison group. Children's placement stability was reported in two studies: an RCT's findings favoured the control, while a quasiexperimental study's findings favoured FGDM. Three studies reported findings for service user satisfaction: one had only 30 participants, one reported a statistically significant positive effect for FGDM, the other found no difference between FGDM and a control. Engagement with support services was reported in two studies; neither reported statistically significant findings
FingerprintDive into the research topics of 'Family group decisionmaking for children at risk of abuse or neglect: A systematic review'. Together they form a unique fingerprint.
- School of Social Sciences, Education and Social Work - Senior Lecturer
- Centre for Evidence and Social Innovation