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Chapter Six: Concluding remarks
1.6.1 This review has comprehensively documented and analysed much of the academic and grey literature available on FGDM. Emerging from New Zealand in 1989, this approach has been adopted in numerous jurisdictions and today forms a principal component of many social welfare and juvenile justice systems. However, despite growth in the model's usage, there remain some persistent doubts regarding its applicability, cost effectiveness and subsequent long-term outcomes.
1.6.2 In terms of the key research questions described in the introduction, while it is relatively straightforward to outline the origin, use and development of the model, the lack of credible research on some aspects of the approach make the provision of other responses problematic. While some guidance can be provided the knowledge, skills and values necessary to deliver FGDM, there are few indications as to whether professional or lay provision of such a service is preferable. There also appears to be great ambiguity in relation to professional opinions - the overwhelming enthusiasm of the few seemingly being pitted against the apparent reluctance of the majority to embrace such a model. In terms of cost effectiveness, there are some indications that the model does lead to savings, although care should be taken to ensure these are not pursued at the expense of the model's core principles.
1.6.3 However, it is in terms of outcomes that the most persistent doubts remain. A lack of rigorous evaluation has resulted in a situation where a glut of evidence exists in relation to the high 'process' satisfaction of participants and some of the short-term outcomes. However, this is not accompanied by a consistent body of evidence showing positive long-term outcomes from the process. While these are not likely to be any worse than those of other decision-making fora, such doubts could be contributing to the marginalisation of the approach within social welfare practices.
1.6.4 Crampton (forthcoming) argues that in view of the impossibility of gaining a complete picture of its effectiveness from research, communities should consider discrete elements of the FGDM research when deciding how to implement schemes. He argues that linking this evidence to decisions about which outcomes are desired (e.g. reductions in numbers on child protection lists), which families should be referred for conferencing and which FGDM processes are important (e.g. trading-off preparation time against volume of referrals) allows communities to 'work backwards' in designing their programme so that it is best placed to achieve relevant goals from the outset. It is argued that this approach, based on programme theory (Weiss: 1998), would also facilitate clearer, more positive evaluations.
1.6.5 While designing services in this way may help improve individual programme implementation, there are a number of potential problems which may inhibit such an approach. Firstly, while communities can easily decide on specific outcomes to be pursued, no coherent body of evidence exists that would permit them to make informed decisions about participation in FGDM or what processes are important. As yet there is no conclusive evidence as to who benefits most from FGDM, experimental groups in research on this matter having been restricted on the basis of participant choice or institutionally defined notions of appropriateness. Similarly, the piecemeal nature of research on key FGDM principles does not facilitate enlightened decision-making about the possible effects of curtailing preparation time etc.
1.6.6 Secondly, such an approach towards programme implementation may have the effect of further curtailing rather than enhancing the coherency of FGDM research. Were programmes to focus increasingly on achieving specific outcomes with specific families using specific elements of the model we may not be able to generalise on the basis of their findings nor compare them usefully with findings from other similar jurisdictions. While the results of individual evaluations may become more positive by adopting such an approach, too little is known about the overall effectiveness of the model to restrict their scope and the scope of potential research on such a basis.
1.6.7 Thirdly, the effects of 'watering down' core principles of the model must be carefully considered. Prescribing outcomes, restricting intakes and curtailing access to elements of the model are not consistent with the philosophy of FGDM. In the absence of a coherent body of research contraindicating adherence to the model's central tenets, it should be assumed that deviation may reduce the effectiveness of interventions. Furthermore, without such evidence, defining the parameters of the model may become a matter of unprincipled professional choice. There is a danger that premature abandonment of the FGDM model may shift the emphasis away from family empowerment, so that organisational objectives rather than the needs of families come to define the nature of interventions. Though unflinching adherence to the FGDM model is not proposed, the philosophical and practical importance of family empowerment demands that appropriate efforts be made to deliver relevant initiatives and that caution should be exercised before dismantling them.
1.6.8 Rather than losing patience with the slow progress of FGDM evaluation or abandoning the prospect of mainstreaming principled practice, it is suggested that efforts to research the model should be redoubled and focused on specific areas. Further research is required on many aspects of the literature - suggestions include:
- Randomised controlled trials of long-term outcomes from FGDM and other traditional decision-making fora;
- Comparative analysis of outcomes in relation to low and high-risk problems;
- A comprehensive analysis of the cost effectiveness of FGDM;
- Examinations of the effect of preparation, private family time etc. on process satisfaction and outcomes;
- Advantages and disadvantages of professional and lay-led schemes;
- The place of FGDM in contemporary social work practice;
- An examination of social work decisions to refer individual families for FGDM;
- Evaluations of training provided to co-ordinators and other FGDM-related staff.
1.6.9 This list merely represents a small proportion of the areas about which further knowledge is needed in order to clarify the effectiveness of, or provide support for, the model. At this stage, the priority of future research should be to establish how effective FGDM can be by examining long-term outcomes and their associated costs. Subsequently, the conditions under which the model can perform most effectively must be established, so that if modification takes place it is properly guided by research.
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