Family group decision‐making for children at risk of abuse or neglect: A systematic review

Tony McGinn; Paul Best; Jason Wilson; Admire Chereni; Mphatso Kamndaya; Aron Shlonsky

doi:10.1002/cl2.1088

. 2020 Jul 12;16(3):e1088. doi: 10.1002/cl2.1088

Family group decision‐making for children at risk of abuse or neglect: A systematic review

Tony McGinn ^1,^✉, Paul Best ², Jason Wilson ³, Admire Chereni ⁴, Mphatso Kamndaya ⁵, Aron Shlonsky ⁶

PMCID: PMC8356301 PMID: 37131917

Abstract

Background

Capturing the scale of child maltreatment is difficult, but few would argue that it is anything less than a global problem which can affect victims’ health and well‐being throughout their life. Systems of detection, investigation and intervention for maltreated children are the subject of continued review and debate.

Objectives

To assess the effectiveness of the formal use of family group decision‐making (FGDM) in terms of child safety, permanence (of child's living situation), child and family well‐being, and client satisfaction with the decision‐making 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Both published and unpublished manuscripts were considered eligible for this review.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 hand‐searched 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 of FGDM, 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 safety well‐being of children; with a focus on family‐centred decision‐making.

Data Collection and Analysis

Two review authors independently extracted the necessary data from each study report, using the software application Covidence. Covidence 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 from 15 studies, involving 18 study samples. Four were randomised controlled trials (RCTs; N = 941) the remainder employed quasi‐experimental designs with parallel cohorts. Three of the quasi‐experimental studies used prospective evaluations of nonrandomly assigned comparison groups (N = 4,368); the rest analysed pre‐existing survey data, child protection case files or court data (N = 91,786). The total number of children studied was 97,095. The longest postintervention follow‐up period was 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 meta‐analysis or otherwise, were statistically significant. Combining findings from the quasi‐experimental studies provided one statistically significant finding, for the reunification of families, favouring FGDM. Ten effect sizes, from nine quasi‐experimental studies, were synthesised to examine effects on the reunification of children with their family or the effect on maintaining in‐home care; in short, the effect FGDM has on keeping families together. There was a high level of heterogeneity between the studies (I ² = 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 in‐home care and reported a similar result: OR, 1.54 (CI, −0.19, 0.66) not statistically significant. The overall effect for continued maltreatment from meta‐analysis of five quasi‐experimental 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). Meta‐analysis 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 quasi‐experimental 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.

Authors' Conclusions

The current evidence base, in this field, is insufficient to draw conclusions about the effectiveness of FGDM. These models of child protection decision‐making may help bring about better outcomes for children at risk, or they may increase the risk of further maltreatment. Further research of rigour, designed to avoid the potential biases of previous evaluations, is needed.

1. PLAIN LANGUAGE SUMMARY

1.1. No evidence that family group decision‐making is better, or worse, than conventional child protection procedures

Family group decision‐making is used to make decisions about how best to protect children, and support families. It engages the family, extended family, and people in the community around the family, in these decisions. It features an independent meeting facilitator, private family time away from professionals and the prioritisation of family plans. This review finds that the evidence base supporting this approach is of poor quality with no clear finding that it is any better or worse than conventional approaches.

1.2. What is this review about?

Child maltreatment is a global problem which can affect victims' health and well‐being throughout their life. Debate continues as to effective systems of detection, investigation and intervention for maltreated children.

This review assesses the effectiveness of the formal use of family group decision‐making in terms of child safety, permanence (of child's living situation), child and family well‐being, and client satisfaction with the decision‐making process.

What is the aim of this review?

This Campbell systematic review assesses the effectiveness of family group decision‐making to tackle child abuse. It summarises the evidence from 15 studies is four countries, with most studies being from the USA.

1.3. What studies are included?

The included studies were about children and young people, aged 0‐18 years, who had been the subject of a child maltreatment investigation. 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 of family group decision‐making 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 meeting with the intention of working collaboratively to develop a plan for the safety and well‐being of children; with a focus on family‐centred decision‐making.

The review authors found 18 eligible study reports, providing findings from 15 studies, involving 18 study samples. Four of the studies were randomised controlled trials.

All but four studies were conducted outside the USA: two in Canada, one in Sweden and one in The Netherlands.

1.4. What are the findings of this review?

Overall, there are few if any significant benefits of family group decision‐making compared to conventional treatment, and the quality of the studies in the evidence base is generally poor.

Four randomised controlled trials found no significant effect on continued maltreatment, reunification of children with families or maintenance of in‐home care, engagement with support services and social support.

The quasi‐experimental studies found a statistically significant finding favouring family group decision‐making for the reunification of families, but not for any other outcomes. In all cases, there is considerable variation in effects between studies.

1.5. What do the findings of this review mean?

The low quality of the evidence base, with no clear consistent finding of positive effects, is at odds with the support family group decision‐making enjoys in social work practice. However, these findings should not be used to discard the approach, but rather to identify the sources of possible shortcomings in the model whilst strengthening the evidence base.

It is possible that this disconnect is explained by the theoretical appeal of the approach. Failure to fully implement the model may come from a focus on the planning stage but not the implementation of that plan, or that promised family supports are not forthcoming, or from social workers' reluctance to hand decision‐making over to families.

More studies are needed. It is important that study designs take account of the many sources of bias, particularly selection bias, to which studies of this topic are prone.

1.6. How up‐to‐date is this review?

The review authors searched for studies published up to June 2019.

2. BACKGROUND

2.1. Description of the condition

Child abuse or neglect, referred to here as child maltreatment, remains a global problem which can affect victims’ health and well‐being throughout their life. The World Health Organisation describes the range of abuses children may suffer: physical and emotional ill‐treatment, sexual abuse, neglect, and exploitation that results in actual or potential harm to the child's health, development or dignity (WHO, 2016). Capturing the scale of maltreatment, is difficult (UNICEF, 2017) but it is estimated that, worldwide, 41,000 child homicides occur each year and as many as one in four adults were physically abused as children (WHO, 2016). Commonly accepted impacts of childhood maltreatment, during the adult life‐course, include clinical depression and anxiety (Li, D'arcy, & Meng, 2016). Evidence to suggest that child maltreatment is passed on from generation‐to‐generation is complex, but extensive (Bartlett, Kotake, Fauth, & Easterbrooks, 2017) and suggests that the parenting capacity of victims of childhood maltreatment can be reduced.

Statutory intervention on behalf of maltreated children is the responsibility of child welfare agencies in most countries. However, systems of detection, investigation and intervention for maltreated children are the subject of continued review and debate. Historically, the removal of maltreated children from their home to a place of perceived safety and better care, often institutionalised care, was the preferred intervention for statutory welfare services. While removing a child is still necessary in some cases, this action is recognised as less preferable than developing safe care, and parenting, for children in their own home; not least because of research evidence suggesting a lack of stability and poor outcomes for children removed from their home (Wick, 2014). Modern child welfare services therefore endeavour to maintain in‐home care for the children they work with. However, investigations and interventions to address child maltreatment are often hinged upon a dilemma between child rescue (removing a child from their home) and supporting a family to maintain a child safely at home (Rauktis, McCarthy, Krackhardt, & Cahalane, 2010).

The United Nations Convention on the Rights of the Child (UNICEF, 1989) promoted more involvement of children in decisions regarding their care. Subsequent decades also saw a focus on developing family participation in decision‐making, and planning, in order to keep children safe within their own family (Pennell & Burford, 2000). Developing mutual relationships between families, children and professionals became a widely accepted priority in child protection work (Berzin, 2006). While the progression of child welfare policy and practice has taken a number of twists and turns over the past 40 years, and differs considerably across regions, there has clearly been a shift towards sharing power and problem‐solving with families (Frost, Abram, & Burgess, 2014; Rauktis et al., 2010).

Against this background of progress in children's and family rights and, also, due in no small measure to indigenous Maori traditions, FGDM emerged in New Zealand as a promising means of formalising family involvement in child protection decision‐making, and forward planning. It became mandatory practice in New Zealand's Children, Young Persons, and Their Families Act, 1989, and child protection policy makers across the globe have been implementing or trialling versions of FGDM since (D. Crampton, 2007; Merkel‐Holguin, Nixon, & Burford, 2003).

2.2. Description of the intervention

In 2007 Crampton suggested that, worldwide, approximately 150 communities had explored, or were exploring, the benefits of FGDM in child welfare practice. More recently, Frost et al. (2014) suggested that the use of FGDM was increasing in child protection work. Acknowledging that FGDM initiatives are on‐going in parts of Europe, the United States, Canada and Australia, we would also point out that it is not main‐stream child protection practice outside New Zealand. The prominence of FGDM varies regionally and, we would add, temporally as policy makers focus and refocus on the various objectives of child protection work.

Several FGDM practice manuals have been published (Jones & Daly, 2004; Partnership for Strong Families, 2009). Berzin's (2008, p. 36) summary captures the central tenets of the intervention:

“In general terms, FGDM is a child welfare decision‐making process in which efforts are made to bring together all parties with an interest in the well‐being of the child and his or her family. At the FGDM meeting, the group works to discuss the concerns that bring the child to the attention of protective services, the strengths that exist in the family system, and the changes necessary to keep the child safe”.

Proponents see it as a means of empowering families to problem solve, a means of enhancing parenting and care capacity to help protect against child maltreatment, and a better conduit to securing permanency of parenting and care, than traditional child protection services (Barnsdale & Walker, 2007; Morris and Connolly, 2012; Rauktis et al., 2010).

Whilst the ethos, and most of the key features of FGDM are consistent where ever it is deployed, several versions of FGDM have emerged since the formal documentation of New Zealand's Family Group Conferencing (FGC) model in 1989 (D. Crampton, 2007). These include: Team Decision Making, Family Team Conferencing, Family Team Meetings, Expedited Family Group Conferencing and Ohana Conferencing. We should also acknowledge that there are variations in the application of these models, regionally, and across agencies (Morris & Connolly, 2012). FGC is arguably the touch‐stone for all FGDM models, and the following intervention components were found to be common to a majority of descriptions offered by previous commentators and researchers (Berzin, Thomas, & Cohen, 2007; D. Crampton, 2007; Dijkstra, Creemers, Asscher, Deković, and Stams, 2016; Doolan, 2007; Hollinshead, 2017; Kempe Centre for Prevention of Child Abuse, 2019; Marsh & Crow, 1998; Merkel‐Holguin, 2003; Partnership for Strong Families, 2009; Rauktis, Bishop‐Fitzpatrick, Jung, & Pennell, 2013; Sundell & Vinnerljung, 2004):

1.
Efforts are made to involve the wider family and/or appropriate individuals from the family's community.
2.
An independent (i.e., noncase carrying) coordinator chairs one or more meetings of family members and child protection service staff.
3.
Family groups are given time to themselves, during, after or between meetings, to help facilitate their own decision‐making and, where appropriate, agreement on a safety plan going forward.
4.
Child protection services prioritise family group plans, providing child protection concerns are adequately addressed.

It should be noted that FGDM interventions are an on‐going active process, during the course of a child protection case. Plans agreed by the family group and child protection staff are reviewed at appropriate intervals. They also hinge on child protection agencies providing appropriate support, in line with the plan agreed by the family group, on an on‐going basis. However, these criteria are equally applicable to most non‐FGDM practice models in the child protection domain, and were not used as selection criteria in this review.

Studies which compared FGDM with more traditional child protection services were included in this review. Traditional child protection services are defined here as those in which decision‐making on children's care plans and placement have been professionally driven, with workers conducting assessments of families’ problems and risk profiles, and determining a care plan with which families are asked to comply (Merkel‐Holguin, 2003; Rockhill 1999). Policy and practice guidance in most developed nations now acknowledges the importance of in‐depth engagement with children's families and extended families where possible (Connolly, 2006; Littell, 2001; Yatchmenoff Diane, 2005). However, FGDM remains distinct from traditional services. None of the comparators in the primary studies reviewed here employed independent, FGDM‐trained chairs, for meetings with private family time and a prioritisation of family‐proposed plans.

2.3. How the intervention might work

We can explore the hypothesised mechanisms of FGDM in more detail. First, in relation to family empowerment: studies which have researched family's perspectives on FGDM have found that they prefer it to traditional child protection practice (Berzin, 2007). This may be the case because it offers a better balance of power to families, or it may be due to increased family unity, brought about by the FGDM process (Pennell & Burford, 2000). Sundell & Vinnerljung (2004) suggests that families are more likely to accept and buy into a plan that they themselves have proposed, than a plan imposed upon them by professionals.

Second, FGDM is designed to seek out and encourage the participation of extended family and community resources. In this way, FGDM models aim to strengthen the family and community network. Creating a strong network of support around the child and caregiver(s) may improve outcomes for children. Attracting investment from extended family through FGDM is thought to increase the likelihood of a kinship placement, when children must move from their home. The involvement of extended family is also thought to increase the likelihood that, when placed, children will remain with their siblings (Connolly & MacKenzie, 1998; C. Lupton & Nixon, 1999; Marsh & Crow, 1998).

Third, FGDM models frame families as competent and often explicitly focus on their strengths, with the aim of empowering families and shifting their experience of child protection service from one characterised by powerlessness to one of self‐determination and collaboration (C. Lupton & Nixon, 1999). Literature across disciplines indicates that therapeutic settings which support clients’ sense of autonomy, relatedness and competence are more likely to bring about compliance with treatment, and greater transfer and maintenance of treatment gains (Dwyer, Hornsey, Smith, Oei, & Dingle, 2011; Ryan, Lynch, Vansteenkiste, & Deci, 2011).

Finally, on how FGDM might work to improve outcomes for maltreated children we should also reference FGDM's theoretical underpinning: FGDM could be said to align with ecological system theory, social network theory and strengths‐based therapeutic practice and intervention (Havnen & Christiansen, 2014; Morris & Connolly, 2012; Nyberg, 2003). Through concerted engagement with families, FGDM is thought to encourage a more comprehensive trawl of the systems within which a child at risk exists, and is therefore more likely to find intrinsic family strengths which can lead to better outcomes.

2.4. Why it is important to do this review

This review contributes to the literature by including the most recent research on FGDM, including outcomes that have not been included in prior reviews, and employing stringent criteria for search, selection, coding, and analysis as specified in the Campbell Collaboration guidelines (Campbell Collaboration, 2016). The question of how effective FGDM is in meeting its objectives has attracted considerable commentary. While commentary on the implementation and success of FGDM is extensive, relatively few studies of efficacy have been conducted (Frost et al., 2014). The current evidence base is routinely cited as positive by researchers studying FGDM, together with reviewers, and commentators on the topic area (including but not limited to: Baumann, 2006; Berzin, 2006; Burford, 1999; Lambert, Johnson, & Wang, 2017; Pennell, Edwards, & Burford, 2010; Sheets et al., 2009).

In 2003, the American Humane Society (2019) published a special issue on FGDM, with 29 submissions from the United States and beyond (forwarded by Merkel‐Holguin, 2003). Much of the material brought together in this special issue relates to the implementation of FGDM projects. Only one of these articles provided sufficient outcome data to facilitate inclusion in the current review. However, Merkel‐Holguin et al. (2003) provided the forward to this volume and summarised that FGDM compared favourably to traditional child protection methods in providing child safety; encouraging kinship placements; encouraging stable children's placements; bringing about reunification with parents, timely decision‐making, increased family support and a reduction in family violence.

Crampton (2006) provided a narrative review of four FGDM evaluations. Primary study effect sizes are not offered. Crampton describes the positive evaluations of two studies (Crampton, 2003; Pennell & Burford, 2000) and the inconclusive findings of Sundell and Vinnerljing's (2004) study and a study by the Centre for Social Services Research (2004). Frost et al. (2014) also completed a narrative review and reported mixed results, while also offering encouragement for the continued practice of FGDM. Frost et al. suggest that studies by Crampton and Jackson (2007); and Pennell and Burford (2000) provide positive results; whilst Berzin (2006) and Sundell and Vinnerljung (2004) provide neutral findings. Frost et al. go on to describe how service users’ evaluations of the process of FGDM are overwhelmingly positive. Participants feel they are being listened to and valued. Frost et al. argue that this demonstrates the value of FGDM in the absence of powerful outcome evidence.

It can be seen that policy makers may find encouragement to deploy FGDM, in these reviews. However, a counter‐standpoint also exists. A number of researchers in this field have argued that the body of evidence supporting FGDM lacks rigour, and that there is insufficient evidence available to make a judgement on the efficacy of FGDM (e.g., Creemers et al., 2016; Havnen & Christiansen, 2014; Weigensberg, Barth, & Guo, 2009). Havnen and Christiansen (2014) found that seven out of ten studies, retrieved for their review, reported positive results. The other three were negative or neutral, and only two of the studies that reported positive results (Wang et al., 2012; Weigensberg et al., 2009) used satisfactory methods. Dijkstra et al. (2016) review is arguably the most comprehensive and rigorous review to date. Dijkstra et al. reviewed 14 studies and concluded that, according to the evidence available, FGDM did not significantly reduce child maltreatment. They highlighted the need for more robust studies of efficacy.

Dijkstra et al. (2016) review has been a step forward in review methodology for the field. Previous reviews did not report systematic literature searches and did not review all of the studies available, or deploy meta‐analysis. However, three studies were included in Dijkstra et al.'s review did not meet the selection criteria for the current review, and an additional three eligible studies were found for the current review.

More generally, there remains a lack of emphasis on study rigour, or a formal assessment of potential bias across FGDM evaluations. In the context of disagreement about FGDM efficacy, a systematic review, completed according to the Campbell Collaboration's standard of methodological rigour (Campbell Collaboration, 2016) provides a more definitive answer to the question. In addition, the acceptance, rejection and discussion of study methodologies, a central focus of Campbell reviews, will provide guidance for the development of more rigorous study protocols, going forward.

In summary, this review considers the problem of how to go about optimum decision‐making for the protection of children from abuse and neglect. This problem is located within on‐going efforts to protect children while also promoting family unity, upholding family's rights and guarding against oppressive statutory intervention in family life. FGDM has been proposed as an effective response to this problem, and this review will help guide the development of this intervention and its evaluation.

3. OBJECTIVES

To assess the effectiveness of the formal use of FGDM in terms of child safety, permanence (of child's living situation), child and family well‐being and client satisfaction with the decision‐making process.

4. METHODS

4.1. Criteria for considering studies for this review

4.1.1. Types of studies

Studies will be eligible for this review if they (a) used random assignment to create treatment and comparison or control groups; or (b) used parallel cohort designs in which groups were assessed at the same points in time (i.e., quasi‐experimental designs that include groups assessed at the same time as opposed to a historical cohort). Single‐group designs and single‐subject designs will be excluded (see “risk of bias” section for further details on included designs).

4.1.2. Types of participants

Children and young people aged 0–18 years who have been the subject of a child maltreatment investigation.

4.1.3. Types of interventions

Any form of FGDM used in the course of a child maltreatment investigation or during the course of services arising from such an investigation. FGDM involves convening family and child protection professionals with one or more of other professionals, extended family, identified friends and/or community members. In an effort to collaboratively develop a plan to maintain child safety, facilitate stable and permanent living arrangements, and promote child well‐being. Therefore, studies will be included in the review if they involve: (a) a concerted effort to convene family, including extended family, friends and community members; and (b) child protection professionals (as well as other professional service providers) participating in; (c) one or more planned meetings with the intention of working collaboratively to develop a plan for the safety, permanence and well‐being of children; (d) with a focus on family‐centred decision‐making; (e) an independent meeting facilitator; (f) private family time during the process.

4.1.4. Types of outcome measures

Primary outcomes

Official reports found in administrative data and case files, were the preferred indicators of outcomes, but studies were also accepted if they used standardised recording tools for study participant reports.

The prevention of child maltreatment, and the stability of child placements following the involvement of a child protection service, were the primary outcomes of interest. The success of FGDM, in preventing child maltreatment, was measured by (in order of preference): substantiated or verified referrals to a child protection authority; referrals (with or without substantiation) to a child protection authority; parent‐report; and child self‐report. Indicators of child placement stability differed depending on the childrens' circumstances. If children resided in the homes of their permanent carers, then a move to an out‐of‐home placement was a negative outcome. Therefore, more child removals, in comparison with a non‐FGDM group of children, were indicative of poor efficacy. Kinship placements (placement in out‐of‐home care with relatives) were interpreted as a positive outcome in comparison to other out‐of‐home placements (e.g., residential care). The achievement of legal permanence, for childrens' placements was accepted as a positive outcome. For example, reunification with birth parents, adoption by related or nonrelated caregivers, placement with relative caregivers, legal guardianship/legal custody by related or nonrelated caregivers.

Studies were only included, in the analysis of primary outcomes, if subjects were followed for at least 6 months after the intervention; to allow for sufficient time to observe outcomes. Where outcomes were reported at multiple time points the longest follow‐up period was used in the data synthesis.

Secondary outcomes

Secondary outcomes included child well‐being, and client satisfaction with the FGDM process and plan. Data were not excluded on the basis of the validity or reliability of any instruments used. However, the reviewers judgements on the validity and reliability of instruments used formed the basis of their judgement on potential bias due to insensitive measurement instruments.

4.2. Search methods for identification of studies

The primary systematic literature search was carried out in July 2016 by library staff, Tania Celeste and Frances Morrissey, from Scholarly Information, University of Melbourne. As this review was in process for 3 years the searches were repeated in August 2019 by the first and second author, date limited from 2016 to 2019. Both published and unpublished were considered eligible for the review. Searches were not restricted to any single language or nationality. One article required translation from Dutch to English, this was completed using Google translate.

4.2.1. Electronic searches

Electronic searches for the identification of appropriate studies were completed as follows:

ASSIA ProQuest Search Strategy (21 July 2016; 2 August 2019)
IBSS ProQuest Search Strategy (22 July 2016; 2 August 2019)
NCJRS ProQuest Search Strategy (22 July 2016; 2 August 2019)
Sociological Abstracts ProQuest Search Strategy (21 July 2016; 2 August 2019)
ProQuest Dissertations & Theses Global Search Strategy (21 July 2016; 2 August 2019)
Family INFORMIT Search Strategy (20 July 2016; 2 August 2019)
CINAHL database using the EbscoHost platform: Search Strategy (20 July 2016; 2 August 2019)
ERIC using the EbscoHost platform: Search Strategy (20 July 2016; 5 August 2019)
SocIndex using the EbscoHost platform: Search Strategy (20 July 2016; 2 August 2019)
Medline using the OVID platform: Search Strategy (14 July 2016; 2 August 2019)
EMBASE searched via the OVID platform (20 July 2016; 5 August 2019)
PsycINFO searched using the OVID platform (14 July 2016; 5 August 2019)
Evidence Based Medicine Reviews was searched via the OVID platform on (14 July 2016; 5 August 2019).

The searches were broadly and substantively similar but leveraged controlled vocabularies and search operators unique to each resource. For example, the construction “random* control* trial” could not be used in ProQuest as the internal wildcards were not recognised. Search facilities were chosen with reference to recent research (McGinn, Taylor, McColgan, & McQuilkan, 2014) on their comparative usefulness for questions related to social work. The search terms, formulae and syntax used on each search facility are described in Appendix C.

4.2.2. Searching other resources

Reviewers checked the reference lists of all relevant articles obtained, and reference lists from previously published reviews. Authors of papers which could potentially have been included in the review, had they reported more details of findings, were emailed. The review team also searched ClinicalTrials.gov and the World Health Organisation's International Clinical Trials Registry Platform.

The following journals were hand‐searched (online) by the review team:

(1)
Child Welfare
(2)
Children and Youth Services Review
(3)
Social Service Review
(4)
Child Maltreatment
(5)
Child Abuse and Neglect
(6)
Journal of Social Services Research
(7)
Social Work
(8)
Research on Social Work Practice
(9)
Social Work Research
(10)
Child Abuse Review

The following sources of grey literature were searched by the review authors: Social Care Institute for Excellence, the Latin American and Caribbean Centre on Health Sciences Research Institute, and the American Institutes for Research. Several country's government websites were searched: Research at Home Office (UK); U.S. Department of Justice; and the Canadian, Australian, New Zealand, French and German government websites. The Proquest Dissertation and Thesis facility was searched by the University of Melbourne Library Team.

Personal communications were also deployed in the search for relevant articles, as described in the review protocol (Shlonsky et al., 2009) these comprised of face‐to‐face discussions with presenters and emails to experts, and relevant study authors.

4.3. Data collection and analysis

4.3.1. Selection of studies

The search outputs, titles and abstracts for 1,576 papers, were uploaded to the software application Covidence. Covidence facilitated the screening and categorisation of the search outputs. Each article title was independently screened by two reviewers. Authors accessed manuscript abstracts, and whole texts where necessary. Covidence facilitates the screening process with a clear audit trail. After duplicates were removed initial screening, by two authors, excluded 1,419 manuscripts. The initial screening questions were: is the population of children and youth who are, or have been, the subject of child protection investigation?; and, is there an intervention related to family group conferencing in the study? Following initial screening, the full text of 100 articles were then independently assessed by two authors against the inclusion and exclusion criteria outlined in the study protocol (Shlonsky et al., 2009). At this level of screening, studies had to satisfy the following criteria: the study evaluated an intervention administered to children and youth aged 0–18; it used an experimental or parallel cohort research design, with a valid control or comparison group. The fundamentals of FGDM, as outlined in section (description of the intervention) were used to ensure study interventions were part of the FGDM family of interventions. Thirteen studies (reported in 15 manuscripts) from the main searches, were found to match selection criteria. Three additional study reports were located through correspondence with primary study authors. One of these provided additional findings for one of the studies located in the main searches; the other two were added to the primary studies for the review, following independent appraisal by two authors. In summary, 15 studies, reported in 18 study reports were selected for review.

4.3.2. Data extraction and management

Two of three review authors, Tony McGinn, Mphatso Kamndaya and Admire Chereni, independently extracted the necessary data from each study report using Covidence. Covidence facilitates the recording of data for:

(1)
Study author(s); year of publication; source; country; and language.
(2)
Characteristics of setting and participants: eligibility criteria for participants; explanation of recruitment procedures, setting (country, location, clinical/nonclinical); demographic features of the sample.
(3)
Sampling: sample sizes for treatment and control; whether power analysis was used to determine sample size; allocation to the treatment and control; explanation of method used to generate the allocation.
(4)
Research design: type of design including major features such as random selection, random assignment, and data relating to potential biases.
(5)
Intervention data: the nature of the interventions (for treatment and comparison/control groups); FGC, FUM, or some other form of FGDM; aim of intervention; length of intervention, whether manuals were used, whether fidelity checks were included, information on possible contamination reported.
(6)
Outcome data: primary and secondary outcomes, measures used, information on reliability/validity of measures.
(7)
Results: attrition at postintervention and follow‐up; number excluded from the analysis; length of follow‐up; statistical methods; type of data effect size is based on; data needed for effect size calculations.

Covidence highlights discrepancies between data extracted by separate reviewers, and prompts further analysis of studies until a consensus can be reached on what data is to be included in the review.

4.3.3. Assessment of risk of bias in included studies

Two authors independently conducted analyses under each of the potential bias categories described in Cochrane Collaboration guidance (Higgins et al., 2011):

Sequence generation
Allocation sequence concealment
Blinding of participants and personnel
Blinding of outcome assessment
Incomplete outcome data
Selective outcome reporting
Other biases.

We considered “other biases” as listed in Cochrane guidance (Higgins et al., 2011):

Design
Baseline imbalance
Differential diagnostic activity
Insensitive instrument used to measure.

In addition, under “other biases” we considered “researcher allegiance bias” and “funding source bias” for similar reasons as those outlined in Maynard, Solis, Miller, and Brendel (2017): studies are more likely to be biased in favour of the treatment intervention when study authors have a direct role in the development or the implementation of the study. We also considered “contamination bias” as this was highlighted as a possible bias in the review protocol (Shlonsky et al., 2009); we also considered potentially confounding variables, in the study environment (Sterne et al., 2016).

The review authors agreed on a priori guidance for the rating of bias in each primary study (see Appendix A). Each study was categorised as “low”, “high”, or “unclear” risk of bias on each of the domains. Extracts, from primary studies, which might underpin judgements on bias, were compiled and reviewed by two review authors. Any discrepancies between review author judgements were resolved through discussion with a third member of the team.

4.3.4. Measures of treatment effect

Continuous data

A standardised mean difference (SMD) was calculated for studies reporting continuous data. A corrected Hedges' g was calculated by dividing the difference between group means by the pooled and weighted standard deviation (SD) of the groups. Specifically, Hedges' g corrects for a bias (overestimation) that occurs when the uncorrected standardised mean difference effect size is used on small samples. We computed a 95% confidence interval (CI) for each combined effect size to test for statistical significance; if the CI did not include zero, we rejected the null hypothesis that there is no difference between the group means.

Dichotomous data

We computed Mantel–Haenszel odds ratios (ORs) for the dichotomous outcome variables. Based on the assumption of proportional odds, ORs can be compared between variables with different distributions, including very rare and more frequent occurrences. Specifically, the odds of an event (e.g., children's reunification with their family) were calculated for each sample by dividing the number of children reunified, by the number of children who were not reunified with their family. We then calculated an OR by dividing the odds of reunificiation for the FGDM group by the odds of the non‐FGDM group of children. In addition, we calculated and reported 95% CIs for the ORs reported.

4.3.5. Unit of analysis issues

The unit of analysis for this review was children. There were no unit of analysis issues identified for the included studies.

4.3.6. Dealing with missing data

Although studies with incomplete outcome data (e.g., missing means, SDs, sample sizes) were included in the review, they were excluded from the meta‐analyses unless the review authors could calculate an effect size from the available information. When outcome data were missing from an article or report, we made reasonable attempts to retrieve these data from the original researchers. Evidence of attrition of study participants or data is described in the quality assessment of primary studies, reported in “Assessment of risk of bias in included studies” section.

4.3.7. Assessment of heterogeneity

We assessed the consistency of results using the I ² statistic (Higgins, 2002, 2003). Evidence of heterogeneity (p value from test of heterogeneity < 0.1 coupled with an I ² value of 25% or greater) for any of the outcomes synthesised, is highlighted in the accompanying narrative to that outcome reporting.

4.3.8. Assessment of reporting biases

Reporting bias was counteracted to some extent by deploying a highly sensitive systematic search of bibliographic databases, and supplementing this with additional searching of grey literature sources, reference list searching, expert consultation and hand searching. Unpublished data from two separate studies were located through author correspondence, and are included in the review. Primary studies were reviewed for references to a study protocol which could be obtained to check for outcome measures being dropped, or added; just one study report referenced a protocol. Primary study authors' choice of outcomes to study and report were appraised. Only four reported on the continued maltreatment of children. The implications of this are discussed in Selective reporting (reporting bias). The use of a funnel plot, to help identify potential reporting bias in primary studies, was not possible given the small number of study findings synthesised under each outcome heading.

4.3.9. Data synthesis

Meta‐analyses were conducted using RevMan 5. None of the primary studies reported on comparisons between FGDM versions, so all syntheses were completed on the absolute effect of FGDM versus no FGDM. Two studies reported findings from samples separated geographically (from separate child protection agencies, or different territories of the same agency) these data were synthesised as separate studies, because there was a degree of heterogeneity between them.

ORs were used to represent binary outcome data. Continuous data were converted into SMDs. All outcomes were presented with 95% CIs. Hedges’ g was used to correct for small sample bias. Where findings for a particular outcome were reported by some studies with continuous data, and with dichotomous data in other studies, the Campbell Collaboration online conversion (Wilson, 2018) calculator was used to convert studies to the majority format.

We assumed there would be unexplained sources of heterogeneity across studies; hence we used a random effects model of meta‐analysis. Results for randomised experiments and quasi‐experimental designs were reported separately. Meta‐analysis was not possible for several of the outcomes reviewed as they were only reported by one or two primary studies. A narrative review is provided for these. Given the small number of studies overall, and the level of heterogeneity between them we did not perceive any opportunities for moderator, sensitivity or outlier analysis. The syntheses completed showed moderate‐to‐high levels of heterogeneity between studies for all outcomes. We deemed the presentation of an overall effect size to be inappropriate for some of the outcomes: when the number of studies synthesised was small, and findings were highly heterogeneous.

4.3.10. Subgroup analysis and investigation of heterogeneity

There were no opportunities to complete a subgroup analysis according to method, FGDM version, population or follow‐up periods. Where studies included findings from interval measures of an outcome, measures taken at the longest time‐period from the intervention were used.

4.3.11. Sensitivity analysis

Due to the small number of primary studies, and limited meta‐analyses completed, there was no opportunity for a sensitivity analysis.

5. RESULTS

5.1. Description of studies

Table 1 provides an overview of primary study characteristics. The included studies are described in terms of the setting, participants, interventions and outcome measures.

Table 1.

Summary of primary study characteristics

First author (year)1	Study design	Population	FGDM version	Control condition	N	Outcomes	Region	Publication status
Baumann (2005)/Sheets (2009)	Nonrandomised controlled comparison	Children removed from home due to abuse and neglect	Not specified	Permanency Planning Team meeting (which parents can attend)	1,110 Parents and relatives	Parent's and relative's satisfaction with the case planning process	Texas, United States	Published journal article
					83 Relatives or foster parents
					83 Relatives or foster parents	Relative's or foster parent's views on child well‐being
					4,066	Relative's or foster parent's views on child well‐being
					4,066	Length of stay in care, and type of permanent placement
					children	Length of stay in care, and type of permanent placement
Berzin (2008)	Randomised controlled trial	Children at risk of further maltreatment and removal	Family unity and family group conferencing	Traditional child protection services without family team meetings	110 children	Service user satisfaction (relatives, parents and children); placement stability; safety‐related outcomes; permanency‐related outcomes	California, United States	Published journal article
Cunning (2006)	Historically controlled comparison (parallel groups)	Children referred to child protection services	Family Group Conferencing	Traditional child protection services	254	Reunification	Toronto, Canada	Published report
						Continued maltreatment
						Placement stability
Crampton (2007)	Historically controlled comparison (parallel groups)	Non‐White children who have had a substantiated CPS case, out‐of‐home placement and no sexual abuse	Family Group Decision‐Making	Traditional child protection services	257	Substantiated re‐referrals	Michigan, United States	Published journal article
						Placement stability
						Reunification
Dijkstra (2018)	Randomised Controlled Trial	All families referred to child protection services	Family Group Conferencing	Intensive Family Case Management	328	Continued maltreatment	Netherlands	Published journal article
						Expedition of case processing
						Service user satisfaction
						Engagement with support services
Edwards (2006)/Pennell (2010)	Historically controlled comparison (parallel groups)	Children removed from home due to abuse and neglect	Family Team Meetings	Traditional child protection services without family team meetings	789 children	Permanency‐related outcomes, length of foster care, and continued maltreatment	Washington, United States	Agency report and published in a journal article
Hollinshead (2017)/Corwin (2019)	Randomised controlled trial	Child welfare involved families receiving in‐home services	Family group conferencing (Ohana model is referenced)	Traditional child protection services	503 families	Substantiated re‐referrals	Colorado, United States	Two published journal articles
						Maintenance of in‐home care
						Case‐workers' perception of family's social support
McRae	Historically controlled comparison (parallel groups)	Children referred to child protection services	Family group conferencing (no further detail is provided)	Traditional child protection services	4,129 children	Referral to and engagement with services	United States (36 states)	Published journal article
Pennell (2000)	Nonrandomised controlled comparison	Children at risk in families with domestic violence	Not specified. Authors refer to both FGDM and FGC (Family Group Conferencing).	Traditional child protection services	63 families (it is unclear how many siblings were in each family)	Permanency outcomes; child safety; child neglect; women abuse	Newfoundland and Labrador, Canada	Published journal article
Sundell (2004)	Nonrandomised controlled comparison	Children involved in child protection services	Authors describe the key principles of FGDM, but do not offer details of the version of FGDM employed	Traditional child protection services	239 children	On‐going service engagement, rate of placement in foster care, type of placement, and case closure	Sweden	Published journal article
Titcomb (2005)	Historically controlled comparison (parallel groups)	Children referred to child protection services	Authors describe the key principles of FGDM, but do not offer details of the version of FGDM employed	Traditional child protection services	540 children	Substantiated reports of abuse within 12 months	Arizona, United States	Published journal article
Walker (2005)	Historically controlled comparison (parallel groups)	Children who are the subject of voluntary foster custody	The Ohana model of Family Group Conferencing	Traditional child protection services	60 children	Permanency of out‐of‐home placement, consumer satisfaction, cost‐effectiveness of conferencing	Hawaii, United States	Published journal article
Wang (2012)	Historically controlled comparison (parallel groups)	Children who had been placed in care for longer than a 3‐day period	The Ohana model of Family Group Conferencing	Not clearly specified. Presumed to be the traditional child protective service process centred on practitioner decision‐making.	80,690	Number of children in permanent placements at 15 months; number of children reunified with their family or placed with relatives at 18 months	Texas, United States	Published journal article
Weigensberg (2009)	Historically controlled comparison (parallel groups)	Children who had contact with welfare services, but who were be cared for at home at baseline	Authors describe the key principles of FGDM, but do not offer details of the version of FGDM employed	Not clearly specified. Presumed to be the traditional child protective service process centred on practitioner decision‐making	5,001 children	Provision of, and engagement with, parent, child and family services	United States, nationwide	Published journal article
Weisz (2006)	Historically controlled comparison (parallel groups)	Children involved in child welfare services	Expedited Family Group Conferencing	Not clearly specified. Presumed to be the traditional child protective service process centred on practitioner decision‐making	66 children	Number of removals during the evaluation period; number of placements; type of most recent placement	Nebraska, United States	Unpublished report

	n	d	95% CI	95% CI	FGDM cases were processed quicker? (Yes/No)
RCTs
Berzin (2008)	50	3.56	−1.10	8.22	No
Dijsktra (2019)	328	0.59	0.35	0.83	No
Quasi‐experimental studies
Weisz (2006)	66	−0.51	0.06	−1.07	Yes
Sundell (2004)	170	0.48	−0.83	−0.12	No
Walker (2005)	84	−8.30	−13.08	−3.52	Yes
Edwards (2006)/Pennell (2010)	649	−0.27	‐0.03	−0.50	Yes

	n	d	95% CI	95% CI	FGDM cases had less placement moves? (Yes/No)
RCTs
Berzin (2018), combined	227	0.20	−0.10	0.50	No
Quasi‐experimental studies
Crampton (2007)	257	−0.56	−0.05	−1.08	Yes
Cunning (2006), region 2	150	−0.31	−1.58	0.96	Yes
Cunning (2006), region 1	104	−0.37	−1.35	0.61	Yes

Methods	Retrospective parallel cohort study
Participants	Children who have been removed from their home for abuse and neglect
Interventions	Family Group Decision Making
Outcomes	Parent's satisfaction (sense of empowerment facilitated by the process)
	Relative's satisfaction (sense of empowerment facilitated by the process)
	Parent's satisfaction (understanding of what was expected of them)
	Relative's satisfaction (understanding of what was expected)
	Parent's satisfaction (with the family plan)
	Relative's satisfaction (with the family plan)
	Number of children exiting care
	Number of children reunified with their family
	Number of children placed with relatives
Notes

Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	High risk	This was a retrospective parallel cohort design
Allocation concealment (selection bias)	High risk	Not achievable with this study method
Blinding of participants and personnel (performance bias)	Low risk	Study participants and practitioners were unlikely to have been aware of the study during intervention
Blinding of outcome assessment (detection bias)	High risk	Study participants and practitioners were unlikely to have been aware of the study during intervention
Incomplete outcome reporting	Unclear risk	A study protocol, in which data collection and analysis would have been described, is not referenced
Attrition bias	Unclear risk	Insufficient information
Study design	Low risk	There is no evidence that the study designed advantaged the FGDM or comparison group
Baseline imbalance	Unclear risk	Insufficient information
Confounding variable	High risk	Social workers deemed some cases to be unsuitable for FGDM
Differential diagnostic activity	Low risk	Diagnostic activity appeared to be similar for both FGDM and the comparison group
Insensitive instrument used to measure	Unclear risk	The data collection point was not precise: five to seventeen months after the child was placed in care
Researcher allegiance	Unclear risk	Possible examples of a lapse in objectivity, in the reporting of study findings, can be found in both the Sheets and Baumann study reports. Authors do offer some appraisal of study limitations
Funding source	Unclear risk	Insufficient information
Contamination	High risk	Authors refer to feedback to staff during implementation. It is likely that learning from the implementation of FGDM cross‐pollinated to the comparison intervention, Permanency Planning Team meetings

Methods	RCT
Participants	Children ages birth to 18 years who were assessed as being at moderate to high risk for further maltreatment and whose families were eligible for voluntary in‐home services
Interventions	Family Team Meetings (blends family unity and family group conference models)
Outcomes	Number of substantiated reports of maltreatment
	Impact on rate of removal from the home
	Placement stability
	Case closure for a positive reason
	Average time to permanency (case closure) for those case which were closed
Notes

Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Authors describe the study as a randomised controlled trial. A ratio of three treatment allocations to two control allocations is described. No further details of sequence generation are provided
Allocation concealment (selection bias)	Unclear risk	Insufficient information
Blinding of participants and personnel (performance bias)	High risk	Both study participants and practitioners were aware that they were involved in either the treatment or control arm of the experiment
Blinding of outcome assessment (detection bias)	High risk	Authors make no reference to the blinding of outcome assessors
Incomplete outcome reporting	High risk	A study protocol is not referenced. The narrative summary provided omits key data such as effect sizes, and variance measures. Data were only available from one of the two counties involved in the trial, for measures of placement permanency
Attrition bias	Unclear risk	Insufficient information
Study design	Unclear risk	The use of “sibling data” to inflate sample sizes, followed by the use of general estimating equations to counteract clustering effects, and the use of a fixed effects model, could be argued to be inappropriate analyses
Baseline imbalance	Unclear risk	A significantly higher number of children in the treatment group were female Descriptive statistics for the samples at baseline are not provided
Confounding variable	High risk	The author suggests that practitioners may have worked the treatment and control groups quite differently; in addition to the differences necessitated by the deployment of FGDM
Differential diagnostic activity	Low risk	Data were harvested in retrospect from a social services database
Insensitive instrument used to measure	Unclear risk	Insufficient information is provided about how data from the social services database was coded
Researcher allegiance	Unclear risk	No information is provided about the authors’ links, or otherwise, to the intervention providers or funders. Authors do offer some appraisal of study limitations
Funding source	Unclear risk	No information provided
Contamination	High risk	The author describes the possibility of contamination bias

Methods	A retrospective parallel cohort study
Participants	Non‐White children who have had a substantiated CPS case, out‐of‐home placement and no sexual abuse
Interventions	Family Group Decision Making (New Zealand family group conferencing is referenced)
Outcomes	Substantiated re‐referrals
	Placement stability (number of placement moves)
	Reunification
Notes

Methods	Retrospective cohort study
Participants	Children who have been referred to a child protection agency
Interventions	Family Group Conferencing
Outcomes	Reunification with family
	Continued maltreatment
	Placement stability
Notes

Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Families were randomly assigned to the experimental and control groups using a computer generated sequence
Allocation concealment (selection bias)	Unclear risk	Insufficient information
Blinding of participants and personnel (performance bias)	Unclear risk	Practitioners and families were aware of the study and which group each family was assigned to
Blinding of outcome assessment (detection bias)	Unclear risk	Insufficient information
Incomplete outcome reporting	Low risk	A study protocol is referenced
Attrition bias	Low risk	There was some imbalance in study drop out across the two groups but it was compensated for using multiple imputation (Graham, 2009)
Study design	Low risk	Considerable depth in study reporting provided. A study protocol is referenced. The study design described largely adheres to accepted guidance on the conduct of randomised controlled trials on complex interventions
Baseline imbalance	Low risk	Baseline characteristics are appropriately reported. No significant differences were found
Confounding variable	Unclear risk	Treatment integrity may have been compromised given the high level of staff turnover during the study
Differential diagnostic activity	Low risk	Diagnostic activity is described appropriately, with no indication of differential treatment across the two groups
Insensitive instrument used to measure	Low risk	Appropriate rationales are provided for each of the measurements applied
Researcher allegiance	Low risk	Authors state that they have no potentially conflicting interests. The topic area and study results are reported in an objective way
Funding source	Low risk	The funding source is identified as the Dutch Organization for Health Research and Development. Reviewers agreed that this organisation was not likely to be invested in a standpoint on FGDM efficacy
Contamination	Unclear risk	Insufficient information

Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	No details of the random sequence generation are provided
Allocation concealment (selection bias)	Unclear risk	Insufficient information
Blinding of participants and personnel (performance bias)	High risk	Practitioners and families were aware of the study and which group each family was assigned to
Blinding of outcome assessment (detection bias)	Unclear risk	Insufficient information
Incomplete outcome reporting	Low risk	A study protocol is referenced. All outcomes are reported
Attrition bias	Low risk	Intention‐to‐treat data were used
Study design	Low risk	No indications of potential study design biases across two study reports
Baseline imbalance	Low risk	Baseline comparisons were extensive and did not highlight differences
Confounding variable	Unclear risk	Data were gathered from casework staff. An unknown number of staff did not provide data. The families, which these staff worked with, were therefore precluded from study participation
Differential diagnostic activity	Low risk	Only 66% of caseworker questionnaires were returned. Authors acknowledged the potential for bias from this, and presented a Missing Completely at Random analysis which showed that the missing data were not systematic and affected both trial arms similarly
Insensitive instrument used to measure	Unclear risk	Case‐workers perceptions of social support could be argued to be an insensitive means of measuring children's risk of abuse and well‐being
Researcher allegiance	Low risk	A conflict of interest statement is provided. No conflicts of interest are provided. The study appears to be presented and reported in an objective way
Funding source	Low risk	Funding sources are declared: Children's Bureau, U.S. Department of Health and Human Services; and Casey Family Programs (U.S.)
Contamination	High risk	Authors point out that some families in the control group may have participated in FGCs. It is unclear if the same practitioners provided both FGC and non‐FGC case processing

Methods	Prospective parallel cohort study
Participants	Children exposed to domestic violence, and at risk of removal from the home by child protection services
Interventions	Family Group Conferencing
Outcomes	Continued maltreatment (number of emergency removals of children from the home; and substantiated reports of maltreatment)
	Child well‐being (number of children self‐harming; number of children attempting to take their own life)
	Score from a domestic violence assessment tool
Notes

Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	High risk	Researchers requested that the most difficult cases be referred for FGDM
Allocation concealment (selection bias)	High risk	Not achievable with this study method
Blinding of participants and personnel (performance bias)	Low risk	Study participants and practitioners were unlikely to have been aware of the study during intervention
Blinding of outcome assessment (detection bias)	High risk	Authors make no reference to the blinding of outcome assessors
Incomplete outcome reporting	High risk	A number of findings are reported for FGDM only. A study protocol is not referenced
Attrition bias	Unclear risk	Insufficient information
Study design	High risk	Qualitative data is cited as evidence of efficacy (alongside quantitative findings)
Baseline imbalance	High risk	For example, child protection events at baseline: FGDM group had 233 events, the comparison had 129 events
Confounding variable	Unclear risk	Insufficient information
Differential diagnostic activity	High risk	Data from case files nad home visits appears to have been gathered in different ways for the two groups
Insensitive instrument used to measure	Unclear risk	A child protection events checklist was employed “culled from relevant literature” (p. 139): additional information was needed
Researcher allegiance	High risk	Authors argue for the benefits of FGDM throughout the article without reference to supporting evidence of rigour
Funding source	Unclear risk	Insufficient information
Contamination	Unclear risk	Insufficient information

Methods	A prospective cohort study
Participants	Children involved in child protection services
Interventions	Family Group Conferencing
Outcomes	Number of case closures
	Number of case re‐openings
	Number of re‐referrals
	Rate of placement in foster care
	Time spent in out‐of‐home care
	Proportion of out‐of‐home placements that were with relatives
Notes

Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	High risk	This was a parallel cohort prospective study with a nonequivalent comparison group
Allocation concealment (selection bias)	High risk	Not achievable with this study method
Blinding of participants and personnel (performance bias)	High risk	Participants self‐selected to a large degree, and social workers decided who was to be offered FGDM
Blinding of outcome assessment (detection bias)	Low risk	Outcome coders were blinded
Incomplete outcome reporting	Unclear risk	A study protocol is not referenced
Attrition bias	Unclear risk	Insufficient information. It is acknowledged that some attrition occurred, it is described as negligible, but details are not provided
Study design	High risk	Given the small sample size, it is very possible that individual social workers’ perspective may have affected results: social workers decided which families were to be offered FGDM. There was also a large degree of participant self‐selection
Baseline imbalance	High risk	Of all families referred to CPS during the study period, 35% were offered an FGC; only one in four of these families accepted the offer
Confounding variable	High risk	A higher proportion of the FGDM group were previously known to CPS (71% vs. 51%)
Differential diagnostic activity	Low risk	Authors report consideration of diagnostic issues, and measures to counteract these
Insensitive instrument used to measure	High risk	Authors acknowledge the imprecision of using re‐referrals as a measure of on‐going abuse
Researcher allegiance	Low risk	Both authors were based in government departments charged with research and evaluation of social services
Funding source	Low risk	Funding was provided by a government department charged with research and evaluation of social services
Contamination	High risk	Social workers from both FGDM and comparison groups were aware of FGDM provision ad involved in treatment allocation

Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	High risk	This was a secondary analysis of existing data
Allocation concealment (selection bias)	High risk	Not achievable with this study method
Blinding of participants and personnel (performance bias)	Low risk	Study participants and practitioners were unlikely to have been aware of the study during intervention
Blinding of outcome assessment (detection bias)	High risk	Authors make no reference to the blinding of outcome assessors
Incomplete outcome reporting	Unclear risk	A study protocol is not referenced. The first author provided all additional data requested through personal correspondence
Attrition bias	Unclear risk	Insufficient information
Study design	Low risk	Researchers published a discrete time survival analysis of pre‐existing data, and revisited the data to extract findings for the purposes of this review
Baseline imbalance	Unclear risk	Insufficient information
Confounding variable	Unclear risk	Insufficient information
Differential diagnostic activity	Low risk	Diagnostic activity was very straightforward
Insensitive instrument used to measure	Unclear risk	Findings provided compare FGDM and comparison group outcomes at 15 months, it is unclear if findings would have differed significantly if a different time period had been chosen
Researcher allegiance	Unclear risk	The researcher is likely to have worked closely with the agency responsible for the delivery of FGDM. Several authors worked for the agency
Funding source	Unclear risk	This study was conducted by the corresponding author under a contract between Texas Tech University and the Texas Department of Family and Protective Services
Contamination	Unclear risk	Insufficient information

Aguiniga, Madden and Hawley (2015)
Reason for exclusion	Wrong study design
Anderson (2003)
Reason for exclusion	No comparison group
Anderson and Whalen, (2003)
Reason for exclusion	Wrong study design
Antle, Barbee, Christensen and Sullivan (2009)
Reason for exclusion	Wrong intervention
Reason for exclusion	Wrong outcomes
Baldry, Bratel, Dunsire and Durrant (2005)
Reason for exclusion	Wrong population
Barlow et al. (2013)
Reason for exclusion	Wrong population
Bell and Wilson (2006)
Reason for exclusion	Wrong study design
Bribitzer and Verdieck (1988)
Reason for exclusion	Wrong intervention
Brody et al. (2012)
Reason for exclusion	Wrong intervention
Bröning et al. (2014)
Reason for exclusion	Wrong intervention
Burford (1999)
Reason for exclusion	Wrong study design
Connell, Dishion, Yasui and Kavanagh (2007)
Reason for exclusion	Wrong intervention
Constantino et al. (2001)
Reason for exclusion	Wrong intervention
Crampton (2003)
Reason for exclusion	Insufficient data
Crampton (2007)
Reason for exclusion	Qualitative study
Crampton, Usher, Wildire, Webster and Cuccaro‐Alamin (2011)
Reason for exclusion	Comparison was not a parrallel cohort
Dalrymple (2002)
Reason for exclusion	Wrong study design
Danielson et al. (2012)
Reason for exclusion	Wrong population
DeGarmo, Reid, Fetrow, Fisher and Antoine (2013)
Reason for exclusion	Wrong intervention
DePanfilis and Dubowitz (2005)
Reason for exclusion	Wrong study design
Dijkstra et al. (2016)
Reason for exclusion	Signs of Safety, not FGDM, was deployed to a significant proportion of the intervention group.
Dobbin (2001)
Reason for exclusion	Wrong comparator
Eaton, Whalen and Anderson (2007)
Reason for exclusion	Wrong study design
Ethier, Couture, Lacharite and Gagnier (2000)
Reason for exclusion	Wrong intervention
Frost (2014)
Reason for exclusion	Wrong study design
Goldbeck, Laib‐Koehnemund and Fegert (2007)
Reason for exclusion	Wrong intervention
Gonzales et al. (2012)
Reason for exclusion	Wrong intervention
Gopalan et al. (2015)
Reason for exclusion	Wrong study design
Greenbaum et al. (2015)
Reason for exclusion	Wrong study design
Guterman et al. (2013)
Reason for exclusion	Wrong intervention
Hendriks, Van der Schee and Blanken (2011)
Reason for exclusion	Wrong patient population
Holland and O'Neill (2006)
Reason for exclusion	Wrong study design
Jeong, McGarrell and Hipple (2012)
Reason for exclusion	Wrong study population (criminal justice‐involved youths) wrong outcome measures
Jones and Finnegan (2004)
Reason for exclusion	Wrong study design
Jouriles et al. (2010)
Reason for exclusion	Wrong intervention
Kolko, Iselin and Gully (2011)
Reason for exclusion	Wrong intervention
Lambert, Johnson, and Wang (2017)
Reason for exclusion	Comparison group was not a parrallel cohort
Landsman, Boel‐Studt and Malone (2014)
Reason for exclusion	Wrong intervention
Liddle, Hogue, JJoM and Therapy (2000)
Reason for exclusion	Wrong intervention
Linares et al. (2015)
Reason for exclusion	Wrong intervention
Lupton (2003)
Reason for exclusion	Insufficient data
Madden and Aguiniga (2013)
Reason for exclusion	Wrong intervention (meditation not FGDM, see page 19)
Malmberg‐Heimonen and Johansen (2014)
Reason for exclusion	Adult population
Marsh (2003)
Reason for exclusion	Wrong study design
Marts, Lee, McRoy and McCroskey (2008)
Reason for exclusion	Wrong study design
McGarrell and Hipple (2007)
Reason for exclusion	Child population not necessarily at risk of abuse or neglect (i.e. young offenders)
Meezan and O'Keefe (1998)
Reason for exclusion	Wrong intervention
Morris and Connolly (2012)
Reason for exclusion	Wrong study design
O Brien (2000)
Reason for exclusion	No comparison group
Olson (2003)
Reason for exclusion	Wrong study design
Onrust, Romijn and de Beer (2015)
Reason for exclusion	Wrong target population (not exclusively children at risk)
Pennell (2006)
Reason for exclusion	No comparison
Perry (2014)
Reason for exclusion	The comparison group also recieved a version of FGC
Prince, Gear, Jones and Read (2005)
Reason for exclusion	Wrong study d
Pugh (2002)
Reason for exclusion	Qualitative study
Quinnett (2003)
Reason for exclusion	Wrong study design
Rauktis et al. (2010)
Reason for exclusion	Wrong study design
Robbins et al. (2011)
Reason for exclusion	Wrong patient population
Rodrigo, Máiquez, Correa, Martín and Rodríguez (2006)
Reason for exclusion	Wrong intervention (community centre‐based program)
Rybski (1999)
Reason for exclusion	Wrong intervention
Sieppert, Hudson and Unrau (2000)
Reason for exclusion	No comparison group
Smith and Efron (2005)
Reason for exclusion	Wrong intervention
Strong Families (2012)
Reason for exclusion	Wrong study design
Swain and Ban (1997)
Reason for exclusion	No comparison group
Taylor, Davis and Kemper (1997)
Reason for exclusion	Wrong patient population
Teal (2013)
Reason for exclusion	No comparison group (see page 33)
Thurston (2016)
Reason for exclusion	Insufficient data
Walker (2010)
Reason for exclusion	Wrong study design
Walton, Roby, Frandsen and Davidson (2004)
Reason for exclusion	No comparison group
Wheeler (2003)
Reason for exclusion	Wrong study design
Wijnen‐Lunenberg (2008)
Reason for exclusion	Outcome was “average number of points of concern”; these were not exclusively indicators of maltreatment or neglect

Outcome or Subgroup	Studies	Participants	Statistical method	Effect estimate
1.1 1.1Reunification of children with families or maintenance of in‐home care	10	86305	Odds Ratio (M‐H, Random, 95% CI)	1.69 [1.03, 2.78]
1.2 Continued maltreatment: effect sizes from nonrandomised studies	5	1779	Odds Ratio (M‐H, Random, 95% CI)	0.73 [0.48, 1.11]
1.3 Continued maltreatment:effect sizes from RCTs	4	1158	Odds Ratio (M‐H, Fixed, 95% CI)	1.29 [0.85, 1.98]
1.4 Kinship placements	5	85537	Odds Ratio (M‐H, Random, 95% CI)	1.29 [0.94, 1.76]

Sequence generation	Studies are to be rated as low risk if they adopted a typical method of random group assignment (for example using computer‐generated random number lists)
	Studies using comparison groups which may represent a population sub‐set are to be rated as high risk in this bias category
	An unclear risk is to be assigned were primary study authors failed to provide sufficient information. Or if they have used a comparison group which is likely to represent the study population with equivalence to the intervention group
Allocation sequence concealment	Randomised trials which concealed the sequence by which study participants were to be allocated, between FGDM and control intervention, from those in charge of study participant allocation were rated as low risk
	Nonrandomised studies are to be rated as having a high risk in this category
	Randomised trials which did not describe a means of allocation sequence concealment are to be rated with an unclear risk
Blinding of participants and personnel	If practitioners were not aware of research study (as is likely with retrospective parallel cohort studies) then the risk should be recorded as low
	If practitioners and participants, involved in delivering and receiving FGDM or the control intervention, were aware that the interventions were under study then the risk is to be recorded as high
	If it is not clear whether practitioners and participants were aware or not then the risk should be recorded as unclear
Blinding of outcome assessment	If a description of how outcome assessors were blinded is provided then the risk of bias should be recorded as low
	Risk of bias should be recorded as high if those charged with outcome data collection were privy to participant allocation between FGDM and the control intervention
	If no information regarding the blinding of outcome assessors is available then the risk of bias should be recorded as unclear
Incomplete outcome data	This should be recorded as low, if all data which plausibly should be reported, is reported, and all study participants are adequately accounted for in the reporting of findings, including data pertaining to participant withdrawals are refusals. In particular, any group differences in which participant withdrawals are refusals, should be described
	If there is a discrepancy between study participant numbers and reported outcome data then risk of bias should be recorded as high
	If data is missing due to participant withdrawal refusal to take part in the risk of bias should be recorded as unclear. If outcome data is only partially reported, for example if a measure of significance is reported without an effect size, or an average is reported without an indicator of variance then risk of bias should be recorded as unclear
Selective outcome reporting	If sufficient information is provided about the outcome measures deployed, and reported study findings correspond to the outcome measures used, then the risk of bias should also be reported as low
	Risk of bias should be recorded as high if only a subset of the original outcomes measured and analysed in a study are fully reported, or if there is any evidence of selective reporting of data on subgroups
	Or if primary study authors use finally treated rather than intention‐to‐treat analyses, if they choose to analyse continuously measured variables categorically, or if categorical variables parameters have been chosen insensitively, then risk of bias should be recorded as unclear
Study design bias	Within the boundaries of the general study design (e.g., a retrospective parallel cohort study will not feature the randomisation of study participants) if study design choices do not appear to have affected findings for intervention and control groups differentially, bias risk should be recorded as low
	Where study design choices, for example having participating families self‐selecting to intervention and control groups, are likely to bring about group differences, or confounding factors bias risk should be recorded as high
	Where study design choices, such as the choice of time point for data collection, have clearly affected findings for intervention and control groups differentially, bias risk should be recorded as unclear
Baseline imbalance	Where baseline differences have been comprehensively assessed, reported and found to be insignificant the risk of bias should be reported as low
	Indicators of sampling bias, such as the recruitment of an FGDM group of children with less complex needs than a comparison group, should attract a high risk rating. Indicators of significant group differences such as differences in the severity of abuse experienced by children in each group at baseline should also attract a rating of high risk
	Where baseline differences have not been assessed or reported adequately the risk should be recorded as unclear
Differential diagnostic activity	Record a low risk where diagnostic activity is adequately described with no apparent differences in how it was performed with the FGDM and comparison groups
	Record a high risk of bias if different measures, timeframes or data collection methods are employed with the intervention and comparison groups
	Record an unclear risk if there is an insufficient description of how data were collected
Insensitive instrument used for measurement	Outcomes of interest such as family permanence, placement stability, and prevention of child maltreatment should be measured sensitively for a low risk rating
	Examples of insensitive instruments will include the use of rating scales which are unlikely to capture the full range of data available. Where this is the case, bias risk should be recorded as high
	Where insufficient information is provided about the measurement tools used, an unclear risk should be recorded
Researcher allegiance bias	Researcher allegiance may affect a researcher's actions, and the reporting of results
	Wilson, G. Terence; Wilfley, Denise E.; Agras, W. Stewart; Bryson, Susan W. (2017‐03‐31). "Allegiance Bias and Therapist Effects: Results of a Randomized Controlled Trial of Binge Eating Disorder". Clinical Psychology: a publication of the Division of Clinical Psychology of the American Psychological Association. 18(2):119–125. ISSN 0969[JW1]
	We would add that practitioners, who are invested in FGDM or control interventions, may advertently or inadvertently affect intervention delivery and outcome data collection
	Where no examples of researcher, or practitioner allegiance bias are found the risk should be reported as low
	Where there are explicit examples of this in the primary study report, for example, the inappropriate characterisation of findings, the risk should be recorded as high
	Less explicit examples should attract an unclear rating
Funding source bias	It is difficult to conceive an assessment of high risk of funding source bias in this field, however where the study has been funded by proponents of FGDM[JW2] [TM3], and steps to ensure researcher independence are not described, it may be appropriate to record a risk of unclear
Funding source bias	Where the funding source bears no plausible connection to the promotion of FGDM or control interventions this risk should be recorded as low
Contamination bias	The key principles of FGDM could conceivably be assimilated into traditional child protection service delivery. In general terms, it is acknowledged that FGDM has influenced the conduct of child protection work across the globe
	Where it is clear that the implementation of FGDM has been kept separate from traditional child protection services then a low risk should be recorded
	Explicit examples of the use of FGDM in control interventions will attract a high risk rating, as would the use of the same practitioners to deliver both interventions
	Where there is insufficient information provided to make a judgement on this risk, but it appears likely that the same practitioners were used for both FGDM and control interventions then on unclear risk should be recorded

Aguiniga	2015	Wrong study design
Anderson	2004	No comparison group
Anderson and Whalen	2003	Wrong study design
Antle	2009	Wrong intervention
Appleton	2013	Wrong outcomes
Baldry	2005	Wrong patient population
Barlow	2013	Wrong patient population
Bell	2006	Wrong study design
Bribitzer	1988	Wrong intervention
Brody	2012	Wrong intervention
Broning	2014	Wrong intervention
Bryant	2010	Wrong intervention
Burford	2006	Wrong study design
Colman	2007	Wrong study design
Connell	2007	Wrong intervention
Constantino	2004	Wrong intervention (Urban Home Intervention)
Crampton	2011	Comparison was not a parallel cohort
Crampton	2001	Insufficient data
Crampton	2003	Insufficient data
Crampton	2007	Qualitative study
Dalrymple	2002	Wrong study design
Danielson	2012	Wrong patient population
DeGarmo	2013	Wrong intervention
DePanfilis	2005	Wrong study design
Dijsktra	2016	Signs of Safety, not FGDM, was deployed to a significant proportion of the intervention group
Dobbin	2001	Wrong comparator
Eaton	2007	Wrong study design
Edwards	2005	Insufficient data
Ethier	2000	Wrong intervention
Frost	2014	Wrong study design
Gatowski	2005	Wrong intervention (mediation not FGDM (see p. 28)
Ghasemi	2014	Wrong intervention
Goldbeck	2007	Wrong intervention
Gonzales	2012	Wrong intervention
Gopalan	2015	Wrong study design
Greenbaum	2015	Wrong study design
Guterman	2013	Wrong intervention
Hendriks	2011	Wrong patient population
Holland	2006	Wrong study design
Jeong	2012	Wrong study population (criminal justice‐involved youths) wrong outcome measures
Jones	2004	Wrong study design
Jouriles	2010	Wrong intervention (support project)
Kolko	2011	Wrong intervention
Lambert	2017	Comparison group was not a parallel cohort
Landsman	2014	Wrong intervention
Liddle	2000	Wrong intervention (family therapy)
Linares	2015	Wrong intervention
Lupton	1997	Insufficient data
Lupton	2003	Wrong study design
Madden	2013	Wrong intervention (meditation not FGDM, see p. 19)
Malmberg‐Heimonen	2014	Adult population
Marsh	2003	Wrong study design
Marts	2008	Wrong study design
McCrae	2010	Wrong study design
McGarrell	2007	Child population not necessarily at risk of abuse or neglect (i.e., young offenders)
Meezan	1998	Wrong intervention
Morris	2012	Wrong study design
O'Brien	2000	No comparison group
Olson	2003	Wrong study design
Onrust	2015	Wrong target population (not exclusively children at risk)
Pennell	2006	No comparison group
Perry	2014	The comparison group also received a version of FGDM
Prince	2005	Wrong study design
Pugh	2002	Qualitative study
Quinnett	2003	Wrong study design
Rauktis	2010	Wrong study design
Robbins	2011	Wrong patient population
Rodrigo	2006	Wrong intervention (community centre‐based program)
Rybski	1999	Wrong intervention
Sieppert	2000	No comparison group
Smith	2005	Wrong intervention
Strong Families	2012	Wrong study design
Swain	1997	No comparison group
Taylor	1997	Wrong patient population
Teal	2013	No comparison group (see page 33)
Thurston	2016	Study will not be completed before completion of current review
Titcomb	2005	Insufficient data
Walker	2010	Wrong study design
Walton	2004	No comparison group
Wheeler	2003	Wrong study design
Wijnen‐Lunenberg	2008	Outcome was “average number of points of concern”; these were not exclusively indicators of maltreatment or neglect
Wingrove	2005	The article/report was intractably unavailable, but study data is believed to be included in Weisz, V., Korpas, A., & Wingrove, T. (2006), which has been included in this review

Set#	Searched for	Results
S1	family group or family decision* or family conferenc* or family meeting or family unity or family team or family centred or family centered or FGC or FGDM	30,333^a
S2	famil* or parent* or caregiver* or guardian*	105,039^a
S3	group conference* or group decision* or team conference* or team decision* or case meeting or case planning or planning meeting or consensus‐based decision‐making or consensus based decision making or consensus based decisionmaking	15,605^a
S4	abuse* or neglect* or maltreat*	44,069^a
S5	SU.EXACT(“Child abuse”) OR SU.EXACT(“Abused children”)	2,642^a
S6	(abuse* or neglect* or maltreat*) OR (SU.EXACT(“Child abuse”) OR SU.EXACT(“Abused children”))	44,069^a
S7	SU.EXACT(“Children”) OR SU.EXACT(“Adolescents”)	56,063^a
S8	((abuse* or neglect* or maltreat*) OR (SU.EXACT(“Child abuse”) OR SU.EXACT(“Abused children”))) AND (SU.EXACT(“Children”) OR SU.EXACT(”Adolescents”))	5,542^a
S9	SU.EXACT(“Child welfare”)	1,210^a
S10	child advocacy	636^a
S11	SU.EXACT(“Social work”)	7,915^a
S12	child protection	3,564^a
S13	engag* or involv* or partnership or participat* or conferenc* or meeting* or mediat*	128,563^a
S14	child protection conference* or child protection meeting* or child protection mediat*	186^a
S15	(family group or family decision* or family conferenc* or family meeting or family unity or family team or family centred or family centered or FGC or FGDM) AND (((abuse* or neglect* or maltreat*) OR (SU.EXACT(“Child abuse”) OR SU.EXACT(“Abused children”))) AND (SU.EXACT(“Children”) OR SU.EXACT(“Adolescents”)))	683^a
S16	(famil* or parent* or caregiver* or guardian) AND (group conference or group decision* or team conference* or team decision* or case meeting or case planning or planning meeting or consensus‐based decision‐making or consensus based decision making or consensus based decisionmaking) AND (((abuse* or neglect* or maltreat*) OR (SU.EXACT(“Child abuse”) OR SU.EXACT(“Abused children”))) AND (SU.EXACT("Children") OR SU.EXACT("Adolescents")))	53^a
S17	SU.EXACT(“Child welfare”) OR (child advocacy) OR SU.EXACT(“Social work”) OR (child protection)	12,616^a
S18	(famil* or parent* or caregiver* or guardian) AND (((abuse or neglect* or maltreat) OR (SU.EXACT(“Child abuse”) OR SU.EXACT(“Abused children”))) AND (SU.EXACT(”Children”) OR SU.EXACT(“Adolescents”))) AND (engag or involv* or partnership or participat* or conferenc* or meeting* or mediat*) AND (SU.EXACT(“Child welfare”) OR (child advocacy) OR SU.EXACT(“Social work”) OR (child protection))	172^a
S19	(famil* or parent* or caregiver* or guardian) AND (child protection conference or child protection meeting* or child protection mediat*)	110^a
S20	(random* control* trial* OR random* control* stud*) OR SU.EXACT(“Clinical randomized controlled trials” OR “Cluster randomized controlled trials” OR “Double blind randomized controlled trials” OR “Randomized consent design” OR “Randomized controlled trials” OR “Single blind randomized controlled trials” OR “Urn randomization”)	14,975^a
S21	((family group or family decision* or family conferenc* or family meeting or family unity or family team or family centred or family centered or FGC or FGDM) AND (((abuse* or neglect* or maltreat) OR (SU.EXACT(“Child abuse”) OR SU.EXACT“Abused children”))) AND (SU.EXACT(“Children”) OR SU.EXACT(“Adolescents”)))) OR ((famil or parent* or caregiver* or guardian) AND (group conference or group decision* or team conference* or team decision* or case meeting or case planning or planning meeting or consensus‐based decision‐making or consensus based decision making or consensus based decisionmaking) AND (((abuse* or neglect* or maltreat) OR (SU.EXACT(“Child abuse”) OR SU.EXACT(“Abused children”))) AND (SU.EXACT(“Children”) OR SU.EXACT(“Adolescents”)))) OR ((famil or parent* or caregiver* or guardian) AND (((abuse or neglect* or maltreat) OR (SU.EXACT(“Child abuse”) OR SU.EXACT(“Abused children”))) AND (SU.EXACT(“Children”) OR SU.EXACT(“Adolescents”))) AND (engag or involv* or partnership or participat* or conferenc* or meeting* or mediat) AND (SU.EXACT(“Child welfare”) OR (child advocacy) OR SU.EXACT(“Social work”) OR (child protection))) OR ((famil or parent* or caregiver* or guardian) AND (child protection conference or child protection meeting* or child protection mediat*))	915^a
S22	((random* control* trial* OR random* control* stud) OR SU.EXACT(“Clinical randomized controlled trials” OR “Cluster randomized controlled trials” OR “Double blind randomized controlled trials” OR “Randomized consent design” OR “Randomized controlled trials” OR “Single blind randomized controlled trials” OR “Urn randomization”)) AND (((family group or family decision or family conferenc* or family meeting or family unity or family team or family centred or family centered or FGC or FGDM) AND (((abuse* or neglect* or maltreat) OR (SU.EXACT(“Child abuse”) OR SU.EXACT(“Abused children”))) AND (SU.EXACT(“Children”) OR SU.EXACT(“Adolescents”)))) OR ((famil or parent* or caregiver* or guardian) AND (group conference or group decision* or team conference* or team decision* or case meeting or case planning or planning meeting or consensus‐based decision‐making or consensus based decision making or consensus based decisionmaking) AND (((abuse* or neglect* or maltreat) OR (SU.EXACT(“Child abuse”) OR SU.EXACT(“Abused children”))) AND (SU.EXACT(“Children”) OR SU.EXACT(“Adolescents”)))) OR ((famil or parent* or caregiver* or guardian) AND (((abuse or neglect* or maltreat) OR (SU.EXACT(“Child abuse”) OR SU.EXACT(“Abused children”))) AND (SU.EXACT(“Children”) OR SU.EXACT(“Adolescents”))) AND (engag or involv* or partnership or participat* or conferenc* or meeting* or mediat) AND (SU.EXACT(“Child welfare”) OR (child advocacy) OR SU.EXACT(“Social work”) OR (child protection))) OR ((famil or parent* or caregiver* or guardian) AND (child protection conference or child protection meeting* or child protection mediat*)))	50^a

PERMALINK

Family group decision‐making for children at risk of abuse or neglect: A systematic review

Tony McGinn

Paul Best

Jason Wilson

Admire Chereni

Mphatso Kamndaya

Aron Shlonsky

Abstract

Background

Objectives

Search Methods

Selection Criteria

Data Collection and Analysis

Main Results

Authors' Conclusions

1. PLAIN LANGUAGE SUMMARY

1.1. No evidence that family group decision‐making is better, or worse, than conventional child protection procedures

1.2. What is this review about?

1.3. What studies are included?

1.4. What are the findings of this review?

1.5. What do the findings of this review mean?

1.6. How up‐to‐date is this review?

2. BACKGROUND

2.1. Description of the condition

2.2. Description of the intervention

2.3. How the intervention might work

2.4. Why it is important to do this review

3. OBJECTIVES

4. METHODS

4.1. Criteria for considering studies for this review

4.1.1. Types of studies

4.1.2. Types of participants

4.1.3. Types of interventions

4.1.4. Types of outcome measures

Primary outcomes

Secondary outcomes

4.2. Search methods for identification of studies

4.2.1. Electronic searches

4.2.2. Searching other resources

4.3. Data collection and analysis

4.3.1. Selection of studies

4.3.2. Data extraction and management

4.3.3. Assessment of risk of bias in included studies

4.3.4. Measures of treatment effect

Continuous data

Dichotomous data

4.3.5. Unit of analysis issues

4.3.6. Dealing with missing data

4.3.7. Assessment of heterogeneity

4.3.8. Assessment of reporting biases

4.3.9. Data synthesis

4.3.10. Subgroup analysis and investigation of heterogeneity

4.3.11. Sensitivity analysis

5. RESULTS

5.1. Description of studies

Table 1.

5.1.1. Results of the search

Figure 3.

5.1.2. Included studies

5.1.3. Excluded studies

5.2. Risk of bias in included studies

Figure 1.

Figure 2.

5.2.1. Allocation (selection bias)

5.2.2. Blinding (performance bias and detection bias)

5.2.3. Incomplete outcome data (attrition bias)

5.2.4. Selective reporting (reporting bias)

5.2.5. Other potential sources of bias

Study design bias

Baseline imbalance bias

Confounding variable bias

Differential diagnostic activity bias

Bias due to the use of insensitive instruments for outcome measurement

Researcher allegiance bias

Funding source bias

Contamination bias

5.3. Effects of interventions

5.3.1. Synthesis of results

5.3.2. Reunification of children with families or maintenance of in‐home care

Set#	Searched for	Results
S1	ab(“randomised controlled trial” OR “randomized controlled trial” OR “randomised controlled study” OR “randomized controlled study”)	432^a
S2	ab((control* OR prospectiv*) N/10 (study or trial))	5,694^a
S3	ab(random*)	12,963^a
S4	ab(“clinical trial”)	296^a
S5	ab((singl* or doubl* or trebl* or tripl) N/10 (blind or mask*))	157^a
S6	S1 OR S2 OR (S3 AND S4) OR S5	5,885^a
S7	ab(“family group” or “family decision” or “family conferenc” or “family meeting” or “family unity” or “family team” or “family centred” or “family centered” or FGC or FGDM)	346^a
S8	ab(famil* or parent* or caregiver* or guardian*)	55,621^a
S9	ab(“group conference” or “group decision” or “team conference” or “team decision” or “case meeting” or “case planning” or “planning meeting” or “consensus‐based decision‐making” or “consensus based decision making” or “consensus based decisionmaking”)	349^a
S10	ab(abuse* or neglect* or maltreat*)	14,974^a
S11	ab(child* OR adolescen* OR teenage* OR infant*)	47,362^a
S12	ab(“child abuse”)	377^a
S13	ab(“child welfare” OR “child advocacy” OR “child protection” OR “social work” OR “social services”)	5,116^a
S14	ab(engag* or involv* or partnership or participat* or conferenc* or meeting* or mediat*)	141,627^a
S15	ab(“child protection conference” or “child protection meeting” or “child protection mediat*”)	1^a
S16	(S10 AND S11) OR S12	2,698^a
S17	S7 AND S16	9^a
S18	S8 AND S9 AND S16	2^a
S19	S8 AND S13 AND S14 AND S16	88^a
S20	S8 AND S15	1^a
S21	(S17 OR S18 OR S19 OR S20) AND S6	2^a

Set#	Searched for	Results
S1	ab(“randomised controlled trial” OR “randomized controlled trial” OR “randomised controlled study” OR “randomized controlled study”)	67^a
S2	ab((control* OR prospectiv*) N/10 (study or trial))	3,410^a
S3	ab(random*)	6,416^a
S4	ab(“clinical trial”)	63^a
S5	ab((singl* or doubl* or trebl* or tripl) N/10 (blind or mask*))	76^a
S6	S1 OR S2 OR (S3 AND S4) OR S5	3,502^a
S7	ab(“family group” or “family decision” or “family conferenc” or “family meeting” or “family unity” or "family team” or “family centred” or “family centered” or FGC or FGDM)	367^a
S8	ab(famil* or parent* or caregiver* or guardian*)	36,128^a
S9	ab(“group conference” or “group decision” or “team conference” or “team decision” or “case meeting” or “case planning” or “planning meeting” or "consensus‐based decision‐making" or “consensus based decision making” or “consensus based decisionmaking”)	286^a
S10	ab(abuse* or neglect* or maltreat*)	32,446^a
S11	ab(child* OR adolescen* OR teenage* OR infant*)	37,317^a
S12	ab(“child abuse”)	5,077^a
S13	ab(“child welfare” OR “child advocacy” OR “child protection” OR “social work” OR “social services”)	5,374^a
S14	ab(engag* or involv* or partnership or participat* or conferenc* or meeting* or mediat*)	74,199^a
S15	ab(“child protection conference” or “child protection meeting” or “child protection mediat*”)	9^a
S16	(S10 AND S11) OR S12	15,842^a
S17	S7 AND S16	71^a
S18	S8 AND S9 AND S16	33^a
S19	S8 AND S13 AND S14 AND S16	809^a
S20	S8 AND S15	6^a
S21	(S17 OR S18 OR S19 OR S20) AND S6	7^a

	Search	Results
S22	(random* control* trial* OR random* control* stud) AND (((family group or family decision or family conferenc* or family meeting or family unity or family team or family centred or family centered or FGC or FGDM) AND (((abuse* or neglect* or maltreat) OR SU.EXACT(“Child Abuse”)) AND (SU.EXACT(“Adolescents”) OR SU.EXACT(“Children”)))) OR ((famil or parent* or caregiver* or guardian) AND (group conference or group decision* or team conference* or team decision* or case meeting or case planning or planning meeting or consensus‐based decision‐making or consensus based decision making or consensus based decisionmaking) AND (((abuse* or neglect* or maltreat) OR SU.EXACT(“Child Abuse”)) AND (SU.EXACT(“Adolescents”) OR SU.EXACT(“Children”)))) OR ((famil or parent* or caregiver* or guardian) AND (((abuse or neglect* or maltreat) OR SU.EXACT(“Child Abuse”)) AND (SU.EXACT(“Adolescents”) OR SU.EXACT(“Children”))) AND (engag or involv* or partnership or participat* or conferenc* or meeting* or mediat) AND (SU.EXACT(“Child Welfare Services”) OR (child advocacy) OR SU.EXACT(“Social Work”) OR (child protection))) OR ((famil or parent* or caregiver* or guardian) AND (child protection conference or child protection meeting* or child protection mediat*)))	34^a
S21	random* control* trial* OR random* control* stud*	2,889^a
S20	((family group or family decision* or family conferenc* or family meeting or family unity or family team or family centred or family centered or FGC or FGDM) AND (((abuse* or neglect* or maltreat) OR SU.EXACT(“Child Abuse”)) AND (SU.EXACT(“Adolescents”) OR SU.EXACT(“Children”)))) OR ((famil or parent* or caregiver* or guardian) AND (group conference or group decision* or team conference* or team decision* or case meeting or case planning or planning meeting or consensus‐based decision‐making or consensus based decision making or consensus based decisionmaking) AND (((abuse* or neglect* or maltreat) OR SU.EXACT(“Child Abuse”)) AND (SU.EXACT(“Adolescents”) OR SU.EXACT(“Children”)))) OR ((famil or parent* or caregiver* or guardian) AND (((abuse or neglect* or maltreat) OR SU.EXACT(“Child Abuse”)) AND (SU.EXACT(“Adolescents”) OR SU.EXACT(“Children”))) AND (engag or involv* or partnership or participat* or conferenc* or meeting* or mediat) AND (SU.EXACT(“Child Welfare Services”) OR (child advocacy) OR SU.EXACT(“Social Work”) OR (child protection))) OR ((famil or parent* or caregiver* or guardian) AND (child protection conference or child protection meeting* or child protection mediat*))	2,095^a
S19	(famil* or parent* or caregiver* or guardian) AND (child protection conference or child protection meeting* or child protection mediat*)	173^a
S18	(famil* or parent* or caregiver* or guardian) AND (((abuse or neglect* or maltreat) OR SU.EXACT(“Child Abuse”)) AND (SU.EXACT(“Adolescents”) OR SU.EXACT(“Children”))) AND (engag or involv* or partnership or participat* or conferenc* or meeting* or mediat*) AND (SU.EXACT(“Child Welfare Services”) OR (child advocacy) OR SU.EXACT(“Social Work”) OR (child protection))	215^a
S17	SU.EXACT(“Child Welfare Services”) OR (child advocacy) OR SU.EXACT(“Social Work”) OR (child protection)	7,039^a
S16	(famil* or parent* or caregiver* or guardian) AND (group conference or group decision* or team conference* or team decision* or case meeting or case planning or planning meeting or consensus‐based decision‐making or consensus based decision making or consensus based decisionmaking) AND (((abuse* or neglect* or maltreat*) OR SU.EXACT(“Child Abuse”)) AND (SU.EXACT(“Adolescents”) OR SU.EXACT(“Children”)))	125^a
S15	(family group or family decision* or family conferenc* or family meeting or family unity or family team or family centred or family centered or FGC or FGDM) AND (((abuse* or neglect* or maltreat*) OR SU.EXACT(“Child Abuse”)) AND (SU.EXACT(“Adolescents”) OR SU.EXACT(“Children”)))	1,811^a
S14	child protection conference* or child protection meeting* or child protection mediat*	247^a
S13	engag* or involv* or partnership or participat* or conferenc* or meeting* or mediat*	248,994^a
S12	child protection	2,684^a
S11	SU.EXACT(“Social Work”)	2,593^a
S10	child advocacy	681^a
S9	SU.EXACT(“Child Welfare Services”)	1,970^a
S8	((abuse* or neglect* or maltreat*) OR SU.EXACT(“Child Abuse”)) AND (SU.EXACT(“Adolescents”) OR SU.EXACT(“Children”))	7,040^a
S7	SU.EXACT(“Adolescents”) OR SU.EXACT(“Children”)	44,888^a
S6	(abuse* or neglect* or maltreat*) OR SU.EXACT(“Child Abuse”)	50,346^a
S5	SU.EXACT(“Child Abuse”)	2,672^a
S4	abuse* or neglect* or maltreat*	50,346^a
S3	group conference* or group decision* or team conference* or team decision* or case meeting or case planning or planning meeting or consensus‐based decision‐making or consensus based decision making or consensus based decisionmaking	40,651^a
S2	famil* or parent* or caregiver* or guardian*	202,454^a
S1	family group or family decision* or family conferenc* or family meeting or family unity or family team or family centred or family centered or FGC or FGDM	76,352^a

Set#	Searched for	Results
S1	ab(“randomised controlled trial” OR “randomized controlled trial” OR “randomised controlled study” OR “randomized controlled study”)	1,998^a
S2	ab((control* OR prospectiv*) N/10 (study or trial))	65,981^a
S3	ab(random*)	121,337^a
S4	ab(“clinical trial”)	3,044^a
S5	ab((singl* or doubl* or trebl* or tripl) N/10 (blind or mask*))	2,949^a
S6	S1 OR S2 OR (S3 AND S4) OR S5	68,289^a
S7	ab(“family group” or “family decision” or “family conferenc” or “family meeting” or “family unity” or “family team” or "family centred” or “family centered” or FGC or FGDM)	1,403^a
S8	ab(famil* or parent* or caregiver* or guardian*)	281,239^a
S9	ab(“group conference” or “group decision” or “team conference” or “team decision” or “case meeting” or “case planning” or “planning meeting” or "consensus‐based decision‐making" or “consensus based decision making” or “consensus based decisionmaking”)	1,174^a
S10	ab(abuse* or neglect* or maltreat*)	51,473^a
S11	ab(child* OR adolescen* OR teenage* OR infant*)	202,267^a
S12	ab(“child abuse”)	2,039^a
S13	ab(“child welfare” OR “child advocacy” OR “child protection” OR “social work” OR “social services”)	11,247^a
S14	ab(engag* or involv* or partnership or participat* or conferenc* or meeting* or mediat*)	700,266^a
S15	ab(“child protection conference” or “child protection meeting” or “child protection mediat*”)	9^a
S16	(S10 AND S11) OR S12	14,437^a
S17	S7 AND S16	49^a
S18	S8 AND S9 AND S16	11^a
S19	S8 AND S13 AND S14 AND S16	486^a
S20	S8 AND S15	9^a
S21	(S17 OR S18 OR S19 OR S20) AND S6	27^a

Set#	Searched for	Results
27	((random* control* trial) OR (random control* stud)) AND (((“child protection conferenc” OR “child protection meeting” OR “child protection mediation”) AND (famil OR parent* OR caregiver*…	0
26	(random* control* trial) OR (random control* stud*)	155
21	((“child protection conferenc” OR “child protection meeting” OR “child protection mediation”) AND (famil* OR parent* OR caregiver* OR guardian*)) OR (((child protection) OR (social work) OR…	1,339
20	(“child protection conferenc” OR “child protection meeting” OR “child protection mediation”) AND (famil* OR parent* OR caregiver* OR guardian*)	0
19	((child protection) OR (social work) OR (child advocacy) OR (child welfare)) AND (engag* OR involv* OR partnership* OR participat* OR conferenc* OR meeting* OR mediat) AND ((child OR tee…	1,309
18	(child protection) OR (social work) OR (child advocacy) OR (child welfare)	17,479
17	((child* OR teenage* OR adolescen* OR toddler) AND ((“child abuse”) OR (abuse OR neglect* OR maltreat))) AND (“group conferenc” OR “group decision” OR “team conferenc” OR “team decision"…	13
16	((child* OR teenage* OR adolescen* OR toddler) AND ((“child abuse”) OR (abuse OR neglect* OR maltreat))) AND (“family group” OR “family decision” OR “family conferenc*” OR “family meeting"…	73
15	"child protection conferenc” OR “child protection meeting” OR “child protection mediation"	0
14	engag* OR involv* OR partnership* OR participat* OR conferenc* OR meeting* OR mediat*	34,274
13	child protection	5,224
12	social work	10,278
11	child advocacy	882
10	child welfare	4,721
9	(child* OR teenage* OR adolescen* OR toddler) AND ((“child abuse”) OR (abuse OR neglect* OR maltreat*))	7,870
8	child* OR teenage* OR adolescen* OR toddler*	38,074
6	(“child abuse”) OR (abuse* OR neglect* OR maltreat*)	10,444
5	"child abuse"	4,840
4	abuse* OR neglect* OR maltreat*	10,444
3	"group conferenc” OR “group decision” OR “team conferenc” OR “team decision*” OR “case meeting” OR "case planning” OR “planning meeting” OR "consensus‐based decision‐making" OR “consensus based de…	57
2	famil* OR parent* OR caregiver* OR guardian*	42,876
1	“family group” OR “family decision” OR “family conferenc” OR “family meeting” OR “family unity” OR “family team” OR “family centred” OR “family centered” OR FGC OR FGDM	370

Set#	Searched for	Results
S23	S20 OR S22	19
S22	S19 AND S21	18
S21	"random* control* trial” OR “random control* stud*"	53,928
S20	S14 OR S15 OR S17 OR S18	9
S19	S14 OR S15 OR S17 OR S18	817
S18	S2 AND S13	12
S17	S2 AND S7 AND S12 AND S16	718
S16	S8 OR S9 OR S10 OR S11	32,402
S15	S2 AND S3 AND S7	11
S14	S1 AND S7	115
S13	"child protection conference” OR “child protection meeting” OR “child protection mediation"	16
S12	engag* OR involv* OR partnership* OR participat* OR conferenc* OR meeting* OR mediat*	353,053
S11	"child protection"	1,374
S10	(MH “Social Work+”)	11,654
S9	(MH “Child Advocacy”)	1,789
S8	(MH “Child Welfare+”)	22,103
S7	S4 OR S5	20,269
S6	S4 OR S5	70,483
S5	(MH “Child Abuse+”)	12,258
S4	abuse* OR neglect* OR maltreat*	70,378
S3	"group conferenc” OR “group decision” OR “team conferenc” OR “team decision*” OR “case meeting” OR “case planning” OR “planning meeting” OR "consensus‐based decision‐making" OR “consensus based decision making” OR “consensus based decisionmaking"	313
S2	(famil* OR parent* OR caregiver* OR guardian*) OR ((MH “Parents+”) OR (MH “Mothers+”) OR (MH “Fathers+”) OR (MH “Family+”))	288,940
S1	“family group” OR “family decision” OR “family conferenc” OR “family meeting” OR “family unity” OR “family team” OR "family centred” OR “family centered” OR FGC OR FGDM OR MH “Decision Making, Family"	9,300

Set#	Searched for	Results
S22	S20 AND S21	2
S21	“random* control* trial” OR “random control* stud*"	1,635
S20	S15 OR S16 OR S18 OR S19	752
S19	S2 AND S14	3
S18	S2 AND S8 AND S13 AND S17	666
S17	S9 OR S10 OR S11 OR S12	12,884
S16	S2 AND S3 AND S8	14
S15	S1 AND S8	94
S14	"child protection conference” OR “child protection meeting” OR “child protection mediation"	3
S13	engag* OR involv* OR partnership* OR participat* OR conferenc* OR meeting* OR mediat*	445,573
S12	"child protection"	751
S11	DE “Social Work"	5,387
S10	DE “Child Advocacy"	2,109
S9	DE “Child Welfare"	6,010
S8	S6 AND S7	18,797
S7	child* or adolescen* OR teenage* OR infan* OR toddler* OR "pre‐school" OR “school age"	367,380
S6	S4 OR S5	33,794
S5	DE “Child Abuse"	7,823
S4	abuse* OR neglect* OR maltreat*	33,794
S3	"group conferenc” OR “group decision” OR “team conferenc” OR “team decision*” OR “case meeting” OR “case planning” OR “planning meeting” OR "consensus‐based decision‐making" OR “consensus based decision making” OR “consensus based decisionmaking"	719
S2	(DE “Family Involvement” OR DE “Parent Participation” OR DE “Family (Sociological Unit” OR DE “Parents” OR DE "Mothers” OR DE “Fathers”) OR (famil* OR parent* OR caregiver* OR guardian*)	219,348
S1	“family group” OR “family decision” OR “family conferenc” OR “family meeting” OR “family unity” OR “family team” OR “family centred” OR “family centered” OR FGC OR FGDM	1,304

Set#	Searched for	Results
1	(family group or family decision* or family conferenc* or family meeting or family unity or family team or family centred or family centered or FGC or FGDM).tw.	4,484
2	(famil* or parent* or caregiver* or guardian*).tw.	1,145,310
3	(group conference* or group decision* or team conference* or team decision* or case meeting or case planning or planning meeting or consensus‐based decision‐making or consensus based decision making or consensus based decisionmaking).tw.	857
4	(abuse* or neglect* or maltreat*).tw.	150,328
5	exp child abuse/	26,297
6	4 or 5	159,169
7	limit 6 to (“all infant (birth to 23 months)” or “all child (0 to 18 years)”)	52,419
8	exp child welfare/	29,089
9	exp child advocacy/	3,904
10	exp social work/	16,289
11	child protection.tw.	1,412
12	(engag* or involv* or partnership or participat* or conferenc* or meeting* or mediat*).tw.	3,173,662
13	(child protection conference* or child protection meeting* or child protection mediat*).tw.	2
14	1 and 7	69
15	2 and 3 and 7	14
16	8 or 9 or 10 or 11	45,148
17	2 and 7 and 12 and 16	611
18	2 and 13	2
19	14 or 15 or 17 or 18	675
20	randomized controlled trial.pt.	423,885
21	randomized controlled trials as topic.sh.	108,073
22	controlled clinical trial.pt.	91,206
23	clinical trial.pt.	503,254
24	exp clinical trials as topic/	298,692
25	random allocation.sh.	87,750
26	double‐blind method.sh.	137,485
27	single‐blind method.sh.	22,335
28	((singl* or doubl* or trebl* or tripl) adj25 (blind or mask*)).ti,ab.	149,749
29	random*.ti,ab.	848,092
30	research design.sh.	90,163
31	comparative study.sh.	1,755,856
32	exp evaluation studies/	221,160
33	follow up studies.sh.	554,365
34	prospective studies.sh.	423,852
35	(control* or prospectiv*).ti,ab.	3,402,454
36	20 or 21 or 22 or 23 or 24 or 25 or 26 or 27 or 28 or 29 or 30 or 31 or 32 or 33 or 34 or 35	6,024,873
37	19 and 36	186

Set#	Searched for	Results
1	(family group or family decision* or family conferenc* or family meeting or family unity or family team or family centred or family centered or FGC or FGDM).tw.	5,745
2	(famil* or parent* or caregiver* or guardian*).tw.	1,458,664
3	(group conference* or group decision* or team conference* or team decision* or case meeting or case planning or planning meeting or consensus‐based decision‐making or consensus based decision making or consensus based decisionmaking).tw.	1,173
4	(abuse* or neglect* or maltreat*).tw.	196,683
5	limit 4 to (infant <to one year> or child <unspecified age> or preschool child <1 to 6 years> or school child <7 to 12 years> or adolescent <13 to 17 years>)	38,160
6	exp child abuse/	32,083
7	exp child welfare/	16,960
8	exp child advocacy/	3,171
9	child protection.tw.	1,827
10	exp social work/	23,230
11	exp community care/	107,829
12	(engag* or involv* or partnership or participat* or conferenc* or meeting* or mediat*).tw.	4,013,539
13	(child protection conference* or child protection meeting* or child protection mediat*).tw.	5
14	5 or 6	56,614
15	1 and 14	89
16	2 and 3 and 14	18
17	7 or 8 or 9 or 10 or 11	147,249
18	2 and 12 and 14 and 17	780
19	2 and 13	2
20	15 or 16 or 18 or 19	867
21	limit 20 to (clinical trial or randomized controlled trial or controlled clinical trial or phase 1 clinical trial or phase 2 clinical trial or phase 3 clinical trial or phase 4 clinical trial)	44
22	randomized controlled trial.tw.	58,941
23	clinical trial.tw.	138,976
24	((singl* or doubl* or trebl* or tripl) adj25 (blind or mask*)).ti,ab.	202,492
25	random*.ti,ab.	1,116,806
26	exp comparative study/	1,142,867
27	exp prospective study/	344,044
28	(control* or prospectiv*).ti,ab.	4,525,323
29	randomised controlled trial.tw.	18,866
30	22 or 23 or 24 or 25 or 26 or 27 or 28 or 29	6,033,580
31	20 and 30	203
32	21 or 31	210

Set#	Searched for	Results
1	(family group or family decision* or family conferenc* or family meeting or family unity or family team or family centred or family centered or FGC or FGDM).mp.	4,670
2	(famil* or parent* or caregiver* or guardian*).mp.	550,505
3	(group conference* or group decision* or team conferenc* or team decision* or case meeting or case planning or planning meeting or consensus‐based decision‐making or consensus based decision making or consensus based decisionmaking).mp.	4,346
4	(abuse* or neglect* or maltreat*).mp.	176,931
5	exp child abuse/	25,163
6	exp abandonment/	437
7	exp child neglect/	3,513
8	exp emotional abuse/	2,189
9	exp physical abuse/	5,316
10	exp sexual abuse/	24,450
11	exp verbal abuse/	429
12	4 or 5 or 6 or 7 or 8 or 9 or 10 or 11	182,530
13	limit 12 to (100 childhood <birth to age 12 yrs> or 120 neonatal <birth to age 1 mo> or 140 infancy <2 to 23 mo> or 160 preschool age <age 2 to 5 yrs> or 180 school age <age 6 to 12 yrs> or 200 adolescence <age 13 to 17 yrs>)	41,953
14	exp child welfare/	7,212
15	exp social casework/	15,762
16	exp protective services/	2,350
17	exp social services/	38,290
18	child protection.mp.	3,322
19	(engag* or involv* or partnership or participat* or conferenc* or meeting* or mediat*).mp.	864,677
20	(child protection conference$ or child protection meeting$ or child protection mediation).mp.	41
21	1 and 13	114
22	2 and 3 and 13	24
23	14 or 15 or 16 or 17 or 18	58,153
24	2 and 13 and 19 and 23	764
25	2 and 20	26
26	21 or 22 or 24 or 25	889
27	1 and 18	48
28	26 or 27	930
29	limit 28 to (“0200 clinical case study” or “0400 empirical study” or “0410 experimental replication” or “0430 followup study” or “0450 longitudinal study” or “0451 prospective study” or “0453 retrospective study” or 1200 meta analysis or 1800 quantitative study or “2000 treatment outcome/clinical trial”)	559
30	(randomised controlled trial or randomized controlled trial).mp.	13,858
31	(random* adj25 allocat*).ti,ab.	3,717
32	exp clinical trials/	9,670
33	exp treatment effectiveness evaluation/	20,513
34	((singl* or doubl* or trebl* or tripl) adj25 (blind or mask*)).ti,ab.	23,197
35	(random* or control* or prospectiv*).ti,ab.	682,112
36	30 or 31 or 32 or 33 or 34 or 35	702,054
37	28 and 36	132
38	29 or 37	581