Family and Group Conferencing for Adults

In the morning, members of the University of Birmingham research team presented on the findings from the national survey and stakeholder interviews (Sharanya Mahesh), and our current best characterisation of the adults’ FGC practice model and its underpinning Programme Theory (Jerry Tew).  Programme Theory provides a mapping of the sorts of outcomes that may be achieved by FGC, how it works (mechanisms and processes), and contextual factors that are likely to support positive outcomes.

There was discussion of key values, including how not to compromise the independence of coordinators, especially given the pressure (sometimes) to step in and fill gaps where social workers or social care practitioners should really be providing the relevant back-up or support.  The idea of FGC as a ‘courageous conversation’ had strong resonance with those present.  Incorporating some final tweaks based on the feedback received, the characterisation of the adults’ FGC practice model, and its underpinning Programme Theory, will be available shortly.

The afternoon featured a series of presentations and discussions around current practice and practice issues.

Sean Ahern and Maria Smith from Camden presented a fascinating story of how Dennis was encouraged and supported to have a Conference to bring together the people who were important to him, and could help to give more consistent support in enabling him to have a safer and more rewarding life in his older age – but in a way that respected who he was and the life that he had led.

Michaela Calvert presented a deeply insightful account of her own experience of having a FGC, how this had changed things for her and what she had learned from this.  Crucial to her had been how the process levelled power hierarchies and brought everyone together (professionals and network members) as part of her circle – and how this enabled her to find her voice at the centre (in her supportive chair that was specially transported in to the venue).

Annie Ho (independent social worker) presented her reflections based on her experience of Court of Protection cases and Safeguarding Adults Reviews (SAR).   These tend to be situations where the person at the centre may lack capacity to articulate their wishes and preferences, and in which there can be deeply entrenched family relationship issues and/or disagreements between network members and professionals.  These can cause great harm to those involved and result in huge costs to network members and/or wider professional systems (including legal costs).  Could a FGC process offer a more restorative opportunity to air and resolve differences and reach a degree of accommodation and shared understanding around the needs of the vulnerable adult?  A relatively small investment could potentially reap great benefits for those involved and also prevent futile expenditure of time and money on things that do not actually help the person at the centre.

Alivia Bray and Yasmin Morgenstern from Essex presented on how they have adapted and developed Family Group Conferencing in an adult mental health service.  There is much about FGC that can be somewhat counter-cultural in an NHS setting where decisions are usually made by clinicians rather than the person and their network.  What was particularly interesting was the time that goes into working with the person during the preparation phase in order to support them in developing their own personal recovery plan which is confidential to them.  It is then for the person to decide what of this they wish to share with their network and practitioners in the FGC process.  This reverses the conventional power relations of clinical practice and puts the person in the ‘driving seat’ of their recovery process, alongside the people that matter to them.

Danielle Valente from Birmingham outlined their plans for integrating FGC practice within the Transitions Service for young people with ongoing support needs as they move from receiving support from children’s to adults’ services.  A particular issue can be enabling parents and family members to adjust to the young person becoming an adult – and the implications of this in terms of how they go about supporting their loved-one through their adult life, and offering recognition to them as a person who will be directing their own life as far as possible.

Paul Allen (also from Birmingham) rounded off the afternoon session by reflecting on a particular conference process and some of the issues that this raised in terms of the conversations that go into preparation.  This highlighted the importance of the coordinator managing the ‘space’ for conversations to take place, but being comfortable living with the uncertainty as to what outcome may emerge from these.