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Summary article De Jong, Schout, Pennell, & Abma (2015)

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Summary of the article 'Family Group Conferencing in public mental health and social capital theory’ by De Jong, Schout, Pennell, & Abma (2015). This is reading material for week 6 of the course Advances in Health and Society at WUR, which is one of the compulsory courses in period 1 of the master MCH.

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Summary article ‘Family Group Conferencing in public
mental health and social capital theory’ – De Jong,
Schout, Pennell, & Abma (2015)
Abstract
Summary: Clients in public mental health care have limited social capital;
they lack trusting and mutually supportive relations within bonded groups
and don’t have accesss to supportive external groups. Family Group
Conferencing (FGC) is a promising decision-making model to restore
social ties and mobilise informal support.
Findings: Conferences were often held as a last resort, in situations
where professional care had already failed prior to the conference. The
intended goals of the conferences weren’t achieved because support from
the social network was insufficiently mobilised and clients themselves felt
helpless that they could improve their conditions.
Applications: Social capital theory points to the necessity of not only
renewing informal networks (‘strong ties’) but of expanding networks
through connecting public mental health care clients to paid and volunteer
work (‘weak ties’). Instituting a family managers to monitor these steps
may support the bonding of ‘strong ties’ and the bridging to ‘weak ties’.

Introduction
Growing interest in family-centred care. A particular form of family
engagement is Family Group Conferencing (FGC). This approach
encourages the involvement of the ‘family group’, which includes the
immediate family, extended family and other informal supports, in making
and carrying out plans.
- Mobilise the extended family
- Little experience in adult care settings (e.g. public mental health
care)

The field of public mental health care focuses in providing care to people
who aren’t being helped within regular mental health settings. Clients
struggle to maintain their living conditions, have several problems
simultaneously (e.g. mental health and addiction) and normally don’t ask
for help or are avoiding the care they actually need  assistance often
unsolicited.

FCG helped in restoring contact with family members and friends,
mobilising their support and overcoming social isolation.

The majority of the conferences were used as a last resort, in situations
where professional care previously had failed. The clients referred to the
conferences as having limited social capital.

Family Group Conferencing
FGC is a decision-making and community-building that is derived from
Maori culture in NZ. The intent was to ensure that families would have the

, opportunity to develop a plan on their own before professionals
intervened.
In a family group conference, all of those who can support individuals or
families are invited to formulate an action plan in response to a problem
situation. An independent coordinator prepares the conference in close
consultation with the family. Each potential participant is approached
individually.
It consists of 3 parts:
- Sharing information  professionals share information on the
problem situation and possible solutions.
- Private family time  free from the oversight of professionals, the
family members are empowered to develop their own plan in
consultation with others in their social network.
- Agreeing on the plan  describes interventions that should be
carried out after the conference and the role of the various
participants in implementing action steps.

Potential benefits of FGC for client systems with limited social capital
Bourdieu:
Social capital= the aggregate of the actual or potential resources which
are linked to possession of a durable network of more or less
institutionalised relationships of mutual acquaintance and recognition
(membership in a group) which provides each of its members with the
backing of the collectively-owned capital, a ‘credential’ which entitles
them to credit, in the various sense of the word.

Time, intensity, intimacy and reciprocity are the engine for strong ties in
networks.
- Reciprocity  obligations between people.
o Networks with more mutual obligations have a robust social
capital  also consist of strong ‘bounded solidarity’; people
who identify with a group are willing to help others. People
with no reciprocity have limited social capital on which they
can rely.

Clients in public mental health care and multi-problem families in youth
care often have limited social capital  few informal resources  lack of
support from social network. Often little faith in integrity of others.

When families lack a sense of self-efficacy and informal support they often
wait until organisations intervene  vicious circle: family expect
professionals to take action; professionals assume that families are
motivated to improve their conditions themselves.
Alternative: create virtuous circles where informal support is mobilised and
sustained for vulnerable families and thus opportunities for new social
structures arise  strengthening the social capital of people reduces their
vulnerability as they can rely on the help of family and friends.

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