What is Family Engagement?
Family engagement is an active partnership between families and service providers. It can be an individual relationship between a clinician and a family, an organizational alliance between an agency and families in their community, or a systemic recognition of family-centred care. Regardless of the definition, when families are engaged, programs and services are stronger and young people are healthier.
In a study that asked families of children and youth in mental health care “what do families want from their health care provider”, Fereday et al. (2010) concluded that partnership was identified as the overarching theme. Partnership was described as positive parent-professional relationships, including equality, mutual respect, open communication, genuine caring, provision of information, commitment, skills, trust, quality, empathy, service coordination, advocacy, honesty, mutually agreed upon goals and shared planning and decision making.
There are three main categories of involvement for families:
- Families as recipients of services: Programs are typically led by professionals and improve the ability to deal with behaviours through improved problem-solving and reduced stress.
- Family-led supports/programs/Families as co-therapists: Families helping families such as family-driven support groups and mutual support programs are associated with reduced subjective burden and distress
- Engagement through the process of involvement: Factors that impact on family involvement in care (e.g., therapeutic alliance, empowerment, expectations of families and choice)
Family Engagement is a Family-Centred Approach
Agencies and organizations have a responsibility to engage families in their treatment. Family engagement is a multifaceted construct, made up of key elements and principles that work together to promote ongoing partnerships between families and service providers. Over time, there has been a transition in understanding and practice from a traditional service model (professional-as expert model) to a family model of care (family-as-full-partner model) in mental health. True family engagement that is meaningful to the family and considers the family the expert on their child or youth is part of a family-centred model of care.
Families can be involved in the child and youth mental health system as more than passive recipients of services. In fact, meaningful engagement requires that families have more active roles in their child or youth’s care. While family engagement is often considered as involvement in their child or youth’s treatment, it can also mean involvement at the service/program level or at the policy level. Not only does engagement at the service/program and policy levels promote engagement of parents in their child or youth’s care, but it offers agencies and organizations opportunities to legitimately understand family concerns, challenges and ideas for positive change. Family engagement means utilizing families’ vast expertise to improve services.
Family-centred care is based on the following principles:
- Recognition that families are experts in the needs of their loved ones
- Practices that promote equal partnerships among family members, service providers and the client
- Supports the family’s role in decision making and contributions to ongoing care and planning for the client
Family: A circle of care and support offering enduring commitment to care for one another related either biologically, emotionally or legally and takes into account those who the client or person with lived experience identifies as significant to his/her well-being.
Family-centred: A philosophy and evidence-informed approach to practice focused on meeting the needs of both client and families (family as defined) where the family is seen as a primary component and unit of attention.
Family involvement: Families are involved when they support and participate in their child or youth’s mental health care, create home environments that support the child or youth and collaborate with the broader community to provide resources/services to help community mental health agencies succeed.
Family engagement: The term engagement is a more active partnership between families and service providers. For service providers, this means listening to what families think, engaging them in two-way communication and involving them as essential allies in decision making so that their involvement is meaningful and has a purpose. Effective family engagement requires the service provider to develop a relationship-building process focused on listening.
Family as Experts: Within the literature and in practice, there is a shift to referring to family members as experts in their children/youth. While the term expert can be controversial, it is not meant to suggest that families are experts in mental health, treatment or interventions. Families-as-experts does, however, recognize that families have expertise in their children and youth, and can offer valuable insight and knowledge when collaborating with mental health professionals.
Control: The term control is often used to describe the shift in decision-making power from the professional to families. Use of the term control does not suggest that families will make all of the decisions, but is used to denote the shift in balance from a professionally driven model to one where families are able to make decisions and provide input in collaboration with mental health professionals to determine the best possible course of action for their children or youth.
Why Family Engagement?
It is widely understood that access to mental health services by children and youth depends on the recognition and action of key adults (Hoagwood, 2005) and that family involvement in treatment and planning can contribute to positive mental health outcomes for children and youth (Dixon et al., 2001; Glick, Stekoll, & Hays, 2011). Child and youth community mental health agencies are beginning to recognize the importance of family engagement to improve clinical outcomes, ensure accountability and provide relative and accessible programming.
Family Engagement at Child and Family Centre
The Child and Family Centre is in the process of developing a family engagement and support group with the guidance of The Ontario Centre of Excellence for Child and Youth Mental Health and Parents for Children’s Mental Health.
It is our hope that with the help of parents, staff, and management that we can develop our family-centred approach and as always strive toward the very best services possible for the children and youth of our community.