Everson, J. & Zhang, D.,

2000,

Reviewed by Janet Robertson, Institute for Health Research,
Lancaster University

Methodology

This study uses a focus group interview to explore the views of 9 people who were engaged in Personal Future Planning (PFP). A year before the study took place, the first author conducted a 2 day workshop on PFP for 37 participants representing 8 potential focus persons and potential members of their circles of support. A year later, 5 of the circles were selected to take part in the study. These were selected to represent more and less successful circles. Each circle was invited to send 2 participants to the focus groups: the facilitator (or "primary person"); and a second person who the facilitator believed had made a significant contribution to the circle's functioning. Of the 10 eligible focus group participants, 9 took part in the focus group interview. This included 4 parents, a self advocate, a friend, a case manager, and 2 service staff.

Predetermined probe questions were posed and discussions facilitated during the two hour focus group interview. These questions covered 3 areas: the inhibitors and supports to PCP; the role of circle members in the PCP process; and longitudinal satisfaction with PCP activities and outcomes. Data was collected by tape recording and transcribing conversations and note taking of observations. The resulting data was coded into themes by both authors with meetings being held to resolve any differences in coding.

Critical appraisal

This is a small scale qualitative study based on a one-off 2 hour focus group discussion. There is no data given with regard to the characteristics and situations of the people at the centre of the PCP circles of support. A particular problem with the study is that it selects circle members who are either the facilitator or someone who had had significant input in the PCP process. This selection process means that those circle members who may have had a more negative experience of the process, or who were noted to lack commitment, were absent from discussion. Work is needed to look at what inhibits these people from taking a more committed and active role in the process. Lastly, the use of colloquial expressions from the US means some quotes are not easily understood.

Key findings

There were some problems that all circles experienced in their initial development that have been outlined below:

• the focus person was initially unable or unwilling to express what they wanted.
• scheduling circle meetings was very difficult and for 2 circles this caused difficulty getting started and caused slower development of PCP.
• circle member commitment to circle activities was difficult to maintain. It was difficult to keep community members and extended family members invested and interested in circle activities.
• For some circles, accomplishment a year on was still restricted to circle development, whereas for other circles specific and individualised goals had been met.

For all 5 circles, the "future vision" included a quest for more friendships and social activities.

There were several common inhibitors or problems in the PCP process. The behaviour of the focus person could adversely affect their acceptance by others and work was needed to assist peers and community members in better understanding and accepting the focus person. All focus group participants pointed to the focus person's lack of communication and social skills in interactions with others. With respect to circle members, it was very hard to schedule meetings when most members could attend. All circles had difficulty keeping parties other than service staff involved and it was also difficult to include the focus person's peers in the circle. Family members and service staff sometimes held opposing views that could inhibit progress. Some family members were either too optimistic or pessimistic in their development of future visions, for example believing that someone could never live alone even when service staff considered this a possibility.

Supports for the PCP process that were noted were: the active involvement of the focus person; respecting the needs and wants of the focus person; trying to understand the focus person's dream; and encouraging the circle's future vision, goals and activities to be around the focus person's wants and needs. Also, family members and community members became more supportive of the focus person.

Finally, all focus group participants were positive about PCP and would "do it again".

Social work practice/policy implications

The PCP process appears to have been a positive one for the people involved in the focus group. What remains to be seen is how the process can be made more positive for those groups where commitment to the circle activities was weak, such as extended family and community members.