LANDSCAPES OF PRACTICE

Research in practice:Evaluating the effectiveness of a therapeutic parenting programme

Alison Prowle Rosie Walker

Centre for Early Childhood University of Worcester

Welcome to our presentation it is a professional privilege when we are invited to enter the world of the parent in order to work collaboratively.

Claire Majella RichardsIntroduction:This presentation underlines the importance of professional collaboration between parents, carers and early years services and suggests this is an essential part of quality improvement.It provides a brief overview (a summary paper of this overview with full references is available) and moves on to report a specific research project exploring an evaluation of a parent support programme.

Transformation and changeThe sheer diversity of family life now rules out one size fits all approaches. Giving families access to information, advice and support of various kinds that they can use as and when they think best is much more likely to be effective (Page 5)

Department for Children,Schools and FamiliesSupport for All (Green Paper) Presented to Parliament by the Secretary of State for Children, Schools and FamiliesJanuary 2010

Hallmarks for successful and sustained engagement with families:

practitioners work alongside families in a valued working relationship;practitioners and parents are willing to listen to and learn from each other;practitioners respect what families know and already do;practitioners find ways to actively engage those who do not traditionally access services;parents are seen as decision-makers in organisations and services;families views, opinions and expectations of services are raised;there is support for the whole family;there is provision of universal services but with opportunities for more intensive support where most needed;there is effective support and supervision for staff, encouraging evaluation and self-reflection;there is an honest sharing of issues around safeguarding.

The Principles for Engaging with Families(NQIN, 2010).ContextGrowing policy emphasis on working with parents Growing recognition that parenting intervention can be effective as part of an approach to support/empower families.Financial austerity and value for money

PurposeThe research aims to review the impact of an existing parenting programme within one English Local AuthorityThis programme is one strand of an existing comprehensive programme of parenting support provided by the Local Authority.

Supporting Parents throughParenting ProgrammesBehaviourist ApproachesStrong evidence baseLongitudinal studies

Therapeutic ApproachesEmerging evidence base. Limited research available Strongly valued by practitioners and parents

Key features of programme:Focused on enabling parents to improve their emotional wellbeing and parenting practices by addressing the emotional determinants of behaviour and relationships. The programme addresses the following issues: Promoting emotional literacy ;Raising self-esteem; Developing communication and social skills; Teaching positive ways to resolve conflict; Providing effective strategies to encourage cooperative; responsible behaviour and manage; challenging behaviour in children; Offering insights into the impact of feelings on behaviour; and Encouraging adults to take time to look after themselves.

Aims of researchTo consider the value of therapeutic parenting programmes as part of a wider package of parenting supportTo consider the experiences of practitioners and parents within the programmeTo evaluate the outcomes from the parenting programme both in relation to parents and their children

Research approachConsiders interface between practice and theoryMixed methods approach interconnecting both qualitative and quantitative data Ethicality observed throughoutResearch involved a number of stakeholders:local authority officers with responsibility for parenting and family intervention;parents who had participated within programmemulti- agency practitioners with responsibility for delivering programmea local head teacherReview of the published literatureDesk based analysis of data from previous groups ( 200+ parents)A case study of two cohorts from starting point to conclusion of the groups and beyond including situational interviews (24 parents)Turning the curve exercise, considering progress against agreed outcomesFocus groups with parent group facilitators Focus group with parents who had completed less than six months prior to research.

Data collection methods

Research findings:Impact on parentsQuantitative Data For vast majority of parents, overall wellbeing had increased, in many cases very significantly.

In the remaining parents overall wellbeing scores had remained static or decreased very slightly.

Across the entire cohort, the average overall wellbeing score rose from 2.83 pre intervention to 3.35 post intervention, representing an increase in wellbeing of more than 20%.

Qualitative dataAlmost all parents reported benefits

Most commonly reported benefits were increased confidence, feeling calmer, better coping strategies, improved understanding of own and child behaviour.

Improvements appear to be sustainable in short and medium term

I am a lot happier and feel I am becoming a better mum. Me and (husband) talk about situations and plan strategies together. We are a lot more constructive and co-operative. I am much more self aware and practising lots of the techniques. Feel more confident and in control! Our home is a happier, kinder place to be. We are all more aware of each others feelings.I am actively getting off the sofa and dealing with problems

Measures of wellbeingUsing Warwick Edinburgh Mental Wellbeing Scale15 Perceptions of change: parents changed Research findings Visible impact on child outcomesPractitioners saidSDQ- scores for 75 parents suggest that overall, their perception of child strengths had improved slightly and their perception of difficulties had decreased more significantly. Practitioners said..the programme delivers improved outcomes for children One child with multiple exclusions in a previous school has avoided any exclusions since parent attended the programme SATS results for five children in year 6 show marked improvement against earlier predictions;One family avoided Child Protection involvement, and voluntarily engaged with Common Assessment Framework following programmeOne child from Traveller Community has increased attendance from 23% to 98% following programme , and is making very good progress in all curriculum areas Parent perceptions of child strengths Parent perceptions of child difficultiesResearch findings: turning the curve ( Friedman, 2005) Improvement in :Ability to manage childrens behaviour; Childrens behaviour at home and school;Ability to enhance relationships and nurturing skills within the family; Child meeting appropriate expectations;Confidence and empathy in relation to managing children; Childs attitude towards parents, peers and others;Circumstances e.g. Childs improved attendance at school, child protection registration, common assessment framework take up; andPhysical health.

Some early evidence of disruption of intergenerational cycles of sub-optimal parenting;

Analysis and Implications: implementation issuesResearch highlighted ways in which value for money could be improved by addressing implementation issues:Data CollectionReferral Pathways Initial EngagementRetention of Parents on Programmes Workforce Development

Analysis and Implications:value for money Unit cost for a family accessing the programme with crche provision relatively low There is anecdotal evidence from the research that programme can play a vital role in preventing costly higher tier intervention, thus offering the potential for substantial savings in both professionals time and foster and residential care provision.

Value for MoneyCare typeCost per child per annum ()BasisResidential care130,000Cost of 2000/3000 per child per weekFoster care36,000Foster care per child per week (excluding London) 0f 694Social services support3000Social Service support 305 per child per annumFSW 2 hours per child per weekAssessment costs - 500FLNP programme155Including crcheAssuming a once-off intervention per annumResearch SummaryKey findingsStrong early evidence that the programme is delivering improvements in wellbeing for parents, and that these improvements may be sustainable at least in the medium term (i.e. 6 months to 2 years after the end of the programme);Some early evidence that the programme is delivering improvements in outcomes for children;The programme is meeting the indicators of positive intervention outcomes as identified from the literature review and analysis;Small improvements to the overall implementation of the programme could further enhance the effectiveness of the programme.

Key messagesProgramme appears to have much merit in allowing parents to understand their own and their childrens behaviour Early evidence that such improvements are sustainable at least in the short to medium termThere is some merit in therapeutic programmes as part of a package of parenting support

Key messages contd.Initial engagement of parents is crucial.Parental ownership of the programme is vital. Introducing mechanisms for measuring readiness to change, motivational interviewing and keeping in touch approaches could all potentially support improved parent engagement. Need for further research, including longitudinal study.

Slide references Allen, G. & Duncan Smith, I. (2011) Early Intervention:, Good Parents ,Great Kids, Better Citizens. [Online] Available from: http://www.centreforsocialjustice.org.uk/client/downloads/EarlyInterventionpaperFINAL.pdf Desforges, C & Abouchaar, A (2003) The Impact of Parental Involvement, Parental Support and Family Education on Pupil Achievements and Adjustment: A Literature Review. London, Department for Education and Skills.Friedman, M. (2005) Trying Hard is not Good Enough. Canada, Trafford Publishing.Goodman, R. (1997) Strengths and Difficulties Questionnaire. [Online} Available from:www.sdqinfo.com/b1.htmlHarris, A. and Goodall, J. (2007) Engaging Parents in Raising Achievement Do Parents Know They Matter? DCSF Research Report RW004. [Online] Department forChildren, Schools and Families. Available from: https://www.education.gov.uk/publications/standard/publicationdetail/page1/DCSF-RW004 Cultivating communities of practice: a guide to managing knowledge. Etienne Wenger, Richard McDermott, and William Snyder, Harvard Business School Press, 2002.

Slide references contd.Reed, M and Canning, N (eds) (2010) Reflective Practice in the Early Years London, SAGEReed, M. (2011) 2nd Edition. Reflective Practice and Professional Development In Page-Smith, A and Craft, A (eds) Developing Reflective Practice in the early years. Milton Keynes, Open University Press. Paper: an adapted version of the full text with references from, Reed, M and Murphy, A. (2012) Parental partnership and professional support In: Reed, M and Canning, N. (eds) Implementing Quality Improvement and change in the Early Years. London: Sage publications, pp 156-171 (Also available as an ebook from Sage Publications) Tennant, R., Hiller, L., Fishwick, R., Platt, S., Joseph, S., Weich, S., Parkinson, J., Secker, J., and Stewart-Brown (2007) The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation. Health Quality of Life Outcomes, 5: 63, 21.The Young Foundation. (2011) Sinking or Swimming, Understanding Britains Unmet Needs. [Online] Available from:http://www.youngfoundation.org/general-/-all/news/sinking-and-swimming-understanding-britains-unmet-needsWinnicott, DW. The maturational process and the facilitative environment. New York: International Universities Press, 1965.

Any Questions?

For more information please contact: Rosie Walker r.walker@worc.ac.uk542266

Alison Prowlea.prowle@worc.ac.uk01905 542261