Transcript LANDSCAPES OF 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 Richards
Introduction:
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 change
The 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 Families
Support for All (Green Paper)
Presented to Parliament by the Secretary of State for Children, Schools and Families
January 2010
Hallmarks for successful and sustained engagement
with families:
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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).
Context
 Growing 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
Purpose
 The research aims to review the impact of an existing
parenting programme within one English Local
Authority
 This programme is one strand of an existing
comprehensive programme of parenting support
provided by the Local Authority.
Supporting Parents through
Parenting Programmes
Behaviourist
Approaches
 Strong evidence base
 Longitudinal studies
Therapeutic Approaches
 Emerging 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 research
 To consider the value of therapeutic parenting
programmes as part of a wider package of parenting
support
 To consider the experiences of practitioners and
parents within the programme
 To evaluate the outcomes from the parenting
programme both in relation to parents and their
children
Research approach
 Considers interface between practice and theory
 Mixed methods approach interconnecting both qualitative
and quantitative data
 Ethicality observed throughout
 Research involved a number of stakeholders:
 local authority officers with responsibility for
parenting and family intervention;
 parents who had participated within programme
 multi- agency practitioners with responsibility for
delivering programme
 a local head teacher
Data collection methods
 Review of the published literature
 Desk 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 outcomes
 Focus groups with parent group facilitators
 Focus group with parents who had completed less
than six months prior to research.
Research findings:
Impact on parents
Quantitative 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 data
 Almost 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
Our home is a
happier, kinder place
to be. We are all
more aware of each
other’s feelings.
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!
I am actively getting off the
sofa and dealing with
problems
Measures of wellbeing
Using Warwick Edinburgh Mental Wellbeing Scale
4.50
4.00
3.50
3.00
2.50
2.00
1.50
pre intervention
post intervention
1.00
0.50
0.00
Perceptions of change: parents
changed
25
20
15
10
5
0
number of parents reporting
improvements
Research findings
Visible impact on child outcomes
Practitioners said……
 SDQ- 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 programme
 One 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
3.0
2.5
2.0
1.5
1.0
0.5
0.0
pre intervention
post intervention
Parent perceptions of child
difficulties
3
2.5
2
1.5
1
0.5
0
pre-intervention
post- intervention
Research findings:
turning the curve ( Friedman, 2005)
Improvement in :
 Ability to manage children’s behaviour;
 Children’s 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;
 Child’s attitude towards parents, peers and others;
 Circumstances e.g. Child’s improved attendance at school, child
protection registration, common assessment framework take up; and
 Physical health.
 Some early evidence of disruption of intergenerational cycles of sub-
optimal parenting;
Analysis and Implications:
implementation issues
Research highlighted ways in which value for money
could be improved by addressing implementation
issues:
 Data Collection
 Referral Pathways
 Initial Engagement
 Retention of Parents on Programmes
 Workforce Development
Analysis and Implications:
value for money
 Unit cost for a family accessing the programme with
crèche 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 Money
Care type
Cost per
child per
annum (£)
Basis
Residential care
130,000
Cost of £2000/£3000 per child per week
Foster care
36,000
Foster care per child per week (excluding London) 0f £694
Social
support
services
FLNP programme
3000
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Social Service support £305 per child per annum
FSW – 2 hours per child per week
Assessment costs - £500
155
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Including crèche
Assuming a once-off intervention per annum
Research Summary
Key findings
 Strong 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 messages
 Programme appears to have much merit in allowing
parents to understand their own and their children’s
behaviour
 Early evidence that such improvements are sustainable
at least in the short to medium term
 There is some merit in therapeutic programmes as part
of a package of parenting support
Key messages cont’d.
 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,
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Better Citizens. [Online] Available from:
http://www.centreforsocialjustice.org.uk/client/downloads/EarlyInterventionpaper
FINAL.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.html
Harris, 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/DCS
F-RW004
Cultivating communities of practice: a guide to managing knowledge. Etienne
Wenger, Richard McDermott, and William Snyder, Harvard Business School Press,
2002.
Slide references cont’d.
 Reed, M and Canning, N (eds) (2010) Reflective Practice in the Early Years London, SAGE
 Reed, M. (2011) 2nd Edition. ‘Reflective Practice and Professional Development’ In PageSmith, 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 StewartBrown (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 Britain’s Unmet Needs.
[Online] Available from:
http://www.youngfoundation.org/general-/-all/news/sinking-and-swimming-understanding-britainsunmet-needs
 Winnicott, DW. The maturational process and the facilitative environment. New York:
International Universities Press, 1965.
Any Questions?
For more information please
contact:
Alison Prowle
Rosie Walker
[email protected]
01905 542261
[email protected]
1905542266