Evidence-based parenting programs have a key role to play in improving child and parent outcomes for families experiencing multiple and complex needs, and should be a central part of regular service provision.
This is the key recommendation from a systematic evidence review commissioned by Foundations (the UK’s national What Works Centre for Children and Families) and undertaken by CEI’s UK team with Dr Sophia Backhaus from the University of Amsterdam, Professors Frances Gardner and Jane Barlow from the University of Oxford, and Professor Aron Shlonsky from Monash University.
The review has informed the recently released “Parenting through Adversity Practice Guide” which provides national guidance to local authorities in England.
“Children whose parents face complex problems – such as poor mental health, poverty or addiction – have a higher risk of child maltreatment or abuse. Our research team investigated the role of parenting programs in reducing these risks, and in building more positive parenting practices and better parent–child relationships,” says CEI Principal Advisor Anne-Marie Baan.
“There have been many individual evaluations involving parents facing adversity that demonstrate the effectiveness of parenting programs as an intervention. But there remained a question whether, overall, parenting programs are the right approach for parents facing the highest levels of disadvantage, or whether those issues create too many obstacles for parenting programs to ‘work’.”
To answer this, the research team brought together results from 95 studies across 50 different parenting programs, which focused on parents of children aged 0 to 10 who face the most disadvantage.
“Our review provides a unique contribution to the literature, with its explicit focus on rigorous evaluations of parenting programs across this age range with parents facing adversity,” Anne-Marie notes.
Key findings were:
- Overall, parenting programs have positive impacts (ranging small to moderate) on most child outcomes assessed: child attachment, child behaviour problems, child externalising behaviour, child wellbeing, and parent–child relationships (the reduction in child internalising behaviour was not statistically significant)
- Parenting programs produce an improvement in positive parenting (e.g. appropriate disciplining, praise, warmth and nurturing behaviours) and a reduction in negative parenting (e.g. overprotective, lax or hostile parenting or emotional violence)
- There was a small positive effect on parental mental health and parental stress, which are known risk factors for poor child outcomes
- There was a small (but statistically non-significant) effect for maltreatment and harsh parenting
“We also analysed the specific practice elements within parenting programs (that is, the discrete practices, strategies, techniques and delivery characteristics), to see which are most effective for parents with complex needs,” Anne-Marie explains. “To dig deeper, we looked at whether the theoretical foundation of parenting programs influences effectiveness, as well as some of the specific practice elements utilised.”
“We found greater effectiveness for programs based on social learning theory – which emphasise modelling and observation, positive behaviour reinforcement, and boundaries and natural consequences for children. In terms of particularly effective practice elements, two stood out: setting expectations about appropriate boundaries, and equipping parents with skills in child-directed interactions.”
The duration of programs and whether they were delivered in group or individual settings were found to be factors of less importance in producing positive gains for children and parents.
“Our results do not point to the need to focus on more resource-intensive options – such as 1-to-1 programs, programs delivered to individuals, or longer duration programs. We found, rather, that there is good benefit to quality parenting programs across a range of different program types, and with more or less resource-intensive delivery. This is a very encouraging finding for service providers,” says Anne-Marie.
“Across the three prioritised outcomes – child maltreatment and negative parenting, parent poor mental health, and positive parenting – our findings provide a clear endorsement of the benefits of parenting programs for parents experiencing complex and multiple needs.”
The evidence review is available for download HERE
More about the evidence review
A search of relevant published studies identified 131 reports presenting findings from 106 trials of 56 parenting programs. Of these, 95 trials of 50 programs were able to be included in the meta-analysis for the systematic evidence review.
The 95 studies analysed involved disadvantaged and at-risk populations, with a wide range of risk factors.
To answer questions about what works for parents experiencing complex and multiple needs, quantitative synthesis methods were used.
More about the practice guide
Foundations’ new Practice Guide: Parenting through adversity sets out key principles and recommendations, based on this systematic review and other recent evidence, to support senior leaders in local authorities to improve how services are commissioned, developed and delivered.
The Practice Guide recommends evidence-based parenting interventions be made available to families experiencing complex needs, in view of good evidence of benefit.
The 12 principles canvas the need for tailored, strengths-based support that embeds choice for parents; the need to address racial and cultural barriers; the benefits for parents with poor mental health; the need for an end-to-end system of support that is carefully implemented, effectively delivered and with ongoing quality assurance; and the need for local system integration in needs analysis, in referral pathways and in workforce planning and support.
The systematic evidence review, Effective interventions and practices for parents experiencing complex and multiple needs, was co-authored by Anne-Marie Baan from CEI and Dr Sophia Backhaus from the University of Amsterdam, together with Dr Evelyn Tan, Paola Castellanos, Hui Ni Ho, Dr Janell Kwok, Rebecca Dean, Dr Eleanor Ott and Jane Lewis from CEI, Professor Frances Gardner and Professor Jane Barlow from the University of Oxford, and Professor Aron Shlonsky from Monash University.