The cost‐effectiveness of UK parenting programmes for preventing children's behaviour problems – a review of the evidence

Parenting programmes are widely used in the UK, promoted in policy documents as a cost‐effective way for children's services to address behaviour problems and thereby the longer‐term costs associated with conduct disorders, particularly antisocial behaviour and criminality. To explore whether these programmes are a cost‐effective component of family intervention, this paper examines evidence from cost‐effectiveness studies based on randomized controlled trials, modelling studies estimating longer‐term costs and outcomes, and studies estimating costs of UK parenting programmes, including evidence from routine practice. Findings indicate that parenting programmes have the potential to be cost‐saving in the long term; however, gaps in the evidence include: lack of follow‐up of families who drop out of programmes, absence of control groups in longer‐term follow‐ups, and little information about costs and effects of programmes in routine practice. The size of savings resulting from implementation of effective parenting programmes will depend on the extent to which families likely to be most costly to society attend and experience lasting benefit.     

Parenting interventions in shelter settings: a qualitative systematic review of the literature

The aim of this literature review was to critique the state of the research on the effects of implementing parenting programmes in shelters for homeless families. A comprehensive search of multiple databases yielded 12 studies for inclusion. The methodological sophistication of the studies varied, with most investigations based on very small samples and one‐group pre‐post designs. Results indicated that parents generally viewed the interventions as enjoyable and informative, and attendance was good. Incentives were often used to encourage attendance. Evidence was limited in terms of effectiveness of the interventions, but the few studies of evidence‐based parenting programmes showed changes in parenting and child functioning. Suggestions are provided for future investigations in this important yet challenging field of study.     

Searching for effective interventions for foster children under stress: a meta‐analysis

Foster children experience a lot of stress because of their life histories and changes in their family circumstances, such as foster care placement. It is important that foster parents recognize the early signs of stress in foster children and learn how to act in a non‐threatening and understanding manner. Family‐based interventions may help in this. In this paper, we report on a meta‐analysis of studies (n= 19) of the effectiveness of such interventions. All studies used a pre‐test/post‐test design. Both problem behaviour in foster children and the parenting skills of foster parents improved by 30%; however, none of the interventions were specifically intended to help young children (<4 years) to cope with stress. The importance of interventions for young foster children is discussed, as well as the necessary elements these interventions should include.     

Treatment‐as‐usual in effectiveness studies: What is it and does it matter?

Andrée Löfholm C, Brännström L, Olsson M, Hansson K. Treatment‐as‐usual in effectiveness studies: What is it and does it matter? A hallmark of an evidence‐based practice (EBP) is the systematic appraisal of research related to the effectiveness of interventions. This study addressed the issue of interpreting results from effectiveness studies that use treatment‐as‐usual (TAU) as a comparator. Using randomised controlled studies that evaluate the effectiveness of multisystemic therapy as an illustrative example, we show that TAU includes a wide variety of treatment alternatives. Estimated treatment effects on recidivism suggest that TAU seems to contain a greater variation in underlying risk than experimental conditions, supporting the hypothesis that the content of TAU could affect outcomes. Implications for the realisation of an EBP are discussed.     

Psychometric properties of an adapted version of the parental sense of competence (PSOC) scale for Portuguese at‐risk parents

Parental sense of competence is one of the central dimensions targeted on psychosocial interventions aimed at supporting at‐risk families. Researchers and practitioners need reliable instruments to assess the parental role adapted for these families. Although the parental sense of competence (PSOC) scale has been frequently used to assess this construct, there is still no adapted version for Portuguese parents. In this study, the reliability, validity and factor structure of the PSOC scale is examined with a clinical sample of 146 mothers from at‐risk families receiving psychosocial interventions for family preservation from Child Protective Services. Results show that the Portuguese version of the PSOC measures three distinct constructs with acceptable psychometric properties: efficacy, dissatisfaction and controllability. As expected, the obtained factors were significantly and positively related to parenting alliance and family cohesion, and negatively associated with parenting stress. In sum, the proposed Portuguese version shows reliability and validity evidences to measure three relevant dimensions of parental self‐evaluation, and it constitutes a cost‐ and time‐effective instrument suited for at‐risk mothers.     

Preventive Services for Adolescents: Exploring the Process of Change

This paper reports on a quasi-experimental study which comparedoutcomes for young people referred to specialist family supportteams with those for others referred to mainstream social workteams. Although there was no evidence that the specialist servicewas more effective in promoting changes in child and familyfunctioning, nevertheless, many young people in both groupsshowed improvement in this respect. This paper explores how,why and in what circumstances these positive changes occurred.The factors which moderated or mediated the effectiveness ofinterventions included both risk and protective factors foremotional and behavioural problems and aspects of the interventionsthemselves. The paper explores the mechanisms whereby thesefactors interacted to help or hinder workers’ effortsto promote change. Child and family attributes and histories,the duration of child and family difficulties, motivation andoptimism all moderated the impact of interventions, making changemore, or less, likely to occur. Aspects of the interventionsthemselves also mediated their effectiveness, such as theirecological approach, the strategies used to change child behaviourand parenting style and the development of a therapeutic alliance.These moderators and mediators of change had a stronger impacton the outcome of interventions than differences in servicetype.     

Two‐generation preschool programme: immediate and 7‐year‐old outcomes for low‐income children and their parents

Preschool children living in low‐income families are at increased risk for poor outcomes; early intervention programmes mitigate these risks. While there is considerable evidence of the effectiveness of centre‐based programmes in other jurisdictions, there is limited research about Canadian programmes, specifically programmes that include children and parents. The purpose of this study was to evaluate a single‐site, two‐generation preschool demonstration programme for low‐income families in Canada. A single group, pre‐test (programme intake) /post‐test (programme exit) design with a 7‐year‐old follow‐up was used. Between intake and exit, significant improvements in receptive language and global development were found among the children, and significant improvements in self‐esteem, use of community resources, parenting stress and risk for child maltreatment were found among the parents. These positive improvements were sustained until the children were 7 years old. Public investment in two‐generation preschool programmes may mitigate risks for suboptimal child development and improve parental psychosocial outcomes.     

Parenting is genetically influenced: What does that mean for research into child and adolescent social development?

Individual differences in child and adolescent social development are due to a combination of variation in genetic propensity and environmental conditions. That is, variation in social domains like bullying-victimization, loneliness and pro- and antisocial behaviour is genetically influenced to a substantial extent. That is not to say that social contexts also do not play an important role in shaping social development. Indeed, parenting and parent–child relationship quality have been associated with various aspects of social development. What complicates matters is that environmental conditions – including parenting – are under genetic influence as well. Genetic influence on parenting has not received sufficient attention in the literature on social development although it likely biases estimates of parental effects on offspring social development. To change this situation, I review recent twin and molecular research on genetic influence on parenting and discuss why genetically-informed studies improve and enrich contemporary research into social development. The aim of this topic review is to provide an accessible introduction to genetics of parenting and encourage genetically-informed research into social development.     

A review of the research priorities of practitioners working with children in social care

It has been argued both that research in social care is insufficiently relevant to practice, and that a clearer steer is needed from the social work community in shaping national research priorities. The work reported here systematically searched for and analysed findings from studies that asked practitioners working with children for their suggestions for research. Eight studies were found, and authors gave us access to the primary data from four of these, to which we added responses from the What Works for Children? website survey of practitioners’ research priorities. Responses were analysed in terms of both topic and type of research. Family support, parenting and child protection research were among the most frequently requested child‐focused topics. In terms of question type, almost half the research suggestions concerned the effectiveness of interventions. These findings suggest that a commitment to outcomes, and to robustly researched interventions to attain those outcomes, are increasingly important to practitioners. These views from the front line may well be useful in assisting decision‐makers in social work, and research funders, to set priorities.     

Helping parents by working with their children in individual child therapy

The paper describes a small scale pilot process and outcome study that was undertaken at the University of York. The study is based on accounts of treatment interventions with children conducted by trainee play therapists studying on the University's programme in non‐directive play therapy. These are being used to develop a methodology for evaluating the effectiveness of non‐directive play therapy as an intervention for distressed and maltreated children. The focus of this paper is on one finding of the study, namely that play therapy undertaken with individual children, in addition to bringing about improvements in the children's problems, may improve their parents’ parenting behaviour if they are appropriately involved in the therapy. The paper describes the cases and their outcomes at a 6‐month follow‐up. It illustrates the finding of changes in parenting behaviour through three case studies, and discusses the kinds of changes, possible reasons for them, and necessary practice requirements if these changes are to take place. The paper concludes that engaging parents in a broadly collaborative effort may be facilitated by a primary initial focus on their children.     

Patterns of individual change and program satisfaction in a positive parenting program for parents at psychosocial risk

Despite the evidence of effectiveness of positive parenting programs, little is known about the typology of changes that parents at psychosocial risk undergo after an intervention. We compared individual patterns of change in three parenting outcomes in 256 at risk parents with young children attending the group‐based Growing Up Happily in the Family program delivered in municipal social services. We identified four clusters of individual change: Cluster 1 (30.6%) had negative changes in parental child‐rearing attitudes and parenting stress, Cluster 2 (27.7%) had positive changes in child‐rearing attitudes and negative results in parental perceived competence, and Cluster 3 (24.1%) and Cluster 4 (17.6%) showed overall better results. Residential area, type of social support, and quality of implementation characterized cluster membership. Participants in clusters with better results were more satisfied with the program than those with worse results. Practical recommendations are provided for the successful implementation of group parenting programs in family preservation services.     

Caregivers' perspectives on the SafeCare® programme: Implementing an evidence‐based intervention for child neglect

This qualitative study examined caregivers' experiences with SafeCare®, an evidence‐based programme that focuses on child neglect through modules on health, safety, and parenting. Shortly after completing SafeCare, 30 caregivers participated in a semi‐structured interview about their experiences with the programme. Overall, caregivers indicated that the programme helped with improvements in their parenting skills. Among the factors that contributed to a positive experience were the simplicity of language, the skills‐based approach, and the quality of the relationship with the SafeCare provider. Caregivers also noted several factors that made it difficult to fully benefit from the programme, including financial constraints, removal of their child from the home, and general distrust towards the child welfare system. Findings provide relevant information for SafeCare providers in terms of identifying areas that work well for caregivers completing the programme, as well as areas that might serve as impediments. Implications for contemporary child welfare practice are also considered.     

Economic adversity and crime: old theories and new evidence

In this article we make a case for the continuing relevance of economic adversity and social policy in the understanding and prevention of crime. We begin by discussing early theories positing a causal relationship between economic adversity and crime and examine the factors that have led to a loss of confidence in these theories. We then summarise two prominent strands of research investigating important indirect criminogenic effects of economic adversity. The first deals with the long‐term impact of economic adversity on parenting. The second analyses the impact of economic adversity on crime through its effect on informal social controls within a community. Finally, we review recent empirical studies that use modern econometric techniques to explore the direct effects of economic adversity on crime, highlighting research focused on factors such as wages, employment, housing, and income support programs. The paper concludes by suggesting a number of areas for future research.     

A place of our own: a narrative review of the family housing services literature

The problem of family homelessness has been widely recognized by both policymakers and social service providers. What is not clear, however, is the overall effectiveness of housing intervention services provided to homeless families. This narrative review of the literature discusses 10 studies from 1991 to 2013 on both transitional and supportive housing in order to assess under what conditions and for whom these interventions are most effective. More specifically this review evaluates the research regarding which elements of intervention services are most helpful to families, the outcomes associated with these programmes, and the short‐ and long‐term effectiveness of housing interventions. Evidence suggests that while these programmes produce positive outcomes for families, a one‐size‐fits‐all model of housing may not be effective for all families. Limitations and directions for future research are also discussed.     

A systematic review of interventions to support looked‐after children in school

A systematic review of interventions to support looked‐after children in school included interventions that aimed to improve attainment, or prevent drop‐out or exclusions, and those that aimed to reduce absenteeism in the care population. Studies were critically appraised and their results were considered. No study was found robust enough to provide evidence on effectiveness, but promising interventions were identified. The review highlights the lack of evidence in an area that has received a lot of policy attention in the past few years. Future evaluations need to be underpinned by lessons learned from existing evaluations, clearly defined theories and definitions, and by the views of professionals, researchers, policy‐makers and young people in care.     

Family treatment of childhood anxiety

Anxiety in childhood and adolescence can cause serious impairment across many settings in a child's life. Childhood anxiety may be impacted by parent‐child attachment and by three specific parenting characteristics: acceptance, control and modelling of anxious behaviours. We review two evidence‐based family interventions for childhood and adolescent anxiety problems. Cognitive behavioural treatment is currently the most commonly used form of psychotherapy to treat specific anxieties. Global or diffuse anxiety, however, may be better suited to experiential interventions such as communications approaches to family treatment. Experiential therapists examine how dysfunctional family roles exacerbate childhood anxiety. These intervention techniques and their implications for social work practice were discussed.     

Spiritual education programme for primary caregiver parents to build resilience in children with acute anxiety symptoms: A multicity study

This article reports a multicity 1‐year long study on the effect of a customized spiritual education programme (SEP) on parenting and in turn its mediated effect on resilience building for children with acute anxiety symptoms. The treatment group comprised 3,689 primary caregiver parents who participated in the SEP and their children clinically diagnosed with acute anxiety symptoms, from 180 schools across 15 cities. Equal number of primary caregiver parents and children were assigned to the control group. Results showed that post‐test scores of treatment group primary caregiver parents were higher on the parenting style questionnaires, indicating an improved and authoritative parenting style. This positive effect of the SEP on parenting in turn had a mediating effect on resilience of their children, who scored higher on the outcome measures in the post‐treatment phase. Parenting and resilience outcome measures varied due to socio‐economic and SEP‐related variables. Children's perception of post‐treatment parenting influenced their resilience. Findings suggest that SEP could aid positive parenting and hence positive behavioural outcomes in children.     

Is Contracting out of Public Services still the Great Panacea? A Systematic Review of Studies on Economic and Quality Effects from 2000 to 2014

This article presents the results of a systematic review of international studies on economic and quality effects of contracting out published in the period from 2000 to 2014. We conducted a comprehensive search of the literature and identified 49 relevant studies. There are three main findings of the systematic review: (1) cost savings documented in international contracting out literature have been decreasing over time; (2) cost savings have been much greater in technical services than in social services; and (3) economic effects have been twice as large in Anglo‐Saxon countries compared with other countries. With regard to measuring the effect of contracting out on service quality, which is a vital component of any service delivery arrangement, very few studies assess this issue in a comprehensive manner. There is also a significant lack of studies that include measures of transaction costs, thereby making it difficult to evaluate the impact of contracting out on overall cost‐effectiveness of public service delivery. We conclude that generalization of effects from contracting out should be made with caution and are likely to depend, among other things, on the transaction costs characteristics of the service, the market situation and the institutional/regulatory setting.     

Building resilience in a children's home: results from an action research project

This paper reports on the findings of an action research project aimed at building resilience in young people in a residential children's home. Daniel and Wassell's six domains for promoting resilience in young people were adopted as a conceptual framework to guide the residential social workers as they engaged in successive cycles of reflection and action. Two core areas were explored: (a) the approaches deemed to be helpful in building resilience; and (b) the background factors that enabled and constrained the social workers' interventions. The findings showed that the participants acted creatively to use resources and tools both within the system of State‐mandated parenting and the informal, meaning‐oriented world of the young people.     

Influence of Parenting Behavior on Psychosocial Adjustment in Early Adolescence: Mediated by Anger Regulation and Moderated by Gender

Emotion regulation (ER)—one of the most important developmental tasks in early adolescence—has been proposed to mediate the relation between parenting and adolescents’ psychosocial adjustment. The aim of this study was to examine the influence of parental psychological control and autonomy support on adolescents’ problem and prosocial behavior (Strengths and Difficulties Questionnaire), as well as to examine the mediating role of adolescents’ anger regulation and the moderating effect of gender. We collected three‐year longitudinal questionnaire data from N = 923 parents and their (at first assessment) 9‐ to 13‐year‐old children. Path‐analysis results mainly support the mediating role of adolescents’ adaptive and maladaptive anger regulation and suggest parental autonomy support to be beneficial for regulatory abilities and psychosocial adjustment, whereas the opposite was found for psychological control. Gender differences were found for parent report data, but not for adolescent report data. Practical and theoretical implications are discussed.