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Evidence Based Parenting, Social
   Inclusion and the Nurturing
           Programme

   Sarah Darton MA BSc DipHV RGN
   Director Parent Programmes




             © Family Links 2012
Workbreak Alphabet Arms

A   B        C       D       E       F       G       H       I
l   r         r          l       r   b       l       b       r


J   K        L       M       N       O       P       Q       R
r   r        b       l       r       l       b       l           b


S   T        U       V       W       X       Y       Z
r       r        l       r       l       r       b       b




                                                                     2
The Family Links
    Nurturing Programme (FLNP)


Aims to promote family wellbeing and a
  healthy society by:

√   targeting the root causes of poor
    emotional health;
√   breaking the cycle of ineffective,
    neglectful or abusive parenting


                © Family Links 2009      3
The Nurturing Programme is
effective because:
It’s a carefully designed eclectic model combining
affective, cognitive and behavioural
approaches with the affective principles at its
core.




         A therapeutic learning model
                © Family Links 2009              4
Theoretical Model
of the Nurturing         Problem              Programme Theory
Programme
                                                Nurture parents’
                       Relationship        empathetic insight into the
                      between poor         emotional determinants of
                    parental wellbeing      their own behaviour and
                      and quality of        meeting their own needs
                        parenting
                                                 Four constructs of
                                                 positive parenting:
                                                  • self-esteem and
                     Intergenerational              self-awareness
                      transfer of poor       • appropriate expectations
                    parenting practices          • positive discipline
                                                       • empathy

                             Impact of      Help parents draw on their
                       poor parent-child     experiences as children
                        relationships on         to reflect on their
                            children’s:       relationships with their
                       • physical health
                                           children and empower them
                         • mental health
                                                  to make changes
                            • education
                     • social competence
                         • employability     Meet all learning styles
                       • nervous system        through structured
                                              experiential learning
Proximal
   Programme Design                                     Future Outcomes
                                      Outcomes


10 weekly, 2   hour   sessions in
   groups of   6-10   parents
                                       Improve          Reduced mental
                                    parents’ mental    health problems in
         2 trained                     wellbeing      parents and children
    Parent Group Leaders

   Parenting Puzzle Book,
        CD, and DVD
                                                       Improve children’s
                                       Improve             long-term
                                      children’s
 Provide parents with tools to:                       educational and work
                                      behaviour            prospects
  • develop communication and
         relationship skills
     • encourage cooperative,
      responsible behaviours
       • manage challenging                                 Disrupt
   behaviours in a positive way     Improve family     inter-generational
    • enhance relationship and       relationships       cycles of poor
          nurturing skills
                                                      parenting, violence,
• build confidence and empathy
                                                      and social inequity
The Nurturing Programme is based on
4 Constructs, essential to successful family
               relationships




     The Parenting Puzzle p. 18
                © Family Links 2010        7
Developing the evidence base
   Independent RCT in Wales 2011-
    ‘compatible with cost-effectiveness of the
    FLNP offered on a universal basis to
    improve wellbeing and parenting in
    deprived areas’.
   Internal evaluation 2011- parental
    wellbeing improved on average from scores
    better than 18% of the population to scores
    better than 45% of the population, children
    improved on average from borderline risk of
    mental health disorder to normal child
    behaviour.
                © Family Links 2012           8
Making Sense of Early Intervention
      Centre for Social Justice 2011

   “Evidence on effectiveness,
    appropriateness and feasibility
    provides a sounder base for
    evaluating healthcare interventions,
    in that it acknowledges the many
    factors that can have an impact on
    success” p10



              © Family Links 2012          9
Evaluation of Training
   Independent evaluation 257
    trainees - rated the Nurturing
    Programme training very highly
    80.1% rated it 10 out of 10. The
    average for all participants was
    9.7.
   Just under three-quarters (72.1%)
    of trainees expected to run a
    Nurturing Programme course in the
    next six months
             © Family Links 2011    10
The Nurturing Programme and the
Professional/Personal elements

The Nurturing Programme is designed to:
   promote emotional and mental health and
    wellbeing
   enhance relationship and nurturing skills
   build self-esteem and confidence
   encourage positive approaches to
    behaviour management
   build empathy
in Parents and Practitioners

               © Family Links 2009          11
A truly Universal Programme
The Nurturing Programme is designed for both INTERVENTION
and PREVENTION and is therefore valuable for all families.
A truly universal programme, it is socially inclusive with
resources to support work with parents in a wide variety of
circumstances

Parents with:
Children with          Learning             Muslim parents
disabilities           disabilities
                                            Teenage parents
0-3 yr olds            English as a
                                            Prisoners
                       second
3-12 yr olds           language             Online with
teenagers                                   Netmums


                      © Family Links 2011                     12
Universal provision in areas of
geographical deprivation reduces sense
   of being judged, targeted failure

                                Trained Practitioners - Areas of Deprivation

                          60
Number of Practitioners




                          50
                          40
                          30
                          20
                          10
                          0
                               0-9%    10-    20-    30-    40-      50-    60-    70-    80- 90-
                                      19%    29%    39%    49%      59%    69%    79%    89% 100%
                                                       Deprivation by %




                                              © Family Links 2011                                   13
Nurturing Programme
       foster parent feedback

“A couple who have completed their OCN
 portfolios have attended a court hearing and
 are now in a position to receive their 4
 children back home. The next stage was
 going to be adoption for the children, but the
 FLNP OCN results achieved by the parents
 was used as evidence and made a huge
 impact. … many parents undertake various
 parenting programmes and they merely act
 as a temporary fix, but FL has made a lasting
 impact on their attitudes and behaviour and
 this was recognised by the professionals
 involved in their court hearing.”


              Barnardos Hartbeat PGL in Hartlepool
         working with parents with children in care
                © Family Links 2011                   14
Contact Details
        Peterley House
         Peterley Road
 Horspath Industrial Estate
       Oxford OX4 2TZ
     Tel: 01865 401800
     Fax: 01865 401820
Email: info@familylinks.org.uk
  www.familylinks.org.uk

        © Family Links 2009      15

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Family links Panel

  • 1. Evidence Based Parenting, Social Inclusion and the Nurturing Programme Sarah Darton MA BSc DipHV RGN Director Parent Programmes © Family Links 2012
  • 2. Workbreak Alphabet Arms A B C D E F G H I l r r l r b l b r J K L M N O P Q R r r b l r l b l b S T U V W X Y Z r r l r l r b b 2
  • 3. The Family Links Nurturing Programme (FLNP) Aims to promote family wellbeing and a healthy society by: √ targeting the root causes of poor emotional health; √ breaking the cycle of ineffective, neglectful or abusive parenting © Family Links 2009 3
  • 4. The Nurturing Programme is effective because: It’s a carefully designed eclectic model combining affective, cognitive and behavioural approaches with the affective principles at its core. A therapeutic learning model © Family Links 2009 4
  • 5. Theoretical Model of the Nurturing Problem Programme Theory Programme Nurture parents’ Relationship empathetic insight into the between poor emotional determinants of parental wellbeing their own behaviour and and quality of meeting their own needs parenting Four constructs of positive parenting: • self-esteem and Intergenerational self-awareness transfer of poor • appropriate expectations parenting practices • positive discipline • empathy Impact of Help parents draw on their poor parent-child experiences as children relationships on to reflect on their children’s: relationships with their • physical health children and empower them • mental health to make changes • education • social competence • employability Meet all learning styles • nervous system through structured experiential learning
  • 6. Proximal Programme Design Future Outcomes Outcomes 10 weekly, 2 hour sessions in groups of 6-10 parents Improve Reduced mental parents’ mental health problems in 2 trained wellbeing parents and children Parent Group Leaders Parenting Puzzle Book, CD, and DVD Improve children’s Improve long-term children’s Provide parents with tools to: educational and work behaviour prospects • develop communication and relationship skills • encourage cooperative, responsible behaviours • manage challenging Disrupt behaviours in a positive way Improve family inter-generational • enhance relationship and relationships cycles of poor nurturing skills parenting, violence, • build confidence and empathy and social inequity
  • 7. The Nurturing Programme is based on 4 Constructs, essential to successful family relationships The Parenting Puzzle p. 18 © Family Links 2010 7
  • 8. Developing the evidence base  Independent RCT in Wales 2011- ‘compatible with cost-effectiveness of the FLNP offered on a universal basis to improve wellbeing and parenting in deprived areas’.  Internal evaluation 2011- parental wellbeing improved on average from scores better than 18% of the population to scores better than 45% of the population, children improved on average from borderline risk of mental health disorder to normal child behaviour. © Family Links 2012 8
  • 9. Making Sense of Early Intervention Centre for Social Justice 2011  “Evidence on effectiveness, appropriateness and feasibility provides a sounder base for evaluating healthcare interventions, in that it acknowledges the many factors that can have an impact on success” p10 © Family Links 2012 9
  • 10. Evaluation of Training  Independent evaluation 257 trainees - rated the Nurturing Programme training very highly 80.1% rated it 10 out of 10. The average for all participants was 9.7.  Just under three-quarters (72.1%) of trainees expected to run a Nurturing Programme course in the next six months © Family Links 2011 10
  • 11. The Nurturing Programme and the Professional/Personal elements The Nurturing Programme is designed to:  promote emotional and mental health and wellbeing  enhance relationship and nurturing skills  build self-esteem and confidence  encourage positive approaches to behaviour management  build empathy in Parents and Practitioners © Family Links 2009 11
  • 12. A truly Universal Programme The Nurturing Programme is designed for both INTERVENTION and PREVENTION and is therefore valuable for all families. A truly universal programme, it is socially inclusive with resources to support work with parents in a wide variety of circumstances Parents with: Children with Learning Muslim parents disabilities disabilities Teenage parents 0-3 yr olds English as a Prisoners second 3-12 yr olds language Online with teenagers Netmums © Family Links 2011 12
  • 13. Universal provision in areas of geographical deprivation reduces sense of being judged, targeted failure Trained Practitioners - Areas of Deprivation 60 Number of Practitioners 50 40 30 20 10 0 0-9% 10- 20- 30- 40- 50- 60- 70- 80- 90- 19% 29% 39% 49% 59% 69% 79% 89% 100% Deprivation by % © Family Links 2011 13
  • 14. Nurturing Programme foster parent feedback “A couple who have completed their OCN portfolios have attended a court hearing and are now in a position to receive their 4 children back home. The next stage was going to be adoption for the children, but the FLNP OCN results achieved by the parents was used as evidence and made a huge impact. … many parents undertake various parenting programmes and they merely act as a temporary fix, but FL has made a lasting impact on their attitudes and behaviour and this was recognised by the professionals involved in their court hearing.” Barnardos Hartbeat PGL in Hartlepool working with parents with children in care © Family Links 2011 14
  • 15. Contact Details Peterley House Peterley Road Horspath Industrial Estate Oxford OX4 2TZ Tel: 01865 401800 Fax: 01865 401820 Email: info@familylinks.org.uk www.familylinks.org.uk © Family Links 2009 15

Editor's Notes

  1. Parental mental health is one of the main determinants of children’s outcomes. Excellent evidence based strategies or interventions will be ineffective if the parents’ own emotional health is poor, they will be unable to take them on board or use them consistently.
  2. Bavolek designed it as a result of work with abused and neglected teenagers. Universal public health model Also, its capacity as a universal public health model, to be a strong prevention work tool as well as an intervention work tool with troubled families. EMPATHY: Bavolek way ahead of his time in stressing the importance of empathy. Empathic, responsive parenting not just the fluffy stuff, it has an effect on how children’s brains develop. Further research just published demonstrates that toddlers who lack empathy are more likely to display antisocial behaviour as teenagers. The programme is influenced by social learning theory, how do toddlers learn empathy, how do parents learn empathy? As professionals as well as parents we need to have empathy as our ace card.
  3. RCT came across many of the problems other real world RCT’s experience, some results were inconclusive, happy to discuss this further with anyone. However researchers stated the above.
  4. Effectiveness is important but in the real world so is appropriateness, for practitioners and parents e.g. If programme designed to be delivered by those with a minimum bachelors level qualification may not be suitable for family support workers in children’s centres. If programme needs high level of English literacy may not be appropriate for some communities. Feasibility of delivery e.g. Accessiblity of resources, cost etc and roll out.
  5. Comment Nurturing Programme is effective with wide range of family types and age groups of children. The Nurturing Programme is designed to be a whole population programme, which means it is designed to have an impact on a wide range of families. Parents whose emotional health is poor may need to complete the programme more than once. Universality reduces stigma This weekend Arifa and I training 20 volunteers from UK Islamic mission, incorporating Islamic values into the programme delivery. FL is a charity, we can do this because Sally has been able to secure funding. PGLs have helped us translate our Parenting Puzzle booklet -> Urdu; Somali; Polish – perhaps Welsh in time. Parent Coordinator Richard trialled NP for Parents & Teens with very challenging groups. Ed. Psych, Ealing – NP for families with children with Aspergers/Autism and other special needs. Prison Handbook trialled by Family Links Directors.
  6. Notes: Geographical need –the people we train work in the most deprived neighbourhoods in England We mapped where all the people we trained between 1 January – 31 March 2011 to run parent groups work. The graph below shows that over half our trainees work in the bottom 30% of deprived neighbourhoods in England. This geographical targeting avoids stigma, but ensures that the families who are benefiting from the Programme are among the most needy in the country. A similar look at where our sales of the The Parenting Puzzle goes shows a similar pattern (yet to be quantified in the same way)
  7. Also offer Open College Network accreditation for parents who may have no previous qualifications.