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Growing Support
5. Parenting education and group support
Introduction: multiple interventions
As noted above, various forms of children's and family centres now provide support to parents, as well as care and stimulation for children. Other forms of intervention are almost exclusively focused on parents, usually with the aim that this will improve the quality of their care. These range from broad primary prevention programmes, which may benefit anyone, to those that particularly target vulnerable families. Some explicitly refer to parents or parenting. Others are couched more in terms of family support, although in many cases they directly involve the parents only. Family support also covers centre-based services, covered in the previous section (Gibbons et al 1990; Higgins 2000), and intensive home visiting programmes discussed in the next.
As we need to note recurrently, many programmes engage mainly or entirely with mothers. On the whole, parenting programmes focus on preparation for parenthood or early parenthood, though some cover a later family stage.
There are a wide variety of initiatives to support and provide training for parents who require additional help in raising their children and there is now extensive evidence to indicate that parental support provides a strategy, which prevents problems from escalating and minimises more 'intrusive' measures (Gilligan 1995). Family support can be provided through a range of naturally occurring sources, but when these are unavailable or insufficient, it is necessary for support to be provided formally by health, education or social services. In North America, evidence indicates that mutli-method programmes are particularly effective (Gilligan 2000). One literature review by DePanfilis (1996) indicates that some degree of improvement in parenting behaviour results when programmes combine a range of direct services with efforts to enhance a family's support network (See also Fuchs 1995.) De Panfilis identified the following important components:
- specific assessment - with a focus on the availability and helpfulness of a family's social network;
- multi-service approach (including concrete help);
- intensive social contact with a volunteer, lay therapist or parent aide;
- use of modelling, coaching, rehearsing, and feedback, both on a one-to-one basis and in a support group, to improve social interactional skills;
- development of personal networks, mutual aid groups and connections to neighbourhood helpers; and
- structured parenting support groups for socialising, support and social parental skill building.
Thus the family receives several different kinds of help (practical assistance, information, learning of skills, emotional help, social support) from several sources (professional, volunteer and peers).
This literature review also suggests that individual support for certain neglectful parents may be required, as they tend to lack the skills needed to participate in a group. A review by Guterman (1997), which examined the effect of early prevention strategies for parents at risk of abuse and/or neglect, similarly showed that parental education and support that linked parents with both formal and informal support networks were effective preventative strategies. Guterman also examined the effect that the duration of interventions had on families and reported that long-term interventions with moderately frequent contact were most effective. In addition to these findings the study showed that professional support was not necessarily most effective, but a combination of paraprofessional support and professional provision produced the best results.
Parent education programmes
There is no sharp distinction between parenting education and parental support, but the former not only tends to have a learning focus and a more structured approach (a curriculum), but also tends to be based in centres where classes or groups meet. Parenting support has a more social and emotional emphasis, though often an advisory or informal teaching element is present. It is often provided to people in their own homes, but can also be group-based.
According to Pugh et al (1995) there has been an increase in the uptake of parent education programmes in the UK and it is estimated that approximately 4 per cent of the parent population has attended one of these at some time (Smith 1996). However, as indicated by Utting et al (1993) this is a small proportion of the total parent population and most of those attending appear to come from the middle classes, so that relatively few vulnerable families are likely to be reached.
Evidence of the effectiveness of parent education programmes has largely come from the US where the evaluations have mainly focused on parenting children with behavioural problems. The incidence and prevalence of such difficulties are not closely related to material disadvantage (Stewart-Brown 1998). Unfortunately there is limited evidence on the effectiveness of programmes that simply aim to improve family life and empower disadvantaged/vulnerable parents to care for their children (Lloyd 1999). This is somewhat surprising considering this type of programme has been identified as very important and as beneficial as the more problem-orientated programmes (Smith and Pugh 1996).
One example of relevant British research is an evaluation of a parenting project run by Barnardos Northern Ireland, although this project was not confined to the 0-3 age group. The aim of this project was to provide parenting education and support to parents with children in the early and middle years and adolescence. It was based on a community education and development approach and focused on improving self-esteem and developing practical skills for parents in order to improve the parent-child relationship (Lloyd 1999). The evaluation did not use an experimental design but did adopt a longitudinal approach. It showed that parents experienced greater confidence, reported less stress and isolation, developed greater understanding and better management of children's behaviour and improved relationships with their children. These benefits also appeared to have been sustained after 12-18 months.
Grimshaw and McGuire (1998) obtained information from professionals and parents about 'open access' parenting programmes. Low awareness of the existence of the programmes reduced attendance, while lack of childcare facilities was another factor which deterred some from attending. About half of the parents who did attend said it was helpful. On the whole users preferred to have as leaders other parents rather than professionals.
It would appear that there is a lack of research regarding the effectiveness of formal parent education for vulnerable families with children age 0-3 years. The emphasis seems to be on education programmes for parents who have children with behavioural problems or for education programmes aimed at more affluent families. Whilst there are a number of studies examining user views and satisfaction of parenting programmes, there are a limited number of rigorous experimental studies that examine the impact of parent education for the group under discussion. Lloyd (1999) suggests that in order to develop effective programmes for this group it is necessary to assess how best parents can be supported in order to implement effective programmes specific to these needs. This is also echoed by others who have suggested that the reasons why vulnerable families do not attend parenting classes is due to the lack of services specific to their needs, the lack of transport and the lack of child care, which all act as barriers to attending (Pugh et al 1995).
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