Embedding the Family Check-Up and evidence-based parenting programmes in Head Start to increase parent engagement and reduce conduct problems in young children

Abstract

Parent engagement (i.e., enrollment, ongoing attendance, participation quality) remains a major obstacle to fully realizing the benefits of evidence-based preventive parent management training in community settings. We describe an approach to parent engagement that addresses the myriad motivational, cognitive, and pragmatic barriers parents face by embedding services in Head Start and applying a parent engagement model, the Family Check Up, as a pre-intervention to augment parent training. In this article, we present the rationale for applying FCU to advance parent readiness for engagement and we describe the process by which we partnered with the community to modify FCU to be most impactful for enhancing parent engagement in one specific program, the Incredible Years Parenting Series. We conclude with preliminary data from our ongoing pilot trial that supports our approach.

Parenting Skills and Parent Readiness for Treatment Are Associated With Child Disruptive Behavior and Parent Participation in Treatment

“…Given that these parents presented with concerns to a children's mental health clinic, it seems likely that they would benefit from some form of intervention; however, their profiles indicate that they may yet not be ready to participate in standard parenting treatment. This knowledge is important because it can inform implementation and testing of therapeutic approaches, including motivational enhancement strategies such as motivational interviewing and other structured interventions prior to intensive parent group treatment, to foster participation by parents who may not be ready to engage in treatment (Nock & Kazdin, 2005;Sanders et al, 2004;Shepard et al, 2012). These pretreatment interventions may provide the scaffolding these almost ready parents may require to effectively engage in a longer and more intensive clinical service and maximize benefits.…”

“…Given this, it is quite unclear whether this pretreatment heterogeneity is well suited to a structured approach to treatment (Nock & Ferriter, 2005;Shepard et al, 2012). Parents recommended for group-based treatments may vary considerably in their understanding of effective parenting strategies and in their ability to implement these approaches.…”

“…Others have focused on parental variables, such as parental cognitions and mental illness that predict engagement and participation in group or parent-child mental health treatment (Morrissey-Kane & Prinz, 1999). Reducing barriers has been shown to improve parent attendance in interventions (Nock & Kazdin, 2005;Shepard, Armstrong, Silver, Berger, & Seifer, 2012).…”

“…Elucidating these factors may contribute to refined approaches to fit parents with a suitable treatment, rather than a general approach in which all parents are recommended a single evidence-based treatment (regardless of their level of skills and beliefs). Client-centered approaches to treatment selection and engagement may contribute to better outcomes (Nock & Kazdin, 2005;Shepard et al, 2012).…”

A randomized trial of methods to engage Mexican American parents into a school-based parenting intervention.

“…A few researchers have studied the effects of providing incentives on attendance, and most have reported disappointing results (Dumas, Begle, French, & Pearl, 2010; Gross et al, 2011). In the only published, experimental prevention study that tested motivational enhancement techniques, Shephard, Armstrong, Silver, Berger, and Seifer (2012) reported preliminary results suggesting that a two-session, in-home motivational interviewing intervention increased engagement into the Incredible Years parenting program: 53% of parents in the motivational interviewing condition initiated (i.e., attended at least one session) compared to 33% in the control condition. Although these findings are encouraging, a two-session, in-home engagement intervention may be cost-prohibitive and thus difficult to implement on a wide scale.…”