Informing the personalisation of interventions for parents of children with conduct problems: a qualitative study

Abstract

Background Parenting programmes aim to alleviate behavioural problems in children, including conduct disorder. This study was part of a multi-phase mixed-methods project seeking to extend the reach of parenting programmes for the treatment of conduct problems through developing an evidence base to inform a personalised approach. It explored the narratives of parents of children with behavioural and conduct problems about parenting programmes to identify how such programmes could be personalised in order to extend their reach to parents and children who do not currently benefit. Methods Face-to-face semi-structured interviews with a purposive sample of 42 parents, who had different experiences of parenting programmes. Interviews were conversational and informed by a topic guide. Analysis of transcripts of audio-recorded interviews drew on inductive thematic approaches and was framed largely within a phenomenological perspective. Results Parents’ accounts demonstrated three themes: 1) a personalised approach needs to include the child; 2) a supportive school matters; and, 3) the programme needs to feel personal. Parents were more likely to have a positive experience at a parenting programme, and for their child to demonstrate positive behavioural changes, when they felt their concerns were validated within the group and they also felt supported by the child’s teachers. Parents whose children had been assessed prior to undertaking the programme were also more likely to perceive the programme to be beneficial, compared to parents who felt their child’s individual issues were never considered. Conclusions Our findings point to the potential for personalised approaches to extend the reach of parenting programmes to parents and children who do not currently benefit from such programmes. Important in personalising parenting programmes is assessing children before parents are referred, to directly work with children as well as parents, and to work collaboratively with parents and children to identify which families are most suited to group support or one-to-one support and how this may change depending on circumstances.

Rapid white matter changes in children with conduct problems during a parenting intervention

“…Also, CU traits can be fractionated into distinct subtypes, which may have variable susceptibility to change in response to group or personalised interventions. Primary CU traits, for example, refers to those with a greater genetic underpinning, are associated with abnormalities in the oxytocin system [ 80 ], and underpinned by deficits in emotion processing [ 81 ]. However, secondary CU traits refer to those that are more related to environmental factors, such as parental rejection and childhood trauma [ 81 ].…”

Do Parents Perceive Practitioners to Have a Specific Role in Change? A Longitudinal Study Following Participation in an Evidence-Based Program

“…The practitioners’ flexibility and sensitivity towards each parent’s specific needs is one of the fundamental principles guiding the IY program, which although manualized is not meant to be treated as a precise script or recipe to be recited to parents [ 39 ]. Several studies with different parenting programs have highlighted that parents valued a collaborative, non-directive approach to delivery, where strategies are suggested rather than taught and personalized or tailored to meet the specific needs of parents [ 8 , 33 , 34 ]. Thus, a balance between fidelity and flexibility seems to be required so that the practitioner can manage to “make the shoe fit” for each participant in the program ([ 29 ], p. 755).…”

“…Some authors consider that it is important to measure what individuals are saying to themselves about the change process [ 28 ] and that the picture of change is completed only by incorporating the first-hand accounts from intervention participants [ 29 ]. In the field of parenting interventions, quantitative studies have generally neglected parents’ perceptions about their own processes of change; instead, most of the existing evidence comes from the qualitative literature [ 8 , 29 , 30 , 31 , 32 , 33 , 34 ]. In fact, a few qualitative studies have tried to understand parents’ perceptions about the mechanisms of change of parenting interventions, and the role of the practitioner was often implicitly referred to, among other key factors of change such as program or group characteristics [ 29 , 30 , 31 ].…”

“Sometimes I think my frustration is the real issue”: A qualitative study of parents’ experiences of transformation after a parenting programme

“…The overall aim of the quantitative and qualitative phases of the PPC study was to develop insights on how programmes led to good outcomes for some parents and poor outcomes for others. In a previous publication from the qualitative phase [ 21 ], we described parents’ priorities for personalising parenting programmes and identified several changes that programmes could make to better align with the needs and preferences of individual parents. In the current article we report on the same qualitative dataset but focus specifically on how, from the perspective of parents, the current programmes altered their perceptions and enabled them to make positive changes in their parenting.…”