The effectiveness of a therapeutic parenting program for children aged 6–11 years with behavioral or emotional difficulties: Results from a randomized controlled trial

Abstract

The aim of the study was to evaluate the implementation and effectiveness of a therapeutic parenting program that targets parents of children aged 6 to 11 years identified as having behavioral and emotional difficulties. The intervention comprises two parts, delivered sequentially: a 10-12-week group-based program for all parents, and one-to-one sessions for up to 12 weeks with selected parents from the group-based element.Methods/Design: In a randomized controlled trial, 264 participants were allocated to the Inspiring Futures program (intervention) or services as usual (control) arms with follow-up assessments at 16 (post-group program) and 32 (post-one-to-one sessions) weeks. The primary outcome was the parent-rated Strengths and Difficulties Questionnaire (SDQ) Total Difficulties score at 32 weeks. Secondary outcomes included parent-rated SDQ subscales, parent coping strategies, empathy in parenting and parenting skills.Results: All 264 participants were included in outcome analyses. There was no statistically significant effect on SDQ total difficulties (standardized mean difference: -0.07; 95% CI: -0.30 to 0.16; p = 0.54). There were no sub-group effects. Only 1 of 40 comparisons between the trial arms for secondary outcomes across both follow-ups was statistically significant at the 5% level. The mean number of group sessions attended by intervention arm participants was 6.1 (out of 10 to 12) and only 1 in 20 intervention arm participants received one-to-one support. Based on independent observation, mean adherence, quality and participant responsiveness scores indicated scope to improve fidelity. Conclusions:The intervention is not more effective than services as usual at improving targeted outcomes. This may be related, in part, to implementation issues but arguably more to the inability of a non-behavioral intervention to improve caregiving adequately, particularly when it is not targeted at new parents who have experienced trauma or deprivation early in life or subsequently.

Parental Awareness Towards Child Health: A Study on the Parents of High School Students at Khulna City Corporation in Bangladesh

“…Literature shows that children face multifaceted health problems during their juvenile age, which change their behavior abruptly (Forehand et al, 1984;Axford et al, 2020). Even it can deviate child from the right path.…”

Enhancing Social-Emotional Outcomes in Early Years (E-SEE): Randomized Pilot Study of Incredible Years Infant and Toddler Programs

“…The Medical Research Council (MRC) framework for evaluating complex interventions suggests a pilot study should be conducted to identify potential challenges to be addressed before an expensive full-scale definitive trial is conducted (Craig et al, 2013). This is particularly relevant for E-SEE Steps, given the complexities of the intervention and the observation that RCTs of group-based parenting programs have previously been undermined by challenges in recruiting and retaining sufficient participants, ensuring viable group sizes and maintaining intervention fidelity (Simkiss et al, 2010;Axford et al, 2012;Axford et al, 2020). The emergence of proportionate universal interventions and RCTs also raises challenges in statistical design and analysis that fall outside current evaluation guidelines (see Candlish et al, 2019 for a summary), providing a strong case for analyzing pilot data before finalizing a protocol for a definitive trial (Craig et al, 2013).…”