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Programme

Intervention
Target of intervention

Target population
Age intervention
targets
What does intervention
involve?

Incredible years Intervention Programme


Incredible Years: Parent Training Programme
- child behaviour
- parental competence and attitudes
-emotional regulation
(Jones et al. 2007).
Parents of children with social, emotional or behavioural difficulties (Jones et al. 2007).
1 month 6 years
Baby group: 0-1 year
Toddler group: 1-3 years
BASIC early childhood group: 3-6 years
Parents are taught the following during the programme (Jones et al. 2007):
- how to establish a positive relationship with their child through play and child centred
activities
- encouraging praise, reward and incentives for appropriate child behaviours
- guidance in the use of effective and clear instruction giving
- strategies for managing non-compliance
Parents acquire all of these skills through group discussion, brain storming, videotape
modelling, role-play and rehearsal of taught intervention techniques, both in the group
and at home (by completing homework exercises).
Parents also receive weekly contact from facilitators to check progress and provide
support to parents.
(Levac et al. 2008).

Direct/ Indirect
Direct
intervention
Group vs. individual
Group
therapy
Who carries out
Early years workers (e.g. Nursery staff, SLTs etc all entitled to apply for training).
therapy?
Group Leaders should have training in child development and behaviour management.
Example of a breakdown of ADHD Parenting Programmes used to help inform the group choices within NHS
Lothian:

Training required?
What does training
involve?
Cost of training
Time required for
intervention

Session duration
Location of intervention
Cost effectiveness

Yes. Parent Group Leader Certification is necessary before training parents.


3 day workshops
700 for 2 trainers
Training kit costs 735
Group materials pack costs 611
The programme can be extended for 2-4 sessions depending on the group size, how
readily participants grasp the programme content and material and the level of child
difficulty presented (Webster-Stratton 2004). Groups that require a translator will need
at least 3 additional sessions because of time needed to translate (Webster-Stratton
2004).
2 hours conducted at weekly intervals
Variety of locations: child and family centres, clinics.
Edwards et al. (2007) conducted a cost-effectiveness analysis of the BASIC programme
and found that the programme improved childrens behaviour at a cost of 1344 per
child. The intervention becomes more cost effective for children at greater risk of
developing conduct disorder (Foster et al. 2008).

Efficacy study results


Jones et al. (2007) investigated the efficacy of the Incredible Years BASIC parenting
(clinical effectiveness of programme for a community-based sample of families with pre-school children who are
intervention)
at risk of developing conduct problems and ADHD. The study was carried out in 11
designated Sure Start areas (socially disadvantaged areas) in Wales. It was found that
there were lower levels of parent-reported inattention and hyperactive/impulsive
difficulties following intervention (Jones et al. 2007). Jones et al. (2007) stated that the
BASIC programme was associated with positive outcomes for children. Therefore, the
BASIC programme is a successful early years intervention for pre-school age children
who have ADHD type symptoms and disruptive behaviour (Jones et al. 2007).
Jones et al. (2008) conducted a follow-up study to the one they carried out in 2007. The
study aimed to examine the long-term efficacy of the Incredible Years BASIC parenting
programme. The study was based on 11 Sure Start areas (socially disadvantaged areas)
in Wales with parents of pre-school children (aged 3-6 years) who display signs of
attention deficit hyperactivity disorder (ADHD) and conduct problems. Follow-ups were
carried out 6, 12 and 18 months following delivery of intervention (Jones et al. 2008).
The study revealed that the positive effect of Incredible Years parenting intervention
(improvements in ADHD symptoms and conduct problems) remained stable over time
(Jones et al. 2008). The findings therefore support the long-term efficacy of this parenttraining programme for pre-school children presenting signs of conduct problems and
ADHD (Jones et al. 2008).
Efficacy of the baby and toddlers group is not known.
No. of trained
facilitators
Frequency of delivery
Min-max no of
attendees
Programme
Intervention name
Intervention target

Solihull Approach
Solihull Approach Parenting Group
Parent-child relationships

Solihull Approach
Sleeping, toileting, feeding and behavioural

Target population

Target age
What does intervention
involve?

Behaviour management approaches


Parents of children from birth 18 years
who have difficulties with parent-child
interaction and managing their childs
behaviour.
Birth to 18 years
Involves parents thinking (at home or in
group) about sensitive and effective
approaches to behaviour management.
Addresses parenting problems.

Indirect vs. direct


Direct
Group vs. individual
Group then individual
therapy
Who carries out therapy Community practitioners (health
visitors, school nurses, Child and
Adolescent Mental Health Service
(CAMHS) workers, family workers and
nursery nurses).
Training required
Yes
Location
Health clinics, childrens centres and
schools
Cost effectiveness
No evidence
Efficacy study results
-A pilot evaluation of the SAPG was
carried out by Bateson et al. (2008). It
was found that parents who attended
the groups reported a decrease in child
behaviour problems and parental
anxiety. :

difficulties.
Parents of pre-school age children who have
difficulties with sleeping, toileting, feeding
and behaviour.
Pre-school age children
Integrates psychotherapeutic, child
development and behavioural concepts.
Parents are helped to manage their own
anxieties and emotions and are aided in how
to improve interaction with their child. Health
visitors also offer parents programmes to help
manage their childrens behaviour.
Direct
Group
Community practitioners (health visitors,
school nurses) and other professionals who
work with children and their families (e.g.
social workers, psychologists, Sure Start
workers and teachers).
Yes
Childrens and family centres, health clinics,
the home.
No evidence
-A pilot study investigated the effectiveness
of the Solihull Approach compared to
standard health visitor practice (Milford et al.
2006). At the end of intervention, positive
outcomes were reported for parental
perception of the problem, parent-child

functional interaction and parental distress.


These findings were further enhanced at
follow-up (three months later).
Programme:
Intervention name
Intervention target
Target population

Target age
What does intervention
involve?

Indirect vs. direct


Group vs. individual
therapy
Who carries out therapy
Training required
Location
Cost effectiveness

Triple P: Positive Parenting Programme


Triple P
Behavioural, emotional and developmental problems in children.
Parents and their children who have mild to severe behavioural or emotional problems.
Triple P has been used with a wide range of families including children with, or at risk of,
persistent conduct problems (ODD and CD), ADHD, internalising problems, parents at
risk of child maltreatment and with histories of domestic violence
Birth-16 years.
Aimed to prevent and offer treatment for severe behavioural, emotional and
developmental problems in children. Also intended to enhance knowledge, skills and
confidence of parents.
Triple P incorporates 5 levels of interventions on a continuum of increasing intensity,
and can be administered in a number of fashions: individual consultations (Standard
Triple P), group Triple P or self-directed Triple P.
Direct and indirect
Group and individual
A range of different practitioners.
Yes
Community and service settings including schools and community centres
Mihalopoulos et al. (2007) aimed to look at the extent that Triple P breaks even in terms
of its cost (i.e. whether the cost-offsets (estimated costs associated with preventing
cases of conduct disorder) are greater than the cost of actually implementing/delivering
Triple P (costs of brochures, worksheets, health professional costs and education staff
costs). The study excluded other costs associated with time, transport or childcare
expenses.

Moderate improvements in the incidence of behavioural problems were sufficient to


make the programme cost-effective and to be a cost-saving intervention (Mihalopoulos
et al. 2007).
However, it was noted that the study may have underestimated the benefits of Triple P,
as it only looked at conduct disorder. Triple P may have benefits in other domains.
Efficacy study results

-De Graaf et al. (2008) conducted a meta-analysis to investigate the effectiveness of the
Triple P programme on children with behavioural problems. The authors investigated the
effects of level 4 of the intervention programme, and found it to be a suitable and
worthwhile intervention in the prevention and treatment of behaviour problems in
children. It was found that these effects lasted 6-12 months following intervention. De
Graaf et als (2008) meta-analysis also revealed that Triple P can be used successfully in
a wide and diverse range of families, types of problems, delivery formats and ages of
children.
-Bodenmann et al. (2008) also investigated the efficacy of Triple P (on a European
sample) for improving parenting and child behaviour. They found that Triple P is an
effective method for strengthening parenting competence and for improving childrens
behaviour. Parents reported improved parenting behaviour, improved satisfaction and
confidence in their own parenting and a reduction in reports of disruptive behaviour.
Leung et al. (2003), in a study carried out in Hong Kong, looked at the effectiveness of
level 4 of the programme with children aged 3-7 years who displayed conduct problems.
Again, Triple P was successful in reducing disruptive behaviour problems in children
(Leung et al., 2003). The programme was also successful in reducing dysfunctional
parenting and increasing parental competence, suggesting that the Triple P programme
is acceptable and effective in a different cultural context.
-Sanders et al. (2007) investigated the outcomes of the three Triple P types three years
after intervention when compared to interventions that target changing parenting skills
alone. Sustained improvements in disruptive behaviour were found 3 years postintervention in all Triple P variants.

No. of trained
facilitators
Programme:
Intervention name
Intervention target
Target population
Target age
What does intervention
involve?

Introduction to ADHD (NHS Lothian)


Introduction to ADHD a guide for parents and carers
Learning about core features of ADHD and behaviour management strategies
Parents of children with ADHD

Indirect vs. direct


Group vs. individual
therapy
Who carries out therapy
Training required
Location
Cost effectiveness
Efficacy study results
No. of trained
facilitators
Frequency of delivery
Min-max no of
attendees

Direct
Group

Parents are taught the following during the 3 sessions


How to manage inattention in children with ADHD
How to manage impulsive behaviour
How to manage hyperactivity in children with ADHD
Parents acquire all of these skills through group discussion, mind mapping, role-play,
rehearsal of taught intervention techniques and homework tasks

Nurse specialist, CMHW


No facilitators have a specialist interest in ADHD
Community and service settings including schools and community centres
No evidence available

Programme:
Intervention name
Intervention target

Barnardos
The Parent Factor
Aims to increase parent's understanding and empathy of how ADHD impacts on their
child and improve parental confidence in managing behaviours.
Increase parents knowledge of ADHD and its treatment
To give parents insight into how it feels to be a child with ADHD
To give parents advice on how to promote a more positive relationship with their child
To educate parents on strategies for effective behaviour management

Target population
Target age
What does intervention
involve?

The parent factor in ADHD is designed for all parents of children diagnosed with ADHD
Aged 5-16
8 x2 hour sessions with approx 5-8 parents per group
The programme is based on social learning and behavioural theories and includes
behaviour management techniques, communication skills and providing parents with
information about the education system.
Group discussion/exercises, small group/pair exercises and utilise a variety of support
material such as information sheets, slide presentations, videos and practical activities.
Homework tasks are also incorporated into some of the sessions

Indirect vs. direct


Group vs. individual
therapy

Direct
Group
There is the option for this programme to be delivered on a one-to-one basis.

Who carries out therapy Groups should be facilitated by two workers


Both should have experience of working with groups of parents
Lead practitioners need a minimum QCF level 3 and should have experience of group
work with parents and working with parents of children with ADHD.
Training required
Location

Yes

Cost effectiveness
Efficacy study results

Two day training package (700 per person)


Limited evidence - one evaluation has been completed using pre and post measures
which demonstrated increased child self satisfaction and risk avoidance.

No. of trained
facilitators
Frequency of delivery
Min-max no of
attendees

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