Parents Plus holland Presentation 2016solution-focused-world-conference.nl/2016/images/pdf/S... ·...

Parents Plus Programmes


Solution-‐focused, evidence-‐based and practical interventions for families

John Sharrywww.parentsplus.ie


Parents Plus Charity -‐ Origins

• Parents Plus Programmes were developed at the requestof parents for Irish parenting materials, and for Irishfamilies be involved in making them

• Parents Plus Programmes were developed in collaborationwith Irish professionals in the Mater Child and AdolescentMental Health Service

• Parents Plus was founded by Carol Fitzpatrick and JohnSharry in 1998 and was established as a registered charityunder the auspices of theMater Hospital in 2001

• Parents Plus Charity aims to develop educational andtherapeutic materials for parents and children and toprovide training and support for professionals workingwith families



• Solution-‐focused, practical, evidence-‐based parenting courses and mental health interventions

• Developed in partnership with Irish families and Mater CAMHS

• Delivered over 6 to 12 weeks in small groups and can be combined with individual family work

• Draw on social learning and attachment ideas within solution-‐focused delivery

• Employs DVD scenes to model parenting strategies, backed up by group discussion, role-‐play, homework and hand-‐outs

• Can be used as a clinical intervention in specialist settings but also preventatively in community settings


Parents Plus – Values & Strengths

• Partnershipwith parents, children and families in development – client voice is crucial

• Evidence based – integrating practice and research

• Collaboration with other community groups, agencies and professionals


Current Parents Plus Programmes

Parents Plus Early Years Programme (1-‐6 year olds)John Sharry, Grainne Hampson, Mary Fanning

Parents Plus Children’s Programme (6-‐11 year olds)John Sharry, Carol Fitzpatrick

Parents Plus Adolescent’s Programme (11–16 years olds)John Sharry, Carol Fitzpatrick


Current Parent Plus Programmes

• Parents Plus Parenting When Separated Programme (2012)John Sharry, Michelle Murphy, Adele Keating

• Working Things Out (2005/2011) An evidence-‐based intervention for adolescents promoting positive mental healthEileen Brosnan, Carol Fitzpatrick, John Sharry

• Other Resources and BooksSolution-‐Focused GroupworkCounselling Children and Adolescents Coping with Depression


Parents Plus Early Years Programme (PPEY) – Core Inputs

1. Being a responsive parent2. Child-‐centre play and communication3. Supporting children’s self-‐esteem and confidence 4. Promoting children’s language and development5. Helping children concentrate and learn 6. Building cooperation in young children7. Establishing daily routines8. Managing tantrums, misbehaviour and problems


Parents Plus Adolescent Programme Introduction

1) Positive communication2) Getting along with your teenager3) Encourage your teenager4) Listening to your teenager5) Establishing rules6) Using consequences/ having a discipline plan7) Dealing with conflict and aggression8) Problem solving with young people


Current Parent Plus Programmes

• Parents Plus Parenting When Separated Programme (2012)John Sharry, Michelle Murphy, Adele Keating

• Working Things Out (2005/2011) An evidence-‐based intervention for adolescents promoting positive mental healthEileen Brosnan, Carol Fitzpatrick, John Sharry

• Other Resources and BooksSolution-‐Focused GroupworkCounselling Children and Adolescents Coping with Depression


Working Things Out Programme• Working Things Out (WTO) is a programme to support adolescents

tackling depression, and other mental health problems• DVD-‐based containing the stories of 15 adolescents who tell their own

personal story of how they overcame personal problems• Covers issues such as:

-‐ Bullying & School Pressures-‐ Anxiety, Depression, ADHD & OCD -‐ Depression, Self-‐harm & Suicide-‐ Bereavement-‐ Conflict with parents

• Can be used as clinical intervention for adolescents and preventatively in community settings, for example, promoting positive mental health in schools

• Can be used individually and with small groups of young people


Parents Plus Programmes Research Strong Evidence Base: 19 research studies, including 6 RCTs & 4 studies independent from developers, all show evidence for effectiveness of Parents Plus Programmes.

•Original Programme (Behan et al. 2001; Quinn et al., 2006; 2007)

•Adolescent Programme (Beattie et al., 2007; Nitsch et al., 2011)

•Early Years Programme (Behan et al., 2005; Griffin et al., 2006; Hayes et al., 2013)

•Children’s Programme (Coughlin et al., 2007; Hand et al., 2012; Hand et al., 2013)

•Parenting When Separated (Keating et al., 2013)

•Working Things Out (Brosnan, 2015; Fitzpatrick et al. 2015)

•PPAP & WTO (Rickard et al., 2015; Wynne et al., 2015)

Parents Plus Programmes follow international best practice guidelines and independently evaluated by National Parenting academy in UK


Parents Plus Programmes -‐ Research Evidence

All 19 studies consistently show that the PPP/ WTO are effective in:

•Reducing emotional/ behaviour problems in children and teenagers

•Reducing parental stress

•Achieving high parent satisfaction

in a variety of contexts and with a large range of presenting problems and issues.


Parents Plus -‐ Meta Study

• In 2015 Prof Alan Carr conducted a meta-study of 17 of the 19 studies

Source: Carr, A., Hartnett, D., Brosnan, E., & Sharry, J. (2016). Parents Plus systemic, solution-focused parent training programs: Description, review of the evidence-base, and meta-analysis. Family Process. doi: 10.1111/famp.12225 .


16

Between groups post-treatment effect sizes for goal attainment, parental satisfaction, behaviour problems, and parental stress from 10 studies of Parents Plus Programmes

1.54

0.83

Parental Satisfaction

KPS

Goal Attainment

GS

0.60

Parental Stress

PSI & PSS

0.53

Behaviour Problems

SDQ

1.6

1.5

1.4

1.3

1.2

1.1

1.0

0.9

Large 0.8

0.7

0.6

Medium 0.5

0.4

0.3

Small 0.2

0.1


Before to after treatment, and before treatment to 3-10 month follow-up effect sizes on the SDQ-P total difficulties scale from 16 controlled studies of Parents Plus Programmes

1.0

0.9

Large 0.8

0.7

0.6

Medium 0.5

0.4

0.3

Small 0.2

0.1Post-treatment

Based on 16 studies

Over 800 PP cases

5-10 months follow-up

Based on 10 studies

Over 300 PP cases

.59

.80


Between groups post-treatment effect sizes on indices of behaviour problems for the Parents Plus, Incredible Years and Triple P Programmes

.60

.30

Incredible Years Programmes

49 studies


10 studies

Triple P Programmes

106 studiies

.47

Large 0.8

0.7

0.6

Medium 0.5

0.4

0.3

Small 0.2

0.1

Menting, A. T. A., Orobio, d. C., & Matthys, W. (2013). Effectiveness of the incredible years parent training to modify disruptive and prosocial child behavior: A meta-analytic review.Clinical Psychology Review, 33(8), 901-913.

Sanders, M. R., Kirby, J. N., Tellegen, C. L., & Day, J. J. (2014). The triple P-positive parenting program: A systematic review and meta-analysis of a multi-level system of parenting support. Clinical Psychology Review, 34(4), 337-357.


Parents Plus Out Programmes

Solution-‐focused, evidence-‐based and practical interventions for families

John Sharrywww.parentsplus.ie


PPEY Session-‐by-‐Session PlanIndividual Session 1: ScreeningGroup 1: Tuning into your child & Pressing the Pause ButtonGroup 2: Child-‐centred play and communication & Taking the lead with childrenGroup 3: Child-‐centred play and communication & Establishing routines and using rewardsIndividual Session 2Group 4: Encouraging and supporting your child & The ‘Praise Ignore’ PrincipleGroup 5: Ensuring encouragement gets through & Dealing with misbehaviour using consequencesGroup 6: Prevention plans & Assertive parenting / Dealing with disrespectIndividual Session 3Group 7: Problem Solving with Children & Step-‐by-‐Step DisciplineGroup 8: Active listening and problem solving & Dealing with special needsGroup 9: Family listening and problem solving & Parent self-‐careIndividual Session 4: Follow Up


Parents Plus Children’s Programme –Core Inputs

1. Child-‐centred play and communication with children

2. Building children’s self esteem and encouraging learning

3. Positive Discipline and behaviour management

4. Problem Solving with children and as a family


PPCP – Session-‐by-‐Session PlanIndividual Session 1: ScreeningGroup 1: Providing positive attention & Pressing the Pause ButtonGroup 2: Play and special time & Using ‘dos’ rather than ‘don'ts' Group 3: Play & Establishing routinesIndividual Session 2Group 4: Encouragement and praise & Using consequences Group 5: Encouraging homework and learning & Using sanction systemsGroup 6: Prevention plans & Assertive parenting / Dealing with disrespectIndividual Session 3Group 7: Problem Solving with children & Step-‐by-‐step disciplineGroup 8: Active listening and problem solving & Dealing with special needsGroup 9: Family listening and problem solving & Parent self-‐careIndividual Session 4: Follow Up


Parents Plus Adolescent Programme – Core Inputs

1. Relationship Building with teenagers

2. Conflict resolution / Behaviour management

3. Problem Solving for families

Extra topics can be added on:

• Depression / Anxiety

• Education, homework & learning

• Specific issues such as technology, bullying etc.

Can be combined with family therapy/ individual work etc.


PPAP – Session-‐by-‐Session Plan

Individual Session 1: ScreeningGroup 1: Introduction to course & Positive communication Group 2: Getting to know your teenager & Establishing rules Group 3: Connecting with your teenager & Communicating rules positivelyIndividual Session 2Group 4: Encouraging your teenager & Using consequences Group 5: Listening to your teenager & Having a discipline planGroup 6: Empowering teenager & Dealing with conflict and

aggression Individual Session 3Group 7: Problem Solving & Dealing with specific issues Group 8: Dealing with specific issues & Course evaluationIndividual Session 4: Follow Up


Section 9 – Extra input on specific issues1. Importance of Parent Selfcare2. Remaining Calm in tough situations3. Parents working together4. Separated parents working together 5. Supporting education and school6. Dealing with special needs 7. Sibling rivalry/conflict between children 8. Anxiety in children and teenagers 9. Depression in children and teenagers 10. Self harm and suicide11. Attention Deficit Hyperactivity Disorder12. Dealing with bullying 13. Drugs and alcohol


Session by Session Plans• Individual Session1 - ScreeningGroup 1 Introduction to Course/ Positive communication Group 2 Getting to know your teenager/ Establishing rules Group 3 Connecting with your teen/Communicating rules positively• Individual Session 2Group 4 Encouraging your teenager/ Using consequences Group 5 Listening to your teenager/ Having a discipline planGroup 6 Empowering teenagers/ Dealing with conflict and aggression • Individual Session 3Group 7 Problem solving/ Dealing with specific issues Group 8 Dealing with specific issues/ Closing and course evaluation• Individual Session 4 – Follow up


Working Things Out Programme• Working Things Out (WTO) is a programme to support adolescents

tackling depression, and other mental health problems• DVD-‐based containing the stories of 15 adolescents who tell their own

personal story of how they overcame personal problems• Covers issues such as:

-‐ Bullying & School Pressures-‐ Anxiety, Depression, ADHD & OCD -‐ Depression, Self-‐harm & Suicide-‐ Bereavement-‐ Conflict with parents

• Can be used as clinical intervention for adolescents and preventatively in community settings, for example, promoting positive mental health in schools

• Can be used individually and with small groups of young people


WTO – Session-‐by-‐Session PlanIndividual Session 1: ScreeningGroup 1: Getting StartedGroup 2: How we think affects what we feel and doGroup 3: Managing feeling downIndividual Session 2Group 4: New ways of thinkingGroup 5: Stop and Think – The key to solving problemsGroup 6: Dealing with anger and conflictIndividual Session 3Group 7: Communicating well & Building relationshipsGroup 8: Planning for the future& Making positive choicesIndividual Session 4: Follow Up


Parenting When Separated (PWS) –Core Inputs

1. Solving co-‐parenting problems in a positive, child-‐focused way

2. Coping with the emotional impact of separation and learning stress management techniques

3. Helping children cope with separation, emotionally and practically

4. Enhancing communication with children and children’s other parent


PWS – Session-‐by-‐Session PlanIndividual Session 1: ScreeningGroup 1: Introduction & The impact of separation on (i) parents and (2) childrenGroup 2: Co-‐parenting – Developing a business relationship & Effective communicationGroup 3: Helping children cope; the needs of children at different ages; positive parenting strategies; and talking with children about separationIndividual Session 2Group 4: Being a live away or resident parent and its impact on children & Managing successful contact for childrenGroup 5: Conflict management & Remaining calm in tough situations Group 6: Coping in the long-‐term & Managing new relationships and their impact on children Individual Session 3: Follow Up


Parents Plus Model

• Collaborative Psycho-‐educational Model

• Education/Information AND Support/Therapy

• Researched ideas on behaviour management, language development etc. AND parents own ideas

• Groups – parents learn from one another


Community and Clinical Versions of Each Programme

Preventative Community Groups

(preschools, schools, family centres, Primary Care, youth services)

Clinical/ Specialist Groups (CAMHS, Disability services etc.)

Community Versions of PP programmes

Clinical Versions of PP programmes


Parents Plus and Working Things Out Programmes

Evidence-‐based, positive and practical interventions for families

www.parentsplus.ie


‘Getting Projects off the Ground ’A seminar for Leaders, Managers and Service Commisioners

John Sharry and Eileen Brosnan

Parents Plus.


Parents Plus Experience1. Developing and rolling out evidence based programmes from start

to finish ( e.g. Parenting when separated programme)2. Working with National Agencies on country wide roll outs ( e.g.

NBSS, HSE mental health)3. Working with multi-agency local groups ( e.g. Fingal Parenting

initiative, Ballyfermot schools etc)4. Individual implementations in single agencies


PP learning points1. Take time to understand context and to co-create shared goals2. Adapt to individual goals and needs, while being faithful to

evidence based principles3. Involve families/ clients from day one4. Get the right people on board - Identify local champions5. Use existing community resources – find win wins


PP learning points6. Secure some funding (even a small amount) 7. Have wide representation, but a small executive group8. Provide post-training coaching and support 9. Identify simple but objective outcome measures10. Identify simple but objective quality/ progress measures 11. Have external agency involved (e.g. university)


Parents Plus Early Years Programme (PPEY) – Research in a Clinical Setting -‐ CAMHS

• Multi-‐site controlled clinical study (N = 97) • Families attending PPEY reported:

-‐ Reductions in Total Difficulties as measured by the Strengths and Difficulties Questionnaire (SDQ)

-‐ Reductions in Conduct Difficulties as measured by the SDQ-‐ Reductions in Parental Stress as measured by Parent Stress Scale (PSS)-‐ A reduction in Commands and an increase in Positive attends in parent-‐child

interaction as measured by independent video observation

• Gains were maintained at 5 month follow-‐up• Compared with ‘Treatment as Usual’, more significant reductions

in behavioural problems were associated with the PPEY group• PPEY is equally effective for developmental delay and behaviour

problems


• The Parents Plus Early Years Programme was delivered as part of a suite of interventions to preschool child care services in a disadvantaged areas over several years

• The programme was independently delivered and independently evaluated as part of a clustered RCT

• Significant positive effects were observed within the home learning environment for parents completing the Parents Plus Programme (Hayes et al. 2012)

'In particular, this finding isolates the Parents Plus Community Course as being a key component in improving the home-‐learning environment, even two years after the course was attended' P.39

Parents Plus Early Years Programme –Research in a Community Setting -‐ CDI West Tallaght


Parents Plus Children’s Programme (PPCP) –Research in a Clinical Setting

• Multi-‐Site controlled clinical study• Compared to Treatment as Usual (n=32) the PPCP group (n=42)

showed significant reductions in:-‐ Total Difficulties measured by Strengths and Difficulties Questionnaire (SDQ)-‐ Conduct Difficulties as measured by the SDQ-‐ Parental Stress as measured by Parent Stress Scale (PSS)

• Further, the PP group showed greater parental goal attainment• Significantly, positive changes were maintained at five month

follow-‐up for the PPCP group, in addition to further significant improvements in peer problems and prosocial behaviour


Parents Plus Children’s Programme (PPCP) –Research in a Community Setting

• National delivery by frontline staff in primary schools throughout Ireland (children aged 6-‐11 years)

• RCT design: Treatment Group (n = 44) & No Treatment Control Group (n = 31).

• Significant post-‐treatment improvements were recorded on measures of parenting-‐related stress, child problem behaviour and parent satisfaction, with medium to large effect sizes

• Treatment group results were maintained at 6 month follow-‐up

• See Hand et al. (2013) for published study


Parents Plus Adolescent Programme (PPAP) -‐Research in a Clinical Setting -‐ CAMHS

• Multi-‐Site controlled clinical study • Compared to ‘Treatment as Usual’ (n=38), PPAP group (n=17)

showed significant reductions in:-‐ Total Difficulties measured by the Strengths and Difficulties Questionnaire (SDQ)-‐ Conduct Difficulties as measured by the SDQ-‐ Peer Difficulties as measured by the SDQ

• Further, the PPAP group showed greater parental goal attainment and reported greater improvement in their relationship with their teenagers


Parents Plus Adolescent Programme –Research in Community Settings -‐ Schools

• Participants: 126 parents (85% mothers of children ages 11-‐16 years (mean age 12.5 years) were recruited from the community through promotion in schools and media advertisements in the southwest of Ireland

• Random Allocation: Two-‐to-‐one -‐ 82 treatment, 44 control

• Data Collection: Time 2 data was collected from 70 in the PP group and 39 in the control group

• Follow up: Data collected from 42 participants of the Treatment group (5 months post-‐group)


44

PaperKeating, A., Sharry, J., Murphy, M. Rooney, B. & Carr, A. (2015).

An evaluation of the Parents Plus Parenting when Separated programme. Clinical Child Psychology and Psychiatry, DOI: 10.1177/1359104515581717.

DesignIn this RCT there were 82 separated parents in the PP-PWS group

and 79 in a waiting list control group recruited through the Unmarried and Separated Families of Ireland

71 parents were female and had custody; parents and children’s mean ages were 39 and 9 years respectively; families were separated for an average of 3 years.

The 6-week PP-PWS programme was facilitated by supervised and trained professionals at 16 community sites.

Results Compared with the control group, from pre- to post-treatment,

the PP-PWS group showed significant goal attainment on the goals scale and increases in parenting satisfaction on the KPS.

They also showed decreases in child behaviour problems of the SDQ total difficulties scale, parental adjustment problems on the MHI-5 and interparental conflict on the Quality of Co-parental Communications Scale.

An evaluation of the Parents Plus – Parenting When Separated Programme Adele Keating et al., 2015



Sample footage from Parents Plus Programme



Evidence-‐based, positive and practical interventions for families

www.parentsplus.ie


For Further information on Facilitator Training:

www.parentsplus.ie

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