• By Laura Whybra
  • Posted on Thursday 26th June, 2014

Effects of the Incredible Years parenting program still strong after a year, Irish study finds

strong>Parenting programs help improve parenting skills and children’s behavior in the short term – but do the effects last? Yes, they can, says a recent study in Ireland among disadvantaged families. Twelve months after the program, parents were still happier, able to parent better, and less worried about their kids’ behavior than before the program. What’s more, the cost of other service use fell by 40% - pointing to major long-term savings. Much previous research supports the effectiveness of parenting training programs. But less is known about their long-term effects and cost implications, particularly in community settings. A recent follow-up study of the Incredible Years parenting program aims to fill that gap. It suggests that benefits for child behavior and parenting were maintained one year later in disadvantaged families. The use of other services associated with conduct problems – such as GPs, nurses, social work services, and special education resources – also declined. The cost of the services used at the 12-month follow-up was about 60% of the cost at the start of the program.Incredible Years follow-upThe current study evaluated the well-known Incredible Years (IY) parenting program delivered in community services in Ireland. IY is a brief and manualized intervention that aims to foster parent-child relationships, positive parenting, and discipline strategies to tackle behavior problems in children. It is delivered to groups of approximately 12 parents over 14 weekly, two-hour sessions by two trained facilitators. In past studies, IY significantly reduced conduct problems, oppositional defiance, and hyperactivity in children. This study reported on the 12-month follow-up assessment and cost analysis. 149 families with children aged two to seven years were randomly assigned to receive the intervention immediately or six months later (at the end of the program for the intervention group). These families lived in disadvantaged urban areas, and the children were experiencing behavior difficulties. The 12-month follow-up compared outcomes to baseline scores for the 103 families who initially received the intervention. At one-year follow-up, data for 87 families was available and data was imputed for the remaining families. The researchers looked at three types of results. First, child behavior outcomes included delinquency, temper tantrums, and aggression. Second, parent outcomes included parent-child interactions, parental stress and well-being, and marital conflict. Third, service utilization included common services associated with conduct problems: visits to GPs or hospitals; use of speech, language, psychological and social work services; and hours spent receiving special educational resources. The six-month results were positive on most measures, and this 12-month follow-up found that most intervention effects were maintained. According to parents’ reports, the improvements in children’s behavior at six months were sustained at the one-year mark. On average, parents reported similar levels of problem behavior, emotional symptoms, conduct problems, peer problems, hyperactivity, inattention and restlessness as they had at six months. Parents also reported reduced problem behavior of siblings from before the intervention to the one-year follow-up. There was an increase in positive parenting and a decrease in critical parenting. Post-intervention improvements in parental well-being were maintained. Parents were also less likely to report conflicts with partners over disciplinary matters, or fights in front of the child. Finally, there were further reductions in costs from six months to 12 months based on service utilization. After six months, the costs were 83% of that at the start of the program. After 12 months, they were down to 60%.For further researchThe overall picture from the follow-up study is very bright. Children with conduct disorder are at higher risk for a raft of later problems, including worse prospects at school, at work, and with mental and physical health. The cost to them as individuals, to their families, and to society can be substantial. The prospect that a brief, relatively inexpensive parenting program could improve outcomes and reduce long-term costs is very attractive.There is one caveat to the overall positive results. Parents’ reports indicated that improvements in children’s behavior were maintained from the six-month to 12-month mark. However, child behavior was also observed for about 60% of the children – and for this subset of children, the observations of child behavior indicated a return to baseline levels of conduct problems. Certainly, parents seem happier with themselves and their kids, able to parent better, and less in need of other services as a result of the Incredible Years program. Even if outside observers find a return to higher levels of conduct problems, it appears that the parents feel better able to cope with their kids’ behavior. Comparisons between parents’ reports and observations would benefit from further research.The overall positive findings are consistent with previous research. However, about 30% of the children experienced continued behavior difficulties despite parent training. A similar result has been found in other studies. It may be that factors such as single parenthood, high levels of adversity, and very poor mental health among parents create such difficult family conditions that a parenting program is not enough to change children’s behavior. More research to explore the factors that help or hinder the success of programs like IY might help with the design of more effective programs. It might also help to demonstrate when families need more substantial help before a parenting program will work for them. ***********ReferenceMcGilloway, S., et al. (2014). Reducing child conduct disordered behaviour and improving parent mental health in disadvantaged families: a 12-month follow-up and cost analysis of a parenting intervention. European Child & Adolescent Psychiatry, DOI 10.1007/s00787-013-0499-2.

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