Child Behavior Problem, Parent-Child Relations
Conditions
Keywords
child behavioural problems, parent training, Nurtured Heart Approach, guided self-help, single case design
Brief summary
Behavioural problems are prevalent in children, yet the consequences can be significant for the child, family and wider society. Effective intervention is paramount in reducing the impact of childhood behavioural problems. The Nurtured Heart Approach (NHA; Glasser & Easley, 2016) is an atheoretical parenting intervention which aims to reduce childhood behavioural problems. Although used in clinical practice, there is little empirical research on the effectiveness of the NHA. The aims of the study were to examine whether the NHA reduced parent-reported child behavioural problems, reduced negative parenting practices, and increased parental reflective functioning. The study used a multiple baseline single case design. Parents of children with behavioural problems were recruited from CAMHS waiting lists. The NHA was delivered in a guided self-help format, using the Transforming the Intense Child workbook (Glasser, 2016) and weekly phone calls. Data collection involved psychometric measures of parent-reported child behavioural problems, parenting practices and parental reflecting functioning. Measures were repeated throughout baseline and intervention phases. A follow-up four weeks after the intervention included final measure administration and a change interview. The data were graphed and visually analysed. Supplementary analysis included reliable and clinically significant change, Tau-U and percentage exceeding the median. Framework analysis was used to analyse the change interview.
Interventions
BEHAVIORALTransforming the Intense Child Workbook (Glasser, 2016)
The NHA was delivered in a guided self-help format, using the Transforming the Intense Child workbook (Glasser, 2016) and weekly phone calls.
Sponsors
University of Lincoln
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Single case design
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
Participants will be parents/carers of children who have been referred to National Health Service (NHS) children's services for behavioural problems. Participants will be recruited from waiting lists of NHS children's services at the two research sites in the East Midlands. Inclusion criteria: * The referred child is aged between three and eleven years old. * The referred child is on a waiting list for an NHS children's service at the two research sites. * The referred child's behavioural problems are one of the primary reasons for referral to the NHS service. * The parent/carer identifies the referred child's behaviour as problematic.
Exclusion criteria
* The referred child has a diagnosis of developmental delay or learning disability. * The family is current receiving active multi-agency involvement (e.g. social care, police or youth offending in addition to NHS services). * The parent/carer is aged under 18. * The parent/carer is unable to read or speak English fluently.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Parent-reported Child Behavioural Problems | Measure across the baseline phase (3 weeks), intervention phase (6 weeks) and follow up (one month post intervention) | Results state the number of children for whom parents reported an improvement in behaviour using the Brief Problem Monitor (Achenbach et al., 2011). |
| Idiographic Measure of Parent-perceived Problems | Measured at the beginning of the baseline and follow up (one month post intervention) | Results state the number of children for whom parents reported an improvement on the ideographic goals set by parents. Measured using the PSYCHLOPS (Ainsworth et al., 2009) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Negative Parenting Practices | Measure across the baseline phase (3 weeks), intervention phase (6 weeks) and follow up (one month post intervention) | Parents whose negative parenting practices reduced, measured using the Multidimensional Assessment of Parenting Scale (Parent and Forehand, 2017) |
| Parental Reflective Functioning | Measure across the baseline phase (3 weeks), intervention phase (6 weeks) and follow up (one month post intervention) | Parents whose parental reflective function improved due to the intervention, measured using the Parental Reflective Functioning Questionnaire (Luyten et al., 2017) |
| Parental Wellbeing | Measured at the beginning of the baseline and follow up (one month post intervention) | Number of parents whose wellbeing improved when measured using the SWEMWBS (Tennanet et al., 2007). |
Countries
United Kingdom
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Intervention Arm Participants receiving the intervention whilst on a waiting list for treatment as usual
Transforming the Intense Child Workbook (Glasser, 2016): The NHA was delivered in a guided self-help format, using the Transforming the Intense Child workbook (Glasser, 2016) and weekly phone calls. | 5 |
| Total | 5 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Withdrawal by Subject | 1 |
Baseline characteristics
| Characteristic | Intervention Arm | — |
|---|---|---|
| Age, Customized Age of referred child - 10 years | 1 participants | — |
| Age, Customized Age of referred child - 11 years | 2 participants | — |
| Age, Customized Age of referred child - 8 years | 1 participants | — |
| Age, Customized Age of referred child - 9 years | 1 participants | — |
| Race and Ethnicity Not Collected | — | — Participants |
| Sex/Gender, Customized Sex of referred child - female | 4 participants | — |
| Sex/Gender, Customized Sex of referred child - male | 1 participants | — |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 6 |
| other Total, other adverse events | 0 / 6 |
| serious Total, serious adverse events | 0 / 6 |
Outcome results
Primary
Idiographic Measure of Parent-perceived Problems
Results state the number of children for whom parents reported an improvement on the ideographic goals set by parents. Measured using the PSYCHLOPS (Ainsworth et al., 2009)
Time frame: Measured at the beginning of the baseline and follow up (one month post intervention)
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Intervention Arm | Idiographic Measure of Parent-perceived Problems | 3 participants |
Primary
Parent-reported Child Behavioural Problems
Results state the number of children for whom parents reported an improvement in behaviour using the Brief Problem Monitor (Achenbach et al., 2011).
Time frame: Measure across the baseline phase (3 weeks), intervention phase (6 weeks) and follow up (one month post intervention)
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Intervention Arm | Parent-reported Child Behavioural Problems | 1 participants |
Secondary
Negative Parenting Practices
Parents whose negative parenting practices reduced, measured using the Multidimensional Assessment of Parenting Scale (Parent and Forehand, 2017)
Time frame: Measure across the baseline phase (3 weeks), intervention phase (6 weeks) and follow up (one month post intervention)
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Intervention Arm | Negative Parenting Practices | 1 participants |
Secondary
Parental Reflective Functioning
Parents whose parental reflective function improved due to the intervention, measured using the Parental Reflective Functioning Questionnaire (Luyten et al., 2017)
Time frame: Measure across the baseline phase (3 weeks), intervention phase (6 weeks) and follow up (one month post intervention)
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Intervention Arm | Parental Reflective Functioning | 3 participants |
Secondary
Parental Wellbeing
Number of parents whose wellbeing improved when measured using the SWEMWBS (Tennanet et al., 2007).
Time frame: Measured at the beginning of the baseline and follow up (one month post intervention)
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Intervention Arm | Parental Wellbeing | 2 participants |