Resources

Strengthening child-parent relationships

07 November 2018

Understanding Your Child’s Behaviour (UYCB):

Evaluating a Solihull Approach face-to-face 10-week group for parents.

Dr Rebecca Baladi (BSc (Hons)., DClinPsy.)

Clinical Psychologist

Birmingham Children’s Hospital

Steelhouse Lane

Birmingham, B4 6NH

Tel: 0121 333 8046

Email: rebecca.baladi@bch.nhs.uk

 

*Dr Rebecca Johnson (BA (Hons)., DclinPsy., CPsychol.)

Consultant Clinical Psychologist

Bishop Wilson Clinic

Craig Croft

Birmingham

B37 7TR

Tel: 0121 296 4448

Mobile: 07870 648855

Email: rebecca.johnson2@heartofengland.nhs.uk

 

Dr G. Urquhart Law (BSc (Hons)., DClinPsy., CPsychol., AFBPsS)

Senior Clinical Lecturer & Child Clinical Psychologist

School of Psychology

University of Birmingham

Birmingham, B15 2TT

Tel: 0121 414 6296

Email: g.u.law@bham.ac.uk

 

*Correspondence author

 

Clinical psychologists Dr Rebecca Baladi, Dr Rebecca Johnson and Dr Gary Urquhart Law, all based in Birmingham, carried out a study to explore the efficacy of Understanding Your Child’s Behaviour – a 10-week programme for parents of children aged 0-18 years based on the Solihull Approach (Douglas, 2012) - assessing its impact on child-parent relationships, and the sustainability of effects over time.


Introduction

‘Understanding your child’s behaviour’ (UYCB) (Solihull NHS Care Trust, 2010), is a group for parents based on the Solihull Approach (Douglas, 2012), a theoretical model drawing together ideas from psychoanalytic (containment), child neurodevelopment (reciprocity) and learning (behaviour management) theories.

Developed in the late nineties out of a collaboration between Douglas, a Child Psychotherapist and Clinical Psychologist, and local health visitors, the Solihull Approach proposes that if a parent is supported to process their own emotions (containment) this will “free them up” to think about the meaning of their child’s behaviour and what emotions their child is trying to communicate (reciprocity). Consequently, through the processes of containment and reciprocity, parents should be more able to effectively and sensitively manage their child’s behaviour (behaviour management). Douglas (2007) proposed that it is the integration of the psychoanalytic, neurodevelopmental, and behavioural approaches that leads to improved emotional well-being in both the child and the parent, resulting in an overall improvement in the parent-child relationship.

UYCB introduces parents to the Solihull Approach model, with an emphasis on the links between behaviour and emotions, and parental as well as child emotional regulation. It explores issues such as: tuning in to children; exploring feelings; parenting styles; communication – what is being communicated through a behaviour; temper tantrums and what might be meant by them; sleep patterns, and behavoural difficulties.

Health visitors and school nurses were key contributors to the early development and ongoing delivery of both training for professionals and facilitation of parent groups.

There have been a number of studies demonstrating the effectiveness of the Solihull Approach for professionals in community practice (Douglas & Ginty, 2001; Maunders et al., 2007; Whitehead & Douglas, 2005) and for supporting parents to improve children’s behaviour and their own well-being (Bateson et al., 2008; Douglas & Brennan, 2004).

UYCB has been shown to have high parental satisfaction, and lead to improvements in family relationships (Cabral, 2013; Johnson & Wilson, 2012) and parents have reported enhanced self-belief, alongside the development of more reflective and empathic parenting styles (Vella et al., 2015). UYCB is widely delivered across the UK, is included as an implementation example in the National Institute for Health and Care Excellence (NICE) guidance on the management of conduct disorders in children (NICE, 2013), and it is increasingly being adopted internationally.

Study aim

This study was undertaken to explore the efficacy of the UYCB programme in a larger sample of parents than previously studied, and for the first time, to assess its impact on child-parent relationships. A follow-up three months after the end of the programme was included to examine the sustainability of effects over time.

Ethical approval

The study was approved by the NHS Research Ethics Service North West – Cheshire (Ref: 12/NW/0278).

What is Understanding Your Child’s Behaviour?

UYCB is a two hours x 10 week programme for parents of children aged 0-18 years. Groups are run in community venues by a range of practitioners (e.g. health visitors, school nurses, education workers, support workers) trained as Solihull Approach Group Facilitators  (3-days). Each UYCB group is facilitated by two practitioners, who have access to a manual outlining the content and delivery methods for each session. Mentoring is also provided throughout the 10-week period to support reflective functioning in the facilitators and ensure programme fidelity. UYCB groups are advertised through universally accessible children’s services, and parents can self-refer. See Table 1 for programme content.  

Who attended?

Courses were offered at a range of venues (e.g. schools, children’s centres, health clinics) and the usual clinical practice pathways used by the facilitators were used to recruit parents into this study. Parents eligible for participation in the study (see Table 2 for inclusion criteria) were provided with information and consent forms 2-4 weeks prior to groups starting. Questionnaires were presented to parents agreeing to take part in the study at session one (‘pre’), session 10 (‘post’), and three-months later (‘follow-up’). Data were collected from 46 UYCB groups within two cites of the West Midlands region of the UK over a 14-month interval. From 242 potential recruits attending an UYCB group, 160 parents completed questionnaires at the start (66% response rate), 74% (n=119) of whom also completed questionnaires post- group. 30% (n=35) of those completing pre and post responses also returned three-month follow-up questionnaires which were posted to them.


Method

Measures

The same three measures were used across the three timepoints:

1. The Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997) is a widely used, 25-item, brief screening measure for child emotional and behavioural difficulties. Five subscales assess: conduct problems, hyperactivity, emotional symptoms, peer relationship difficulties, and pro-social behaviour. The SDQ ‘impact’ score (an assessment of distress and impairment caused to the child by any difficulties) was also used to explore change.

2. Depression Anxiety Stress Scale, Short Version (DASS-21; Lovibond & Lovibond, 1995) is a standardised, widely used, 21-item measure of well-being, assessing self-reported symptoms of parental depression, anxiety and stress.

3. Child-Parent Relationship Scale, Short Version (CPRS; Pianta, 1992), is a 15-item scale measuring parental perceptions of conflict and closeness in their relationship with their child(ren). A total relationship score can be derived by calculating the average item score.

Participants

Of the 119 parents, the majority were female (92%). Most parents fell within the age category of 30-39 years (56%) and 94% were the identified child’s biological parent. 71% of parents were not in paid employment and 25% classed themselves as a “lone parent”.

The mean age of children was 5.07 years, (SD=3.6; range 0-14); 52% of whom were female. 17% of children were reported by parents as having an “additional need” (e.g., physical health problems) and 25% were receiving additional professional support (e.g., social workers, family support workers) at the time of intervention.

Analyses:

Two analyses were undertaken: firstly the pre-post group scores of 119 parents who completed an UYCB group were compared; and secondly scores were compared across three timepoints for the smaller group of 35 parents who completed questionnaires before, after and three months following the group.

Paired-samples t-tests were used to compare pre and post scores given by the larger sample of 119 parents, on those measures meeting the assumptions of parametric testing (i.e where the spread of scores were equally distributed); Wilcoxon rank sums t-test were used as the non-parametric equivalent – this test compares medians rather than means. A one-way repeated measures analysis of variance (ANOVA) was conducted to analyse the data for the 35 parents who completed questionnaires at the start of the group (T1), at completion of a group (T2) and at 3-month follow-up (T3).

Statistical tests calculate the probability that the differences between the scores of two or more groups (defined by the mean (average) or median (middle) scores) occurred by chance, rather than as a result of any intervention. The smaller the probability (represented by a ‘p’ value) the more likely that the difference occurred as a result of some other factor (for example the intervention). Statistical tests are considered to be significant if the ‘p’ value is less than, or equal to (≤), 0.05. This would mean that there is at least a 95% chance that the intervention led to the difference between the groups. A ‘p’ value of 0.001 means there is a 99.9% chance that the difference did not happen by chance, i.e. almost certain.      

Results

Child Behaviour (SDQ)

The SDQ showed statistically significant improvements in scores across all subscales from baseline (T1) to completion (T2) of the UYCB groups in the large sample, with the exception of the ‘peer relationship difficulties’, which showed no discernible change, see Table 3. The SDQ ‘total difficulties’ score showed a highly statistically significant decrease from T1 to T2 (p<0.001), as did the overall ‘impact’ score, which had significantly reduced by the time of group completion, indicating an improvement in the children’s’ behaviour problems reported by parents.

Three significant results were found in the smaller follow-up sample, see Graph 1 and Table 4. The SDQ ‘total difficulties’ score showed a small, but statistically significant (p=0.05) decrease from T1 to T2, but with no further change at T3. Significant improvements were found for ‘pro-social behaviour’ (p=0.01) across all three time points, showing that changes occurred between T1-T2 and from T2-T3. For ‘conduct problems’, scores significantly decreased from T1-T2, but then increased slightly at T3, however overall the improvement in conduct problems subscale was statistically significant across all three time points. However, using guidelines suggested by Cohen (1988) the magnitude of these changes was small (ηp²=0.09 - 0.15).

These results show that attendance at UYCB improved the total difficulties, pro-social behaviour, hyperactivity, emotional problems, impact of difficulties, and conduct problems in a large sample of parents. However, the change is most notable immediately after the end of the group. Whilst the improvements in total difficulties and conduct problems were maintained at 3 months in the small number of parents that responded to the follow-up there was no evidence of ongoing improvement over time. However, pro-social behaviour did continue to improve in the smaller sample. It is not known whether the changes post group were maintained or improved in the larger sample.

Parental Depression, Anxiety and Stress (DASS-21)

Parents in the larger sample reported significant improvements in their own ‘depression’ (p=<0.001), ‘anxiety’ (p=0.01) and ‘stress’ (p=<0.001) between T1 and T2, i.e. on completion of UYCB groups. DASS-21 ‘total’ scores also decreased significantly (p=<0.001) from T1 to T2, see Table 3. Overall, both subscale and total scores showed an improvement in wellbeing between the start and completion of UYCB groups.  

However, no statistically significant changes in the mean depression, anxiety or stress scores for parents were found in the smaller sample after 3 months, see Table 4. Depression and anxiety scores decreased between T1 and T2, but both showed a slight increase at three-month follow-up. For stress, scores decreased across all three time points and, while this was not statistically significant, a trend in the data was evident (p=0.08). DASS-21 total scores showed a decrease from T1 to T2, a slight increase at follow-up, and a trend towards statistical significance between time one and subsequent time points (p=0.06).

Child-Parent Relationship (CPRS)

There were highly statistically significant improvements on CPRS ‘total relationship’ scores (p=<0.001), with a significant increase in the ‘closeness’ subscale score between T1 and T2 (p=<0.001), as well as a significant decrease in the ‘conflict’ subscale score (p=<0.001) - see Graph 2 and Table 3. Overall, there was evidence of significant improvements in the child-parent relationship.

Closeness and conflict scores also showed an improvement from T1 to subsequent time points in the smaller sample who responded to the follow-up. For closeness, there was an increase in scores from T1 to T2, with a small decrease between T2 and follow-up (see Graph 3). Changes between scores at T1 and subsequent time-points were significant (p=0.02), although the effect size was small. For conflict, scores decreased across all three time points, but the changes fell just short of significance (p=0.06). A statistically significant (p= 0.01) improvement was found for the CPRS ‘total relationship’ between T1 and subsequent timepoints (see Table 4).

Discussion

The results show that, at the conclusion of the 10-session UYCB group, parents reported improvements in their child’s behavioural and emotional functioning.  ‘Peer problems’ did not reach statistical significance, but did show a clinically significant improvement (i.e., scores moving from the SDQ ‘borderline’ to ‘normal’ range). In the follow up sample there was no additional improvement three months after the group finished, however the positive changes had been maintained. Pro-social behaviour and conduct problems subscale scores remained significantly different at follow-up compared to pre-group scores

Parental well-being – parental depression, anxiety and stress - also significantly improved by the time parents had completed the group. Stress levels even showed a trend towards continued improvement three months later, although this did not reach statistical significance.

There were also highly statistically significant improvements in the child-parent relationship as a result of attendance at the ten-week group. Improvements in parental report of reductions in conflict and increases in closeness in their relationship with their children by the conclusion of the group, which were maintained at three months, are not likely to have occurred by chance; they can therefore can be attributed to attendance at UYCB. Closeness scores at follow-up remained statistically significantly different to pre-group scores. However, conflict subscale scores did not quite reach significance at follow-up. Relationships are considered to be essential to the development of emotional self-regulation and long-term resilience to mental health difficulties, and are thereby the mechanism by which children’s behavioural and emotional functioning can improve.

The finding of improvements in children’s behaviour and parental wellbeing are consistent with previous evaluations of UYCB (Bateson et al., 2008) and parenting programmes more generally (e.g., Barlow, 1999; Barlow et al., 2002; Barlow et al., 2010; Bunting, 2004; Gibbs et al., 2003).

The reduction in parental stress and improvements in child-parent relationships also concord with a qualitative analysis of parents’ experiences of UYCB 9-11 months after completing the group, which found that ongoing learning takes place after completion of the group, and that parents find alternative ways to view their child’s presenting difficulties and develop coping strategies to manage stress (Vella et al., 2015).

Overall, the findings show that parents who have attended an UYCB programme report positive outcomes in the areas of child behaviour, parental depression, stress and anxiety, and the child-parent relationship, immediately following attendance at a parenting programme. It is encouraging that such a programme, aimed at a universal population, can show significant results in these areas as effective universal offers are likely to increase the social acceptability to parents in more complex situations.

The follow-up results cannot be claimed as robust evidence for continued improvements after completion of an UYCB group, but have shown maintenance of effects from post-group levels across outcome variables. It may be useful for facilitators to provide booster sessions to help with either the maintenance or the continued improvement of positive effects of the group.

The limitations of the study include the small sample size at the three-month follow-up. This will have reduced the power of the pre-post-follow-up analysis and therefore increased the likelihood of a Type II error, not finding an effect where one exists. The outcomes in this study also rely on parental self-report which, whilst being practical for research undertaken in real clinical settings, may suffer from bias which would benefit from corroboration via observational research tools. 

Another weakness is the lack of a control group, which means that more robust conclusions about the effectiveness of UYCB versus either a wait-list control or other active parenting intervention cannot be made.

As well as establishing the positive short-term outcomes of attending an UYCB group, the current study also explored the degree to which any effects were either maintained or improved upon over time. While the follow-up period was short (3-months), the inclusion of this aspect of methodological design is an improvement on previous evaluations of UYCB and the first to look at sustainability of effects for parents, children and the child-parent relationship. Although not unusual for postal questionnaires the 29.4% response rate, out of the initial 119 parents, in the follow-up group, may mean the follow-up results suffer from a non-response bias and must therefore be treated with caution. However, analysis of the results revealed mixed but interesting preliminary findings, which will require further corroboration in subsequent research.

Strengths of this study include the use of a child-parent relationship measure, follow-up time point and utilisation of current clinical practice pathways for recruitment to strengthen the real-world validity and application of the study’s findings. 

Of note is that the non-significant results (maintenance effects) at three-month follow-up might also be due to the relatively healthy scores at baseline on each of the outcome measures, possibly owing to UYCB being a universal group rather than targeted at individuals with difficulties. However, this evaluation underlines the potential and actual utility of the UYCB as a preventative and universal programme from which parents can benefit, even with low level or less severe difficulties.

Implications and recommendations         

UYCB should continue to be offered as part of an evidenced-based parenting strategy by trained community practitioners. Where possible follow-up or booster sessions may help to maintain and possibly see further improvements in parents’ understanding of their child and ability to support their child’s emotional development. This might involve three-month reunion sessions, with time for social reconnection, a recap of the model and the three key questions for parents that feature regularly throughout the group, and revisiting a topic from the original group, dependent on the needs and wishes of the group. Alternatively, open sessions for UYCB ‘graduates’ may provide the opportunity to revisit content and discuss specific issues that have arisen. Pressures on community services may make such options challenging to prioritise, but benefits might include prevention of difficulties requiring more time-consuming intervention further down the line.

Parents can also be encouraged to engage in the online version of the course which, having the same content, may serve to reinforce learning from the face to face group experience. Various funding models are available to make the online courses free to parents where self-funding is prohibitive.


Conclusion

This study provides evidence that parents who have completed a UYCB group report positive impacts in the areas of children’s behavioural and emotional functioning, parental depression, anxiety and stress, and in the child-parent relationship. These results show that after the conclusion of an UYCB group there is evidence for the maintenance, although not for further improvement, of effects at three-months. Future research should include either a wait-list control group or other active parenting intervention, so that the true effectiveness of attendance at UYCB can be demonstrated both at completion and longer-term follow-up, and studies should consider the utility and feasibility of including measures other than parental self-report. 

 

References

Abidin RR. (1995) Parenting Stress Index, Third Edition: Professional Manual. Psychological Assessment Resources, Inc.

Barlow J, Coren E, Stewart-Brown S. (2002) Meta-analysis of the effectiveness of parenting programmes in improving maternal psychosocial health. British Journal of General Practice 52: 223-233. See: https://bjgp.org/content/52/476/223 (accessed 9 October 2018).

Barlow J, Smailagic N, Ferriter M. Bennett C, Jones H. (2010) Group-based parent training programmes for improving emotional and behavioural adjustment in children from birth to three years old. Cochrane Database of Systematic Reviews (3). See: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003680.pub2/abstract (accessed 9 October 2018).

Barlow J. (1999) What Works in Parent Education Programmes: In: Lloyd E. (Ed.) Parenting Matters: What Works in Parenting Education? Barnardo's: Ilford, United Kingdom.

Bateson K, Delaney J,  Pybus R. (2008) Meeting expectations: the pilot evaluation of the Solihull Approach Parenting Group. Community Practitioner 81(5): 28-31. See: https://www.researchgate.net/publication/5308289_Meeting_expectations_the_pilot_evaluation_of_the_Solihull_Approach_Parenting_Group (accessed 9 October 2018).

Bunting L. (2004) Parenting Programmes: The Best Available Evidence. Child Care in Practice 10(4): 327-343. See: https://www.researchgate.net/publication/240240582_Parenting_Programmes_The_Best_Available_Evidence (accessed 9 October 2018).

Cabral J. (2013) The value of evaluating parenting groups: a new researcher’s perspective on methods and results. Community Practitioner 86(6): 30-33. See: http://s571809705.websitehome.co.uk/Images2/cabral,%20judy%20-%20parenting%20uycb%20-%20community%20practitioner%20june%202013.pdf (accessed 9 October 2018).

Cohen, J. (1988) Statistical power analysis for the behavioral sciences. 2nd Edition. Lawrence Erlbaum Associates.

Douglas H, Brennan A. (2004) Containment, reciprocity and behaviour management: preliminary evaluation of a brief early intervention (the Solihull Approach) for families with infants and young children. International Journal of Infant Observation 7(1): 89-107. See: https://www.researchgate.net/publication/233446829_Containment_reciprocity_and_behaviour_management_preliminary_evaluation_of_a_brief_early_intervention_the_Solihull_Approach_for_families_with_infants_and_young_children (accessed 9 October 2018).

Douglas H, Ginty M. (2001) The Solihull Approach: changes in health visiting practice. Community Practitioner 74(6): 222-224. See: http://s571809705.websitehome.co.uk/Images2/changes-in-health-visiting-practice.pdf (accessed 9 October 2018).

Douglas H. (2012) Solihull Approach Resource Pack: The First Five Years, 5th edn. Jill Rogers Associates, Cambridge.

Gibbs J, Underdown A, Stevens M, Newberry J, Liabo K. (2003) Group-based parenting programmes can reduce behaviour problems of children aged 3-12 years. What Works for Children group Evidence Nugget April 2003. See: https://pdfs.semanticscholar.org/0750/95a853d97b816300ef3ec8ce163d1a2bff63.pdf (accessed 9 October 2018).

Goodman R. (1997) The Strengths and Difficulties Questionnaire: a research note. Journal of Child Psychology & Psychiatry 38(5): 581-586.  See: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1469-7610.1997.tb01545.x (accessed 9 October 2018)

Johnson R, Wilson, H. (2012). Parents’ evaluation of Understanding Your child’s Behaviour, a parenting group based on the Solihull Approach. Community Practitioner 85(5): 29-33. See: http://solihullapproachparenting.com/wp-content/uploads/delightful-downloads/2015/11/Johnson.-R-and-Wilson-H-.-Parents-evaluation-of-UYCB-2012.pdf (accessed 9 October 2018).

Lovibond S, Lovibond, P. (1995) Manual for depression, anxiety and stress scale. Sydney: Psychology Foundation.

Maunders H, Giles D. Douglas H. (2007) Mothers’ perception of community health professional support. Community Practitioner  80(4): 24-29. See: http://s571809705.websitehome.co.uk/Images2/research,%20publications%20&%20evaluations%20full2.pdf (accessed 9 October 2018).

National Institute for Health and Care Excellence (NICE). (2013) Antisocial behaviour and conduct disorders in children and young people: recognition and management. See: www.nice.org.uk/guidance/CG158 (accessed 19 October 2018).

Pasalich D, Dadds M, Hawes D. Brennan J. (2011) Assessing Relational Schemas in Parents of Children with Externalising Behaviour Disorders: Reliability and Validity of the Family Affective Attitude Rating Scale. Psychiatry Research 185(5): 438-443. See: https://www.sciencedirect.com/science/article/pii/S016517811000466X (accessed 9 October 2018).

Pianta R. (1992) Conceptual and methodological issues in research on relationships between children and non-parental adults. In: Pianta RC. (Ed.), Beyond the parent: The role of other adults in children’s lives. San Fransisco: Josey-Bass.

Solihull NHS Primary Care Trust. (2010) Solihull Approach Parenting Group: Supporting Parent/child Relationships, 2nd edn. Jill Rogers Associates Ltd, Cambridge.

Vella L, Butterworth RE, Johnson R, Urquhart Law G. (2015) Parents’ experiences of being in the Solihull Approach parenting group, ‘Understanding Your Child’s Behaviour’: an interpretative phenomenological analysis. Child: Care, Health and Development  41(6): 882-894. See:  https://onlinelibrary.wiley.com/doi/full/10.1111/cch.12284 (accessed 9 October 2018).

Whitehead R, Douglas H. (2005) Health Visitors experiences of using the Solihull Approach. Community Practitioner 78(1): 20-23. See:   https://www.researchgate.net/publication/233705662_Health_visitors'_experience_of_using_the_Solihull_Approach (accessed 9 October 2018).

Acknowledgements

The authors would like to thank the facilitators and parents who agreed to take part and make this study possible. Particular thanks must also go to the parenting teams in Walsall and Solihull, and to Tracy Mansbridge, Lisa Baker and Georgina Atkins especially.


Tables and Graphs

Table 1: Programme sessions

Session

Title

1

Introduction

2

How are you and your child feeling?

3

Tuning into your child’s development

4

Responding to your child’s feelings

5

Different styles of parenting

6

Parenting child partnership- having fun together

7

The rhythm of interaction and sleep

8

Self-regulation and anger

9

Communication and attunement – how to recover when things go wrong

10

Celebration

 

Table 2. Participant Inclusion and Exclusion Criteria.

Inclusion Criteria

Exclusion Criteria

Parents/carers of children aged 0-18 years

 

Parents whose child’s behaviour difficulties are such that they require more immediate and intensive input from a Child and Adolescent Mental Health Service or other specialist team

Parents with a sufficient understanding of spoken and written English to participate in the group and complete questionnaires

Parents whose language or literacy skills are limited such that they will not be able to complete the questionnaire booklet

Parents with children who have some degree of behaviour difficulty and would therefore benefit from a better understanding of their child’s behaviour

Parents of children with a diagnosed learning disability

 

Parents attending at least 8 out of the 10 group sessions, with sessions missed not occurring on consecutive weeks

Young parents (under the age of 18)

 

Table 3. Pre-post group changes.

 

Pre

Post

 

 

 

 

Variable

M or  [mdn]

SD or [IQR]

M  or [mdn]

SD or [IQR]

t

z

df

p

Child behaviour (SDQ)

 

 

 

 

 

 

 

Conduct problems

[3]

[3]

[2]

[3]

-

-5.19

108

<0.001*

Hyperactivity

5.72

2.65

4.94

2.59

3.50

-

109

    0.01*

Emotional symptoms

[3]

[ 4]

[2]

[2]

-

-4.59

109

<0.001*

Peer relationship difficulties

[3]

[3]

[2]

[3]

-

-0.37

109

    0.71*

Pro-social behaviour

[7]

[3]

[2]

[3]

-

-4.25

109

<0.001*

Impact

[1]

[2]

[0]

[1]

-

-4.17

109

<0.001*

Total difficulties

14.70

7.48

12.40

6.51

3.10

-

109

<0.001*

Parental well-being (DASS-21)

 

 

 

 

 

 

 

Depression

[6]

[12]

[2]

[8]

-

-4.27

117

<0.001*

Anxiety

[2]

[10]

[2]

[6]

-

-2.45

117

     0.01*

Stress

[10]

[10]

[8]

[12]

-

-3.23

117

   0.001*

Total score

[21]

[30]

[12]     

[21]

-

3.91

116

<0.001*

Child Parent Relationship Scale  (CPRS)

 

 

 

 

 

 

Closeness

[30]

[6]

[32]

[6]

-

-3.72

111

<0.001*

Conflict

22.96

8.34

20.22

8.14

4.34

-

111

<0.001*

Total relationship

3.62

0.75

3.89

0.75

4.62

-

111

<0.001*

 

M=Mean, mdn=Median, SD=Standard deviation, IQR=Inter-quartile range, t=paired-sample t-test, z=Wilcoxon rank sums t-test, p=significance level, *=statistically significant at p=<0.05, df=degrees of freedom

Table 4. Pre-post-follow-up changes.

 

 

 

 

 

 

 

 

 

 

 

 

Pre

Post

Follow-up

 

 

 

 

Variable

M

SD

M

SD

M

SD

F

Df

p

ηp²

Child behaviour (SDQ)

 

 

 

 

 

 

 

 

 

 

Emotional problems

2.26

1.58

1.97

1.87

1.88

2.18

0.86

1.91

0.42

0.03

Hyperactivity

5.29

2.46

4.71

2.21

4.74

2.92

1.23

1.92

0.27

0.04

Conduct problems

3.41

2.39

2.35

1.67

2.79

2.40

4.29

1.73

0.02*

0.12

Peer relationship difficulties

2.82

2.26

2.29

1.90

2.24

2.28

1.84

1.83

0.17

0.05

Pro-social behaviour

6.97

1.77

7.74

1.60

7.88

1.92

5.95

1.85

0.01*

0.15

Impact

1.38

2.90

0.71

1.36

0.85

1.89

2.07

1.63

0.15

0.59

Total difficulties

13.44

6.19

11.29

5.08

11.65   

7.50

3.220

1.92

0.05*

0.09

Parental well-being (DASS-21)

 

 

 

 

 

 

 

 

 

Depression

6.76

8.92

4.06

6.08

4.82

7.03

2.57    

1.44

0.10

0.07

Anxiety

4.53

6.46

3.06 

5.83

3.12

6.01

1.64

1.32

0.21

0.47

Stress

11.12

9.36

9.41

8.68

8.18

9.50

2.83

1.70

0.08

0.79

Total score

22.44

23.58

15.29

17.54

16.12 

21.22

3.34

1.55

0.06

0.09

Child Parent Relationship Scale  (CPRS)

 

 

 

 

 

 

 

 

Closeness

30.06

4.45

31.62

2.40

31.56 

2.85

4.35

1.88

0.02*

0.12

Conflict

21.09

8.17

18.82

7.15

18.35 

6.98

3.06

1.90

0.06

0.09

Total relationship

3.79

.75  

4.05

.54

  4.07    

.58

5.24

1.73

0.01*

0.14   

 

M=Mean, SD=Standard deviation, p=significance level, *=statistically significant at ≤0.05, df=degrees of freedom, ηp²=partial eta squared 

 

Graph 1

*Statistical significance (p≤0.05) 

Graph 1. Mean pre, post and follow up SDQ scores (n=35). 

 

*Statistical significance (p≤0.05)

Graph 2. Mean pre and post CPRS scores (n=119).

 

Graph 3

*Statistical significance (p≤0.05)

Graph 3. Mean pre, post and follow up CPRS scores (n=35).

 

Download PDF

Subscription Content

Click To Return To Homepage

Only current Unite/CPHVA members or Community Practitioner subscribers can access the Community Practitioner journals archive. Please provide your name and membership/subscriber number below to verify access:

Name
Membership number

If you are not already a member of CPHVA and wish to join please click here to JOIN TODAY

Membership of Unite gives you:

  • legal and industrial support on all workplace issues 
  • professional guidance on clinical and professional issues 
  • online information, training and support 
  • advice and support for all health professionals and health support workers
  • access to our membership communities 
  • CPHVA contribution rate is the Unite contribution rate plus £1.25 per month 

Join here https://www.unitetheunion.org/join-unite/

If you are not a member of Unite/CPHVA but would like to purchase an annual print or digital access subscription, please click here

Top