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Implementing child mental health interventions in service settings: lessons from three pragmatic randomised controlled trials in Wales
- Authors:
- HUTCHINGS Judy, et al
- Journal article citation:
- Journal of Children's Services, 3(1), September 2008, pp.17-27.
- Publisher:
- Emerald
This article reports on three pragmatic randomised controlled trials (RCTs) to help children at risk of conduct disorder (CD): two involved the Incredible Years (IY) BASIC parent programme and other concerned the IY teacher programme. All three interventions took place in regular service settings in North- and Mid-Wales. In all three studies, staff from the provider agency delivered the programme and participated in RCT evaluations in which participants were randomly allocated to intervention or waiting-list control conditions. After a brief introduction to the research into the prevention or treatment of CD, and the issues to be considered by services in selecting and delivering interventions, this article summarises the structure, content and evidence base of the IY programmes. The three Welsh studies are briefly described before exploring what factors contributed to service participation in the trials and the benefits and lessons learned in undertaking them.
Parenting intervention in Sure Start services for children at risk of developing conduct disorder: pragmatic randomised controlled trial
- Authors:
- HUTCHINGS Judy, et al
- Journal article citation:
- British Medical Journal, 31.03.07, 2007, pp.678-682.
- Publisher:
- British Medical Association
This study aimed to evaluate the effectiveness of a parenting programme as a preventive intervention with parents of preschool children considered to be at risk of developing conduct disorder. Eleven Sure Start areas in north and mid-Wales were used in the evaluation. The participants were 153 parents from socially disadvantaged areas, with children aged 36-59 months at risk of conduct disorder defined by scoring over the clinical cut off on the Eyberg child behaviour inventory. Participants were randomised on a 2:1 basis, 104 to intervention and 49 to remaining on the wait listing (control). Twenty (13%) were lost to follow-up six months later, 18 from the intervention group. The Webster-Stratton Incredible Years basic parenting programme, a 12 week group based intervention was used. The main outcome measures were problem behaviour in children and parenting skills assessed by self reports from parents and by direct observation in the home. Parents' self reported parenting competence, stress, and depression. Standardised and well validated instruments were used throughout. At follow-up, most of the measures of parenting and problem behaviour in children showed significant improvement in the intervention group. The intention to treat analysis for the primary outcome measure, the Eyberg child behaviour inventory, showed a mean difference between groups of 4.4 points on the problem scale with an effect size of 0.63, and a mean difference of 25.1 on the intensity scale with an effect size of 0.89. This community based study showed the effectiveness of an evidence based parenting intervention delivered with fidelity by regular Sure Start staff. It has influenced policy within Wales and provides lessons for England where, to date, Sure Start programmes have not been effective.
Behaviour therapy: what do health visitors know?
- Authors:
- HUTCHINGS Judy, NASH Susan
- Journal article citation:
- Community Practitioner, 71(11), November 1998, pp.364-367.
- Publisher:
- Community Practitioners' and Health Visitors' Association
Health visitors spend increasing amounts of time with families of children with severely disruptive behaviours. Reports on the knowledge, practice and attitudes of health visitors towards behavioural intervention techniques with these children and families.