Evaluation of the Enhancing Parenting Skills 2014 Programme for Parents of Young Children with Behaviour Problems

Introduction: Child behaviour problems are a global issue (Polanczyk et al., 2015). The long-term prognosis for child behaviour problems is poor (Colman et al., 2009) so early intervention before problems become embedded is crucial. Parenting is a key risk factor for the development of child behaviour problems (Farrington & Welsh, 2007) and parenting programme are effective in reducing these problems (Furlong et al., 2012). Not all parenting programmes are effective for all families and some research suggests that individually delivered programmes are more effective for disadvantaged families (Lundahl et al., 2006). The Enhancing Parenting Skills (EPaS) 2014 programme is an individually delivered, behavioural parent support package consisting of three phases: standardised assessment, structured case analysis formulation, and intervention strategies. Previous studies have shown promising results, however the programme has not been evaluated using a randomised controlled trial design.

Methods: This study was a pragmatic pilot randomised controlled trial in four primary care settings. Health visitors (public health nurses) were recruited to undertake EPaS training and to identify two families who were reporting a young child (aged 2-4 years) with behaviour problems based on the Eyberg Child Behaviour Inventory (ECBI; Eyberg, 1980). Twenty-nine health visitors and 58 families were recruited. Families were randomised to either an intervention or wait-list control condition. The main outcome was child behaviour, based on the ECBI, and secondary outcomes included child hyperactivity, parenting skills, and parental mental health. Data was collected pre- and post-intervention and included parent reports and a blind observation of parent-child interaction.

Results: Families in the intervention condition showed significant reductions in child behaviour problems (ECBI Intensity d=0.88, p=.029). A sub-group analyses showed that families who completed all three phases of EPaS showed significant reductions in child behaviour problems (ECBI Intensity d=1.30, p=.014; ECBI Problem d=1.53, p=.031) compared to the control condition. Health visitors reported high levels of satisfaction with the EPaS training with all reporting they would continue to use the methods taught.

Conclusions: The results are promising and suggest that EPaS 2014 is a potentially effective intervention for families of children with behaviour problems. Further research with a larger sample needs to be conducted to confirm these results. The results also highlight the fact that health visitors can effectively deliver parenting programmes to disadvantaged families.