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Parents Plus Adolescent Programme

Evidence rating
2
Cost rating
2
Review: September 2017

Note on provider involvement: This provider has agreed to EIF’s terms of reference, and the assessment has been conducted and published with the full cooperation of the programme provider.

Parents Plus Adolescent Programme (PPAP) is for parents who have concerns about the behaviour or emotions of a child between the ages of 11 and 16. However, it can also be delivered as a universal/preventative intervention or as a more targeted intervention with parents of adolescents identified with emotional/behaviour problems.

Parents attend approximately eight group sessions where they learn effective methods for communicating with, and disciplining their teenager. The programme involves reviewing DVD parenting and communication clips and group discussion, amongst other activities, and aims to improve positive family relationships and improve child behaviour.  

EIF Programme Assessment

Evidence rating
2

Parents Plus Adolescent Programme has preliminary evidence of improving a child outcome, but we cannot be confident that the programme caused the improvement.

What does the evidence rating mean?

Level 2 indicates that the programme has evidence of improving a child outcome from a study involving at least 20 participants, representing 60% of the sample, using validated instruments. 

This programme does not receive a rating of 3 as its best evidence is not from a rigorously conducted RCT or QED evaluation.

What does the plus mean?

The plus rating indicates that a programme’s best available evidence is based on an evaluation that is more rigorous than a level 2 standard but does not meet the criteria for level 3. 

Cost rating
2

A rating of 2 indicates that a programme has a medium-low cost to set up and deliver, compared with other interventions reviewed by EIF. This is equivalent to an estimated unit cost of £100–£499.

Child outcomes

According to the best available evidence for this programme's impact, it can achieve the following positive outcomes for children:

Supporting children's mental health and wellbeing

based on

Preventing crime, violence and antisocial behaviour

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This programme also has evidence of supporting positive outcomes for couples, parents or families that may be relevant to a commissioning decision. Please see About the evidence for more detail.

Parents Plus Adolescent Programme

Key programme characteristics

Who is it for?

The best available evidence for this programme relates to the following age-groups:

  • Preadolescents
  • Adolescents

How is it delivered?

The best available evidence for this programme relates to implementation through these delivery models:

  • Group

Where is it delivered?

The best available evidence for this programme relates to its implementation in these settings:

  • Secondary school

The programme may also be delivered in these settings:

  • Home
  • Children's centre or early-years setting
  • Primary school
  • Community centre
  • In-patient health setting
  • Out-patient health setting

How is it targeted?

The best available evidence for this programme relates to its implementation as:

  • Targeted selective

Where has it been implemented?

Ireland, Netherlands, United Kingdom

UK provision

This programme has been implemented in the UK.

UK evaluation

This programme’s best evidence does not include evaluation conducted in the UK.

Spotlight sets

EIF includes this programme in the following Spotlight sets:

  • Parenting programmes with violence reduction outcomes
  • Programmes for children with recognised or possible special education needs
Parents Plus Adolescent Programme

About the programme

What happens during delivery?

How is it delivered?
  • The main, group-work component of Parents Plus Adolescent is delivered in eight sessions of 2.5 hours’ duration each by two practitioners, to groups of 15 parents.
  • In addition, parent sessions are offered, involving individual sessions prior to group work (1-2 one-hour sessions), and family sessions are offered, involving four individual family sessions with the parent and teenager. NB: In the most robust study, only the main group work component was offered.
What happens during the intervention?
  • The main, group-work component involves reviewing DVD parenting and communication clips, as well as group discussion, worksheets, role-play, homework handouts, and learning of mindfulness and stress management techniques. 
  • In the family sessions, parents and their teenager are coached together in positive communication and family problem solving. The goal is to teach parents specific communication, relationship and behaviour management, skills while giving them the opportunity to practise these skills over time at home as well as in coached family sessions.

What are the implementation requirements?

Who can deliver it?
  • Two practitioners deliver this programme. Both are Parents Plus Facilitators with QCF-6 level qualifications.
What are the training requirements?
  • The practitioners have 22.5 hours of programme training. Booster training of practitioners is recommended.
How are the practitioners supervised?
  • It is recommended that practitioners are supervised by one host-agency supervisor (qualified to QCF-6 level).
  • It is recommended that practitioners are also supervised by one programme developer supervisor (qualified to QCF-6 level).
What are the systems for maintaining fidelity?
  • Training manual
  • Other printed material
  • Other online material
  • Video or DVD training
  • Face-to-face training
  • Fidelity monitoring
  • Published quality protocol with monitoring checklist.
Is there a licensing requirement?

There is no licence required to run this programme.

How does it work? (Theory of Change)

How does it work?
  • Developing and maintaining warm, positive, and enjoyable relationships with children is central to changing behaviour.
  • Once parents ‘tune in to’ and understand their children, they are in a better position to learn more effective parenting strategies.
  • Parents unintentionally reinforce unwanted child behaviours through ineffective parenting strategies.
  • PPAP assumes that when parents have the opportunity to reflect on the reasons underpinning their child’s behaviour they will understand how they can change their attention to encourage children’s positive behaviours rather than inadvertently rewarding negative child behaviours through ineffective parenting strategies.
  • More effective parenting strategies lead to short term improvements in children’s behaviour and reduced parenting stress.
  • In the longer term, children will be less likely to engage in antisocial behaviour, have an improved sense of self and perform better in school.
Intended outcomes

Supporting children's mental health and wellbeing
Preventing child maltreatment
Enhancing school achievement & employment
Preventing crime, violence and antisocial behaviour
Preventing substance abuse
Preventing risky sexual behaviour & teen pregnancy
Preventing obesity and promoting healthy physical development

Contact details

John Sharry
Parents Plus Charity
[email protected]

www.parentsplus.ie

Parents Plus Adolescent Programme

About the evidence

Parents Plus Adolescents’ most rigorous evidence comes from an RCT which was conducted in Ireland. This study (level 2+) identified statistically significant positive impact on a number of child and parent outcomes.

A programme receives the same rating as it's most robust study. This programme is underpinned by one study with a level 2+, hence the programme receives a level 2+ rating overall.

Study 1

Citation: Nitsch et al. (2015)
Design: RCT
Country: Ireland
Sample: 126 parents, with children between 10-16 (mean age 12.3)
Timing: Post-test
Child outcomes: Reduced emotional symptoms
Improved total child behaviour
Reduced conduct problems
Reduced peer problems
Improved pro-social behaviour
Other outcomes: Improved parenting stress
Improved satisfaction with parenting
Study rating: 2+

Nitsch, E., Hannon, G., Rickard, E., Houghton, S., & Sharry, J. (2015). Positive parenting: a randomised controlled trial evaluation of the Parents Plus Adolescent Programme in schools. Child and adolescent psychiatry and mental health, 9(1), 43.

Available at
https://capmh.biomedcentral.com

Study design and sample

The first study is an RCT. 

This study involved random assignment of children to a Parents Plus Adolescent group and a wait-list control group. 

This study was conducted in Ireland, with a sample of children who were between 10 and 16 (mean age 12.3); parents self-referred on the basis of concern for child’s behaviour.

Measures

Assessments were conducted at pre-test, post-test, and at a 6-month follow-up (though the control group was not followed-up at this 6-month point). Child behaviour (including emotional problems; conduct problems; hyperactivity; peer problems and prosocial behaviour) was measured using the Strengths and Difficulties Questionnaire (SDQ) ( parent report).  Parenting stress was measured using the Parenting Stress Index ( parent report). Satisfaction with parenting was measured using the Kansas Parenting Satisfaction Scale ( parent report).

Findings

At post-test, this study identified statistically significant positive impact on a number of child and parent outcomes. This includes the Strengths and Difficulties Questionnaire, the Parenting Stress Index and the Kansas Parenting Satisfaction Scale.

The conclusions that can be drawn from this study are limited by methodological issues pertaining to a lack of intention-to-treat analysis and a lack of clarity over the extent to which attrition may have undermined the equivalence of groups, hence why a higher rating is not achieved.

More Less about study 1

Other studies

The following studies were identified for this programme but did not count towards the programme's overall evidence rating. A programme receives the same rating as its most robust study or studies.

Beattie, D., O’Donohoe, P., Guerin, S., & Fitzpatrick, C. (2011). An evaluation of a parent management training program as a treatment for adolescents attending a child and adolescent mental health service. Dublin, Ireland: School of Psychology, University College Dublin (unpublished manuscript) - This reference refers to a study, conducted in Ireland.

Wynne, C., Doyle, C., Kenny, R., Brosnan, E., & Sharry, J. (2016). A first-level evaluation of a family intervention for adolescent social, emotional and behavioural difficulties in Child and Adolescent Mental Health Services. Journal of Child & Adolescent Mental Health, 28(1), 33-46 - This reference refers to a quasi-experimental design, conducted in Ireland.

Rickard, E., Brosnan, E., O’Laoide, A., Wynne, C., Keane, M., McCormack, M. et al. (2015). A first-level evaluation of a schools-based family program for adolescent social, emotional and behavioural difficulties: Child Psychology and Psychiatry - This reference refers to a pre-post study, conducted in Ireland.

Carr, A., Hartnett, D., Brosnan, E., & Sharry, J. (2017). Parents Plus Systemic, Solution‐Focused Parent Training Programs: Description, Review of the Evidence Base, and Meta‐Analysis. Family process, 56(3), 652-668 - This reference refers to a meta-analysis.

Published March 2024