FI Research Summary: Should parenting programmes engage with both parents?

11 October 2013

Is there added-value to parenting interventions from engaging with two parents rather than one? And if engagement is with one parent only, does it matter which parent is engaged with? Family systems theory would suggest that better outcomes may be achieved by engaging with the most powerful family member (Furrow, 2001). And where studies have investigated the efficacy of engaging with only the father, fathers have been found to be effective ‘change agents’ (Elder et al., 2011) and no less effective than mothers in implementing change (Adesso and Lipson, 1981, Cia et al., 2010). However, few studies have explored this.

 

Some studies have found that even where only one parent participates in the intervention, gains in family functioning are greater or maintained for longer when there is another parent in the home (Bagner and Eyberg, 2003, Hahlweg et al., 2010, Strain et al., 1981). Another-parent-in-the-home also seems to be protective against program drop-out (Bagner, 2013) Confounding variables may include socio-economic status and mental health deficits (Webster-Stratton and Hammond, 1990).

 

Is delivery more effective when both parents participate in the intervention? Anecdotal evidence has long suggested so. For example, in Turkey mothers enrolled in AÇEV’s internationally recognized Mother Support Program asked for a Father Support Program, reportiing that their husbands were ‘obstacles’ in supporting what women were learning to foster positive child development (Dogruöz and Rogow, 2009); and in the UK, a local evaluation of a Webster-Stratton programme found some mothers taking the view that the intervention would have been more effective if their partner had attended (Patterson et al., 2005). Among the indicators that predict failure for family interventions “lack of a supportive partner” has been found to be highly significant (Forgatch, 1989; Forehand et al., 1984).

 

Webster-Stratton (1985) explored the issue of engaging with two parents vs. one more systematically. She randomized but confounded two variables: father-participation in the program and father-presence in the home. Since then, a growing body of evidence suggests the efficacy of engaging with both parents rather than one. May et al. (2013) found better outcomes as have two meta-analyses: Lundahl et al. (2008) and Bakermans-Kranenburg et al. (2003). These both declared interventions delivered to both parents to be ‘significantly more effective’ than interventions delivered to mothers alone. However, numbers were small (for example, there were only 81 fathers across three studies in Bakermans-Kranenburg), and studies such as May et al. did not randomize. It has been suggested that any positive effects of couple-participation may have more to do with the nature of families in which both parents participate, than to joint participation per se.

 

However, three studies have randomized (Rienks et al., 2011, Besnard et al., 2009, Cowan et al., 2009) and all have found benefits from couple-participation. For example, Cowan et al. (2009), comparing outcomes between fathers attending alone and couples attending together (with a control), found improvements in both intervention groups, but greater improvements in a number of domains where couples had participated. Besnard et al. compared solo mother participation with couple participation (and a control) and found mothers’ parenting practices improved when both parents had participated in the intervention. Rienks et al. found improvements both in the parenting alliance and in father-child engagement at home, when fathers had participated in the intervention – whether with their partner or solo. By contrast, where mothers had attended solo, father-child-engagement subsequently declined (it remained neutral in the control group). The authors found ‘somewhat concerning’ their finding that what the women had learned ‘may not have been accurately transferred to partners’, given that ‘mothers are much more likely to participate in relationship education programs’.

 

References

ADESSO, V. J. & LIPSON, J. W. (1981). Group Training of Parents as Therapists for Their Children. Behavior Therapy, 12, 625-633.

BAGNER, D. M. (2013). Father’s role in parent training for children with developmental delay. J Fam Psychol, 27, 650-657.

BAGNER, D. M. & EYBERG, S. M. (2003). Father involvement in parent training: when does it matter? J Clin Child Adolesc Psychol, 32, 599-605.

BAKERMANS-KRANENBURG, M. J., VAN IJZENDOORN, M. H. & JUFFER, F. (2003). Less is more: Meta-analyses of sensitivity and attachment interventions in early childhood. Psychological Bulletin, 129, 195-215.

BESNARD, T., CAPUANO, F., VERLAAN, P., POULIN, F. & VITARO, F. (2009). Effet ajouté de la participation des pères à une intervention familiale (Added effect of the fathers’ participation in a family intervention). Revue de Psychoéducation, 38, 45-71.

CIA, F., BARHAM, E. J. & FONTAINE, A. M. G. V. (2010). Impacts of a Parent Intervention Program: Their Children’s Academic Achievement and Classroom Behavior. Psicologia-Reflexao E Critica, 23, 533-543.

DOGRUÖZ, D. & ROGOW, D. (2009). And how will you remember me, my child? Redefining fatherhood in Turkey. Quality/Calidad/Qualité (pp. 1-34). New York: The Population Council.

ELDER, J. H., DONALDSON, S. O., KAIRALLA, J., VALCANTE, G., BENDIXEN, R., FERDIG, R., SELF, E., WALKER, J., PALAU, C. & SERRANO, M. (2011). In-Home Training for Fathers of Children with Autism: A Follow up Study and Evaluation of Four Individual Training Components. Journal of Child and Family Studies, 20, 263-271.

FOREHAND, R., FUREY, W.M. & MCMAHON, R.J. (1984). The role of maternal

depression in a parent training program to modify child non-compliance. Behavioural Psychotherapy, 12: 93-108.

FORGATCH, M. S. (1989). Patterns and outcome in family problem solving: The disrupting effect of negative emotion. Journal of Marriage and the Family, 51(1): 15-24.

FURROW, J.L. (2001).Tools for the trade: clinical interventions with fathers in family therapy. In J. Fagan & A.J. Hawkins (Eds). Clinical and Educational Interventions with Fathers. New York: the Harworth Clinical Press

HAHLWEG, K., HEINRICHS, N., KUSCHEL, A., BERTRAM, H. & NAUMANN, S. (2010). Long-term outcome of a randomized controlled universal prevention trial through a positive parenting program: is it worth the effort? Child Adolesc Psychiatry Ment Health, 4, 14.

LUNDAHL, B. W., TOLLEFSON, D., RISSER, H. & LOVEJOY, M. C. (2008). A meta-analysis of father involvement in parent training. Research on Social Work Practice, 18, 97-106.

MAY, F. S., MCLEAN, L. A., ANDERSON, A., HUDSON, A., CAMERON, C. & MATTHEWS, J. (2013). Father participation with mothers in the Signposts program: an initial investigation. J Intellect Dev Disabil, 38, 39-47.

PALM, G. & FAGAN, J. (2008). Father involvement in early childhood programs: Review of the literature. Early Child Development and Care, 178, 745-759.

PANTER-BRICK, C. & LECKMAN, J. F. (2013). Editorial Commentary: Resilience in child development – interconnected pathways to wellbeing. Journal of Child Psychology and Psychiatry, 54, 333-336.

PATTERSON, J. MOCKFORD, C. & STEWART-BROWN, S. (2005). Parents’ perceptions of the value of the Webster-Stratton Parenting Programme: a qualitative study of a general practice based initiative. Child Care, Healthand Development, 31(1): 53-64.

RIENKS, S. L., WADSWORTH, M. E., MARKMAN, H. J., EINHORN, L. & ETTER, E. M. (2011). Father Involvement in Urban Low-Income Fathers: Baseline Associations and Changes Resulting From Preventive Intervention. Family Relations, 60, 191-204.

STRAIN, P.S., YOUNG, C.C., & HOROWITZ, J. (1981). An examination of child and family demographic variables related to generalized behavior change during oppositional child training. Behavior Modification, 5: 15-26.

WEBSTER-STRATTON, C. (1985). The effect of father involvement in parent training for conduct problem children. Journal of Child Psychiatry, 26, 801-810.

WEBSTER-STRATTON, C. & HAMMOND, M. (1990). Predictors of treatment outcome in parent training for families with conduct problem children. Behavior Therapy, 21: 319-337.

 

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