Making communications land - Are they received and understood as intended? we...
The British Psychological Society
1. Technique Is Not Enough:
A framework for ensuring that
evidence-based parenting
programmes are socially
inclusive
A British Psychological Society
Professional Practice Board
Discussion Paper
Published 20 September 2012
Dr. Fabian A. Davis
Consultant Clinical Psychologist
BPS Social Inclusion Group Chair
Prof. Lynn McDonald,
Professor of Social Work Research at
Middlesex University
Dr. Nick Axford
Senior Researcher.
The Social Research Unit, Dartington
2. The context
• Some aspects of UK child wellbeing are very poor and worsening
• Positive parenting and good family life protects children from stress
• Evidence-based programmes work but reach few marginalised families
• To reach the most families, programmes must be socially inclusive
• There have been attempts to identify inclusion factors but few RCTs
• Need to identify practice-based evidence from evidence-based practice
www.bps.org.uk
3. The BPS approach
• Address child wellbeing and social inclusion “inclusively”
• Discover an inclusive perspective through “co-production”
• Exemplify socially inclusive practice and related outcomes
• Ask whether socially inclusive practice has “outcome value”?
• Concluded that “sustainable inclusion” requires many levels of
collaboration between programme
developers, services, commissioners, psychologists, parents and
communities www.bps.org.uk
4. Uses for the TINE framework
• Describes the issues at stake
• Guides the identification of socially inclusive practice
• Summarises the principles behind “social productivity”
• Enables innovative re-combinations of practice to be considered
• Promotes inclusive practice evaluation in all replications
• Supports the need for socially inclusive outcome measurement
www.bps.org.uk
5. TINE - meeting the challenge
• Created a process to enable professionals, practitioners and families
to agree on some mutually understood and agreed themes
• Surveyed the UNODC top 23 programmes for their inclusive practices
• Identified four principles underlying current socially inclusive practice
• These principles can assist in practice development, evaluative
research and rationalising the commissioning process
• Social inclusion factors should be included in ranking systems and
recommendations of evidence-based programmes to governments
www.bps.org.uk
6. The TINE framework
1. Maximise accessibility
2. Be culturally sensitive via co-production
3. Build social capital in the wider community
4. Design in sustainability from the outset
www.bps.org.uk
7. TINE Principle 1
Programmes should promote their accessibility by:
• Monitoring the retention and drop-out rates of all families especially
disadvantaged families
• Publishing and vigorously pursuing their best practices for
increasing the initial engagement and programme retention of
socially marginalised families
www.bps.org.uk
8. Accessibility examples - 20% to 80%
• Culturally congruent parent volunteer/programme graduate outreach
• “External” factors addressed by programmes themselves
• Partnering with schools, health, education and social care staff
• Running programmes when and where convenient for parents
• Using culturally congruent content
• Using local customs and social mores in practical learning sessions
• Empowering parent “graduates” and ethnic heritage matched trainers
• Learning “parenting principles” in an empowering social context
www.bps.org.uk
9. TINE principle 2
Programmes should be culturally sensitive to their participants by:
• Parents being equal partners in co-producing local programmes
• Staff and parent trainers being culturally representative role models
• Culturally adapting form and content whilst retaining core components
• Maintaining model fidelity and internal logic during local evolutions
• “Graduates” as recruiters, facilitators, teachers, trainers and evaluators
www.bps.org.uk
10. Sensitivity - co-production examples
• Genuinely adapted local replication - not simple duplication or cloning
• Scaling-up programmes whilst accounting for their cultural specificity
• Knowing & retaining what is universal and works in each programme
• Adapting the social forms of learning and culture dependant content
• Co-producing with parents enabling accurate cultural adaptations
• Co-production teams modelling lay & professional knowledge equality
• Social class congruity may be the most powerful factor in modelling
www.bps.org.uk
11. TINE Principle 3
Programmes should build social capital in their host communities by:
• Developing trust through peer support by programme participants
• Building mutuality of trust between participants & friends, extended
family and other sources of social capital in their local community
• Maximising naturalistic social supports for parent participants rather
than relying on traditional services, wherever possible
• Empowering participants to lead “booster” sessions and run on-going
local training, quality assurance and evaluation mechanisms
www.bps.org.uk
12. Building social capital - examples
• Enriching parent experience & social networks brings long-term gains
• Supporting reciprocal parent to parent relationships across families
• Integrating programmes into stable community institutions e.g. school
• Encouraging parent progression - participant to trainer to evaluator
• Sharing marketing and local development with empowered parents
• Local people acting as volunteers and programme champions
• Parent to parent networking to improve school atmosphere
• Networking local groups with same programme peers in other areas
www.bps.org.uk
13. TINE Principle 4
Programmes should create the conditions for long term sustainability by:
• Co-producing quality assurance systems to assess impact beyond
the home, in the classroom and in the wider community
• Creating a lasting context for sustaining the programme’s knowledge
and practice base by partnering with local professionals and families
• Taking account of and helping to meet the wider needs of the service
systems in which they aspire to become “services as usual”
• Developing supervision, guidance and support systems around
implementation that address services’ unique contextual needs
www.bps.org.uk
14. Sustainability - examples
• Scaling up – mixed picture: investment stops, staff leave, fidelity suffers
• However programmes are aspiring to become “services as usual”
• Providing manuals, marketing materials, training the trainers, supporting
adaptation, costings and fidelity checklists enable “system readiness”
• Congruity with local “system values” and local must-do’s are required
• External fidelity monitoring and evaluation support are crucial
• Sustainability plans, real capacity and staff buy-in are essential
• “Communities of Practice” working at multiple levels are developing
www.bps.org.uk
15. Technique Is Not Enough!
"Over the last ten or more years I have been caught in arguments between
two camps: one camp claiming that providing anything other than parenting
programmes evaluated using randomised control trial design and delivered
with fidelity is a waste of public money and bound to fail. The other camp
argues that unless programmes are co-designed with users themselves
and are sensitive to local differences and capitalise on the judgement of
those providing the programmes to adjust them according to local need
and circumstances, they are bound to fail. This paper presents a coherent
approach to bringing these two seemingly opposing positions together.“
p.5 Naomi Eisenstadt CB. May 2012
www.bps.org.uk
16. Debate and further activity
• Research is required that respects effectiveness and social inclusion outcomes
and which takes us beyond inclusion’s currently recognised “Process Value”.
• We need to know which inclusive practices have the greatest “Outcome Value”?
• Your continuing efforts can be drawn together by the TINE framework as we
wish to revisit our call for evidence again today and offer to publish an update.
• We are lobbying the UNODC and others to adopt social inclusion outcomes.
www.bps.org.uk
17. Contact & follow-up details
Dr Fabian Davis
Email: Fabian.davis@oxleas.nhs.uk
Website: www.developbromley.com
Electronic copies of the BPS paper “Technique Is Not Enough” can be obtained from:
www.bpsshop.org.uk and hard copies are in your conference packs.
Guardian Society section “second thoughts” article downloadable from:
www.guardian.co.uk/society/2012/sep/18/framework-for-parenting-programmes
Editor's Notes
Child wellbeing in the UK is the poorest in the industrialised world and worsening in the recessionShort term and long term intervention strategies are requiredUnderlying economic factors are significant contributors but raising income alone is insufficientPositive parenting and good quality of family life protects children from socio-economic stressEvidence based parenting and family skills training programmes work for families who attend but they reach very few familiesThere is great need - service gapParenting programmes are being promoted widely in the UKEvidence-based programmes have poor recruitment and retention rates but some do much betterIn order to reach the most families in need programmes must become more socially inclusiveTherefore the academic community must recognise inclusion rates and social inclusion practices as factors in ranking and recommending evidence-based programmes to governmentsThis means developing criteria for evidence-based parenting programmes that include social inclusion practiceThis is an emerging field with many hurdles to overcome and little RCT based analysis of inclusion practiceThere have been some helpful theoretical attempts to pin these down but no comprehensive framework existsTherefore we need to identify practice-based evidence from evidence-based programmesSo we surveyed the UNODC top 23 programmes and asked for their examples of inclusion practicesAs a result we have identified four principles behind the socially inclusive practices conducted by the currently most effective evidence-based parenting practitionersWe have made the theory-practice links and now recommend a number of principles that can be used to guide further practice development, evaluative research and local commissioning decisions
Child wellbeing in the UK is the poorest in the industrialised world and worsening in the recessionShort term and long term intervention strategies are requiredUnderlying economic factors are significant contributors but raising income alone is insufficientPositive parenting and good quality of family life protects children from socio-economic stressEvidence based parenting and family skills training programmes work for families who attend but they reach very few familiesThere is great need - service gapParenting programmes are being promoted widely in the UKEvidence-based programmes have poor recruitment and retention rates but some do much betterIn order to reach the most families in need programmes must become more socially inclusiveTherefore the academic community must recognise inclusion rates and social inclusion practices as factors in ranking and recommending evidence-based programmes to governmentsThis means developing criteria for evidence-based parenting programmes that include social inclusion practiceThis is an emerging field with many hurdles to overcome and little RCT based analysis of inclusion practiceThere have been some helpful theoretical attempts to pin these down but no comprehensive framework existsTherefore we need to identify practice-based evidence from evidence-based programmesSo we surveyed the UNODC top 23 programmes and asked for their examples of inclusion practicesAs a result we have identified four principles behind the socially inclusive practices conducted by the currently most effective evidence-based parenting practitionersWe have made the theory-practice links and now recommend a number of principles that can be used to guide further practice development, evaluative research and local commissioning decisions