Preventing child maltreatment through parenting ...

5 downloads 1350 Views 207KB Size Report
Nov 28, 2011 - http://www.tandfonline.com/loi/pedp20. Preventing child maltreatment through parenting programmes implemented at the local social services ...

This article was downloaded by: [University of La Laguna Vicerrectorado] On: 12 April 2012, At: 03:25 Publisher: Psychology Press Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK

European Journal of Developmental Psychology Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/pedp20

Preventing child maltreatment through parenting programmes implemented at the local social services level a

a

María José Rodrigo , Sonia Byrne & Míriam Álvarez

a

a

Department of Psychology, University of La Laguna, La Laguna, Spain Available online: 28 Nov 2011

To cite this article: María José Rodrigo, Sonia Byrne & Míriam Álvarez (2012): Preventing child maltreatment through parenting programmes implemented at the local social services level, European Journal of Developmental Psychology, 9:1, 89-103 To link to this article: http://dx.doi.org/10.1080/17405629.2011.607340

PLEASE SCROLL DOWN FOR ARTICLE Full terms and conditions of use: http://www.tandfonline.com/page/termsand-conditions This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sublicensing, systematic supply, or distribution in any form to anyone is expressly forbidden. The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae, and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand, or costs or damages

Downloaded by [University of La Laguna Vicerrectorado] at 03:25 12 April 2012

whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material.

EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2012, 9 (1), 89–103

Downloaded by [University of La Laguna Vicerrectorado] at 03:25 12 April 2012

Preventing child maltreatment through parenting programmes implemented at the local social services level Marı´ a Jose´ Rodrigo, Sonia Byrne, and Mı´ riam A´lvarez Department of Psychology, University of La Laguna, La Laguna, Spain In the area of child maltreatment prevention, there is still a limited use of evidence-based parenting programmes based on the concept of positive parenting and devoted to the strengthening and empowering of at-risk families and children in the context of families–services partnerships. The aim of this paper is to examine how group-based programmes for parents of at-risk families can best be implemented and evaluated at the local social services level, as a sustained psycho-educational resource for the prevention of child maltreatment. To this end, and after reviewing some evidence of the effect of these programmes on family outcomes, we address the conditions under which these programmes might be successfully integrated into the family preservation services delivered at the local level. The implementation and evaluation of some of these programmes in Spain are used to illustrate the strategy of incorporation followed. Finally, we provide preliminary evidence of the impact of one of these programmes on professional development as one of the key factors in facilitating the sustainability of the programmes. Keywords: Child maltreatment prevention; Evidence-based parenting programmes; Evaluation and sustainability of the programmes; Implementation; Professional development.

Correspondence should be addressed to Marı´ a J. Rodrigo, Departamento de Psicologı´ a Evolutiva y de la Educacio´n, Facultad de Psicologı´ a, Universidad de La Laguna, Campus de Guajara, s/n. 38071. La Laguna, Spain. E-mail: [email protected] The implementation and evaluation of the parenting programmes for at-risk parents, was supported by the Spanish Ministry of Science and Innovation (TRA2009_0145), Community of Castile & Leo´n and the municipalities of this region. ! 2012 Psychology Press, an imprint of the Taylor & Francis Group, an Informa business http://www.psypress.com/edp

http://dx.doi.org/10.1080/17405629.2011.607340

90

RODRIGO, BYRNE, A´LVAREZ

A well-known definition describes child maltreatment as: All forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power.

Downloaded by [University of La Laguna Vicerrectorado] at 03:25 12 April 2012

(World Health Organization, 1999)

Child maltreatment is a serious public health problem with extensive shortand long-term health consequences (US Department of Health and Human Services, 2008). In addition to the immediate physical and emotional effects of maltreatment, children who have experienced abuse and neglect are at increased risk of adverse health outcomes and risky health behaviours in adolescence and adulthood, such as alcoholism, drug abuse, depression, smoking, multiple sexual partners, suicide, and chronic disease (Gilbert et al., 2008; Springer, Sheridan, Kuo, & Carnes, 2007). The frequency of the problem and the seriousness of its consequences have led to growing concern about the importance of taking preventive actions to reduce it (World Health Organization; WHO, & International Society for Prevention of Child Abuse and Neglect; ISPCAN, 2006). There is a great need for prevention strategies that go beyond the early identification of cases of child maltreatment and intervention to protect the children involved. To stop abuse and neglect before they occur, policy and programme measures addressing risk and protective factors need to be implemented. Among the policy measures, there is a need to improve the delivery of effective child protection services to increase the chances of preserving the unity of the family living under at-risk circumstances, thereby avoiding removal of the minor from the family home. Among the programme measures, it is essential that effective prevention programmes be developed that target such at-risk populations according to the current standards of prevention intervention (Flay et al., 2005). Whether these interventions are targeted at individuals, groups or entire communities, they need to be evaluated to determine their effectiveness. The aim of this paper is to examine how group-based programmes for parents of at-risk families can best be implemented at the local social services level as a sustained psycho-educational resource for the prevention of child maltreatment. To this end, we first review evidence-based parent education programmes for at-risk families. Then, we address the conditions under which these programmes might be successfully integrated into the family preservation services delivered at the local level, based on the Spanish experience. Finally, we provide preliminary evidence of the impact of one of these Spanish programmes on professional development, to illustrate one of the key factors in facilitating the sustainability of the programmes.

PREVENTING CHILD MALTREATMENT

91

Downloaded by [University of La Laguna Vicerrectorado] at 03:25 12 April 2012

EVIDENCE-BASED PARENT EDUCATION PROGRAMMES FOR AT-RISK FAMILIES Taking a preventive stance to child maltreatment involves a profound shift in the way we view at-risk families. Simply characterizing these families as ‘‘dysfunctional’’, ‘‘disorganized’’, or ‘‘multi-problematic’’ does not help in the design of preventive actions. Families should be placed, instead, along a continuum of risk and protective factors that enable them to perform the parenting task more or less adequately according to the balance achieved among these factors (Rodrigo, Ma´iquez, Martı´ n, & Byrne, 2008). Interventions should be directed at diminishing the impact of the risk factors and promoting the protective factors present in the family, the neighbourhood, the larger social structure, and the economic, political, and cultural environment (Stith et al., 2009; WHO & ISPCAN, 2006). Therefore, there is a need to abandon the deficit perspective and move toward a strengthening approach that identifies parents’ existing skills and strengths and builds on these (Kumpfer & Alvarado, 2003). In the same spirit, the positive parenting initiative launched by the Council of Europe, Rec(2006)19 on Policy to Support Positive Parenting (Committee of Ministers of the Council of Europe, 2006), involves a focus on the empowerment of parents and vulnerable families in the context of families–services partnerships (Rodrigo, 2010). Here, positive parenting has been defined as parental behaviour ensuring the fulfilment of the best interests of the child ‘‘that is nurturing, empowering, non-violent and provides recognition and guidance which involves the setting of boundaries to enable the full development of the child’’. Under this positive approach, it is recognized that the parenting task needs social support to be adequately performed. This is especially crucial for families experiencing negative psychosocial conditions (e.g., marital violence, low educational background, poverty, lack of social support, substance abuse). Therefore, the positive parenting initiative recommends the use of parenting programmes as an important source of social support to promote parents’ capabilities to raise children under these circumstances. Research into the efficacy of programmes involving at-risk families has shown that, for the most part, parenting programmes that incorporate a strengths-based approach and are based on psycho-educational and cognitive-behavioural strategies achieve more positive results than programmes that operate from a deficit perspective (Chaffin, Bonner, & Hill, 2001; MacLeod & Nelson, 2000). Among the parental outcomes promoted are an increase in the parents’ knowledge about child development and in positive discipline strategies, an increase in parents’ confidence in their capacities as parents, and the development of practical skills to deal with everyday stressors (Johnson et al., 2008). However, the evidence of the

Downloaded by [University of La Laguna Vicerrectorado] at 03:25 12 April 2012

92

RODRIGO, BYRNE, A´LVAREZ

effectiveness of these interventions remains limited, as very few of the parenting programmes applied to these families have empirical support or are evidence-based programmes (Barth et al., 2005; Webster-Stratton & Reid, 2010). In a review of community and centre-based parent education programmes targeting at-risk families, researchers identified improvements in knowledge of child development, more positive discipline, increased parenting self-efficacy, and reduced negative parenting perceptions (Holzer, Higgins, Bromfield, & Higgins, 2006). In another recent study using The Family Tree’s Positive Parenting Programme with at-risk families, five parenting-related protective factors (appropriate expectations of child development, view of corporal punishment, power and independence, appropriate family roles, and empathy toward the child) were enhanced and one risk factor (low self-esteem) was reduced following intervention (Woodruff & Young, 2009). In a pilot study of adaptation of the Incredible Years Programme to at-risk parents, a significant reduction was found for measures of parental stress (Webster-Stratton & Reid, 2010). These results are very promising, since protective factors against child maltreatment include the acquisition of more knowledge and skills related to parenting and child development (Berger & Brooks-Gunn, 2005; Connell-Carrick & Scannapieco, 2006) and more parental empathy and warmth (Shahar, 2001; Slack, Holl, McDaniel, Yoo, & Bolger, 2004). However, more comprehensive reviews of the characteristics of effective programmes for child maltreatment prevention are needed, especially in the European context, so as to provide guidelines to practitioners and inform the decisions made by policy makers (Rodrigo, 2010).

IMPLEMENTING PARENT EDUCATION PROGRAMMES AT THE LOCAL SOCIAL SERVICES LEVEL Knowing that a given programme works for the target population is an important step toward making informed decisions. However, the sustainable use of evidence-based programmes in the real world involves knowing how to implement them well (Fixsen, Naoom, Blase´, Friedman, & Wallace, 2005). There is a need to determine the field conditions that will assure the correct implementation of the programme (e.g., adequate training of professionals, procedures used to create groups, strategies applied to reduce attrition rates, human and material resources needed). Getting communities and practitioners to want the programme proves an equally important factor in ‘‘bringing the programme to scale’’ (McCall, 2009). In the following sections, we present some of the obstacles to the implementation process as well as a number of proposals to overcome them, building on examples from Spain.

Downloaded by [University of La Laguna Vicerrectorado] at 03:25 12 April 2012

PREVENTING CHILD MALTREATMENT

93

Child protection services in many European countries advocate the development of services (e.g., family preservation services) to prevent unnecessary foster-care placement of children from maltreating families or those at-risk of maltreatment. In fact, European Union (EU) Member States are devoting increased attention to parenting support policies and programmes through the introduction of a family support dimension to the provision of health and social services (ChildONEurope Secretariat, 2007). These programmes are usually provided by professionals and mostly delivered through community centres, which are considered an asset of family services. In the same vein, the existing network of basic and specialized social services in Spain offers a promising launch pad for family centred initiatives to prevent child maltreatment. In fact, most regional child protection agencies in Spain have embarked on the design of preventive actions at the local social services level, a reasonably well resourced, and systematically organized, sector engaged in the delivery of family services throughout the country. Group-based parenting programmes are the flagships of these initiatives. These programmes are conceived as community-based proactive interventions delivered by the municipal social services to provide the most focused and longest possible service, offered as close as possible to the home environment. Examples of such programmes include ‘‘Apoyo Personal y Familiar’’ (‘‘Personal and Family Support’’: 32 weekly group sessions for at-risk parents of children from 0 to adolescence) and ‘‘Crecer Felices en Familia’’ (‘‘Growing up Happily in the Family’’: 20 weekly group sessions for at-risk parents and their children aged 0–6). The content of these programmes is based on the approaches of attachment, parental cognition and child-rearing practices, parental and child agency, communication and conflicts, life transitions, family stress and social support. Given the participants’ low educational level and diverse cultural backgrounds, materials include vignettes, videos, case studies, guided fantasies, puzzles, games, and group discussions. An experiential methodology was designed that helps at-risk parents to verbalize their interpretations of a variety of family situations, enrich their interpretations with perspectivistic thinking, reflect upon the consequences of their actions on family life and reach compromises of change (Rodrigo, Correa, Ma´iquez, Martı´ n, & Rodrı´ guez, 2006; Rodrigo, Ma´iquez, Correa, Martı´ n, & Rodrı´ guez, 2006). Social services staff in each municipality (e.g., psychologists, social workers, social or family educators) are responsible for selecting the families to form the groups among those being referred to the social services for living under psychosocial risk conditions and having at least one minor at home. These groups also include families from the same neighbourhoods that have not been referred to the social services. In this way, a continuum of at-risk family situations is considered, instead of only focusing on high-risk

Downloaded by [University of La Laguna Vicerrectorado] at 03:25 12 April 2012

94

RODRIGO, BYRNE, A´LVAREZ

situations. The typical risk profile includes low-income parents exhibiting poor models of parenting, a lack of personal empowerment, inadequate life management skills, inconsistent and unresponsive parenting, punitive approaches to managing children’s behaviour or inadequate supervision of children and neglect of their basic needs. But families considered at-risk due to other circumstances (e.g., difficulties in establishing a work–life balance or a family breakdown resulting from an unpleasant divorce) can be found in any social, cultural and economic context. These families might also benefit from attending a parenting programme as a way to promote positive parenting and reduce the risk of child maltreatment. However, there are many obstacles, both professional and organizational, to introducing a parent education programme into social services (DePanfilis & Wilson, 1996; Rodrigo, Ma´iquez, & Martı´ n, 2010b; Webster-Stratton & Reid, 2010). The typical deficit view of at-risk families makes it more difficult for practitioners and families to identify strengths in these problematic contexts. For instance, little attention is paid to the family support system and the quality of the neighbourhoods, thus disregarding an important pillar for successful group intervention. On the other hand, parental risk factors for child maltreatment (such as mental health problems and drug or alcohol use) may exacerbate the difficulty of establishing a trusting and open dialogue with parents. It can also be difficult for practitioners to separate the roles of supporter and supervisor, showing a tendency to inadequately mix up the two. Finally, practitioners are more inclined to rely upon individual interventions (e.g., home visits or interviews), as they do not feel skilful enough to monitor groups. With regard to local policy makers or co-ordinators of social services, several obstacles to the adoption of group-based parent education programmes should be removed. First, local services need extra funding to implement these programmes, because they are lengthier and require specific training for the professionals involved. Second, there is the fear that structured, manual programmes may not be flexible enough to fulfil the many and changing needs of these families. Third, extremely high attrition rates might be expected, due to parents’ lack of motivation to attend the programmes or the sudden appearance of stressful life events, among other factors. Finally, and most importantly, since there is no tradition of sound evaluation, there is a lack of understanding of the extra effort required in getting the programme properly evaluated. This is a signal that the adoption of evidence-based orientation in practice settings is still a far-reaching outcome (Bellamy, Bledsoe, Mullen, Fang, & Manuel, 2008). To overcome these obstacles, we participated in a primary prevention action that consisted of promoting the notion of positive parenting among local social services across Spain. The Spanish Ministry of Health, Social Policy and Equality designed this action in partnership with the Spanish

Downloaded by [University of La Laguna Vicerrectorado] at 03:25 12 April 2012

PREVENTING CHILD MALTREATMENT

95

Federation of Provinces and Municipalities. Three documents were drafted to introduce practitioners and local family politicians to the basic principles of the European Recommendation on Policy to Support Positive Parenting (Rodrigo, Ma´iquez, & Martı´ n, 2010a, 2010b, 2011). The documents also included a set of guidelines to promote the exercise of parental responsibility at the municipal level, by describing services and programmes to create a healthy and supportive environment for families. Special emphasis was placed on parent education programmes as one of the psycho-educational resources available, establishing the conditions that should be met to successfully implement and evaluate these programmes. On-line courses and workshops were also organized to disseminate these materials. A second action taken was to establish a partnership scheme with those Spanish autonomous regions that decided to implement our programmes (Canary Islands, Castile and Leo´n, and Castile-La Mancha) at the local social services. Bringing a programme to large-scale implementation requires considerable joint efforts involving policy makers and officials, practitioners and co-ordinators, and researchers (Horwath & Morrison, 2007). Several measures were taken in this respect. A co-funding scheme with the local agencies and sectorial NGOs was elaborated to ensure sustained support for the project. We also negotiated specific funding for the performance of a rigorous implementation and evaluation of the programme while motivating and engaging practitioners in both processes (see Table 1 as an illustration of implementation conditions). It is known that organizational and professional factors can be the most significant obstacles to or enhancers of evidenced-based practices (Hodson, 2003). As for the evaluation, we recommended using a research design with a control group, providing evidence of short-term and sustained effects and a sizable preventive effect for child maltreatment (Barth et al., 2005; Johnson et al., 2008; WHO & ISPCAN, 2006). Finally, we promoted the co-ordination and integration of the programme into the network of existing social resources (e.g., ways of cross-referring families, combined use of resources) to ensure that the programme was well known and valued by other services and professionals.

TOWARDS THE SUSTAINABILITY OF PARENT EDUCATION PROGRAMMES AT THE LOCAL LEVEL As a result of the dual strategy described in the previous section, it has been possible to perform outcome and process evaluations over eight years, especially with the Personal and Family Support Programme (three community trials from 2001 to 2009). These yielded evidence of positive short-term changes in parental functioning and social support (Byrne, 2010; Rodrigo, Correa et al., 2006; Rodrigo, Ma´iquez et al., 2006). Attrition rates

96

RODRIGO, BYRNE, A´LVAREZ TABLE 1 Description of the best conditions for programme implementation at the social services level

Downloaded by [University of La Laguna Vicerrectorado] at 03:25 12 April 2012

Conditions for programme implementation . Have the programme officially supported, properly advertised through media and launched with a special event presenting the programme as an opportunity for all the families to improve parenting. . Perform a careful group selection and undertake prior home visit work to explore participants’ needs and to model their expectations. . Form mixed groups with various levels of risk, instead of only high-risk groups. . Assure programme fidelity by stating the core elements to be preserved across sites. . Ensure intensive training and continuity of the professionals and their full integration into the intervention team. . Provide practitioners with an on-line forum to exchange information with the research team and with other practitioners from different sites. . Practitioners to work in collaboration with parents, avoiding lecturing and dependency by creating a process of co-construction with emotional involvement. . Provide transport facilities, refreshments and parallel activities for children. . Arrange a set of cultural group activities to be offered as programme incentives and as a way to promote social integration. . Provide certificates of completion and hold a closing ceremony with media.

were kept at a low level across trials—around 22%—and the programme worked well also for at-risk parents. Parents’ support for simple and passive views about child development, such as nurturist and nativist beliefs and the reported use of permissive-neglect and coercive practices, significantly decreased after programme completion. The parents (mostly mothers) also reported an increased use of induction, that is, giving reasoning and explanations when disciplining the child. Concerning parental agency, these mothers felt more competent, had more internal control over their lives, showed more couple agreement, and perceived their maternal role as harder after the programme completion than at the beginning. Programme mothers, as compared to control mothers, reduced their support of nurturist views, perceived more self-efficacy, internal control, and role difficulty, and reported an increased use of reasoning. In the first two trials relatively small effect sizes (ES) were found for nurturism and nativism beliefs, couple agreement, permissive–negligent practices, and coercive practices. Medium ES were found for role difficulty and inductive practices. Large ES were found for perceptions of self-efficacy and internal control. However, larger ES for changes in child-rearing practices than for parental agency factors was obtained in the third trial (Byrne, 2010). There were also large ES for the increase in the use of and satisfaction with informal and formal support with respect to both the pre-test and the control group. Finally, over the eight years that the programme was evaluated, there were no reported cases

Downloaded by [University of La Laguna Vicerrectorado] at 03:25 12 April 2012

PREVENTING CHILD MALTREATMENT

97

of child maltreatment among the parents attending the programme, a result that is particularly important in the high-risk parents (20% of the total sample), who usually exhibited a rate of reported cases of child maltreatment of around 25%. This is an important programme outcome, as few studies directly examine the impact of parent training programmes on child safety in high-risk populations (Johnson et al., 2008). Showing positive results on parental functioning, social support and a reduction in subsequent child maltreatment is a good starting point for assuring the sustainability of these programmes in the social services. Sustainability refers here to the extent to which an intervention becomes institutionalized or part of routine organizational policies and practices of an agency (August, Bloomquist, Lee, Realmuto, & Hektner, 2006). However, local agents may also wish to know whether the programme has an impact on service outcomes when deciding on its continuity. Providing that regular funding is not a problem, an important factor for the sustainability of these group-based parent programmes is the positive attitude of the professionals towards the programme. In this sense, group facilitators and co-ordinators might vary in the extent to which they consider that the programme has brought about positive changes in their professional development. Some may feel that managing the groups represents an added burden to their existing workload, whereas others may find new ways to use the programme as a resource in planning their casework with families. Some may think that the programme changes the way the team sees its work with families, by placing a major emphasis on the prevention side instead of merely focusing on those families at a high-risk of dissolution. For instance, the programme may facilitate an increased professional surveillance of the family, leading either to the earlier detection of a problem or the prevention of such a problem arising in the first place. Changes in relationships with other professionals and in co-ordination with other services might also be areas of potential benefit for the professionals involved. In an attempt to study the long-term impact of the Personal and Family Support programme on professional development, in the last trial, a random selection of participants from among those who had finished the programme (representing around 20% of the total) was performed one year after its conclusion in 2009 (Byrne, 2010). The resulting group of 95 parents (42.7% at-risk), mostly mothers, had a socio-demographic profile that did not significantly differ from the original sample. The practitioners (25 in total) who managed the groups in which those parents participated were also contacted through their respective social services. External evaluators who were not aware of the family risk status and the programme results made observational measures at home and collected the practitioners’ self-reports on changes in professional development at the social services (only the

Downloaded by [University of La Laguna Vicerrectorado] at 03:25 12 April 2012

98

RODRIGO, BYRNE, A´LVAREZ

results on professionals will be reported here). A set of exploratory questions, rated on a 0–4 scale of agreement, was drafted, examining: (a) practitioners’ changes in their work with families (7 items, e.g., ‘‘discover new indicators of parental strengths’’); (b) teams’ or services’ changes in work with families (5 items, e.g., ‘‘Now the team distinguishes between different levels of psychosocial risk in the family’’); (c) co-ordination with other services (4 items, e.g., ‘‘The services exchange information about the participants of the programmes’’); and (d) relationship with professionals of other services (7 items, e.g., ‘‘Programme promotes meeting other professionals’’). Descriptive analyses showed that those professionals who acknowledged greater improvements were younger, had attended the training workshops, had worked with both only risk and mixed groups, and with both small and large groups. That means that early professional motivation and good training for the programme are important conditions for the positive long-term effects on professional development (Beidas & Kendall, 2010). On the other hand, being exposed to very demanding groups is also a source of professional knowledge. Heterogeneous groups, according to the experiential methodology, provide a rich variety of experiences for parents as well, generating a sociocultural environment where knowledge is co-constructed in a shared and negotiated way (Rodrigo et al., 2008). The practitioners’ gender also moderated the results on professional development. Men reported more benefits on the personal and interpersonal aspects (a and d), whereas women reported more benefits on organizational matters (b and c). That probably means that the learning process produced more changes in those areas in which they traditionally had less experience or were less skilful: the interpersonal world for men and the institutional world for women. To what extent was the long-term professional achievement related to the parents’ level of competence achieved in the groups? In a previous intervention study we demonstrated that a collaborative, and nondirective management of the group predicted the positive group changes at the end of the programme (Rodrigo, Correa et al., 2006). The role of the practitioner was especially relevant for reinforcing the mothers’ confidence in their own resources and for facilitating the change of child-rearing practices. If skilful practitioners got better group results, then we can expect that those professionals might be the ones that would achieve better professional development in the long run. To explore this hypothesis, in the last trial, the 95 parents mentioned above were classified into two groups according to their results at the end of the programme, using cluster analyses (Byrne, 2010): those with more favourable changes (43 parents showing partial and total positive changes to parental cognitions and practices as well as in parental agency) and those with less favourable or mixed results on the same outcomes (52 parents). A discriminant function analysis was carried out to

Downloaded by [University of La Laguna Vicerrectorado] at 03:25 12 April 2012

PREVENTING CHILD MALTREATMENT

99

determine the extent to which the changes in professional development reliably distinguished between the two groups. A significant discriminant function was obtained that helped to correctly classify 74.7% of the sample, after controlling for gender, age, and initial training. Results indicated that those parents with better programme results had worked with practitioners who showed a better profile of professional development one year on. These practitioners learned to discover new indicators of parental strengths, praise families for being less dependent on the professionals, show a better casework organization, create an informal support network among the practitioners, achieve better co-ordination between agencies, and show improvements in the use of community resources. More research is needed with a larger sample of professionals to fully demonstrate this proposed parallelism in the development of parental and professional competences.

CONCLUSIONS In this paper we have summarized some promising results of parenting programmes on parental outcomes to prevent child maltreatment, based on a strengths-based approach with at-risk families. We have argued that local social services are well positioned to develop prevention strategies for child maltreatment through the use of these programmes. The existence of basic and specialized teams of practitioners at this local level and the fact that the assistance is provided free of charge makes it possible for integrative work to be done across different levels of risk. In this sense, it is not a good strategy to develop a separate agenda for the prevention of child maltreatment and another for the more intensive treatment of families who already maltreat their children. Any child maltreatment prevention agenda should be developed as part of a global plan that also includes child protection. While it is important that high-risk or maltreating families receive appropriate treatment, it is also equally important to avoid the stigmatization and lack of social integration of these families. Therefore, the level of assistance provided to a family should be commensurate with the risk and capacity levels they exhibit. The higher the risks and the lower the capacities, the more assistance they should receive at individual, group and community levels. It is also true that at-risk families are heavily dependent on the quality of their neighbourhoods and the existence of cohesive and well-resourced environments to satisfy their many needs. Therefore, it is crucial for the services to involve agencies and community groups not traditionally considered to be connected with child maltreatment, but whose activities can have a significant impact on the wellbeing of the community at large. The real challenge is to create comprehensive and integrated systems that serve all families and empower communities (McCall, 2009).

Downloaded by [University of La Laguna Vicerrectorado] at 03:25 12 April 2012

100

RODRIGO, BYRNE, A´LVAREZ

A second important challenge is to continue promoting quality standards and good practices at the level of the local delivery system. In this sense, innovation and quality assurance are the key words to advance in this direction. As an important step we have presented the double strategy followed in Spain that consisted of the promotion of the notion of positive parenting among local social services across Spain and the implementation of parenting programmes in several regions. Moreover, we have presented preliminary evidence that the introduction of a parent education programme would provide opportunities for a change in how social services work with families and in their organizational culture. Beyond the professional’s satisfaction with the programme, there is a great amount of knowledge and skills to be acquired while working with families during the programme. For this reason, it is important to provide professionals with initial and followup training not only on the core principles, methodology, and evaluation of the programme, but also on how to implement it successfully and how to integrate it into their existing work plan. The adoption of a strength-based approach, the importance placed on collaborative work with families, the creation of effective connections with other agencies and services, and the building of a supportive network with other professionals are just some examples of the benefits that can be derived from the introduction of parenting programmes at the local services level. For instance, the building of social networks to support professionals provides them with opportunities to reflect upon their own practices while facilitating the transmission of good practices. Explaining the results of the programme evaluation to them and the changes that will be introduced is also a good way to enhance the culture of evidence-based practices. To conclude, it can be said that there is life beyond testing the impact of parenting programmes on family outcomes. There are practitioners running groups who can develop better careers in better organizational environments. There are opportunities to strengthen the links with other services and agencies to provide more co-ordinated support to at-risk families. And there is a community at large that can provide a caring and healthy environment for these vulnerable families. While it is true that programmes need a minimum of community capacity to thrive, it is also true that implementing effective programmes may empower communities to find their own ways of improvement. The challenge remains, however, for researchers to elaborate comprehensive accounts and methods to envision the whole process.

REFERENCES August, G. J., Bloomquist, M. L., Lee, S. S., Realmuto, G. M., & Hektner, J. M. (2006). Can evidence-based prevention programs be sustained in community practice settings? The Early Risers’ Advanced-Stage Effectiveness Trial. Prevention Science, 7, 151–165.

Downloaded by [University of La Laguna Vicerrectorado] at 03:25 12 April 2012

PREVENTING CHILD MALTREATMENT

101

Barth, R. P., Landsverk, J., Chamberlain, P., Reid, J. B., Rolls, J. A., Hurlburt, M. S., et al. (2005). Parent-training programs in child welfare services: Planning for a more evidencebased approach to serving biological parents. Research on Social Work Practice, 15, 353–371. Beidas, R. S., & Kendall, P. C. (2010). Training therapists in evidence-based practice: A critical review of studies from a systems-contextual perspective. Clinical Psychology: Science and Practice, 17, 1–30. Bellamy, J., Bledsoe, S. E., Mullen, E., Fang, L., & Manuel, J. (2008). Agency–university partnership for evidence-based practice in social work. Journal of Social Work Education, 44, 55–76. Berger, L. M., & Brooks-Gunn, J. (2005). Socioeconomic status, parenting knowledge and behaviors, and perceived maltreatment of young low-birth-weight children. Social Service Review, 79, 237–267. Byrne, S. (2010). Evaluation of the Personal and Family Support Program for families at psychosocial risk. Unpublished doctoral dissertation, University of La Laguna. Chaffin, M., Bonner, B. L., & Hill, R. F. (2001). Family preservation and family support programs: Child maltreatment outcomes across client risk levels and program types. Child Abuse & Neglect, 25, 1269–1289. ChildONEurope Secretariat (European Network of National Observatories on Childhood). (2007). Survey on the role of parents and the support from the Governments in the European Union. Florence, Italy: Instituto degli Innocenti. Committee of Ministers of the Council of Europe. (2006). Recommendation 19. (Available from: http://www.coe.int/t/dg3/youthfamily) Connell-Carrick, K., & Scannapieco, M. (2006). Ecological correlates of neglect in infants and toddlers. Journal of Interpersonal Violence, 21, 299–316. DePanfilis, D., & Wilson, C. (1996). Child protective services: Applying the strengths perceptive with maltreating families. APSAC Advisor, 9, 15–20. Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M., & Wallace, F. (2005). Implementation research: A synthesis of the literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network. Flay, B. R., Biglan, A., Boruch, R. F., Gonza´lez, F., Gottfredson, D., Kellam, S., et al. (2005). Standards of evidence: Criteria for efficacy, effectiveness and dissemination. Prevention Science, 6, 151–175. Gilbert, R., Widom, C. S., Browne, K., Fergusson, D., Webb, E., & Janson, S. (2008). Child maltreatment 1: Burden and consequences of child maltreatment in high-income countries. Lancet, 373, 68–81. Hodson, R. (2003). Leading the drive for evidence based practice in services for children and families: Summary report of a study conducted for research in practice. Dartington, UK: Research in Practice. (Available from:http://www.rip.org.uk/devmats/leadership.html) Holzer, P. J., Higgins, J. R., Bromfield, L. M., & Higgins, D. J. (2006). The effectiveness of parent education and home visiting child maltreatment prevention programs. Child Abuse Prevention Issues, 24. (Retrieved online 10 October 2008 from Australian Institute of Family studies at: http://www.aifs.gov.au/nch/pubs/issues/issues24/issues24.html) Horwath, J., & Morrison, T. (2007). Collaboration integration and change in children’s services: Critical issues and key ingredients. Child Abuse & Neglect, 31, 55–69. Johnson, M. A., Stone, S., Lou, C., Ling, J., Claassen, J., & Austin, M. J. (2008). Assessing parent education programs for families involved with child welfare services: Evidence and implications. Journal of Evidence-Based Social Work, 5, 191–236. Kumpfer, K. L., & Alvarado, R. (2003). Family strengthening approaches for the prevention of youth problem behaviors. American Psychologist, 58, 457–465.

Downloaded by [University of La Laguna Vicerrectorado] at 03:25 12 April 2012

102

RODRIGO, BYRNE, A´LVAREZ

MacLeod, J., & Nelson, G. (2000). Programs for the promotion of family wellness and the prevention of child maltreatment: A meta-analytic review. Child Abuse & Neglect, 24, 1127–1149. McCall, R. B. (2009). Evidence-based programming in the context of practice and policy. Social policy report, 23, 3–18. Rodrigo, M. J. (2010). Promoting positive parenting in Europe: New challenges for the European Society of Developmental Psychology. European Journal of Developmental Psychology, 7, 281–294. Rodrigo, M. J., Correa, A. D., Ma´iquez, M. L., Martı´ n, J. C., & Rodrı´ guez, G. (2006). Family preservation services on the Canary Islands: Predictors of the efficacy of a parenting program for families at-risk of social exclusion. European Psychologist, 11, 57–70. Rodrigo, M. J., Ma´iquez, M. L., Correa, A. D., Martı´ n, J. C., & Rodrı´ guez, G. (2006). Outcome evaluation of a community centre-based program for mothers at high psychosocial risk. Child Abuse & Neglect, 39, 1049–1064. Rodrigo, M. J., Ma´iquez, M. L., & Martı´ n, J. C. (2010a). La Educacio´n Parental como recurso psicoeducativo para promover la parentalidad positiva [Parental Education as a psychoeducational resource to promote positive parenting]. Madrid, Spain: Federacio´n Espan˜ola de Municipios y Provincias (FEMP). Rodrigo, M. J., Ma´iquez, M. L., & Martı´ n, J. C. (2010b). Parentalidad Positiva y Polı´ticas Locales de Apoyo a las familias. Orientaciones para favorecer el ejercicio de las responsabilidades parentales desde las corporaciones locales [Positive parenting and local policy to support families: Orientations to facilitate the exercise of parental responsibilities at the local services]. Madrid, Spain: Federacio´n Espan˜ola de Municipios y Provincias (FEMP). Rodrigo, M. J., Ma´iquez, M. L., & Martı´ n, J. C. (2011). Buenas pra´cticas profesionales para el apoyo de la parentalidad positiva [Good professional practices to support positive parenting]. Madrid, Spain: Federacio´n Espan˜ola de Municipios y Provincias (FEMP). Rodrigo, M. J., Ma´iquez, M. L., Martı´ n, J. C., & Byrne, S. (2008). Preservacio´n familiar. Un enfoque positivo para la intervencio´n con familias [Family preservation. A positive approach to family intervention]. Madrid, Spain: Pira´mide. Shahar, G. (2001). Maternal personality and distress as predictors of child neglect. Journal of Research in Personality, 35, 537–545. Slack, K. S., Holl, J. L., McDaniel, M., Yoo, J., & Bolger, K. (2004). Understanding the risks of child neglect: An exploration of poverty and parenting characteristics. Child Maltreatment, 9, 395–408. Springer, K. W., Sheridan, J., Kuo, D., & Carnes, M. (2007). Long-term physical and population-based sample of men and women. Child Abuse & Neglect, 31, 517–530. Stith, S. M., Liu, T. L., Davies, C., Boykin, E. L., Alder, M. C., Harris, J. M., et al. (2009). Risk factors in child maltreatment: A meta-analytic review of the literature. Aggression and Violent Behavior, 14, 13–29. US Department of Health and Human Services, Administration of Children, Youth and Families. (2008). Child Maltreatment 2006. Washington, DC: US Government Printing Office. Webster-Stratton, C., & Reid, M. J. (2010). Adapting the Incredible Years, an evidence-based parenting programme, for families involved in the child welfare system. Journal of Children Services, 5, 25–42. Woodruff, K., & Young, R. H. (2009). Evaluating outcomes for at-risk families participating in the Family Tree’s Positive Parenting Program: A retrospective study—Interim report. Community & School-based Research: Systematic Reviews. Center for Families and Children. University of Maryland, Baltimore. (Available from: http://hdl.handle.net/10713/ 274)

PREVENTING CHILD MALTREATMENT

103

Downloaded by [University of La Laguna Vicerrectorado] at 03:25 12 April 2012

World Health Organization; WHO. (1999). Child abuse prevention. Geneva, Switzerland: WHO Press. World Health Organization; WHO, & International Society for Prevention of Child Abuse and Neglect; ISPCAN. (2006). Preventing child maltreatment: A guide to taking action and generating evidence. Geneva, Switzerland: WHO Press.

Suggest Documents