Home and community based parenting support programmes and interventions: report of Workpackage 2 of the DataPrev project

The last decade has witnessed an increasing interest in the promotion of mental health and wellbeing because of its importance for health and social functioning at the individual level and for the social and economic wellbeing of societies. Recent research from a range of disciplines has highlighted the importance of the quality of the parent-child relationships and parenting on children‟s emotional and social development, and on adult mental health and wellbeing. Intervention studies involving children of all age groups have shown that if parenting can be influenced for the better outcomes can be changed. The DataPrev project was funded by the 6th Framework of the European Community Research Programme under Policy-Orientated Research with the aim of establishing a database of evidence-based programmes in Europe that promote mental health and wellbeing and prevent mental illness throughout the life course. This is the report of the Workpackage 2 describing the international evidence base on programmes to support parenting, including home and community based programmes

Children's Reintegration: Strategies to Ensure the Sustainable Reintegration of Children Without Parental Care - JUCONI, Mexico

This paper reports on the Mexican arm of Family for Every Child's three-country study on strategies to ensure the sustainable reintegration of children without parental care. It set out to address the question: "What are successful elements in strategies to ensure the sustainable reintegration of children without parental care?", as identified from a 15-month study on work on family reintegration with boys who have lived on the streets (or been at identifiably high risk of doing so), and their families, in Puebla, Mexico. The study shows that satisfying family reintegration is possible even for boys who have had histories of violence and loss in the context of social exclusion, and in families with transgenerational failures of attachment. However, the 'elements' of successful reintegration cannot be introduced without understanding JUCONI's theoretical foundation. A key recommendation of this study for organisations that work with comparable populations is to explore this foundation, since it could enable them to adapt and develop strategies that are appropriate to their own context

Systematic review of interventions for the secondary prevention and treatment of emotional abuse of children by primary carers

Background Emotional abuse (or psychological maltreatment, as it is more commonly called in the US) is an inadequately researched and poorly understood concept, despite increasing awareness about the harm it can cause to children‟s lives. Although it unifies and underpins all types of maltreatment it also occurs alone and when it does, tends to elude detection and intervention. There have to date been no systematic reviews of the literature on the secondary prevention and treatment involving the parents or primary carers of emotionally abused children. Objective The objective of the review was to identify studies that evaluate the effectiveness of interventions in the secondary prevention and treatment of child emotional abuse involving the parents or primary carers of children aged 0 – 19 years. Methods Studies were included if they involved any intervention which was directed at emotionally abusive parenting and that measured change in (i) emotional unavailability (ii) negative attributions (i.e. that involve the parent attributing negative intentions, beliefs or attitudes toward the child); (iii) developmentally inappropriate interactions; (iv) lack of recognition of children‟s boundaries; (v) inconsistency of parenting role; (vi) missocialisation or consistent failure to promote the child‟s social adaptation. The primary outcomes evaluated involved proxy measures of a range of parent, family and child outcomes including parental psychopathology, parenting attitudes and practices, family functioning and/or child behaviour and the child‟s development and adaptation. . A broad search strategy was developed in order to identify as many relevant studies as possible. An electronic search of a wide range of databases was carried about. No study type was excluded. The search was augmented by direct contact with academics and practitioners known in this field. The search included studies written in English, Spanish, French and German. Studies were included if the intervention was described, and the impact on at least one indicator of emotional abuse was assessed. Included studies were critically appraised by two reviewers using standard criteria. Data were extracted using a standard proforma, and a qualitative synthesis of results was carried out. Results The initial search yielded 4248 publications of potential interest. Of these, 175 were obtained for possible inclusion or as background material. A total of 21 studies of 18 interventions, met all the inclusion criteria. A further 43 studies were relevant, but did not meet all of the inclusion criteria. Studies were organised according to the type of emotional abuse targeted: emotionally abusive parenting; parents of infants with faltering growth; missocialisation: parenting interventions with substance-abusing mothers. Twelve included studies had quantitative designs. Of these, 6 comprised randomised controlled trials; 1 comprised a follow-up of a randomised controlled trial; 2 were controlled studies; and 3 had one-group pre- and post-designs. The remaining 9 were case studies. Included studies involved a wide range of interventions. The 8 studies for parents which address emotionally abusive parenting (rejection, misattribution, parent-child role reversal and anger management) involved evaluations of cognitive-behavioural training (CBT), behavioural training and parent-infant psychotherapy. Two further case studies involved cognitive-behavioural training, mentalisation and family-based therapy. The 9 interventions with parents of infants with faltering growth evaluated CBT, behavioural training, parent infant psychotherapy and interaction guidance; lay home visitors, and a range of therapeutic options based on the diagnostic condition of the parents. The 3 studies of interventions for substance abusing mothers evaluated a relational psychotherapy group for mothers, and a residential treatment for substance abuse with a parenting component. The sample sizes for quantitative studies were small and ranged from 17 to 98 participants. Ten interventions involved mothers alone, while a further 11 included fathers, either at the outset or at a later stage, and in 3 cases extended family members. Interventions for emotionally abusing parents The findings from the 8 included studies evaluating CBT, psychotherapy, and behavioural approaches suggest that group-based CBT may be an effective means of intervening with this group of parents, although it cannot currently be recommended with parents experiencing symptoms of severe psychopathology. While one comparative study showed a psychotherapeutic intervention to be more effective than a CBT focused intervention, the outcomes measured in this study (i.e. parent and child representations) favoured the former. Behavioural case work involving the use of problem-solving techniques may also have a role to play with some parents, although further research is still needed. Interventions to enhance parental sensitivity The findings from a systematic review of 81 interventions that aimed at enhancing parental sensitivity and / or infant attachment found strong evidence that short term (less than 16 sessions) interventions, with a behavioural focus and aimed exclusively at enhancing maternal sensitivity were also most effective in enhancing infant attachment security. This supports the notion of a causal role of sensitivity in shaping attachment. Interventions that included fathers as well as mothers showed higher effect sizes but results are tentative since they are based on a small number of small scale trials. Parental behaviours associated with faltering growth Nine studies evaluated a range of interventions with parents of babies with faltering growth including interaction guidance, home visiting; parent-child psychotherapy, behavioural casework and multi-component interventions. The findings show that interaction guidance and parent-infant psychotherapy may be potentially effective means of working with this group of clients along with behavioural casework, but that further research is needed before these can be recommended. Missocialisation: Parenting interventions for substance-abusing parents 5 studies (one of which was a 6-month follow-up) evaluated interventions for substance abusing mothers, including a relational psychotherapy group and a residential treatment for substance abusing adults with a parenting component. The findings show that initial gains made in the former were not sustained at 6-months and few benefits from residential intervention. Conclusions Emotional abuse is a complex issue resulting in part from learned behaviours, psychopathology and/or unmet emotional needs in the parents, and often compounded by factors in the families‟ immediate and wider social environment. As such, a „one-approach-fits-all‟ is unlikely to lead to sustained change. The evidence base is weak, but suggests that some caregivers respond well to cognitive behavioural therapy. However, the characteristics that define these parents are not clear. There is currently no evidence to support the use of this intervention alone in the treatment of severely emotionally abusive parents. Some of the evidence suggests that a certain form of emotional abuse (for example, highly negative parent affect, which may be expressed as frightened and frightening behaviours in the parent) stemming from unresolved trauma and loss, is less amenable to CBT. There is some evidence that interaction guidance and psychotherapeutic approaches can generate change in parents with more severe psychopathology. Further research is urgently needed to evaluate the benefits of both psychotherapeutic and cognitive behavioural interventions, including those which take the form of family therapy, with parents at the more severe end of the spectrum, with fathers, and with older children. There is also a need to gain further understanding about which forms of emotional abuse respond best to different treatments

Safeguarding children from emotional maltreatment: what works

Emotional maltreatment is widespread and has a profoundly harmful effect on a child's development. The effects of abuse are often carried into adulthood, and emotionally abused children are more likely to experience a range of problems as adults including depression, substance misuse and eating disorders. This book sets out to identify 'what works' in preventing emotional maltreatment from recurring. Since most emotional maltreatment takes place within the family home, involves the primary care-giver and reflects ongoing patterns of damaging parent-child interaction rather than isolated incidents, interventions directly targeting parent-child interactions are highlighted. The authors explore the available treatments, identifying which approaches work, who they work with and the limitations of each. Conclusions and recommendations based on the key findings are presented, including implications for practice and over-arching issues to be addressed. Safeguarding Children from Emotional Maltreatment is essential reading for all practitioners working in the field of emotional abuse and neglect, including social workers, health visitors, community paediatricians and psychologists

The United Nations Convention on the rights of the child and HIV/AIDS

The development of the human rights framework in place today can be charted back to the creation of the United Nations (UN) following the Second World War. The system of treaties gives formal recognition to certain rights for all human beings that states have a duty to uphold and protect. Children fall within the bounds of all human rights treaties but, because of their unique biological, economic and social dependency, children need extra care and protection and these are enshrined in the UN Convention on the Rights of the Child (UNCRC)

Safeguarding children from emotional abuse: what works?

Emotional maltreatment (or psychological maltreatment, as it is more commonly called in the US) is an inadequately researched and poorly understood concept, despite increasing awareness about the harm it can cause to children’s lives. This review of the literature summarises the evidence about what works to prevent child emotional maltreatment before if occurs and also to prevent its recurrence (i.e. once it has taken place), and focuses on the parents or primary carers of children aged 0-19 years

Systematic review of interventions to promote mental wellbeing in primary schools

This report is a systematic review of the published literature on the effectiveness of school based interventions that aim to promote mental wellbeing amongst children in primary education and that both take a universal approach and are primarily focussed on the prevention of violence or bullying. It reports data from 17 studies outside the United Kingdom. The following definitions of mental wellbeing, bullying and violence are used: •Mental wellbeing encompasses emotional, psychological and social wellbeing •Bullying is a form of aggression in which one or more children repeatedly and intentionally intimidate, harass or physically harm a victim who cannot easily defend him or herself •Violence is an act of aggression directed to another person or persons, or to property. It covers individual acts such as homicide and infliction of non-fatal injury. It may include the carrying of weapons. It usually implies physical aggressio

The role of non-formal education interventions in getting out-of-school children back into the formal education system; A mixed-methods systematic review on effectiveness, barriers and facilitators.

This is a protocol for a mixed method systematic review looking at effectiveness, barriers and facilitators of non-formal education interventions in reintegrating or transitioning out-of-school children into the formal education system in low-middle-income countries. <div><br><div>PLEASE NOTE: This protocol is based on the PROSPERO template as it was initially sent to PROSPERO but <u>was rejected since it did not include health related outcomes</u>. </div></div