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What is the Parents as Partners programme?

The Parents as Partners (PAP) Programme is an evaluated, group work programme for parents who are struggling with conflict and stress in their parenting and relationships. This transformative programme, funded by the Department for Work and Pensions and operated in the UK by the Tavistock Centre for Couple Relationships with support from Family Action, is designed to support couples as they resolve relationship issues that affect their ability to parent their children effectively. Despite a strong evidence base in support of the pivotal role of high quality, positive couple relationships in a range of outcomes for the whole family, very few family interventions include a focus on the couple relationship, and fewer still are designed for both mothers and fathers to attend together.

The PAP programme is based on the pioneering work of Professors Philip and Carolyn Cowan in the US (Cowan et al., 2005; Cowan et al., 2009; Cowan et al., 2011). Conducting longitudinal studies with families for over a decade, the Cowans have consistently demonstrated the value of including couple-focused content in preventative interventions to enhance children’s wellbeing.

Here, under the guidance of the Cowans, we have adapted their successful Supporting Father Involvement (SFI) model for delivery to parents in the UK. Long term evaluation of the SFI programme with low-income Mexican American and European American families has shown that parents who attended couples’ groups reported sustained improvements in terms of fathers’ engagement and children’s problems, as well as stable levels of relationship satisfaction and a decline in parenting stress over a period of 18 months (Cowan et al., 2009). Longitudinal outcomes from the Cowan’s programmes point to the added and lasting value of including couple relationship content in family interventions, and highlight the importance of involving both parents in interventions aimed at strengthening families and relationships.

Who attended the first Parents as Partners programme groups in London?

Questionnaire data collected before the start of group sessions indicate that parents attending the Parents as Partners groups represent a vulnerable population; in addition to experiencing relatively poor quality relationships (as rated on the Quality of Marriage Index), and high levels of conflict, half of all parents (50.7%) report clinically relevant levels of psychological distress (as measured by CORE), while two thirds (66.3%) were measured to be clinically depressed;  almost half (48%) report clinical levels of stress in relation to parenting.

Furthermore, over a third (34.0%) obtained scores on the Brief Child Abuse Potential Inventory sufficient to be considered ‘at risk’ of engaging in future abusive behaviour, while 35.3% also reported levels of child emotional and behaviour difficulties above that which would be expected in the general population (using the Strengths and Difficulties questionnaire).

What are the early outcome findings from the first Parents as Partners programme groups in London?

Data collected from 90 parents (45 couples) at the end of group sessions (that is, after 16 weeks) indicate promising improvements on a number of indices, as set out below.

Parents’ psychological distress

Reductions were found in overall psychological distress for mothers and fathers, and this was statistically significantly for mothers (B= -2.44, SE= .58, z= -4.24, p<. 001). Indeed, almost half (48.5%) of parents were no longer 'clinical cases' when the groups had ended; while of those displaying clinical levels of depression at Time 1, over a third (36.8%) were no longer when the groups had ended (as measured by the Beck Depression Inventory)

Furthermore, fathers reported reductions in some specific areas of psychological distress, for example in relation to alleviation of tension and anxiety/reduced pre-occupation with anxieties.

Parenting Stress

Parenting stress was reduced both for mothers and fathers,  and this was statistically significantly  for mothers (B= -7.94, SE= 2.59, z= -3.06, p<. 01). Of the 48% who were reporting clinically relevant levels of stress at the start of the programme, 40% were reporting sub-clinical levels after the end of group sessions.

Parents’ relationship quality

Both mothers and father reported improvements in the quality of their relationship after attending the programme (B= 3.31, SE= .73, z= 4.52, p<. 0001).

This is noteworthy given the well-documented decline in couple relationship quality over time (Hirschberger, 2009). Indeed, even the originators of the PAP programme were only able to maintain the initial level of couple relationship quality, making this an exceptionally good outcome.

Couple Communication

Reductions were found in the overall amount of conflict for mothers and fathers  and these were, again, statistically significantly  for mothers (B= -8.57, SE= 2.62, z= -3.27, p<. 001). ‘Conflict’ covered a range of topics, including disagreements about money, the children, and time spent together.

Both mothers and fathers reported a significant decrease in violent problem solving (B= -1.48, SE= .22, z= -6.47, p<. 0001) and mothers reported a decrease in the overall amount of conflict with their partner.

Brief Child Abuse Potential Inventory

Both mothers and fathers reported decrease in BCAP scores,  with the reduction being statistically significant for mothers (B= -1.70, SE= .49, z= -3.46, p<. 001). Of those parents considered ‘at risk’ based on their responses to the BCAP before the start of group sessions, 31.0% were no longer considered at risk after completing group sessions.

Children’s outcomes

Significant reductions were found for both mothers and fathers on the Strengths and Difficulties Questionnaire (in which parents are asked to rate how their children are faring in terms of emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behaviour) (B= 2.11, SE= .71, z= -2.96, p<. 01). The proportion of children with emotional and behavioural difficulties considered to be within the 'abnormal' range (as reported by their parents on the SDQ) fell from 35.9% to 18.1% after the end of group sessions.

Employment

Of those unemployed at the first point at which data was collected (13), 53.9% were in full- or part-time employment by the end of the programme.

Benefits

Of those receiving benefits at the first point at which data was collected (8), 42.9% were no longer after having completed the programme/group sessions

Further follow-up

The findings summarised above are very encouraging and replicate the findings of previous longitudinal studies that have included control groups.

We are currently collecting follow-up data from parents, 6 months after their last group session. These findings will be reported in due course. 

References

Cowan, P. A., Cowan, C. P., Ablow, J., Johnson, V., & Measelle, J. (Eds.). (2005). The Family Context of Parenting in Children's Adaptation to School. Mahwah, NJ: Lawrence Erlbaum Associates.

Cowan, P. A. & Cowan, C. P. (2002). Interventions as tests of family systems theories: Marital and family relationships in children’s development and psychopathology. Development and Psychopathology, 14, 731-759.

Cowan, P. A., Cowan, C. P., Pruett, M., Pruett, K., and Wong, J.J. (2009). Promoting fathers’ engagement with children: Preventive interventions for low-income families. Journal of Marriage and Family, 71(3), 663-679.

Hirschberger, G., Srivastava, S., Marsh, P., Cowan, P. A., & Cowan, C. P. (2009). Married with children: Attachment, marital satisfaction, and divorce in the first fifteen years of parenthood. Personal Relationships, 16, 401-420.