Parents as Partners Programme
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The Effectiveness of Couple Therapy
Our study shows improvments in relationships and mental health


A blog by Richard Meier (Tavistock Centre for Couple Relationships) and Rachel Tonkin (Family Lives)

TCCR and Family Lives were delighted to jointly host a policy roundtable last week on integrating approaches to parenting, couple relationships and mental health.

Senior officials from the Department for Work and Pensions and the Child Poverty Unit (responsible for drafting the forthcoming Life Chances Strategy) attended the event, chaired by Baroness Tyler, as did former Ministers Tim Loughton MP and Paul Burstow, and around twenty leaders from the voluntary sector.

In a key note speech in January, the Prime Minister signalled that he would like to see a renewed focus on parenting, with a view to improving the quality of parenting by all parents: “getting parenting and the early years right isn’t just about the hardest-to-reach families, frankly it’s about everyone”.

TCCR and Family Lives hosted the event in response to this announcement as a way of helping to shape the debate and thinking around how the major themes of the proposed Life Chances Strategy – parenting, mental health and relationships – could be better woven together to ensure that the strategy is as effective as possible at helping to improving outcomes for children.

The event opened with Susanna Abse, Chief Executive of the Tavistock Centre for Couple Relationships, setting out why it is important that the links between adult mental health and relationship quality, and between relationships difficulties and children’s mental health are acknowledged, and reflected in the eventual strategy; Susanna was followed by Pamela Park, Deputy Chief Executive of Family Lives, who spoke of the importance of building on the experience of, and knowledge gained through, the previous national parenting pilot, CANParent.

These presentations were followed by one by Professors Phil and Carolyn Cowan, who described the work they have undertaken over thirty years in the U.S., and more recently the U.K., in running psycho-educational groupwork programmes for parent couples which focus on the quality the adult couple relationship rather than, as traditionally has been the case, the relationships between mother and child or father and child.

Phil and Carolyn Cowan set out the impressive results their programmes have achieved in a number of longitudinal, randomised controlled trials. These results have included: maintaining the quality of the parental couple relationship (no mean feat given the research that shows that, without intervention, relationship quality tends to decline after the birth of the first child); reductions in children’s internalising and externalising problems; reductions in harsh parenting practices; and reductions in parents’ violent problem-solving.

The Cowans’ presentation concluded with an overview of the results of the Parents as Partners programme (which is based on the Cowans’ programme in the US). Parents as Partners has reported findings which are very similar to those achieved in the US. However, the Cowans were very keen to note that – unlike the US programmes – the UK version has achieved an increase in participants’ parental relationship quality. Funding for the programme has now been extended for another year, and TCCR will be submitting the results of the programme to a peer-reviewed journal shortly, with a view to publication later in the year.

During the discussion which then followed, former Minister for Mental Health, Paul Burstow, asked about the potential long-term impact of Parents as Partners and the attrition rates. TCCR replied that attrition rates are low, at 20%, and that a cost-benefit analysis, based on model employed by the Treasury, is currently being prepared.

The issue of family stability was then discussed, with Professor Phil Cowan stating that the cohesion of the parenting relationship may be more important than family stability per se; he explained that if you can provide a working relationship between the parents, this will radiate outward more than in.

Susanna Abse spoke about how psychological health often runs throughout all of the issues such as worklessness, drug or alcohol abuse etc., and that a lot of these issues may be related to attachment insecurity. Pamela Park noted that when couples receive support and there is an improvement in couple stability, there is often an impact on work.

Philip Cowan remarked that changing culture in the way we work with families is essential; he stressed that although Parents as Partners would not be a universal approach, it could nevertheless demonstrate rather that this way of thinking works. He explained that where Parents as Partners services were embedded into existing services, they often began to change the way of working, such as with fathers.

Mark Molden, Chief Executive of Marriage Care, referred to the results from the programme about couple relationship satisfaction and asked whether we underselling the effect of impact on relationship satisfaction. Rebecca Johnson, Solihull Approach, agreed that we need to change the culture and make the focus about all relationships, and help people to understand that behaviour is linked back to emotions.

The question of how commissioners can integrate family and relationship support was raised. It was suggested that we need to focus on transition points for the whole family and need radical changes in how we deliver services.

It was generally agreed that there is a huge evidence gap about the impact of couple relationship support on improving child outcomes. There was also agreement that there needs to be new research, but that building an evidence base and achieving culture change will take time; but that, in the mean-time, we need to get the messages about family relationships support out across the variety of sectors involved.