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Approaching Alternative Care Through an Emphatic Lens - The Incredible Years Programme

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Isabel Silva PhD and Maria Filomena Gaspar PhD Faculty of Psychology and Educational Sciences University of Coimbra, Portugal

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APPROACHING ALTERNATIVE CARE THROUGH AN EMPATHIC LENS – THE INCREDIBLE YEARS PROGRAMME Isabel Silva, PhD & Maria Filomena Gaspar, PhD Faculty of Psychology and Educational Sciences University of Coimbra, Coimbra, Portugal BASPCAN Congress, Edinburgh, Scotland April 13, 2015

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It is wonderful to be here! University of Coimbra I. Silva, Edinburgh, April 13, 2015

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Overview • Background • The Incredible Years Training Programme • Implementation of the IY in RCC • Outline some findings • Comments and questions

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Background • Behaviour problems a growing issue in RCC; becoming more prevalent at younger ages (ISS, 2011, 2012) • Residential Child Care Staff: Assumes parental, teaching, counseling and therapeutic functions (Anglin, 2002; Shealy, 1995; Moses 2000) • Lack of: Care staff skills to manage behaviour problems; specific training in evidence-based child management skills; a clear, coherent, positive framework for delivering quality care practices (Martins, 2004; Pereira, 2009; Santos, Calheiros, Ramos & Gamito, 2011) • Council of Europe, 2009: Recommends the promotion of quality care to improve children living in residential settings.

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How to empower care staff skills in order to positively deal with resident children? Training and Group Setting as a skill’s development context Research question & challenge…

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Behaviour problems through a new lens A New Perspective…

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• “Family” as metaphor in residential care (Anglin, 2002; Kendrick 2013) • Research suggests that is possible to consider residential staff carers’ interventions in the light of current literature on parental childrearing and parent-child relationships (Bastiaanssen et al., 2012; Boone, 2012; Petrie et al., 2006) • Parenting Training research points to positive results in improving parents skills and reducing behaviour problems in children (Kaminski et al., 2008; Taylor & Biglan, 1998; Webster-Stratton, 1998) Why use Parenting Training resources? Rationale for the study

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One of the most effective and evidenced-based psychosocial intervention programmes, for both the treatment and prevention of conduct disorder in children (3-8 years old) (Webster-Stratton, 2011; Webster-Stratton & Reid, 2006; Webster-Stratton, Reid, & Hammond, 2004) Successfully transported to the Portuguese context (Azevedo et al., 2013; Cabral et al., 2009/2010; Webster-Stratton, Gaspar, & Seabra-Santos, 2012) Promising results with other caregivers (foster care, nursery care) reported increases in positive parenting and decreases in child conduct problems (Bywater et al., 2011; Bywater, Hutchings, Gridley, & Jones, 2011; Hutchings & Bywater, 2013; Linares, Montalto, Li, & Oza, 2006; McDaniel, Braiden, Onyekwelu, Murphy, & Regan, 2011; Nilsen, 2007) IY offers: 1) Theoretical model (social learning theory; coercion process; modeling theory; relational and attachment theories); 2) Structured training in effective parenting practices; 3) Daily practice; 4) Tollkit to support the care staff teams in their role The specific case of the Incredible Years Basic Parent Programme…

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Teacher Programme 6 full day sessions held monthly Child Dinosaur treatment Programme: 6 children, 18 - 22 weekly sessions Child Dinosaur Classroom Programme:3 year curriculum, 2 sessions per week, 30 weeks ADVANCED Programme: 9 sessions helping adults communicate & problem solve The Incredible Years Programmes School Aged BASIC Parent Programme: 10 - 12 sessions, 6 - 12 years Pre-School BASIC Parent Programme: 14-18 weekly sessions, 3 – 6 years School Readiness Programme: 4 pre-school sessions 2 – 4 years Infant (eight sessions) 0 - 12 months toddler 1 - 3 year olds (13 sessions) programmes

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• Translation and adaptation of materials • Leader training and supervision • Research Basic Parenting Programme - with a community sample - with a clinical sample - with socioeconomically-disadvantaged families - with staff carers in the context of residential child care Teacher Classroom Management Programme (TCM) Basic Parenting Programme plus TCM - research trial in Portugal that aimed to study the efficacy of the Incredible Years Basic Parent programme plus TCM in the reduction of early disruptive behaviour in preschoolers Development of the IY programmes in Portugal…

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Participants Children Ages Context Duration Design 2 Intervention Groups (n = 27) Children (n = 12) 2 Non- Intervention Groups (n = 20) Children (n = 13) 3-8 Residential Child Care Centers (RCC) 13 sessions (1 weekly session = 2 hours; 2 IY trained facilitators) Exploratory Study Non- Randomized Assessment: Moment 1 (baseline); Moment 2 (after intervention; 6 months after M1); Moment 3 (12 months after M1). Implementation of the IY in RCC: Method

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I. Silva, Coimbra, January 7, 2014 Group Sessions: • 13 weeks (2-hour sessions) of training with the IY (Webster-Stratton, 2000) • Led by two trained professionals in IY • Run in the residential centre, on the day and time best suited for the group • Make-up sessions Method & Process: • Focus on cognitive, behaviour & affect, collaborative approach and skill development through: Group discussion, Video Modeling, Role plays & practice/rehearsal, Weekly assignments; Reading materials; Weekly evaluations Training Targets: • Play; Involvement; Descriptive Comments • Praise; Rewards • Effective Limit Setting; Clear Commands; Household Rules • Handling misbehaviour; Ignoring; Time-Out; Consequences; Problem SolvingBottom - use liberally; Top - use selectively Intervention

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Measures Care Staff: Childrearing Practices, Sense of Parental Competence and Depressive Symptoms • Adult‐Adolescent Parenting Inventory: Form A & Form B (AAPI – 2; Bavolek & Keene, 2001) • Parental Sense of Competence Scale (PSOC; Johnston & Mash, 1989) • Beck Depression Inventory (BDI; Beck et al., 1961) Carer-Child Interaction • Dyadic Parent-Child Interaction Coding System (DPICS; Robinson & Eyberg, 1981) | Evaluates a range of carer and child behaviours, while playing with fixed set of toys. The situation was recorded for 25 minutes at pre-post moments. Children: Behaviour Problems Reported by Care Staff • Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997) Satisfaction with the IY Programme • Weekly Evaluation (content, DVD’s, group leaders, group discussion) • Final Satisfaction Questionnaire programme overall (teaching format, usefulness of specific educational techniques, group leader(s), group support) (http://incredibleyears.com/for- researchers/measures/)

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Some data… Carer - Child Interaction Intervention IC1 (N=15) IC2 (N=12) Pre M±SD Post M±SD Test (Z)a Sig (p) Pre M±SD Post M±SD Test (Z)a Sig (p) CARER Positive parenting 23.53±13.17 42.60±15.08 -2.95 .003 18.83±9.09 53.42±31.59 -3.06 .002 Negative commands 6.13±3.85 2.73±2.34 -2.39 .017 3.33±4.03 0.75±1.14 -2.20 .027 Total commands 97.87±40.97 68.53±27.68 -2.61 .009 76.42±34.05 42.17±22.39 -2.98 .003 Critical statements 18.00±10.34 10.13±7.68 -2.45 .014 14.25±13.94 5.50±6.10 -2.14 .033 Total critical 24.13±12.80 12.87±9.20 -2.64 .008 17.58±16.22 6.25±6.51 -2.59 .010 CHILD Negative behaviours 11.27±7.81 5.67±5.08 -2.32 .020 21.55±37.72 5.42±6.83 -2.54 .011 Note: a. Non-Parametric Test: Wilcoxon; Children (3-8 years): (IC1 Pre n=6; IC1 Post n=6); (IC2 Pre n=6; IC2 Post n=5)

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• These preliminary observations suggest gains in the quality of the interactions between staff carers and resident children, in short term, after the delivered of an evidence-based program, like the IYP. Nevertheless, future studies must be undertaken (small sample). • As residential care workers we want to enhance children’s empathy, safety, welfare and well-being. To sum it up…

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Some words of the care workers… • “I was amazed when at dinner time one of the children turned to another and said: “Good job, you are eating all the fish! Very good!” (Modelling Principle) • “The Reward Programme it’s working! The children can tighten their seat belts alone when we get into the van!” (Principle of rewarding the daily success) • “I have learned to apply new strategies, new ways to deal with the children’s behaviour. The group training allows us to achieve some consensus in the way we all deal with the children.” • “For me it was important to improve the relationship with the children as a result of the improvement of my behaviour. Now, I think with a “cold head”: I’m an adult, I have to stay calm.”

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Webster-Stratton, C. (2010). Os Anos Incríveis: Guia de resolução de problemas para pais de crianças dos 2 aos 8 anos de idade (M. I, Donnas Botto, Transl; M. F. Gaspar & M. J. Seabra-Santos, Revisão Científica). Braga: Psiquilíbrios Edições (Original publicado em 2005). Silva, I. S., Gaspar, M. F., & Anglin, J. P. (2014). Webster-Stratton Incredible Years Basic Parent Programme (IY) in child care placements: Residential staff carers’ satisfaction results. Child and Family Social Work, 1-11. doi:10.1111/cfs.12129 Silva, I. S., & Gaspar, M. F. (2014). Supporting Portuguese Residential Child Care Staff: An Exploratory Study with the Incredible Years Basic Parent Programme. Psychosocial Intervention, 23(1), 33-41. doi: 10.5093/in2014a4 Silva, I. S. & Gaspar, M. F. (2014). The challenge of improving positive residential care practices: Evidence from staff experiences in Portugal. International Journal of Child and Family Welfare, 15(1/2), 92-109. REFERENCES

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THANKS FOR YOUR ATTENTION! COMMENTS & QUESTIONS For more information, feel free to email: Isabel Silva | isabel.s.silva@sapo.pt Maria Filomena Gaspar | ninigaspar@fpce.uc.pt https://www.facebook.com/anosincriveis.Portugal http://incredibleyears.com

More Related Content

Approaching Alternative Care Through an Emphatic Lens - The Incredible Years Programme

  • 1. APPROACHING ALTERNATIVE CARE THROUGH AN EMPATHIC LENS – THE INCREDIBLE YEARS PROGRAMME Isabel Silva, PhD & Maria Filomena Gaspar, PhD Faculty of Psychology and Educational Sciences University of Coimbra, Coimbra, Portugal BASPCAN Congress, Edinburgh, Scotland April 13, 2015
  • 2. It is wonderful to be here! University of Coimbra I. Silva, Edinburgh, April 13, 2015
  • 3. Overview • Background • The Incredible Years Training Programme • Implementation of the IY in RCC • Outline some findings • Comments and questions
  • 4. Background • Behaviour problems a growing issue in RCC; becoming more prevalent at younger ages (ISS, 2011, 2012) • Residential Child Care Staff: Assumes parental, teaching, counseling and therapeutic functions (Anglin, 2002; Shealy, 1995; Moses 2000) • Lack of: Care staff skills to manage behaviour problems; specific training in evidence-based child management skills; a clear, coherent, positive framework for delivering quality care practices (Martins, 2004; Pereira, 2009; Santos, Calheiros, Ramos & Gamito, 2011) • Council of Europe, 2009: Recommends the promotion of quality care to improve children living in residential settings.
  • 5. How to empower care staff skills in order to positively deal with resident children? Training and Group Setting as a skill’s development context Research question & challenge…
  • 6. Behaviour problems through a new lens A New Perspective…
  • 7. • “Family” as metaphor in residential care (Anglin, 2002; Kendrick 2013) • Research suggests that is possible to consider residential staff carers’ interventions in the light of current literature on parental childrearing and parent-child relationships (Bastiaanssen et al., 2012; Boone, 2012; Petrie et al., 2006) • Parenting Training research points to positive results in improving parents skills and reducing behaviour problems in children (Kaminski et al., 2008; Taylor & Biglan, 1998; Webster-Stratton, 1998) Why use Parenting Training resources? Rationale for the study
  • 8. One of the most effective and evidenced-based psychosocial intervention programmes, for both the treatment and prevention of conduct disorder in children (3-8 years old) (Webster-Stratton, 2011; Webster-Stratton & Reid, 2006; Webster-Stratton, Reid, & Hammond, 2004) Successfully transported to the Portuguese context (Azevedo et al., 2013; Cabral et al., 2009/2010; Webster-Stratton, Gaspar, & Seabra-Santos, 2012) Promising results with other caregivers (foster care, nursery care) reported increases in positive parenting and decreases in child conduct problems (Bywater et al., 2011; Bywater, Hutchings, Gridley, & Jones, 2011; Hutchings & Bywater, 2013; Linares, Montalto, Li, & Oza, 2006; McDaniel, Braiden, Onyekwelu, Murphy, & Regan, 2011; Nilsen, 2007) IY offers: 1) Theoretical model (social learning theory; coercion process; modeling theory; relational and attachment theories); 2) Structured training in effective parenting practices; 3) Daily practice; 4) Tollkit to support the care staff teams in their role The specific case of the Incredible Years Basic Parent Programme…
  • 9. Teacher Programme 6 full day sessions held monthly Child Dinosaur treatment Programme: 6 children, 18 - 22 weekly sessions Child Dinosaur Classroom Programme:3 year curriculum, 2 sessions per week, 30 weeks ADVANCED Programme: 9 sessions helping adults communicate & problem solve The Incredible Years Programmes School Aged BASIC Parent Programme: 10 - 12 sessions, 6 - 12 years Pre-School BASIC Parent Programme: 14-18 weekly sessions, 3 – 6 years School Readiness Programme: 4 pre-school sessions 2 – 4 years Infant (eight sessions) 0 - 12 months toddler 1 - 3 year olds (13 sessions) programmes
  • 10. • Translation and adaptation of materials • Leader training and supervision • Research Basic Parenting Programme - with a community sample - with a clinical sample - with socioeconomically-disadvantaged families - with staff carers in the context of residential child care Teacher Classroom Management Programme (TCM) Basic Parenting Programme plus TCM - research trial in Portugal that aimed to study the efficacy of the Incredible Years Basic Parent programme plus TCM in the reduction of early disruptive behaviour in preschoolers Development of the IY programmes in Portugal…
  • 11. Participants Children Ages Context Duration Design 2 Intervention Groups (n = 27) Children (n = 12) 2 Non- Intervention Groups (n = 20) Children (n = 13) 3-8 Residential Child Care Centers (RCC) 13 sessions (1 weekly session = 2 hours; 2 IY trained facilitators) Exploratory Study Non- Randomized Assessment: Moment 1 (baseline); Moment 2 (after intervention; 6 months after M1); Moment 3 (12 months after M1). Implementation of the IY in RCC: Method
  • 12. I. Silva, Coimbra, January 7, 2014 Group Sessions: • 13 weeks (2-hour sessions) of training with the IY (Webster-Stratton, 2000) • Led by two trained professionals in IY • Run in the residential centre, on the day and time best suited for the group • Make-up sessions Method & Process: • Focus on cognitive, behaviour & affect, collaborative approach and skill development through: Group discussion, Video Modeling, Role plays & practice/rehearsal, Weekly assignments; Reading materials; Weekly evaluations Training Targets: • Play; Involvement; Descriptive Comments • Praise; Rewards • Effective Limit Setting; Clear Commands; Household Rules • Handling misbehaviour; Ignoring; Time-Out; Consequences; Problem SolvingBottom - use liberally; Top - use selectively Intervention
  • 13. Measures Care Staff: Childrearing Practices, Sense of Parental Competence and Depressive Symptoms • Adult‐Adolescent Parenting Inventory: Form A & Form B (AAPI – 2; Bavolek & Keene, 2001) • Parental Sense of Competence Scale (PSOC; Johnston & Mash, 1989) • Beck Depression Inventory (BDI; Beck et al., 1961) Carer-Child Interaction • Dyadic Parent-Child Interaction Coding System (DPICS; Robinson & Eyberg, 1981) | Evaluates a range of carer and child behaviours, while playing with fixed set of toys. The situation was recorded for 25 minutes at pre-post moments. Children: Behaviour Problems Reported by Care Staff • Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997) Satisfaction with the IY Programme • Weekly Evaluation (content, DVD’s, group leaders, group discussion) • Final Satisfaction Questionnaire programme overall (teaching format, usefulness of specific educational techniques, group leader(s), group support) (http://incredibleyears.com/for- researchers/measures/)
  • 14. Some data… Carer - Child Interaction Intervention IC1 (N=15) IC2 (N=12) Pre M±SD Post M±SD Test (Z)a Sig (p) Pre M±SD Post M±SD Test (Z)a Sig (p) CARER Positive parenting 23.53±13.17 42.60±15.08 -2.95 .003 18.83±9.09 53.42±31.59 -3.06 .002 Negative commands 6.13±3.85 2.73±2.34 -2.39 .017 3.33±4.03 0.75±1.14 -2.20 .027 Total commands 97.87±40.97 68.53±27.68 -2.61 .009 76.42±34.05 42.17±22.39 -2.98 .003 Critical statements 18.00±10.34 10.13±7.68 -2.45 .014 14.25±13.94 5.50±6.10 -2.14 .033 Total critical 24.13±12.80 12.87±9.20 -2.64 .008 17.58±16.22 6.25±6.51 -2.59 .010 CHILD Negative behaviours 11.27±7.81 5.67±5.08 -2.32 .020 21.55±37.72 5.42±6.83 -2.54 .011 Note: a. Non-Parametric Test: Wilcoxon; Children (3-8 years): (IC1 Pre n=6; IC1 Post n=6); (IC2 Pre n=6; IC2 Post n=5)
  • 15. • These preliminary observations suggest gains in the quality of the interactions between staff carers and resident children, in short term, after the delivered of an evidence-based program, like the IYP. Nevertheless, future studies must be undertaken (small sample). • As residential care workers we want to enhance children’s empathy, safety, welfare and well-being. To sum it up…
  • 16. Some words of the care workers… • “I was amazed when at dinner time one of the children turned to another and said: “Good job, you are eating all the fish! Very good!” (Modelling Principle) • “The Reward Programme it’s working! The children can tighten their seat belts alone when we get into the van!” (Principle of rewarding the daily success) • “I have learned to apply new strategies, new ways to deal with the children’s behaviour. The group training allows us to achieve some consensus in the way we all deal with the children.” • “For me it was important to improve the relationship with the children as a result of the improvement of my behaviour. Now, I think with a “cold head”: I’m an adult, I have to stay calm.”
  • 17. Webster-Stratton, C. (2010). Os Anos Incríveis: Guia de resolução de problemas para pais de crianças dos 2 aos 8 anos de idade (M. I, Donnas Botto, Transl; M. F. Gaspar & M. J. Seabra-Santos, Revisão Científica). Braga: Psiquilíbrios Edições (Original publicado em 2005). Silva, I. S., Gaspar, M. F., & Anglin, J. P. (2014). Webster-Stratton Incredible Years Basic Parent Programme (IY) in child care placements: Residential staff carers’ satisfaction results. Child and Family Social Work, 1-11. doi:10.1111/cfs.12129 Silva, I. S., & Gaspar, M. F. (2014). Supporting Portuguese Residential Child Care Staff: An Exploratory Study with the Incredible Years Basic Parent Programme. Psychosocial Intervention, 23(1), 33-41. doi: 10.5093/in2014a4 Silva, I. S. & Gaspar, M. F. (2014). The challenge of improving positive residential care practices: Evidence from staff experiences in Portugal. International Journal of Child and Family Welfare, 15(1/2), 92-109. REFERENCES
  • 18. THANKS FOR YOUR ATTENTION! COMMENTS & QUESTIONS For more information, feel free to email: Isabel Silva | isabel.s.silva@sapo.pt Maria Filomena Gaspar | ninigaspar@fpce.uc.pt https://www.facebook.com/anosincriveis.Portugal http://incredibleyears.com

Editor's Notes

  1. Why did we undertake this research?
  2. With regard to the intervention... Incredible Years Series designed by Prof. Carolyn Webster-Stratton recognized for effectively reduce child behaviour problems Training targets included: play, praise... And the main ideia is to use liberally the strategies which are in the base of the pyramid and build a strong foundation and promote positive behaviours; and use selectively the strategies which are on the top of the piramid, to decrease negative/agressive behaviours.
  3. An analysis of the data suggest an improvement in the staff carer’s Positive Parenting (that includes Positive Affect) scores, and a significant reduction in their Total Commands and Total Critical scores that represent the coercive authority styles. Furthermore, decreases in the Child Deviancy (coded negative behaviour and non-compliance) scores were observed. Our results must be carefully interpreted, taking into account the small sample size and the study’s exploratory characteristic.