As programme duration is an important driver of cost, what constitutes most effective length is an important research question. Proxy measure trials were more likely to be positive if they were intensive, carried out over 6 months or more, took a strengths based approach and included social support. Another driver of programme cost involves the qualifications of the providers. One additional review Kendrick, presents a focused meta-analysis of studies reviewed in Elkan et al. It concluded that no single approach is effective with all populations; the quality of the relationship established between caregiver and the practitioner may be more important than the theoretical orientation of the intervention. August Revoked in South Carolina; suspended in Massachusetts. The NBAS showed a small to moderate impact on parent behaviour, knowledge, parental representations, and increases in mother—infant and father—infant interaction.
Sensitivity focused interventions, however, had a small positive impact. Excessive levels of stress, resulting from sub-optimal parenting in the early years, can seriously disrupt the child's developing nervous system and stress hormone regulatory systems, damaging the developing brain architecture and chemistry Shore, ; Centre on the Developing Child at Harvard University, The best known are offered to groups of 8—12 parents weekly for 10—12 weeks. The NBAS showed a small to moderate impact on parent behaviour, knowledge, parental representations, and increases in mother—infant and father—infant interaction. We extracted data on the intervention approach and setting, the characteristics of the populations studied, the methodology of the study and outcomes measuring infant or parent mental health, parenting or the quality of parent—child relationships. Policies and programmes to support parenting offer much scope for improving mental health. In addition, Magill-Evans et al. The evidence was most robust for formal parenting programmes. While the classic parenting programmes are manualized and standardized, one-to-one home visiting programmes can be more flexible, tailored to individual needs and their length can vary considerably. Home visiting programmes also appear to be most effective where they are focused on a broad range of outcomes and are multi-focused, targeted, and are of medium to long-term duration. Over the last half-century a large body of research has emerged which has shifted the balance of belief on the relative influence of nature and nurture, by illustrating just how much parenting influences children's development. The dividing line between those in this group and that in group 2 is subtle and there is some overlap. One review Coren and Barlow, showed modest effects on parenting efficacy and attitudes, but non-significant effects on children's behaviour. The largest and most comprehensive review of original studies Elkan et al. Many of the programmes were holistic aiming to influence many aspects of child health. Two out of four attachment-based outcomes in these studies showed positive results 2—4 days post-delivery. Effective provision requires a skilled workforce and careful application of approaches that have been found to work. Programmes generally last 8—12 weeks. Social support individual, including home visiting, or group-based interventions is valuable for women who have sub threshold symptoms and who have not had a previous episode of depression or anxiety NICE, Quality was taken into account in the narrative synthesis of the findings reported in the full study and has informed the conclusions presented in this paper. All included systematic reviews were critically appraized using a standard checklist CASP, One review of 18 studies Guterman, found evidence that programmes which employed screening for psychosocial risk, reported less good outcomes than those which offer enrolment to all parents with certain recognized demographic risk factors e. The results of four trials in Doughty showed that parent—infant psychotherapy can be effective in reducing infant-presenting problems, decreasing parenting stress and reducing maternal intrusiveness and mother—infant conflict Doughty, These programmes form an important bedrock of parenting support. Behaviourally focused interventions including video interaction delivered one-to-one were found to be effective in increasing parental sensitivity. The main drawback of reviews of reviews is timeliness. Five focused on specific risk groups—parents of children aged 0—3 years Barlow and Parsons, ; parents of 3—10 year olds Barlow, ; teenage parents Coren and Barlow, ; parents with intellectual disabilities Feldman, and parents from minority ethnic groups Barlow et al.
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