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European Child & Adolescent Psychiatry

, Volume 23, Issue 9, pp 783–794 | Cite as

Reducing child conduct disordered behaviour and improving parent mental health in disadvantaged families: a 12-month follow-up and cost analysis of a parenting intervention

  • Sinead McGillowayEmail author
  • Grainne NiMhaille
  • Tracey Bywater
  • Yvonne Leckey
  • Paul Kelly
  • Mairead Furlong
  • Catherine Comiskey
  • Donal O’Neill
  • Michael Donnelly
Original Contribution

Abstract

The effectiveness of the Incredible Years Basic parent programme (IYBP) in reducing child conduct problems and improving parent competencies and mental health was examined in a 12-month follow-up. Pre- to post-intervention service use and related costs were also analysed. A total of 103 families and their children (aged 32–88 months), who previously participated in a randomised controlled trial of the IYBP, took part in a 12-month follow-up assessment. Child and parent behaviour and well-being were measured using psychometric and observational measures. An intention-to-treat analysis was carried out using a one-way repeated measures ANOVA. Pairwise comparisons were subsequently conducted to determine whether treatment outcomes were sustained 1 year post-baseline assessment. Results indicate that post-intervention improvements in child conduct problems, parenting behaviour and parental mental health were maintained. Service use and associated costs continued to decline. The results indicate that parent-focused interventions, implemented in the early years, can result in improvements in child and parent behaviour and well-being 12 months later. A reduced reliance on formal services is also indicated.

Keywords

Conduct disorder Child development Parenting Parenting intervention Parent–child relationships Cost analysis 

Notes

Acknowledgments

This research was funded by the Atlantic Philanthropies, with some small additional support from the Dormant Accounts Fund in Ireland. We would like to extend a sincere thanks to Archways (http://www.Archways.ie) for their support and facilitation of this research and to all of the families who participated in this research. We would also like to thank all of the community-based organisations and the parent group facilitators for their co-operation and support throughout the research process. We also acknowledge with thanks, the invaluable and continuing support and advice that we have received from the Expert Advisory committee which included: Dr Mark Dynarski; Dr Paul Downes; Dr Tony Crooks; Ms Catherine Byrne; and Professor Judy Hutchings. We also acknowledge with gratitude, the help provided by Dr Yvonne Barnes-Holmes during the observational element of this study.

Ethical standard

This study was granted ethical approval from the Ethics Committee of the National University of Ireland Maynooth.

Conflict of interest

None.

References

  1. 1.
    Meltzer H, Gatward R, Goodman R, Ford F (2000) Mental health of children and adolescents in Great Britain. Stationery Office, LondonGoogle Scholar
  2. 2.
    Williams J, Greene S, Doyle E et al (2009) Growing up in Ireland: the lives of nine-year olds. Stationery Office, DublinGoogle Scholar
  3. 3.
    Webster-Stratton C (1998) Preventing conduct problems in Head Start children: strengthening parent competencies. J Consult Clin Psychol 66:715–730PubMedCrossRefGoogle Scholar
  4. 4.
    Hobcraft JN, Kiernan KE (2010) Predictive factors from age 3 and infancy for poor child outcomes at age 5 relating to children’s development, behaviour and health: evidence from the Millennium cohort study. University of York, YorkGoogle Scholar
  5. 5.
    Guajardo NR, Snyder G, Petersen R (2009) Relationships among parenting practices, parental stress, child behaviour, and children’s social-cognitive development. Infant Child Dev 18:37–60CrossRefGoogle Scholar
  6. 6.
    Evans J, Harden A, Thomas J, Benefield P (2003) Support for pupils with emotional and behavioural difficulties (EBD) in mainstream primary classrooms: a systematic review of the effectiveness of interventions. EPPI-Centre, LondonGoogle Scholar
  7. 7.
    Odgers CL, Moffitt TE, Broadbent JM et al (2008) Female and male antisocial trajectories: from childhood origins to adult outcomes. Dev Psychopathol 20:673–716PubMedCrossRefGoogle Scholar
  8. 8.
    Scott S (2005) Do parenting programmes for severe child antisocial behaviour work over the longer term, and for whom? One year follow-up of a multi-centre controlled trial. Behav Cogn Psychoth 33:1–19CrossRefGoogle Scholar
  9. 9.
    Scott S, Knapp M, Henderson J, Maughan B (2001) Financial cost of social exclusion: follow-up study of antisocial children into adulthood. Br Med J 323:1–5CrossRefGoogle Scholar
  10. 10.
    Sainsbury Centre for Mental Health (2011) Mental health promotion and mental illness prevention: The economic case. Department of Health, LondonGoogle Scholar
  11. 11.
    Barlow J, Smailagic N, Ferriter M, Bennett C, Jones H (2010) Group-based parent-training programs for improving emotional and behavioural adjustment in children from birth to three years old. Cochrane Database Syst Rev 3:CD003680. doi: 10.1002/14651858.CD003680 PubMedGoogle Scholar
  12. 12.
    Furlong M, McGilloway S, Bywater T, Hutchings J, Donnelly M, Smith SM (2012) Behavioural/cognitive-behavioural group-based parenting interventions for children age 3-12 with early onset conduct problems. Cochrane Database Syst Rev 2:CD008225. doi: 10.1002/14651858.CD008225.pub2
  13. 13.
    Mihalic S, Fagan A, Irwin K, Ballard D, Elliott D (2002) Blueprints for violence prevention replications: Factors for Implementation Success. Center for the Study and Prevention of Violence, BoulderGoogle Scholar
  14. 14.
    National Institute for Health and Clinical Excellence (2007) Parent-training/education programmes in the management of children with conduct disorders. National Institute for Health and Clinical Excellence, LondonGoogle Scholar
  15. 15.
    Reid JM, Webster-Stratton C, Baydar N (2004) Halting the development of conduct problems in Head Start children: the effects of parent training. J Clin Child Adolesc 33:279–291CrossRefGoogle Scholar
  16. 16.
    Hutchings J, Bywater T, Daley D, Gardner F, Whitaker C, Jones K, Eames C, Edwards RT (2007) Parenting intervention in Sure Start services for children at risk of developing conduct disorder: pragmatic randomised controlled trial. BMJ 334:678–685PubMedCentralPubMedCrossRefGoogle Scholar
  17. 17.
    Hartman RE, Stage SA, Webster-Stratton C (2003) A growth-curve analysis of parent training outcomes: examining the influence of child risk factors (inattention, impulsivity, and hyperactivity problems), parental and family risk factors. J Consult Clin Psychol 44:388–398Google Scholar
  18. 18.
    Jones K, Daley D, Hutchings J, Bywater T, Eames C (2007) Efficacy of the IY Basic parent training programme as an early intervention for children with conduct problems and ADHD. Child Care Health Dev 33:749–756PubMedCrossRefGoogle Scholar
  19. 19.
    Reid MJ, Webster-Stratton C, Hammond M (2003) Follow-up of children who received the Incredible Years intervention for oppositional defiance disorder: maintenance and prediction of 2 year outcome. Behav Ther 34:471–491CrossRefGoogle Scholar
  20. 20.
    Larsson B, Fossum S, Clifford G, Drugli M, Handegård B, Mørch W (2009) Treatment of oppositional defiant and conduct problems in young Norwegian children. Eur Child Adolesc Psychiatry 18:42–52PubMedCrossRefGoogle Scholar
  21. 21.
    Baydar N, Reid JM, Webster-Stratton C (2003) The role of mental health factors and programme engagement in the effectiveness of a preventive parenting programme for Head Start mothers. Child Dev 74:1433–1453PubMedCrossRefGoogle Scholar
  22. 22.
    Barlow J, Coren E, Stewart-Brown S (2002) Meta-analysis of the effectiveness of parenting programs in improving maternal psychosocial health. Br J Gen Pract 52:223–233PubMedCentralPubMedGoogle Scholar
  23. 23.
    Gardner F, Burton J, Klimes I (2006) Randomised controlled trial of a parenting intervention in the voluntary sector for reducing child conduct problems: outcomes and mechanisms of change. J Child Psychol Psychiatry 47:23–32CrossRefGoogle Scholar
  24. 24.
    Beauchaine TP, Webster-Stratton C, Reid JM (2005) Mediators, moderators and predictors of one-year outcomes among children treated for early-onset conduct problems: a latent growth curve analysis. J Consult Clin Psychol 73:371–388PubMedCrossRefGoogle Scholar
  25. 25.
    McGilloway S, Ni Mhaille G, Bywater T, Furlong M, Leckey Y, Kelly P, Comiskey C, Donnelly M (2012) A parenting intervention for childhood behavioral problems: a randomized controlled trial in disadvantaged community-based settings. J Consult Clin Psychol 80:116–127PubMedCrossRefGoogle Scholar
  26. 26.
    Weisz JR, Sandler IN, Durlak JA, Anton BS (2005) Promoting and protecting youth mental health through evidence-based prevention and treatment. Am Psychol 60:628–648PubMedCrossRefGoogle Scholar
  27. 27.
    Axberg U, Broberg AG (2012) Evaluation of “the incredible years” in Sweden: the transferability of an American parent-training program to Sweden. Scand J Psychol 53:224–232. doi: 10.1111/j.1467-9450.2012.00955.x PubMedCrossRefGoogle Scholar
  28. 28.
    Bywater T, Hutchings J, Daley D, Whitaker C, Tien Yeo S, Jones K, Eames C, Edwards RT (2009) Long-term effectiveness of a parenting intervention for children at risk of developing conduct disorder. Br J Psychiatry 195:318–324PubMedCrossRefGoogle Scholar
  29. 29.
    Sandler I, Schoenfelder E, Wolchik S, MacKinnon D (2011) Long-term impact of prevention programs to promote effective parenting: lasting effects but uncertain processes. Annu Rev Psychol 62:299–329PubMedCentralPubMedCrossRefGoogle Scholar
  30. 30.
    Drugli MB, Larsson B, Fossum S, Morch WT (2010) Five- to six-year outcome and its prediction for children with ODD/CD treated with parent training. J Child Psychol Psychiatry 51:559–566PubMedCrossRefGoogle Scholar
  31. 31.
    Webster-Stratton C, Rinaldi J, Reid JM (2011) Long-term outcomes of Incredible Years parenting program: predictors of adolescent adjustment. Child Adolesc Ment Health 16:38–46PubMedCentralPubMedCrossRefGoogle Scholar
  32. 32.
    Charles JM, Bywater T, Edwards RT (2010) Parenting interventions: a systematic review of the economic evidence. Child Care Health Dev. doi: 10.1111/j.1365-2214.2011.01217 Google Scholar
  33. 33.
    Allen G (2011) Early intervention: next steps. Cabinet Office, LondonGoogle Scholar
  34. 34.
    Edwards R, Céilleachair A, Bywater T, Hughes D, Hutchings J (2007) Parenting programme for parents of children at risk of developing conduct disorder: a cost-effectiveness analysis. BMJ 334:682–688PubMedCentralPubMedCrossRefGoogle Scholar
  35. 35.
    O'Neill D, McGilloway S, Donnelly M, Bywater T, Kelly P (2013) A cost-effectiveness analysis of the Incredible Years parenting programme in reducing childhood health inequalities. Eur J Health Econ 14:85–94PubMedCrossRefGoogle Scholar
  36. 36.
    Serketich WJ, Dumas JE (1996) The effectiveness of behavioural parent training to modify antisocial behaviour in children: a meta-analysis. Behav Ther 27:171–186CrossRefGoogle Scholar
  37. 37.
    Weisz JR, Gray JS (2008) Evidence-based psychotherapy for children and adolescents: data from the present and a model for the future. Child Adolesc Ment Health 13:54–65CrossRefGoogle Scholar
  38. 38.
    Eyberg S, Pincus D (1999) Eyberg Child Behaviour Inventory and Sutter-Eyberg Student Behaviour Inventory-Revised: professional manual. Psychological Assessment Resources, FloridaGoogle Scholar
  39. 39.
    Haase T, Pratschke J (2008) New measures of deprivation for the Republic of Ireland. Pobal, DublinGoogle Scholar
  40. 40.
    Goodman R (1997) The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry 38:581–586PubMedCrossRefGoogle Scholar
  41. 41.
    Conners CK (1994) The Conners Rating Scales: use in clinical assessment, treatment planning and research. In: Maruish M (ed) Use of psychological testing for treatment planning and outcome assessment. Erlbaum, New York, pp 550–578Google Scholar
  42. 42.
    Corrigan A (2002) Social Competence Scale—parent version, grade 1/year 2 (Fast Track project technical report). http://www.fasttrackproject.org. Accessed 16 April 2013
  43. 43.
    Abidin RR (1995) Parenting Stress Index, 3rd edn. Psychological Assessment Resources, OdessaGoogle Scholar
  44. 44.
    Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571PubMedCrossRefGoogle Scholar
  45. 45.
    O’Leary KD, Porter B (1987) Overt hostility toward partner. University of Department of Psychology, New YorkGoogle Scholar
  46. 46.
    Robinson EA, Eyberg SM (1981) The Dyadic Parent-child Interactive Coding System: standardisation and validation. J Consult Clin Psychol 49:245–250PubMedCrossRefGoogle Scholar
  47. 47.
    Beecham J, Knap M (1992) Costing psychiatric interventions. In: Thornicroft G, Brewin C, Wing J (eds) Measuring mental health needs. Gaskill, London, pp 179–190Google Scholar
  48. 48.
    Schafer JL (1999) Multiple imputation: a primer. Stat Methods Med Res 8:3–15PubMedCrossRefGoogle Scholar
  49. 49.
  50. 50.
    Cohen J (1988) Statistical power for the behavioural sciences. Erlbaum, New JerseyGoogle Scholar
  51. 51.
    Casemix Ireland. http://www.casemix.ie/index.jsp. Accessed 16 July 2013
  52. 52.
    Nicholson BC, Fox RA, Johnson SD (2005) Parenting young children with challenging behaviour. Infant Child Dev 14:425–428CrossRefGoogle Scholar
  53. 53.
    Salekin RT, Lochman JE (2008) Child and adolescent psychopathy: the search for protective factors. Crim Just Behav 35:159–172CrossRefGoogle Scholar
  54. 54.
    Trapolini T, McMahon C, Ungerer JA (2007) The effect of maternal depression and marital adjustment on young children’s internalising and externalising behaviour problems. Child Care Health Dev 33:794–804PubMedCrossRefGoogle Scholar
  55. 55.
    Gardner F, Hutchings J, Bywater T, Whitaker C (2010) Who benefits and how does it work? Moderators and mediators of outcomes in an effectiveness trial of a parenting intervention. J Clin Child Adolesc 39:568–580CrossRefGoogle Scholar
  56. 56.
    Sonuga-Barke EJS, Brandeis D, Cortese S et al (2013) Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomised controlled trials of dietary and psychological treatments. Am J Psychiatry 170:275–289PubMedCrossRefGoogle Scholar
  57. 57.
    Barrera M, Biglan A, Taylor TK, Gunn BK, Smolkowski K, Black C, Ary DV, Fowler RC (2002) Early elementary school intervention to reduce conduct problems: a randomised trial with Hispanic and non-Hispanic children. Prev Sci 3:83–93PubMedCrossRefGoogle Scholar
  58. 58.
    Hollis S, Campbell F (1999) What is meant by intention to treat analysis? Survey of published randomised control trials. Br Med J 319:670–674CrossRefGoogle Scholar
  59. 59.
    Reyno SM, McGrath PJ (2006) Predictors of parent training efficacy for child externalising behaviour problems: a meta-analytic review. J Child Psychol Psychiatry 47:99–111PubMedCrossRefGoogle Scholar
  60. 60.
    Furlong M, McGilloway S (2011) The Incredible Years parenting program in Ireland: a qualitative analysis of the experience of disadvantaged parents. Clin Child Psychol Psychiatry 14:616–630Google Scholar
  61. 61.
    Collishaw SB, Maughan B, Goodman R, Pickles A (2004) Time trends in adolescent mental health. J Child Psychol Psyc 45:1350–1362CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Sinead McGilloway
    • 1
    Email author
  • Grainne NiMhaille
    • 1
  • Tracey Bywater
    • 2
  • Yvonne Leckey
    • 1
  • Paul Kelly
    • 1
  • Mairead Furlong
    • 1
  • Catherine Comiskey
    • 3
  • Donal O’Neill
    • 5
  • Michael Donnelly
    • 4
  1. 1.Department of PsychologyNational University of Ireland MaynoothMaynoothIreland
  2. 2.Institute for Effective EducationUniversity of YorkYorkUK
  3. 3.School of Nursing and MidwiferyTrinity College DublinDublinIreland
  4. 4.Centre for Public HealthQueen’s University BelfastBelfastNorthern Ireland
  5. 5.Department of EconomicsNational University of Ireland MaynoothMaynoothIreland

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