Journal of Child and Family Studies

, Volume 24, Issue 7, pp 1917–1931 | Cite as

ABC for Parents: Pilot Study of a Universal 4-Session Program Shows Increased Parenting Skills, Self-efficacy and Child Well-Being

  • Pia Enebrink
  • Maja Danneman
  • Valeria Benvestito Mattsson
  • Malin Ulfsdotter
  • Camilla Jalling
  • Lene Lindberg
Original Paper


The aim of the present pilot study was to provide an initial evaluation of a brief, 4-session, universal health promoting parenting group program, the “ABC”. We examined the effects of the program on improving parental strategies, parental self-efficacy, and child well-being. We also hypothesized that in a health promoting intervention implemented in the general population, increased parental self-efficacy and parental strategies would be associated with improvements in child well-being after 4 months. Parents living in 11 municipalities and local community agencies in Sweden enrolled in the project were invited to participate in the study. A repeated measurement within group design was used to assess the effects. In total, parents of 104 children aged 2–12 years participated in the ABC-study. Parental and child outcomes were evaluated before, after the intervention, and at a 4-month follow-up with parental self-report questionnaires. Paired t tests and ANOVA repeated measures showed statistically significant improvements of parental strategies (showing guidance, empathy/understanding, having rules/boundaries), parental self-efficacy (self-competence, knowledge/experience), and child well-being (emotional well-being, independence) from pre- to post measurement, with small to moderate effect sizes. Improvements were maintained at the 4-month follow-up, apart from changes in parental knowledge. University education and increased pre- to post improvements in self-efficacy predicted child emotional well-being at the 4-month follow-up. The findings suggest that the ABC-group intervention was effective in terms of improving child well-being, parental strategies and self-efficacy. This pilot study provides promising evidence for the ABC as a universal parenting program but further more rigorous evaluations are needed.


Health promotion Parenting program Prevention Pilot study Self-efficacy 



We would like to thank the Swedish National Institute of Public Health for financial support, the parents who took part in the study, contact persons in the municipalities/city districts for their recruitment of parents, and group leaders for performing the intervention.


  1. Ainsworth, M. D. S., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: A study of the strange situation. Hillsdale, NJ: Erlbaum.Google Scholar
  2. Amato, P. R., & Fowler, F. (2002). Parenting practices, child adjustment and family diversity. Journal of Marriage and Family, 64(3), 703–716.CrossRefGoogle Scholar
  3. Anthony, L. G., Anthony, B. J., Glanville, D. N., Naiman, D. Q., Waanders, C., & Shaffer, S. (2005). The relationships between parenting stress, parenting behaviour and preschoolers’ social competence and behaviour problems in the classroom. Infant and Child Development, 14(2), 133–154.CrossRefGoogle Scholar
  4. Ardelt, M., & Eccles, J. S. (2001). Effects of mothers’ parental efficacy beliefs and promotive parenting strategies on inner-city youth. Journal of Family Issues, 22(8), 944–972.CrossRefGoogle Scholar
  5. Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191–215.PubMedCrossRefGoogle Scholar
  6. Bariola, E., Gullone, E., & Hughes, E. K. (2011). Child and adolescent emotion regulation: The role of parental emotion regulation and expression. Clinical Child and Family Psychology Review, 14(2), 198–212.PubMedCrossRefGoogle Scholar
  7. Bloomfield, L., & Kendall, S. (2010). Audit as evidence: The effectiveness of “123 Magic” programmes. Community Practitioner, 83(1), 26–29.PubMedGoogle Scholar
  8. Bloomfield, L., & Kendall, S. (2012). Parenting self-efficacy, parenting stress and child behaviour before and after a parenting programme. Primary Health Care Research and Development, 13(4), 364–372.PubMedCrossRefGoogle Scholar
  9. Cavaleri, M. A., Olin, S. S., Kim, A., Hoagwood, K. E., & Burns, B. J. (2011). Family support in prevention programs for children at risk for emotional/behavioral problems. Clinical Child and Family Psychology Review, 14(4), 399–412.PubMedCentralPubMedCrossRefGoogle Scholar
  10. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, New Jersey: Lawrence Earlbaum Associates.Google Scholar
  11. Costello, J. E., Egger, H., & Angold, A. (2005). 10-year research update review: The epidemiology of child and adolescent psychiatric disorders: 1. Methods and Public Health Burden. Journal of American Academy of Child and Adolescent Psychiatry, 44(10), 972–986.CrossRefGoogle Scholar
  12. Currie, C., Zanotti, C., Morgan, A., Currie, D., de Looz, M., Roberts, C., et al (eds). (2012). Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: International report from the 2009/2010 Survey. Copenhagen: WHO Regional Office for Europe, Health Policy for Children and Adolescents, No. 6.Google Scholar
  13. Durlak, J. A., & Wells, A. M. (1997). Primary prevention mental health programs for children and adolescents: A meta-analytic review. American Journal of Community Psychology, 25(2), 115–152.PubMedCrossRefGoogle Scholar
  14. Eyberg, S. M., Nelson, M. M., & Boggs, S. R. (2008). Evidence-based psychosocial treatments for children and adolescents with disruptive behaviour. Journal of Clinical Child and Adolescent Psychology, 37(1), 215–237.PubMedCrossRefGoogle Scholar
  15. Farrant, B. M., Devine, T. A. J., Maybery, M. T., & Fletcher, J. (2012). Empathy, perspective taking and prosocial behaviour: The importance of parenting practices. Infant and Child Development, 21(2), 175–188.CrossRefGoogle Scholar
  16. Ford, T., Goodman, R., & Meltzer, H. (2003). The British child and adolescent mental health survey 1999: The prevalence of DSM-IV disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 42(10), 1203–1211.PubMedCrossRefGoogle Scholar
  17. Gillham, J. E., Shatté, A. J., & Reivich, K. (2001). Needed for prevention research: long-term follow-up and the evaluation of mediators, moderators, and lay providers. Prevention and Treatment, 4(1), 9c.CrossRefGoogle Scholar
  18. Goldberg, D. P., & Williams, P. (1988). A user’s guide to the general health questionnaire. Windsor UK: NFER-Nelson.Google Scholar
  19. Greenberg, M. T., Dimitrovich, C., & Bumbarger, B. (2001). The prevention of mental disorders in school-aged children: Current state of the field. Prevention and Treatment, 4(1), 1a.Google Scholar
  20. Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85(2), 348–362.PubMedCrossRefGoogle Scholar
  21. Health and Safety Executive. (2012). Stress and psychological disorders.
  22. Hiscock, H., Bayer, J. K., Price, A., Ukoumunne, O. C., Rogers, S., & Wake, M. (2008). Universal parenting programme to prevent early childhood behavioural problems: Cluster randomised trial. British Medical Journal, 336(7639), 318–321.PubMedCentralPubMedCrossRefGoogle Scholar
  23. Jones, T. L., & Prinz, R. J. (2005). Potential roles of parental self-efficacy in parent and child adjustment: A review. Clinical Psychology Review, 25(3), 341–363.PubMedCrossRefGoogle Scholar
  24. Kazdin, A. E. (2007). Mediators and mechanisms of change in psychotherapy research. Annual Review of Clinical Psychology, 3, 1–27.PubMedCrossRefGoogle Scholar
  25. Kendall, S., & Bloomfield, L. (2005). Developing and validating a tool to measure parenting self-efficacy. Journal of Advanced Nursing, 51(2), 174–181.PubMedCrossRefGoogle Scholar
  26. Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005a). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593–602.PubMedCrossRefGoogle Scholar
  27. Kessler, R. C., Chiu, W. T., Demler, O., Merikangas, K. R., & Walters, E. E. (2005b). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 617–627.PubMedCentralPubMedCrossRefGoogle Scholar
  28. Kling, A., Forster, M., Sundell, K., & Melin, L. (2010). A randomized controlled effectiveness trial of parent management training with varying degrees of therapist support. Behavior Therapy, 41, 530–542.Google Scholar
  29. Koretz, D. S., & Mościcki, E. K. (1997). An ounce of prevention research: What is it worth? American Journal of Community Psychology, 25(2), 189–195.PubMedCrossRefGoogle Scholar
  30. Lindberg, L., Ulfsdotter, M., Jalling, C., Skärstrand, E., Lalouni, M., Lönn Rhodin, K., et al. (2013). The effects and costs of the universal parent group program—all children in focus: A study protocol for a randomized wait-list controlled trial. BMC Public Health, 13, 688.Google Scholar
  31. Loeber, R., & Farrington, D. P. (Eds.). (1998). Serious and violent juvenile offenders: Risk factors and successful interventions. Thousand Oaks, CA: Sage.Google Scholar
  32. Maughan, D. R., Christiansen, E., Jenson, W. R., Olympia, D., & Clark, E. (2005). Behavioral parent training as a treatment for externalizing behaviors and disruptive behavior disorders: A meta-analysis. School Psychology Review, 34(3), 267–286.Google Scholar
  33. Milevsky, A., Schlechter, M., Netter, S., & Keehn, D. (2007). Maternal and paternal parenting styles in adolescents: Associations with self-esteem, depression and life-satisfaction. Journal of Child and Family Studies, 16, 39–47.CrossRefGoogle Scholar
  34. Morawska, A., Haslam, D., Milne, D., & Sanders, M. R. (2011). Evaluation of a brief parenting discussion group for parents of young children. Journal of Developmental and Behavioral Pediatrics, 32(2), 136–145.PubMedCrossRefGoogle Scholar
  35. National Institute for Health and Clinical Excellence (NICE). (2013). Antisocial behavior and conduct disorders in children and young people: recognition, intervention, and management. Clinical guideline 158. London: NICE 2013.
  36. Niccols, A. (2009). Immediate and short-term outcomes of the “COPEing with Toddler Behaviour” parent group. Journal of Child Psychology and Psychiatry, 50(5), 617–626.PubMedCrossRefGoogle Scholar
  37. OECD. (2013). Mental Health and Work. Sweden: OECD Publishing. doi: 10.1787/9789264188730-en.Google Scholar
  38. Ravens-Sieberer, U., & The European KIDSCREEN Group. (2006). The KIDSCREEN questionnaires Quality of life questionnaires for children and adolescents—Handbook. Lengerich: Pabst Science Publishers.Google Scholar
  39. Reedtz, C., Handegård, B. H., & Mörch, W. T. (2011). Promoting positive parenting practices in primary pare: Outcomes and mechanisms of change in a randomized controlled risk reduction trial. Scandinavian Journal of Psychology, 52(2), 131–137.PubMedCrossRefGoogle Scholar
  40. Reyno, S. M., & McGrath, P. J. (2006). Predictors of parent training efficacy for child externalizing behavior problems—A meta-analytic review. Journal of Child Psychology and Psychiatry, 47(1), 99–111.PubMedCrossRefGoogle Scholar
  41. Rishel, C. W. (2007). Evidence-based prevention practice in mental health: What is it and how do we get there? American Journal of Orthopsychiatry, 77(1), 153–164.PubMedCrossRefGoogle Scholar
  42. Rose, G. (1981). Strategy of prevention: Lessons from cardiovascular disease. British Medical Journal, 282, 1847–1851.PubMedCentralPubMedCrossRefGoogle Scholar
  43. Sanders, M. R. (2008). Triple P-Positive Parenting program as a public health approach to strengthening parenting. Journal of Family Psychology, 22(4), 506–517.PubMedCrossRefGoogle Scholar
  44. Sanders, M., Calam, R., Durand, M., Liversidge, T., & Carmont, S. A. (2008). Does self-directed and web-based support for parents enhance the effects of viewing a reality television series based on the Triple P-Positive Parenting programme? Journal of Child Psychology and Psychiatry, 49(9), 924–932.PubMedCrossRefGoogle Scholar
  45. Sandler, I. N., Schoenfelder, E. N., Wolchik, S. A., & MacKinnon, D. P. (2011). Long-term impact of prevention programs to promote effective parenting: Lasting effects but uncertain processes. Annual Review of Psychology, 62, 299–329.PubMedCentralPubMedCrossRefGoogle Scholar
  46. Scheel, M. J., & Rieckmann, T. (1998). An empirically derived description of self-efficacy and empowerment for parents of children identified as psychologically disordered. The American Journal of Family Therapy, 26(1), 15–27.CrossRefGoogle Scholar
  47. Sherr, L., Solheim Skar, A.-M., Clucas, C., von Tetzchner, S., & Hundeide, K. (2013). Evaluation of the International Child Development Programme (ICDP) as a community-wide parenting programme. European Journal of Developmental Psychology, 11, 1–17.PubMedCentralPubMedCrossRefGoogle Scholar
  48. Simkiss, D. E., Snooks, H. A., Stallard, N., Davies, S., Thomas, M. A., Anthony, B., et al. (2010). Measuring the impact and costs of a universal group based parenting programme: Protocol and implementation of a trial. BMC Public Health, 10, 364.PubMedCentralPubMedCrossRefGoogle Scholar
  49. Simkiss, D. E., Snooks, H. A., Stallard, N., Kimani, P. K., Sewell, B., Fitzsimmons, D., et al. (2013). Effectiveness and cost-effectiveness of a universal parenting skills programme in deprived communities: Multicentre randomised controlled trial. BMJ Open, 3(8), e002851.PubMedCentralPubMedCrossRefGoogle Scholar
  50. Skovgaard, A. M., Houmann, T., Christiansen, E., Landorph, S., Jörgensen, T., CCC 2000 Study Team, et al. (2007). The prevalence of mental health problems in children 1½ years of age—The Copenhagen child cohort 2000. Journal of Child Psychology and Psychiatry, 48(1), 62–70.PubMedCrossRefGoogle Scholar
  51. SOU. (2008:131). Föräldrastöden vinst för alla. Nationell strategi för samhällets stöd och hjälp till föräldrar i deras föräldraskap. Stockholm: Fritzes.Google Scholar
  52. Sourander, A. (2001). Emotional and behavioural problems in a sample of Finnish three year olds. European Child and Adolescent Psychiatry, 10(2), 98–104.PubMedCrossRefGoogle Scholar
  53. Spoth, R. L., Kavanagh, K. A., & Dishion, T. J. (2002). Family-centered preventive intervention science: Toward benefits to larger populations of children, youth, and families. Preventive Science, 3(3), 145–152.CrossRefGoogle Scholar
  54. Stewart-Brown, S. (2008). Improving parenting: The why and the how. Archives of Disease in Childhood. Education and Practice Edition, 93(2), 102–104.CrossRefGoogle Scholar
  55. Stewart-Brown, S. L., & Schrader-McMillan, A. (2011). Parenting for mental health: what does the evidence say we need to do? Report of Workpackage 2 of the DataPrev project. Health Promotion International, 26, i10–i28.PubMedCrossRefGoogle Scholar
  56. Stockholms läns landsting. (2012). Årsstatistik 2012 för Stockholms län och landsting. Stockholm: Stockholms läns landsting: Tillväxt, miljö och regionplanering.Google Scholar
  57. Webster-Stratton, C. (1998). Preventing conduct problems in head start children: Strengthening parenting competencies. Journal of Consulting and Clinical Psychology, 66(5), 715–730.PubMedCrossRefGoogle Scholar
  58. Webster-Stratton, C., & Reid, M. J. (2010). The Incredible Years parents, teachers, and children training series: A multifaceted treatment approach for young children with conduct disorders. In J. R. Weisz & A. E. Kazdin (Eds.), Evidence-based psychotherapies for children and adolescents (pp. 194–210). New York: Guilford Press.Google Scholar
  59. Webster-Stratton, C., & Taylor, T. (2001). Nipping early risk factors in the bud: Preventing substance abuse, delinquency, and violence in adolescence through interventions targeted at young children (0–8 years). Prevention Science, 2(3), 165–192.PubMedCrossRefGoogle Scholar
  60. Weisz, J. R., Sandler, I. N., Durlak, J. A., & Anton, B. S. (2005). Promoting and protecting youth mental health through evidence-based prevention and treatment. American Psychologist, 60(6), 628–648.PubMedCrossRefGoogle Scholar
  61. Wilson, K. R., Havighurst, S. S., & Harley, A. E. (2012). Tuning into kids: An effectiveness trial of a parenting program targeting emotion socialization of preschoolers. Journal of Family Psychology, 26(1), 56–65.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Pia Enebrink
    • 1
  • Maja Danneman
    • 2
  • Valeria Benvestito Mattsson
    • 3
  • Malin Ulfsdotter
    • 1
  • Camilla Jalling
    • 4
  • Lene Lindberg
    • 5
  1. 1.Division of Psychology, Department of Clinical NeurosciencesKarolinska InstitutetStockholmSweden
  2. 2.Nyköping Young Adult ClinicSörmland County CouncilNyköpingSweden
  3. 3.Behavioral Medicine Pain Treatment ServiceKarolinska University HospitalStockholmSweden
  4. 4.STAD, Stockholm Centre for Psychiatry Research and EducationKarolinska InstitutetStockholmSweden
  5. 5.Department of Public Health SciencesKarolinska InstitutetStockholmSweden

Personalised recommendations