[Implementation Of Social Service]

by

ACKNOWLEDGEMENT

I would take this opportunity to thank my research supervisor, family and friends for their support and guidance without which this research would not have been possible.

DECLARATION

I, [type your full first names and surname here], declare that the contents of this dissertation/thesis represent my own unaided work, and that the dissertation/thesis has not previously been submitted for academic examination towards any qualification. Furthermore, it represents my own opinions and not necessarily those of the University.

Signed __________________ Date _________________

ABSTRACT

The current research focuses on examining the effectiveness of behavioural and cognitive-behavioural group-based parenting programmes for a number of important outcomes and used sensitivity analyses to address shortcomings related to the risk of bias in the trials. In addition, the review incorporated an evaluation of the cost-effectiveness of parenting programmes and investigated moderators of impact, including socioeconomic status and implementation fidelity. We could not conduct the prespecified meta-regression of putative mechanisms of change within group-based parenting programmes due to a lack of reported outcomes relating to parenting skills and parental confidence. However, a later updated review may provide sufficient studies to explore predictors of change.

TABLE OF CONTENTS

ACKNOWLEDGEMENTII

DECLARATIONIII

ABSTRACTIV

CHAPTER 1: INTRODUCTION1

Background2

Description of the intervention3

Objectives of the study5

CHAPTER 2: LITERATURE REVIEW6

How the intervention might work6

Implications For Practice8

Government, Societal and Cultural Considerations8

Generic Parenting Initiatives8

ID Specialism9

Sector Organization10

Generic or Specialist Services11

Supporting People12

Individual Level13

The Dos Of Working With Parents With Intellectual Disabilities14

The Don TS Of Working With Parents With Intellectual Disabilities14

Community-based Support for Parents15

The History Of Support To Families In Britain19

Support To Parents Of Young Children23

Parenting Skills And Child Behaviour Problems26

Support For Parents Of Adolescents29

Behavioural Approaches To Support Children With Behavioural Difficulties32

CHAPTER 3: METHODOLOGY40

Types of studies40

Types of participants40

Types of interventions41

Types of outcome measures41

(A) Child outcomes41

(B) Parent outcomes41

Secondary outcomes42

(A) Child outcomes42

(B) Parent outcomes42

(C) Adverse outcomes42

Data sources43

Timing of outcome assessment43

Search methods for identification of studies43

Data extraction and management43

Assessment of risk of bias in included studies44

CHAPTER 4: RESULTS AND ANALYSIS46

Results of the search46

Randomised controlled trials47

Sample sizes47

Setting48

Participants49

Outcomes52

Conduct problems52

Parental mental health53

Parenting practices53

Economic evaluations55

Summary of main results56

Child conduct problems57

Parental mental health58

Parenting practices58

Child emotional problems and child cognitive and education abilities60

Economic outcomes60

Overall completeness and applicability of evidence61

Quality of the evidence62

Potential biases in the review process64

Agreements and disagreements with other studies or reviews65

CHAPTER 5: CONCLUSION67

CHAPTER 1: INTRODUCTION

Conduct problems in children are common and costly. In the UK and the USA, approximately 5% to 10% of children between five and 15 years of age present with clinically significant conduct problems. In Western countries, there has been a steady increase in the incidence of such problems since the 1930s. Conduct problems are the most common reason for referral to psychological and psychiatric services in childhood (NICE 2006). They typically include troublesome, disruptive and aggressive behavior; an unwillingness or inability to perform school work; few positive interactions with adults; poor social skills; low self-esteem; non-compliance with instructions; and emotional volatility.

These kinds of problems tend to exist on a continuum of severity (Burke 2002; Dretzke 2009). Children with the most severe disruptive behaviors may be diagnosed with Conduct Disorder (CD) or Oppositional Defiant Disorder (ODD) (see Diagnostic and Statistical ...