Technique Is Not Enough:A framework for ensuring

thatevidence-based parentingprogrammes are socially

inclusive

A British Psychological Society Professional Practice

Board Discussion Paper

Published 20 September 2012

Dr. Fabian A. Davis Consultant Clinical PsychologistBPS Social Inclusion Group Chair

Prof. Lynn McDonald, Professor of Social Work Research at

Middlesex University

Dr. Nick Axford Senior Researcher.

The Social Research Unit, Dartington

The context

• Some aspects of UK child wellbeing are very poor and worsening

• Positive parenting and good family life protects children from stress

• Evidence-based programmes work but reach few marginalised families

• To reach the most families, programmes must be socially inclusive

• There have been attempts to identify inclusion factors but few RCTs

• Need to identify practice-based evidence from evidence-based practice

www.bps.org.uk

The BPS approach

• Address child wellbeing and social inclusion “inclusively”

• Discover an inclusive perspective through “co-production”

• Exemplify socially inclusive practice and related outcomes

• Ask whether socially inclusive practice has “outcome value”?

• Concluded that “sustainable inclusion” requires many levels of

collaboration between programme developers, services, commissioners,

psychologists, parents and communitieswww.bps.org.uk

• Describes the issues at stake

• Guides the identification of socially inclusive practice

• Summarises the principles behind “social productivity”

• Enables innovative re-combinations of practice to be considered

• Promotes inclusive practice evaluation in all replications

• Supports the need for socially inclusive outcome measurement

www.bps.org.uk

Uses for the TINE framework

TINE - meeting the challenge

• Created a process to enable professionals, practitioners and families to agree on some mutually understood and agreed themes

• Surveyed the UNODC top 23 programmes for their inclusive practices

• Identified four principles underlying current socially inclusive practice

• These principles can assist in practice development, evaluative research and rationalising the commissioning process

• Social inclusion factors should be included in ranking systems and recommendations of evidence-based programmes to governments

www.bps.org.uk

The TINE framework

1. Maximise accessibility

2. Be culturally sensitive via co-production

3. Build social capital in the wider community

4. Design in sustainability from the outset

www.bps.org.uk

TINE Principle 1

Programmes should promote their accessibility by:

• Monitoring the retention and drop-out rates of all families especially

disadvantaged families

• Publishing and vigorously pursuing their best practices for

increasing the initial engagement and programme retention of

socially marginalised families

www.bps.org.uk

Accessibility examples - 20% to 80%

• Culturally congruent parent volunteer/programme graduate outreach

• “External” factors addressed by programmes themselves

• Partnering with schools, health, education and social care staff

• Running programmes when and where convenient for parents

• Using culturally congruent content

• Using local customs and social mores in practical learning sessions

• Empowering parent “graduates” and ethnic heritage matched trainers

• Learning “parenting principles” in an empowering social context

www.bps.org.uk

TINE principle 2

Programmes should be culturally sensitive to their participants by:

• Parents being equal partners in co-producing local programmes

• Staff and parent trainers being culturally representative role models

• Culturally adapting form and content whilst retaining core components

• Maintaining model fidelity and internal logic during local evolutions

• “Graduates” as recruiters, facilitators, teachers, trainers and evaluators

www.bps.org.uk

Sensitivity - co-production examples

• Genuinely adapted local replication - not simple duplication or cloning

• Scaling-up programmes whilst accounting for their cultural specificity

• Knowing & retaining what is universal and works in each programme

• Adapting the social forms of learning and culture dependant content

• Co-producing with parents enabling accurate cultural adaptations

• Co-production teams modelling lay & professional knowledge equality

• Social class congruity may be the most powerful factor in modelling

www.bps.org.uk

TINE Principle 3

Programmes should build social capital in their host communities by:

• Developing trust through peer support by programme participants

• Building mutuality of trust between participants & friends, extended family and other sources of social capital in their local community

• Maximising naturalistic social supports for parent participants rather than relying on traditional services, wherever possible

• Empowering participants to lead “booster” sessions and run on-going local training, quality assurance and evaluation mechanisms

www.bps.org.uk

Building social capital - examples

• Enriching parent experience & social networks brings long-term gains

• Supporting reciprocal parent to parent relationships across families

• Integrating programmes into stable community institutions e.g. school

• Encouraging parent progression - participant to trainer to evaluator

• Sharing marketing and local development with empowered parents

• Local people acting as volunteers and programme champions

• Parent to parent networking to improve school atmosphere

• Networking local groups with same programme peers in other areas

www.bps.org.uk

TINE Principle 4Programmes should create the conditions for long term sustainability by:

• Co-producing quality assurance systems to assess impact beyond the home, in the classroom and in the wider community

• Creating a lasting context for sustaining the programme’s knowledge and practice base by partnering with local professionals and families

• Taking account of and helping to meet the wider needs of the service systems in which they aspire to become “services as usual”

• Developing supervision, guidance and support systems around implementation that address services’ unique contextual needs

www.bps.org.uk

Sustainability - examples

• Scaling up – mixed picture: investment stops, staff leave, fidelity suffers

• However programmes are aspiring to become “services as usual”

• Providing manuals, marketing materials, training the trainers, supporting

adaptation, costings and fidelity checklists enable “system readiness”

• Congruity with local “system values” and local must-do’s are required

• External fidelity monitoring and evaluation support are crucial

• Sustainability plans, real capacity and staff buy-in are essential

• “Communities of Practice” working at multiple levels are developing

www.bps.org.uk

Technique Is Not Enough!

"Over the last ten or more years I have been caught in arguments between

two camps: one camp claiming that providing anything other than

parenting programmes evaluated using randomised control trial design and

delivered with fidelity is a waste of public money and bound to fail. The

other camp argues that unless programmes are co-designed with users

themselves and are sensitive to local differences and capitalise on the

judgement of those providing the programmes to adjust them according to

local need and circumstances, they are bound to fail. This paper presents

a coherent approach to bringing these two seemingly opposing positions

together.“

p.5 Naomi Eisenstadt CB. May 2012www.bps.org.uk

Debate and further activity

• Research is required that respects effectiveness and social inclusion outcomes

and which takes us beyond inclusion’s currently recognised “Process Value”.

• We need to know which inclusive practices have the greatest “Outcome Value”?

• Your continuing efforts can be drawn together by the TINE framework as we

wish to revisit our call for evidence again today and offer to publish an update.

• We are lobbying the UNODC and others to adopt social inclusion outcomes.

www.bps.org.uk

Contact & follow-up detailsDr Fabian Davis

Email: Fabian.davis@oxleas.nhs.uk

Website: www.developbromley.com

Electronic copies of the BPS paper “Technique Is Not Enough” can be obtained from:

www.bpsshop.org.uk and hard copies are in your conference packs.

Guardian Society section “second thoughts” article downloadable from:

www.guardian.co.uk/society/2012/sep/18/framework-for-parenting-programmes