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There is strong evidence that parenting support services improve outcomes for children and adults in families experiencing adversity, councils have been told.
The latest government-commissioned practice guide to what works in children’s social care said interventions for parents of children aged 0-10 could improve parenting practices and child behaviour, lessen levels of stress and support adults mental health.
It also highlighted the vital importance of practitioners’ skills in building trusting relationships with, and in empowering, parents, and also the value placed by staff and parents alike on interventions that recognised the interconnections between parents’ and children’s needs.
Case for prioritising parenting support ‘has never been stronger’
Sector what works body Foundations, which published the guide today, said it was based on the first major review of UK and international evidence on parenting support for families experiencing adversity, including adult mental health problems, substance misuse or domestic abuse.
On the back of the guide, Foundations’ deputy chief executive, Donna Molloy said: “As councils struggle to cope with the costs of children’s social care, our evidence shows that proven models of parenting support can help to keep children safe with their families, improve their outcomes and alleviate pressure on an already overstretched system.
“The case for prioritising proven parenting interventions has never been stronger.”
Evidence to meet government social care outcomes
The practice guide is the second of a series of Department for Education-commissioned resources from Foundations designed to provide senior leaders in councils and partner agencies with the strongest available evidence to deliver on the outcomes in the children’s social care national framework.
The DfE-issued statutory guidance, published in 2023 under the previous government’s children’s social care reforms, sets four overarching objectives for the sector and three key enablers for achieving them:
- Outcome 1: children, young people and families stay together and get the help they need.
- Outcome 2: children and young people are supported by their family network.
- Outcome 3: children and young people are safe in and outside of their homes.
- Outcome 4: children in care and care leavers have stable, loving homes.
- Enabler 1: multi-agency working is prioritised and effective.
- Enabler 2: leaders drive conditions for effective practice.
- Enabler 3: the workforce is equipped and effective.
The first guide, on kinship care, was published in October last year, and the one on parenting through adversity for parents of babies and children aged 0-10 is the first of four on parenting support. The others will cover support for families in adversity with children aged 11-19, parents or carers of children with disabilities or severe mental illness and adoptive and foster parents.
Rising parental mental health needs ahead of family help reforms
The parenting through adversity guide comes amid a growth in the numbers of children in need assessments identifying parental mental health or substance misuse problems, which directors of children’s services have warned is increasing risks to the youngest children.
At the same time, councils are set to implement significant reforms to the way they support families, through the rollout of the family help model in 2025-26.
This involves the merger of targeted early help and child in need services into multidisciplinary teams, designed to provide families experiencing adversity with early, non-stigmatising help, =to resolve issues and prevent them escalating into child protection concerns.
Though the government is providing a £270m grant to implement the changes, the reforms come with councils under significant financial strain.
Guide ‘will help councils focus resources on what works’
Foundations’ head of practice guides, social worker Nimal Jude, said the latest guide would enable authorities to determine where to invest their resources.
“We are acutely aware of some of the workforce pressures and the wider financial situations that local areas are in,” she said.
“It feels like this guide has come at such a crucial time during this transformation to family help, because you can really make some decisions about what things that you might want to scale back and what things that you might want to focus attention on, not least because you can now focus your attention with the full confidence that this is actually the best available evidence.”
The evidence base
The guide is based on two systematic reviews of the evidence around parenting support for families with multiple and complex needs.
The first, carried out by the Centre for Evidence and Implementation (CEI), in partnership with the universities of Oxford, Amsterdam and Monash, examined which interventions relevant to the UK, had the strongest evidence for reducing child maltreatment or improving child outcomes, along with what practice and delivery approaches contributed to success.
It examined 95 randomised controlled trials – where participants are randomly allocated into a group that receives the intervention and a control group – of 50 parenting interventions, finding:
- Small to moderate statistically significant effects on children’s emotional and behavioural problems, child wellbeing and parent-child relationships.
- Small to moderate statistically significant effects on promoting positive parenting (for example, appropriate disciplining, praise, warmth, and nurturing behaviours) and reducing negative parenting (for example, hostile parenting or laxness).
- Small statistically significant effects on parental mental health and reducing parental stress.
- Small but non-significant effects on reducing parental maltreatment and child abuse risk.
Strengthening parent-child relationships
Based on the CEI’s systematic review, Foundations said there was “strong evidence” for the benefits of providing parenting interventions to strengthen parent-child relationships, and that councils should make these available to families with children aged 0-3.
It said these should be based on, and delivered by practitioners well-trained in, attachment and/or social learning theory (which posits that children learn through observation, including parental modelling). These staff should be able to observe and reflect on how parents respond to children’s cues and explore parents’ own attachment experiences.
The guide also said there was “strong evidence” for councils commissioning interventions to improve child behaviours, reduce negative parenting practices and improve positive practices.
Improving child behaviour and parenting practices
In relation to behaviour, key features shared by effective interventions were supporting parents in setting clear expectations and boundaries and promoting child-led interactions.
Promoting positive parenting can include practitioners taking on a coaching role, which requires them being skilled in coaching techniques and being able to build long-lasting, trusting relationships with parents.
The guide also said there was “strong evidence” that parenting interventions can reduce parental stress and improve mental health for those with mild-to-moderate problems.
Improving mental health
It said practitioners should be skilled in understanding the impacts of stress on parents experiencing adversity and should be given time to develop relationships with them, to enable parents to learn new skills and make use of feedback.
While the guide stressed that that parenting interventions were not sufficient to achieve significant changes to mental health, it said there was evidence they could improve parenting skills, even in adults with clinical levels of illness.
It said these programmes should involve practitioners offering guidance on child development and supporting parents’ abilities to manage their emotions.
Evidence ‘promising’ in relation to reducing harm
On reducing the risk of harm to children, Foundations said the level of evidence for parenting interventions was “promising”.
It said programmes that involved a fixed and structured series of sessions tended to be more effective in this area than those that were flexible.
The guide added that local leaders should examine the need to invest in these services for families with children on the edge of care and in the rollout of family help.
Vital importance of practitioners’ interpersonal skills
Alongside the CEI review, Foundations carried out its own systematic review of studies on the barriers and enablers to successful implementation of parenting interventions for families in adversity and on parents’ views, experiences and preferences in relation to these. This drew upon 33 studies.
Among two findings that had “high” certainty, based on the strength of the evidence, was that practitioner interpersonal behaviours were “essential to building trusting relationships and empowering parents”.
The review said parents valued practitioner characteristics such as openness, non-judgmentalism and encouragement, which facilitated the development of the trust that was “essential” in promoting change.
Building trust was supported by an initial home visit, communication outside of scheduled sessions, regular attendance from the parent and a consistent workforce, with parents highlighting the challenges of doing so when workers changed.
Recognising that parents’ and children’s needs are ‘intertwined’
The other finding that was deemed to be of high certainty was that both parents and practitioners value interventions that recognise “the intertwined relationship between parents’ practical and psychological needs and the needs of their children”.
Practitioners appreciated that supporting the parent, by focusing on their practical, social and emotional needs, was often the best way to help the child, with this approach welcomed by parents, the review said.
Based on its review, Foundations identified 12 principles for working with families in delivering parenting interventions:
- Tailoring parenting support to ages and stages of child development.
- Using strengths-based approaches to engage parents and offering parenting support across the system.
- Ensuring that parents from minoritised ethnic backgrounds have equitable access to effective parenting interventions and that these are delivered in a way that fully meets
their needs. - Understanding that parenting interventions work well for families where the parent has poor mental health, and, when delivered successfully, support parents to improve parent and child outcomes.
- Prioritising face-to-face delivery of support.
- Implementing both fixed and flexible delivery models to support a mixed local offer and prioritising more structured interventions to effectively reduce the risk of serious harm to children, directing resources where they are most needed.
- Tailoring local programmes to meet the specific needs of families, offering both group and individual options to support engagement and provide parents with choice.
- Focusing on careful implementation, effective delivery, and ongoing quality assurance to ensure the success of interventions.
- That a strong local offer should start with a robust population needs analysis and involve place-based system leadership to develop a multi-agency offer.
- That local areas should have effective referral routes into parenting interventions from a range of local services.
- That effective parenting support requires a skilled and integrated workforce to deliver effective interventions.
- Parenting support should form part of a wider system of support that strengthens the resources available to parents.
