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Randomised feasibility trial of the helping families programme-modified: an intensive parenting intervention for parents affected by severe personality difficulties

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Version 2 2023-06-12, 09:21
Version 1 2023-06-09, 20:34
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posted on 2023-06-12, 09:21 authored by Crispin Day, Jackie Briskman, Mike J Crawford, Lisa Foote, Lucy Harris, Janet Boadu, Paul McCrone, Mary McMurran, Daniel Michelson, Paul Moran, Liberty Mosse, Stephen Scott, Daniel Stahl, Paul Ramchandani, Tim Weaver
Background Specialist parenting intervention could improve coexistent parenting and child mental health difficulties of parents affected by severe personality difficulties. Objective Conduct a feasibility trial of Helping Families Programme-Modified (HFP-M), a specialist parenting intervention. Design Pragmatic, mixed-methods trial, 1:1 random allocation, assessing feasibility, intervention acceptability and outcome estimates. Settings Two NHS health trusts and local authority children’s social care. Participants Parents: (i) primary caregiver, (ii) 18-65 years, (iii) severe personality difficulties, (iv) proficient English, and (v) capacity for consent. Child: (i) 3-11 years, (ii) living with index parent, and (iii) significant emotional/behavioural difficulties. Intervention HFP-M: 16-session home-based intervention using parenting and therapeutic engagement strategies. Usual care: standard care augmented by single psychoeducational parenting session. Outcomes Primary feasibility outcome: participant retention rate. Secondary outcomes: (i) rates of recruitment, eligibility and data completion, and (ii) rates of intervention acceptance, completion and alliance (Working Alliance Inventory-Short Revised). Primary clinical outcome: child behaviour (Eyberg Child Behavior Inventory). Secondary outcomes: child mental health (Concerns About My Child, Child Behavior Checklist-Internalising Scale), parenting (Arnold-O’Leary Parenting Scale, Kansas Parental Satisfaction Scale), and parent mental health (Symptom Checklist-27). Quantitative data were collected blind to allocation. Results Findings broadly supported non-diagnostic selection criterion. Of 48 participants recruited, 32 completed post intervention measures at mean 42 weeks later. Participant retention exceeded a priori rate (HFP-M=18; Usual care=14; 66.7%, 95% CI 51.6%-79.6%). HFP-M was acceptable, with delivery longer than planned. Usual care had lower alliance rating. Child and parenting outcome effects detected across trial arms with potential HFP-M advantage (ES range: 0.0-1.3). Conclusion HFP-M is an acceptable and potentially effective specialist parenting intervention. A definitive trial is feasible, subject to consideration of recruitment and retention methods, intervention efficiency and comparator condition. Caution is required in interpretation of results due to reduced sample size. No serious adverse events reported.

History

Publication status

  • Published

File Version

  • Published version

Journal

BMJ Open

ISSN

2044-6055

Publisher

BMJ Publishing Group

Issue

2

Volume

10

Article number

e033637

Department affiliated with

  • Psychology Publications

Full text available

  • No

Peer reviewed?

  • Yes

Legacy Posted Date

2020-02-10

First Open Access (FOA) Date

2020-02-10

First Compliant Deposit (FCD) Date

2020-02-07

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