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

Day, Crispin, Briskman, Jackie, Crawford, Mike J, Foote, Lisa, Harris, Lucy, Boadu, Janet, McCrone, Paul, McMurran, Mary, Michelson, Daniel, Moran, Paul, Mosse, Liberty, Scott, Stephen, Stahl, Daniel, Ramchandani, Paul and Weaver, Tim (2020) Randomised feasibility trial of the helping families programme-modified: an intensive parenting intervention for parents affected by severe personality difficulties. BMJ Open, 10 (2). e033637. ISSN 2044-6055

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Abstract

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.

Item Type: Article
Keywords: Child behaviour, parenting, child & adolescent psychiatry, personality disorder
Schools and Departments: School of Psychology > Psychology
Depositing User: Sanjeedah Choudhury
Date Deposited: 10 Feb 2020 09:09
Last Modified: 10 Feb 2020 09:15
URI: http://sro.sussex.ac.uk/id/eprint/89812

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