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Produced by the Library & Information Service of the National Children’s Bureau as
a commitment to share current research, development, policy and practice.
highlight no.211 This Highlight has been produced from What Works for Children? evidence
nugget on parenting programmes, which is a longer, more detailed document,
available at www.whatworksforchildren.org.uk
What Works for Children is a collaboration between Barnardo’s, University of
that parents attending the behavioural programme were more likely to report York and the Child Health Research and Policy Unit, City University, funded by
improved child behaviour, but this was not supported by observational reports the UK Economic and Social Research Council.
in the two-year follow-up.26
A qualitative study has indicated that parents may view parenting programmes
across three dimensions: how to deal with the child; how to be a better parent; References
and how to improve the parent–child relationship..27 Barlow and Stewart-Brown 1. Patterson, G R, DeBaryshe D, and Ramsey E (1989) ‘A developmental perspective on
antisocial behaviour’, American Psychologist, 44, 329-35
suggest that a combination programme, using both behaviour and relationship
2. Smith, C (1996) Developing Parenting Programmes. National Children's Bureau
approaches, may better meet the needs of parents.28 3. Webster-Stratton, C (1990) ‘Long-term follow-up of families with young conduct-problem
children: from pre-school to grade school’, Journal of Clinical Child and Adolescent
Policy and practice implications Psychology, 19, 144-9
There are costs to children and families arising from behavioural problems, as 4. Scott, S and others (2001) ‘Multicentre controlled trial of parenting groups for childhood
antisocial behaviour in clinical practice’, British Medical Journal, 323, 7306, 194-7
well as social costs such as public spending on courts, youth justice, mental 5. University of York, NHS Centre for Reviews and Dissemination (1997) ‘Mental health
health, residential care and social services.29 In the UK, at 1998 prices, the promotion in high risk group’, Effective Health Care, 3, 3, 1-12
identification of a young offender cost the police £1,200 and a successful 6. American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental
Disorders. APA
prosecution a further £2,500, while a week in a local authority secure unit cost
7. Barlow, J (1998) ‘Parent-training programmes and behaviour problems: findings from a
£3,450.29 systematic review’, in Buchanan, A and Hudson, B L (eds) Parenting, Schooling and
29
A study by Scott and others following 142 10-year-old children into adulthood, Children’s Behaviour. Ashgate, pp.89-109
8. Richardson, J and Joughin, C (2002) Parent-training Programmes for the Management of
identified the long-term costs of conduct problems. Children were grouped in Young Children with Conduct Disorders: Findings from research. Gaskell
terms of ‘no problem’, ‘conduct problems’ and ‘conduct disorders’. Data was 9. Yoshikawa, H (1994) ‘Prevention as cumulative protection: effects of early family support
gathered across six domains: special educational provision; foster and and education on chronic delinquency and its risks’, Psychological Bulletin, 15, 28-54
residential care; relationship breakdown (domestic violence and divorce); 10. McCord, W, McCord, J and Howard, A (1963) ‘Familial correlates of aggression in
nondelinquent male children’, Journal of Abnormal and Social Psychology, 62, 72-93
health; crime; and state benefits in adulthood. The mean costs by the age of 28
11. Loeber, R and Farrington, D P (2000) ‘Young children who commit crime: epidemiology,
years were: £7,423 for children with no problems; £24,324 for those with developmental origins, risk factors, early interventions and policy implications’,
conduct problems; and £70,019 for those with conduct disorders.29 Development and Psychopathology, 12, 737-62
12. Patterson, G R, Dishion, T J and Chamberlain, P (1993) ‘Outcomes and methodological
Another study, implementing Webster-Stratton’s parenting programme in a issues relating to treatment of antisocial children’, in Giles, T R (ed.) Handbook of Effective
clinical setting to see whether a behavioural approach group-based parenting Psychotherapy. Plenum Press
programme is an effective treatment for antisocial behaviour, found the cost to 13. Webster-Stratton, C (1999) ‘Researching the impact of parent training programmes on child
conduct problems’, In Lloyd, E (ed.) Parenting Matters: What works in parenting education?
be about £600 per child. This is about the same price as conventional treatment Barnardo's
for behavioural problems in childhood.4 An Ontario study that compared the 14. Ciba Foundation (1996) Genetics of Criminal and Antisocial Behaviour. Wiley
costs of community-based programmes and clinic-based individual parenting 15. Bone, M and Meltzer, H (1989) The Prevalence of Disability Among Children. HMSO
programmes indicated that group programmes based in the community were 16. Campbell, S (1995) ‘Behaviour problems in pre-school children: a review of recent research’,
Journal of Child Psychology and Psychiatry, 36, 1, 113-49
more than six times as cost-effective as the individual programmes.30 In the UK,
17. Meltzer, H and others (2000) The Mental Health of Children and Adolescents in Great
the cost of effective group-based parenting programmes ranges from £300 to Britain. TSO
£800 per child.4 18. Moffit, T E and others (1996) ‘Childhood-onset versus adolescent antisocial conduct
problems in males: natural history from ages 3 to 18 years’, Development and
Delivery and take-up Psychopathology, 8, 399-424
19. Rutter, M, Giller, H and Hagell, A (1998) Antisocial Behaviour By Young People. Cambridge
Although there has been a rapid expansion in the number of group-based University Press
parenting programmes there is no framework for systematic provision, nor for a 20. Scott, M J and Stradling, S G (1987) ‘Evaluation of a group programme for parents of
quality-assurance structure.2 There is a range of approaches delivered through a problem children’, Behavioural Psychotherapy, 15, 224-39
myriad of organisations across different sectors. Currently, there are no 21. Webster-Stratton, C (1984) ‘Randomised trial of two parenting programs for families with
conduct-disordered children’, Journal of Consulting and Clinical Psychology, 52, 666-78
standards for parent educators. Consequently, little evidence is available about 22. Coren, E and Barlow, B (2001) ‘Individual and group-based parenting programmes for
the role of parent educators’ attitudes and competencies in determining the improving psychosocial outcomes for teenage parents and their children (Cochrane
outcomes of particular programmes. Review)’, The Cochrane Library, 2004
23. Barlow, J (1999) Systematic Review of the Effectiveness of Parent-Training Programmes in
The average drop-out rate for parenting programmes is about 28 per cent.31 Improving Behaviour Problems in Children aged 3-10 years. University of Oxford, Health
Drop-out rates are higher among mothers reporting high levels of stress, and Services Research Unit
poorer families. Parents of children who have more severe conduct disorder 24. Barlow, J (1999) ‘What works in parent education programmes’, In Lloyd, E (ed.) Parenting
Matters. Barnardo’s
symptoms and more delinquent behaviour, and parents from ethnic minorities 25. Cedar, B and Levant, R F (1990) ‘A meta-analysis of the effects of parent effectiveness
are less likely to complete parenting programmes.32,33 training’, American Journal of Family Therapy, 18, 373-84
26. Bernal, M, Klinnert, M and Schultz, L (1980) ‘Outcome evaluation of behavioural parent
Conclusion training and client-centred parent counselling for children with conduct problems’, Journal
of Applied Behaviour Analysis, 13, 677-91
Children’s relationship with their parents is an important factor in their 27. Miller, S and Sambell, K (2003) ‘What do parents feel they need? Implications of parents’
development. Behaviour problems can disrupt family, school and peer relations perspectives for the facilitation of parenting programmes’, Children & Society, 17, 1, 32-44
and in the longer term may be associated with a range of problems, including 28. Barlow, J and Stewart-Brown, S (2001) ‘Understanding parenting programmes: parents'
views’, Primary Health Care Research and Development, 2, 117-30
criminal behaviour or poor work history. Group-based parenting programmes
29. Scott, S and others (2001) ‘Financial cost of social exclusion: follow up study of antisocial
are not only cost-effective but may also have a long-term impact if they are children into adulthood’, British Medical Journal, 323, 7306, 191-4
offered as a preventive measure before children are diagnosed as having a 30. Cunningham, C E, Bremner, R and Boyle, M (1995) ‘Large group community-based
conduct disorder.34 parenting programs for families of preschoolers at risk of disruptive behaviour disorders:
utilisation, cost-effectiveness and outcome’, Journal of Child Psychology and Psychiatry, 36,
7, 1141-59
Kristin Liabo, Julia Gibbs and Angela Underdown 31. Forehand, R and others (1983) ‘Dropping out of parent-training’, Behaviour Research and
Therapy, 21, 663-8
City University September 2004 32. Kazdin, A E (1990) ‘Premature termination from treatment among children referred for anti-
social behaviour’, Journal of Child Psychology and Psychiatry, 31, 3, 415-25
Further information 33. Holden, G W, Lavigne, V V and Cameron, A M (1990) ‘Probing the continuum of
effectiveness in parent training: characteristics of parents and preschoolers’, Journal of
www.incredibleyears.com for Carolyn Webster-Stratton approaches Clinical Child and Adolescent Psychology, 19, 2-8
www.newpin.org.uk National Newpin, 020 7358 5900 34. Webster-Stratton, C (2001) ‘Commentary: nipping conduct problems in the bud’, British
Medical Journal, 323, 7306, 197-8
www.nfpi.org National Family and Parenting Institute, 020 7424 3460
www.parenting-forum.org.uk Parenting Education & Support Forum,
0207 7284 8370
www.parentlineplus.org.uk Parentline Plus, 0808 800 2222
www.nice.org.uk/page.aspx?o=63312 The National Institute for Clinical Highlight No. 211 © National Children’s Bureau 2004. ISSN: 1365-9081.
Excellence will be issuing a Health Technology Appraisal on parent- Highlights may be reproduced by NCB members for non-commercial circulation
training/education programmes for children with conduct disorders, due in within their own organisation, subject to acknowledgement of source. A special price
December 2004. is available for multiple orders. Please contact the Library for further information.
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