PARENTAL OPINION ON PARENTING PROGRAMMES
Exploring parental opinion on parenting programmes.
By
Abigail Lucas
Submitted in partial fulfilment of the degree of Doctor of Psychology (Clinical Psychology)
School of PsychologyFaculty of Health and Medical Sciences
University of SurreyJuly 2017
© Abigail Rose Lucas 2017
PARENTAL OPINION ON PARENTING PROGRAMMES
Declaration
I confirm that the submitted work is my own work and that I have clearly identified
and fully acknowledged all material that is entitled to be attributed to others (whether
published or unpublished) using the referencing system set out in the programme
handbook/other programme research guidance. I agree that the University may
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PARENTAL OPINION ON PARENTING PROGRAMMES
Table of Contents
Acknowledgements.................................................................................................................5
Overview of Portfolio...............................................................................................................6
Part 4 - Major research project............................................................................................114
Exploring parental opinion on parenting programmes........................................................114
Statement of Journal Choice................................................................................................114
Abstract...............................................................................................................................115
Introduction.........................................................................................................................117
Method................................................................................................................................132
Results.................................................................................................................................137
Discussion...........................................................................................................................152
Limitations..........................................................................................................................159
Future research and implications.........................................................................................160
Conclusion..........................................................................................................................161
References...........................................................................................................................162
Appendix A. Clinical Psychology Review author guidelines..................................................167
Appendix B: Q-sort statements...........................................................................................182
Appendix C: Screen shots of the online Q-sort study..........................................................185
Appendix D: Favourable ethical approval............................................................................192
Appendix E: description of Q Methodology.........................................................................193
PARENTAL OPINION ON PARENTING PROGRAMMES4
Acknowledgements
As I reflect on this process, I am extremely grateful to a number of people. I would
like to thank my research supervisors, Mary John, Kate Gleeson and Robert
Patterson. They have provided me with continual support and encouragement
throughout this process. I would also like to thank Dr. Melanie Orchard for her role
as my mentor. She has been pivotal in me getting to this point in the doctorate
and encouraging and motivating me.
I would also like to thank my partner David who, with his unconditional love and
support I have managed to achieve this part of my journey as a Trainee Clinical
Psychologist. I also want to thank my two children, Edith and Audrey for providing
me with a meaningful, fun and welcome experience away from the intensity of the
project.
Part 4 - Major research project.
PARENTAL OPINION ON PARENTING PROGRAMMES5
Exploring parental opinion on parenting programmes.
Word count: 9954Statement of Journal Choice
This article will target Children and Society based on the content covered within the
study. This study considers literature relevant to children, parents and the wider
society and the views from parents on what they want from parenting programmes.
This study provides an innovative exploration of the currently under researched area
of parental opinion on parenting programmes outlined in the Children and Society
Journal aims and scope. The journal’s guidelines for authors is outlined in Appendix
A.
PARENTAL OPINION ON PARENTING PROGRAMMES6
Abstract
Introduction: Research into parenting programmes has typically found that parental
wellbeing, parenting practices and child wellbeing are linked, with increased parental
wellbeing and supportive parenting practices resulting in better wellbeing and
outcomes for children. As such, parenting programmes have focussed on supporting
parents in how to best manage their child’s behaviour. However, these programmes
have been largely based on professional opinion and ignore parental perspective.
Research has suggested that what parents want and need from a programme may be
different to what is being offered (Hill et al., 2007).
Aims: The research aimed to understand what a group of parents thought about
elements within current parenting programmes.
Method: A q-sort methodology was used to elucidate parental opinion about the parts
of a programme that would have the most impact on their ability to parent effectively.
64 parents were asked to sort a number of statements about current parenting
programmes on offer using an online tool.
Results: A principal components analysis was undertaken with 60 statements and 64
q-sorts. This yielded three factors that were interpreted to represent three different
understandings of parenting programmes. “A parenting toolkit of skills”, “Fix me
first” and “Nurture the nurturer”. The factors shared some similarities of what parents
report with current programmes on offer (e.g. therapeutic relationship, universal,
childcare provision) but also highlighted areas w here parents wanted different
things. The results are discussed in light of the demographics of the individuals
assessed and how this may impact on future parenting programmes.
PARENTAL OPINION ON PARENTING PROGRAMMES7
Conclusion: the results indicated that the main theme overlapped with the typical
concepts embedded in well-established programmes in services. There are however a
small group of parents where these concepts did not meet their needs. Consideration
needs to be given to more mature parents, single parents and fathers.
PARENTAL OPINION ON PARENTING PROGRAMMES8
Introduction
Parenting programmes have a well-established place within health and social care
services with evidence that they play an effective role in supporting parents. This
position has been supported by the evidenced based literature (Hill, Stafford, Seaman,
Ross, & Daniel, 2007). Hill et al. conducted a review of resilience literature and
parenting to consider discrepancies between theory and practice. They acknowledge
that parenting programmes can support parents to be warm, responsive and supportive
towards their children which facilitates positive wellbeing and the ability to cope in
the face of adversity. However, they discussed the significance of distinguishing
between theory and practice within this process. They highlighted that work around
parenting and resilience often comes from ‘expert’ opinion rather than from
discussing parental need with the parents themselves. Discussions with parents in
more detail may help individuals manage adversities more effectively. This potential
discrepancy between ‘expert’ theory and parent experience may go some way to
explain why parenting programmes have variable levels of success in supporting
parents with their own and their child’s wellbeing (Hill et al. 2007).
In addition, poor engagement of these parental programmes has been linked to a
variety of barriers to parents attending the courses in the first place (e.g. Whittaker &
Cowley, 2012). In a systematic review, Whittkaer and Cowley highlighted a number
of factors impacting on parental engagement in the programmes. They showed poor
maternal mental health and low income, poor timing of the programmes, poor
commitment to the programme due to other life commitments, negative parental
beliefs about the programme (such as it being intrusive or too demanding), and
cultural factors all played a part in poor engagement from the parent in attending
and/or completing a programme. Whittaker and Cowley also highlighted that the
programme itself impacted on engagement. For example, their systematic review
indicated that poor clarity over course content and poor understanding of the theories
PARENTAL OPINION ON PARENTING PROGRAMMES9
underpinning the programme may result in inappropriate use of the programme
resulting in lower retention rates. The facilitator of the programme is also a
significant contributor to parental engagement, with characteristics such as non-
judgmental and supportive being key to successful and long-term engagement from
parents in a programme (Miller & Sambell, 2003; Whittkaer & Cowley, 2012).
Additionally, the design of the programme was highlighted as a potential barrier to
attendance where less flexible or adaptable models resulted in poorer attendance. Use
of telephone, individual and group support increased attendance of a programme.
Kane, Wood and Barlow (2007) also found that parents wanted to learn about their
child’s behaviour, to gain more control, to experience and supportive envinroment
from the other parents in the group and to learn ways to cope.
Previous studies suggest if parent’s needs are not addressed or identified,
programmes are less effective. These studies will be discussed in more detail below.
As such, this study aimed to identify what parents think are the most important
aspects contained within the programmes. This was to help establish a more parent-
led approach to the programme’s content in the future to improve their own and
their child’s wellbeing. Evidence suggests that this parent-led approach will
effectively overcome some of the barriers to inclusion frequently seen e.g.
engagement (Miller & Sambell, 2003; Hill et al., 2007). It would increase the
quality of the interaction by improving the ‘fit’ between the needs and
expectations of parents and the provision of services.
Overview of literature
The following study aimed to consider parental opinion on five aspects of parenting
programmes. The programmes were chosen based on high levels of efficacy as
described on the UK government website
(http://www.education.gov.uk/commissioningtoolkit/Programme/ParentsSearch) and
through a previous systematic review undertaken by the author located at the
beginning of this thesis. The programmes were chosen if they scored 4 stars or more
PARENTAL OPINION ON PARENTING PROGRAMMES10
on the UK government website (indicating an effective intervention) or if they arose
from a systematic review (parenting*programmes*parent*wellbeing) and had
effective outcomes (medium/large effect size).
The programmes used from the government website and explored in the literature
review were the Triple p-parenting programme (TP; Sanders, 2008); the Incredible
Years Parent Training programme (IYPT; Webster-Stratton, 1984); and the Parent
Management Training Oregon model (PMTO; Forgatch, Bullock & Patterson, 2004). These
programmes all utilise Patterson’s coercion model of parenting (1982) as there basis for
teaching skills to change behaviour in the child. Alongside teaching behavioural change
skills, research has also shown that supporting parent’s in their own experience of stress and
parental attitudes to parenting result in positive change for parents and their child/ren
(Chronis et al, 2006). The interventions that aimed to support parents in their own
experience of stress were The Coping With Depression Course’ (CWDC; Lewinsohn et
al., 1984); and guided self-help Cognitive Behavioural Therapy (CBT; Palmer et al.,
2012). These programmes/interventions that are more in line with Deater-Deckard’s model
(1998) of parenting where the parent’s appraisal of the situation affects change. More
comprehensive descriptions and efficacy information of the programmes can be found in
the appendix (Appendix A).
To aid with consistency across the document each programme was considered against five
key criteria. These were outlined by the U K government website when describing
courses to parents, professionals and stakeholders
(http://www.education.gov.uk/commissioningtoolkit/Programme/ParentsSearch), and
were identified in a large systematic review of parenting programmes by Koerting et al
(2007). They included: (1) facilitator training/characteristics; (2) type of programme (e.g.
universal/timescale; (3) practical aspects (e.g. childcare and transport); (4) specific needs
addressed (e.g. mental health); and (5) content/models used.
PARENTAL OPINION ON PARENTING PROGRAMMES11
The results of these programmes/interventions and five aspects are discussed and
highlight similarities and differences. These discrepancies were significant in
developing the research question of whether what is currently offered to parents, is in line
with what parents want.
Introduction to the issues
Previous literature has considered the role of parental wellbeing, child wellbeing,
parenting practices and the development of parenting programmes using theoretical
models and evidence-based research (Hill et al., 2007). Theoretical models
hypothesise that parenting can be a stressful experience which impacts on the wellbeing
of both the child and parent (for a review see Bornstein, 2002). These models have
been used to help develop parenting programmes (identified by a previous systematic
review completed by the author) as they provided a framework on which to ‘hang’ the
skills, techniques and methods taught to combat parenting stress and improve
wellbeing (e.g. Deater-Deckard, 1998).
In order to contextualise the study, a definition of parental stress and parenting
programmes, an outline of key theories/parenting models utilised in the development of
parenting programmes and relevant reports are initially discussed.
Definition of parental stress
It is first important to consider the definition of parental stress to understand the
concept and its influence on the development of parenting programmes. Parental stress (for
a review see Bornstein, 2002) has been conceptualised in terms of individual
differences; where the individual’s appraisal of parenting impacts on the level of stress
experienced (Lazarus & Folkman, 1984). The stressors experienced can be understood as
the irritating, frustrating, annoying, distressing demands that to some degree characterize
everyday transactions of parenting (Kanner, Coyne, Schaefer & Lazarus, 1981).
Patterson’s coercion model of parenting (1982)
Patterson’s coercion model (Patterson, 1982) has been utilised as a framework for
PARENTAL OPINION ON PARENTING PROGRAMMES12
developing a number of programmes (e.g. Parent Management Training). Patterson’s
model specifically relates to difficult behaviour and proposes that parents using
coercion to control their child’s behaviour results in problems. Using coercion
techniques inadvertently reinforces the child’s difficult behaviours resulting in a
negative parental response. Parenting programmes aim to break this parent-child
coercive cycle using positive parenting techniques (e.g. positive or negative
reinforcement). Typically, the interventions using this approach show that children’s
behaviour improves post intervention; alongside improvements in child wellbeing,
improvements in the child’s [enhanced] academic performance, and an increased use
and confidence in using these positive parenting practices (e.g. Kratochwill,
McDonald, Levin, Young Bear-Tibbetss, & Demaray, 2004; Hagen, Ogden &
Bjørnebekk. 2010).
Deater-Deckard parenting model
Deater-Deckard (1998) postulated a parenting model that defined parenting stress as
“the aversive psychological reaction to the demands of being a parent” (p. 315),
experienced as “negative feelings toward self and toward the child or
children………directly attributable to the demands of parenthood” (p. 315). Within
this model, the authors postulated that becoming a parent is the trigger for stress. The
parent’s response to their own internal experience of this stress determines their
parenting practice. This has an indirect effect on their own and their child’s wellbeing
(positive and/or negative). When parents do not utilise effective coping in response to
stress it can cause disruptions in parenting. Their poor parental wellbeing can impair
parenting ability (e.g. Lee & Gramotnev, 2007). Therefore, it can be postulated that
effective coping may attenuate levels of parenting stress and psychological wellbeing
(Wheaton, 1985).
Parenting programmes
A useful definition of parenting programmes to help contextualise this study is
PARENTAL OPINION ON PARENTING PROGRAMMES13
provided by the parentinguk website (http://www.parentinguk.org/your-
work/programmes/). They state that 'There are many different types and styles of
parenting programme available. These program`s are designed to improve parental
effectiveness by providing a clear parenting philosophy and a set of positive parenting
skills and strategies. Different programmes are designed for addressing certain issues or
working with certain communities. It is important that practitioners, who know the needs
of the parents they work with, should select programmes suited to them.’
Government policy for parenting programmes
Public and political concern about parenting and the need for parenting programmes led
to two commissioned reports. The two reports highlighted the services on offer to
children and families. They promoted the role of resilience, prevention and early
intervention. In their respective reports they drew attention that care for children and
families was falling below standard and not meeting the needs of parents (Future in
mind: Promoting, protecting and improving our children and young people’s mental
health and wellbeing, Department of Health, 2015; Report on Children, young people and
families, Youngminds, 2014).
They responded to these concerns and limitations in an effort to improve child and
family wellbeing and care. They gathered opinions from experts and parent/carers
and highlighted two short comings in current services: (1) content of the
programmes; and
(2) accessibility to them. In relation to the content emphasised was a need to improve
the parent-child relationship, build resilience and improve child behaviour.
Additionally a need to identify what parents, families and children want and need
from a programme was highlighted. With regards to accessibility, they highlighted
the need for further research into evidence-based programmes to understand what
was hindering parental engagement. Doing this would help overcome/resolve these
issues to increase engagement and potentially effectiveness (Hill et al., 2007).
PARENTAL OPINION ON PARENTING PROGRAMMES14
Critique of the literature
The following analysis identified the common/similarities and discrete differences in
the programmes using the five criteria. This provided a background to the current
study exploring what parents say they want in a parenting programme.
Overview of programmes/interventions
Critique of the five criteria against the programmes
The following section discusses the programmes using the five key criteria identified
at the outset of this document. Similarities and differences in efficacy and parental
views are explored. This critical analysis provides the basis for exploring whether
parental views on parenting programmes/interventions are in line with what is
currently offered.
Facilitator characteristic
Facilitator characteristics have been shown to be significant to parents’ experience of
a programme (e.g. Koerting et al., 2013). In relation to the programmes in this study,
research has shown parents report the therapeutic relationship with the facilitator aids
positive change in child behaviour, parental behaviour and overall wellbeing
(Holtrop, Parra-Cardona & Forgatch, 2014; Akin & Gomi, 2017). Specific facilitator
characteristics valued by parents are being warm, approachable, friendly, non-
judgemental, affirming and making information accessible (TP programme; Wilson et
al. 2012; IYPT programme; Furlong et al., 2010). Parents reported these positive
characteristics facilitated their ability to learn ways to manage their child’s behaviour
(Wilson et al’s, 2012).
Practical aspects
PARENTAL OPINION ON PARENTING PROGRAMMES15
Research has also shown the practical aspects associated with attending parenting
programmes to be significant in its success (Koerting et al., 2013; Law, Plunket,
Taylor& Gunning, 2009; Wilson et al, 2012). Research highlights that parents report
increased engagement when there is a choice of different times for sessions, proximal
closeness to their homes, provision of childcare and being able to physically attend
(TP programme, Sanders 2008; Wilson et al, 2012; CBT; Palmer et al. 2012). Parents
have also reported homework and workbooks helps consolidate learning (PMTO,
Forgatch et al., 2004; Holtrop et al. 2014). Aligned to this consolidation of learning is
the professional perspective outlined in the CWDC manual (Lewinsohn et al, 1984)
which highlighted the importance of homework assignments.
Research has also highlighted parental reports of practical barriers to engagement.
These included poor presentation of information (TP programme, Wilson et al, 2012),
long duration of the programme (TP programme; Wilson et al. 2012; PMTO, Akin &
Gomi, 2017) and external situations impeding engagement such as starting a new job
or being unwell (IYPT; Furlong et al., 2010).
There was variation in parental reports about some practical aspects. For example,
some parents reported a group format as intrusive whereas others reported it as a
valuable learning experience (TP programme; Wilson et al. 2012). In common with
the positive parental reports of a group, the CWDC manual encouraged a group
format to explore alternative views and aid group cohesion (Lewinsohn et al 1984).
Methods of learning were also experienced differently. Some parents reported
enjoying aspects such as role play to consolidate and practice the skills whereas
others found it awkward (PMTO; Holtrop et al. 2014).
Here, the difference in opinion between parents, and between professionals and
parents supports Hill et al’s (2007) observation: what parents want is not always
aligned with what other parents want or with what professionals believe is required.
Type of programme
PARENTAL OPINION ON PARENTING PROGRAMMES16
The ‘type of programme’ refers to whether the programme/intervention is universal
or targeted. Typically research into the TP (Sanders, 2008), IYPT (Webster-Stratton,
1984) and PMTO (Forgatch et al., 2004) have shown a targeted approach to be more
effective than a universal one (see Table 1: TP: Nowak & Heinrich, 2008; IYPT:
Menting, De Castro & Matthys, 2013; Chamberlain et al., 2008; PMTO; Akin &
Gomi, 2017). The research indicates that the parents in a programme that targets a
variety of needs do less well than those with a common concern (see Table 1 with
effect sizes). The reason for this variation is yet to be established but one explanation
is that parents and children in the intensive programmes report higher levels of
distress at the start. They are therefore more likely to make clinically significant gains
in comparison to those who report less distress.
However, it is difficult to disentangle the cause of these differences as being due to
the delivery format of the intervention (targeted or universal) or the level of parental
distress at the outset (high or low).
PARENTAL OPINION ON PARENTING PROGRAMMES17
Table 1. A table showing the effect sizes from three meta-analyses into the TP and IYPT programmes.Study Se
verity of dist
Severity of
Targeted Child
Universal chi
Targeted parent
Universal Par
Nowak& Heinrich, 2008
level 1-3d =
level 1-3
d =.43
d =.20
d =.16
d =.15
Menting, De Castr
n/a n/a
d = .27
n/a n/a n/a
Chamberlain et al., (2008
n/a Highdistress:
n/a n/a d = .50
n/a
Akin&
Gomi (2017)
OR= 1.005, p=.11
n/a
n/a n/a n/a n/a
The Palmer et al’s (2012) study did not report effect sizes but some reports from parents
suggested the universal approach may not have met their needs. For example, parents with
dyslexia (in particular) reported delivery format being a problem. It is possible that parents
with additional needs (e.g. being deaf or visually impaired) require a more targeted and
specialised method of delivery, such as only face-to-face.
PARENTAL OPINION ON PARENTING PROGRAMMES18
Specific needs addressed (e.g. mental health, ADHD, ASD)
Whether a programme focuses on a specific need in a family is also a key criteria in
considering parenting programmes. Results have been mixed, with some positive and
some negative parental reports (TP programme, Sanders, 2008; Wilson et al. 2012;
PMTO; Holtrop et al., 2014). For example, parents in Wilson’s large scale evaluation
(2012) of the TP programme (Sanders, 2008) reported it was aimed at the wrong age
group or at children with discrete difficulties and did not meet their needs (e.g.
Attention Deficit Hyperactivity Disorder; ADHD). However, some parents reported
the variety of children’s ages within the programme was positive as they had the
opportunity to learn about child development. It also raised awareness of future
difficulties and ways to effectively manage them.
Research has also highlighted effective use of the PMTO (Forgatch et al., 2004) for
specific groups of parents (e.g. Holtrop et al. 2014). However, a number of
difficulties have been encountered. For example, Akin and Gomi (2017) found
parental internal and external pressures (e.g. substance abuse) resulted in poor
outcomes due to non-completion of the programme. Programmes focusing on
parental wellbeing may be useful for these parents over and above those focussing
on child behaviour (e.g. Deater-Deckard, 1982).
For example, results of Chronis et al’s (2006) intervention showed that maternal
functioning (depression, anxiety, perceived stress, self-esteem and cognitions about
their child’s behaviour) improved from pre-treatment to post-treatment for the
treatment group relative to the waiting list control (in all cases, p<.05, d<.29). There
were also significant improvements in child behaviour pre to post treatment. The
authors explained these results by improvements in the mother’s depression. Mothers
had more positive perceptions of their child’s behaviour as opposed to their child’s
PARENTAL OPINION ON PARENTING PROGRAMMES19
behaviour actually improving (indicated by no change in teacher ratings of child
behaviour). It supports Deater-Deckards (1998) model of parenting where altering an
internal experience of depression and stress reduces negative appraisals of disruptive
behaviour.
Content/models used
Research has typically highlighted parents felt better able to manage their child’s
behaviour using positive parenting techniques derived from Patterson’s model
(Webster-Stratton, 1984; Hutchings et al., 2007; Scott et al., 2001; Bodenmann, Cina,
Lederman & Sanders, 2008; Sanders, Bor & Morwaska, 2007; Sanders, Markie-
Dadds, Tully & Bor, 2000). Results have indicated that use of less coercive and
punishment based strategies resulted in better behaviour from children and better
wellbeing for children and their parents. (TP programme: Sanders, Kirby, Tellegen &
Day, 2014; IYPT: Furlong et al., 2010; PMTO; Holtrop, Parra-Cardona & Forgatch,
2014).
For example, Sanders et al. (2014) conducted a large scale meta-analysis and
systematic review on 116 eligible studies over a 33-year period, with 101 studies
comprising 16,099 families. They found significant short-term effects for: children's
social, emotional and behavioural outcomes (d = 0.473); positive parenting practices
(d = 0.578); parenting satisfaction and efficacy (d = 0.519); parental adjustment (d =
0.340); improved parental relationships (d = 0.225) and child observational data (d =
0.501). In addition, significant long-term effects were found for all outcomes
including parent observational data (d = 0.249).
Although there is evidence to support the benefits of Patterson’s coercion model of
parenting (1982), some parents have reported the content or teaching of positive
parenting practices as not relevant to them (TP programme; Wilson et al, 2012) or
that
PARENTAL OPINION ON PARENTING PROGRAMMES20
information on how to manage negative behaviours was lacking (IYPT; Furlong et
al., 2010). This raises a question about whether parents feel the model
provides an appropriate explanatory framework for how to parent effectively.
Outlining the theory and rationale behind positive parenting practices at the outset
of a programme may help resolve this.
Both Chronis et al (2006) and Palmer et al’s (2012) study utilised CBT. Parents learnt
ways to manage their thoughts, feelings and behaviours more effectively with the aim
of improving wellbeing and their relationship with their child. Results from the
studies indicated mothers reported improved self-esteem, better coping strategies,
and increased positive thinking about themselves and their parenting skills (e.g.
Chronis et al’s, 2006; mean effect size d= .31). Again, this provides support for a
programme focussing on those with specific needs and that improving parent’s
wellbeing improves the parenting experience (Deater-Deckards, 1982).
Summary
As can be seen from the research explored above, there are varying results in
programme effectiveness and parental reports of what they find helpful and unhelpful.
For example, some parents reported positive experience of a group format (e.g.
Wilson et al. 2012) whereas others report finding this overwhelming and
intrusive (e.g. Holtrop et al., 2014). Some results indicate that the TP programme
has high efficacy (e.g. Nowak & Heinrich, 2008) whereas others question this and
its generalised use as a primary intervention for parents (Wilson et al. 2012).
Research also highlights that some parents value a behavioural approach (e.g.
Sanders et al., 2007) whereas a CBT approach is also helpful for those with specific
needs (e.g. Chronis et al., 2006). This variation in both efficacy and parental views
is in line with the observations outlined by Hill et al (2007). They suggested that
further research on parental views of
PARENTAL OPINION ON PARENTING PROGRAMMES21
parenting programmes is required to ensure their needs are being met. As such, this
study aims to further understand what parents want from parental programmes.
Research question.
This study aimed to understand what parents want from a parenting programme.
Using a Q Methodology, it proposed to clarify what parents felt would be the most
important elements in a parenting programme. It aimed to consider what parents
believe would have a positive effect on them in a parenting programme. This was
explored using the five aspects covered in the programmes/interventions
discussed above. By understanding this, future services can target programmes with
appropriate content for parent’s needs.
Method
General Overview of Q Methodology
Q methodology provides a comprehensive overview of shared viewpoints and
perspectives from the participants regarding the research question (Stephenson,
1953). Research has highlighted that it is an effective exploratory technique
enabling investigation of participant’s beliefs and values (Baker, 2006). As
highlighted by Watts and Stenner (2012) it combines both qualitative and
quantitative research methods to discern participant’s subjective views on a topic.
For a description of Q Methodology see appendix E.
Q Set Design and Content
The Q set is the set of statements or ideas which are prepared by the researcher and
given to the participant to sort. In this study, the Q set was generated from two
different sources. The parental programmes were chosen based on high levels of
efficacy as described on the government website
(http://www.education.gov.uk/commissioning
PARENTAL OPINION ON PARENTING PROGRAMMES22
toolkit/Programme/ParentsSearch) and through a previous literature review
undertaken by the author. The programmes were chosen if they scored 4 stars or more
on the government website (indicating an effective intervention) or if they arose from
a systematic review (parenting*programmes*parent*wellbeing) and had effective
outcomes (medium/large effect size). This process was completed to ensure coverage
and balance within the q-set (Watts & Stenner, 2012).
Each programme was deconstructed according to the five key aspects (type of
programme, facilitator characteristics, content/model, practical aspects, specific
need). Themes from these various sources were then re-framed into ideas for
statements relating to parenting programmes through discussions with child
psychologists, researchers and through a pilot study (discussed below). A
comprehensive list of statements was formulated in line with these five aspects.
This yielded a set of 152 statements. The statements then underwent a process of
development and re-design as some statements had overlapping themes. Again, this
was done in discussions with research supervisors and child psychologists. A
consensus was reached when the overlap was reduced resulting in a final set
containing 60 items (see Appendix A).
Study Pilot
The study was piloted on two participants (parents and colleagues of the researcher)
who were asked for feedback regarding the statement list, the study instructions and
the process of sorting. Participants completed an online version of the q-sort. Both
agreed that the instructions were clear and easy to follow and the Q set covered
relevant aspects. Both participants were able to complete the Q sort and were
satisfied with the result, stating that the final arrangement of statements provided an
accurate description of their view-point.
PARENTAL OPINION ON PARENTING PROGRAMMES23
Participants
Participants were recruited via personal contacts using email and a snowballing
recruitment strategy. As such, demographics were not pre-determined. It was hoped
that using a snowballing strategy would capture a range of parental view-points on
parenting programmes (Sadler, Lee, Lim, & Fullerton, 2010). Personal contacts of
the researcher were approached if they were known parents with children aged
between 0-11 years old. Snowballing was achieved when these personal contacts
provided contacts of parents they knew. The researcher then approached these
parents via email. Participant demographics (age, income, marital status, number
of children, and mental health) was collected (See Table 1).
Administering the Q Sort
Participation was voluntary, confidential and participants were informed that they
could withdraw at any point without consequence. Once recruited to the study,
participants were emailed a link to an online version of the study to complete. All
participants completed the Q sorts in their own time away from the researcher.
The online system included detailed instructions on how to complete the Q sort (see
Appendix B for screen shots of the online q-sort). Participants read a screen outlining
‘Participant Information’ about the study and consent was requested at the bottom of
the page. If participants clicked onto the next page, consent had been agreed.
Participants still had the right to withdraw or stop the study at any point without
consequence.
Participants were asked to read the instructions and short vignette stating “To
complete the task, consider the following: You are thinking about attending a
parenting group. What would you hope to experience? What would be the critical
components for you?”
PARENTAL OPINION ON PARENTING PROGRAMMES24
This ensured participants were able to contextualise the statements as participant
inclusion criteria were both attendance and non-attendance at a parenting programme.
Participants then saw 60 statements about parenting programmes on the screen,
which appeared one at a time. They were asked to sort these into agree, disagree or
neutral ‘piles’ on the screen. Following this, they then sorted the statements into
an online sorting grid depending on how much they agreed, disagreed or felt
neutrally about them. Although participants may have had unequal agree, disagree
and neutral piles initially, the Q sort process forced them to sort the statements in
a particular shape. This meant that statements were sorted by agreement or
disagreement of items relative to each other rather than by absolute agreement. A
13-point scale was used for the forced distribution, with rankings from -6 (strongly
disagree) to +6 (strongly agree). See Figure 1 for a diagram of the sorting grid.
-6 -5 -4 -3 -2 -1 0 +1 +2 +3 +4 +5 +6
Least Important Most important
Figure 1. Q Sort grid
PARENTAL OPINION ON PARENTING PROGRAMMES25
Participants were encouraged to keep moving the statements around until they felt
satisfied with where they were placed. Participants were then asked to submit their
final sort which was stored onto the system under anonymous identification numbers.
Data Statistical Analysis
In this study, all factors were extracted using Horst's 5.5 Centroid Factor Analysis
with iterative solutions for communalities (Horst, 1965). This was used because it is
a more refined approach and does not show some irregularities which can sometimes
be found when using Brown's (1980) customary method of Centroid Factor
Analysis (Schmolck, 2014a). Once extracted, factors were rotated manually
using the PQ Method program (for further information see Schmolck, 2014b)
positioning the factors such that they accounted for the maximum amount of the
study variance, according to statistical criteria (Watts & Stenner, 2012).
Factor extraction and rotation
To be included in the solution, factors needed to satisfy the Kaiser-Guttman criteria
(Guttman, 1954) by having rotated eigenvalues greater than 1.00. In addition, they
needed to satisfy Humphrey’s rule, where the two highest factor loadings multiplied
together should not exceed the standard error. Factors also required two or more
significantly loading Q sorts (Watts & Stenner, 2012). As is customary in Q
methodology (Brown, 1980), significantly loading Q sorts at the 0.01 level were
calculated using the equation 2.58 x (1÷√no. items in Q set) = 0.38. Solutions were
selected where a ‘healthy’ amount of the study variance was accounted for by the
extracted factors (at least 35-40% of the study variance, Kline (1994), where
correlations between the factors were as low as possible and where as many Q sorts
as possible loaded onto the factors.
PARENTAL OPINION ON PARENTING PROGRAMMES26
Ethics
Ethical approval was obtained from The University of Surrey’s Faculty of Arts and
Human Sciences ethics committee (see appendix D for signed ethics approval letter).
Results
Demographic data (see Table 2) indicated that the majority of participants were
female (80%). Most were aged between 35 and 44years old (45%). Most parents
were married (66%), had between 1 and 2 children (95%), earned more than
£50,000 (56%) and most reported having a mental health difficulty (66%). This
sample may be relatively limited in its demographic spread and will be explored in
the context of the results in the discussion section of the document.
PARENTAL OPINION ON PARENTING PROGRAMMES27
Table 2.Demographic Characteristics (N=64).
DepressionAgeLess than 25 (%) 6 (9)25-34 (%) 24 (38)35-44 (%) 29 (45)45-54 (%) 5 (8)GenderMale (%) 13 (20)Female (%) 51 (80)No. Children1 (%) 25 (55)2 (%) 25 (40)3 (%) 2 (3)4 (%) 1 (1)More than 4 1 (1)Marital StatusMarried (%) 42 (66)Single (%) 5 (8)Cohabiting (%) 17 (27)Other (%) 0 (0)Any Reported Mental Health difficultyNone (%) 28 (44)Depression (%) 16 (25)Anxiety (%) 13 (20)OCD (%) 5 (8)Suicide attempts (%) 2 (3)
Other (%) 0 (0)Income (£1000 per year)Less than 10,000 (%) 2 (3)11-15 (%) 4 (6)16-25 (%) 8 (13)26-30 (%) 3 (5)31-40 (%) 5 (8)41-50 (%) 6 (9)50+ (%) 36 (56)
PARENTAL OPINION ON PARENTING PROGRAMMES28
Following the analysis, three factors were manually extracted and rotated. These
three factors (parenting toolkit; fix me first; nurture the nurturer) together explained
39% of the study variance. Thirty-eight of the 64 Q sorts loaded significantly onto
one of these three factors (with factor loadings of +-.38 or above indicating
significance at the p <
.01 level). There were 14 non-significant Q sorts, meaning that they did not load
significantly onto any of the three factors. There were ten confounding factors,
meaning that they loaded significantly onto more than one of the factors. These ten
confounded sorts and 16 non-significant sorts were removed from analysis and not
included in factor interpretation.
Factor interpretation is discussed in the same way for each factor. Each factor has a
title and a brief summary followed by the demographics of participants loading onto
the factor. Presentation of demographic information is common practice in Q
methodology and is mainly used to describe the type of people who load onto each
factor, rather than to compare demographics across factors. Table 3 shows factor
loadings for each participant along with corresponding demographic data. Where
necessary in the text, the ranking of the statement is denoted by the number of the
statement followed by the ranking of that statement (e.g. 10: -3 indicating that
statement 10 was sorted at the -3 point on the grid). Figures representing loadings of
sorts across each array are also included within the text for ease of reference. It
should be noted that the correlations between factors were not significant, indicating
that the factors represent clear distinct ideas (all r’s +/-<.27).
PARENTAL OPINION ON PARENTING PROGRAMMES29
Table 3. Factor loadings for each participant
Ppt Gender Income (£1000)
No. children
Mental health Marital status
Loading on factor 1
Loading on factor 2
Loading on factor 3
1 F 50+ 2 None Married .2091 -.3338 .03622 F 50+ 2 Depression Co-habiting -.1355 -.1009 -.20853 F 31-40 2 None Married .6567 .0418 .28444 F 50+ 1 None Married .4044 -.1500 .54105 F 31-40 8 OCD Single .6829 -.0445 -.06306 F 16-25 1 None Co-habiting .1081 -.1305 -.30527 F 50+ 1 None Married -.0754 .0093 .19018 F 11-15 1 Suicide
attemptsCo-habiting .5280 .5280 -.2187
9 F 50+ 1 Anxiety Married .7304 .0166 .254510 F 50+ 1 None Married .5976 -.1312 .360911 F 16-25 1 Depression Co-habiting .5081 .0342 .176812 F 11-15 1 Anxiety Married .4719 .0053 .043213 M 50+ 2 None Married .4959 -.1370 .585514 M 50+ 2 None Co-habiting .7106 .0408 .243615 F 31-40 1 None Co-habiting .3345 .0049 .125016 F 50+ 2 None Co-habiting .6057 -.0686 .214217 F Less than 10 1 None Co-habiting .4652 .3090 -.170718 F 50+ 2 None Married .6788 -0.450 .033119 F 26-30 3 None Single .2866 -.1279 .266820 F 50+ 2 None Married .7306 .1221 .037221 F 41-50 1 Anxiety Co-habiting .6012 .0551 -.046122 F 41-50 2 None Married .4303 -.3504 .042723 F 50+ 1 None Married .6307 -.0549 .312824 F 50+ 1 Depression Married .4689 .1061 .322825 F 50+ 1 None Married .7246 -.1289 -.059326 F 50+ 2 Depression Married .6958 .0094 .0607
PARENTAL OPINION ON PARENTING PROGRAMMES140
27 F 50+ 3 None Married .4922 .0468 .172328 M 11-15 2 Anxiety Married .5459 .3101 -.041329 F 50+ 2 None Married .6789 .3562 .073230 M 26-30 1 Depression Co-habiting .3434 .4928 -.2642
31 F 16-25 1 Depression Single .3476 .1123 .114932 F 50+ 2 None Married .6192 .0038 .155833 M 31-40 2 Suicide
attemptsCo-habiting .4374 .3217 .0652
34 F 50+ 1 Anxiety Married .3437 .0161 .124335 F 16-25 2 Depression Co-habiting .6094 .2544 -.2664
36 F 11-15 1 None Single .1239 -.2086 .514237 F 50+ 1 Anxiety Co-habiting .6426 .4725 -.1359
38 F 50+ 2 None Married .4555 .1969 .275439 M 26-30 2 Depression Married .6557 -.1664 .282340 F 26-30 2 None Married .3461 -.2963 .333841 M 50+ 1 Anxiety Co-habiting .3665 .5253 -.0966
42 F 50+ 2 None Married .2731 -.3225 .462843 F 41-50 1 None Married .6474 .1682 .288744 F 16-25 1 Depression Co-habiting .6183 .2032 .1573
45 F 50+ 2 None Co-habiting .6688 .2682 -.0997
46 F 16-25 1 Depression Single .2033 -.0256 .3015
PARENTAL OPINION ON PARENTING PROGRAMMES31
47 F 50+ 1 Anxiety Married .6435 .0614 .000748 M 41-50 2 Depression Married .4805 .1405 -.441649 F 31-40 1 Anxiety Married .2535 -.3951 -.410550 F 16-25 1 None Married .2172 .1019 -.078751 M 50+ 4 Depression Married .3158 -.2038 -.419852 F Less than 10 1 None Married .4137 -.0746 -.4788
53 F 16-25 2 OCD Married .4590 -.0199 -.342454 F 50+ 1 OCD Married .3021 -.1263 -.592655 F 50+ 2 Anxiety Married .2234 .0492 -.424756 F 41-50 1 Anxiety Married .2100 -.1165 -.204057 F 41-50 1 OCD Married .5058 -.0668 -.291658 M 50+ 2 Depression Married .3624 -.1436 -.228859 M 50+ 1 Depression Co-habiting -.0073 -.2494 -.1774
60 F 50+ 1 Anxiety Married .3953 .0501 -.548861 M 50+ 1 Depression Married .1272 -.0640 -.134662 F 50+ 1 Anxiety Married .1435 -.3636 -.392863 F 50+ 2 OCD Married .4652 .0092 -.036964 M 50+ 1 Depression Married .3891 -.0087 -.5457
n.b. Numbers in bold represent significant loadings above .38. Data in italics represents confounding sorts, and data in normal font represent
non-significant sorts.
PARENTAL OPINION ON PARENTING PROGRAMMES32
Factor one: parenting toolkit (see figure 2 for factor array; # =factor number from Table 3, + or- signifies where they placed the item onto the q-sort).
Participants on factor one agreed that parenting workshops focussing on their child’s
wellbeing and learning of skills to change their child’s behaviour was most important
over and above the basic practicalities of attending and their own wellbeing. The
individuals in this group wanted to learn specific parenting skills that would enable
them to parent their children more effectively. They wanted to have a ‘toolkit’ of
techniques they could utilise with their children in a practical way. They were less
interested in emotional support.
Factor one had a rotated eigenvalue of 15.27 and explained 24% of the study
variance. Thirty-one participants loaded significantly onto this factor. Participants on
this factor were largely female (84%) with only one of the males in the study
loading onto this factor, with over half being 35 years old or over (58%). The
majority of them had more than one child (58%) and a large proportion of them were
married (68%). Over half of them earned more than £50,000 per year. And it was a
fairly even split between those who did and did not experience mental health
difficulties (52% versus 48%, respectively).
The most defining q-sorts on this factor were around increasing their child’s
wellbeing (child focussed factors) and an externalisation of how this change would
occur (parent focussed factors). In relation to the child focussed factors, the items
focussed on ways in which the child could change or learn new skills to both
behave better and have increased wellbeing that would, in turn improve wellbeing
for the parent. For example, items highlighted as important were to learn how to
build confidence in their children (#8, +6) and to feel more competent as a parent
(#20, +6). Specific skills to help their children manage their own behaviours were
also ranked as significant and included learning how to encourage their child to
problem solve (#23: +4), learning skills to
PARENTAL OPINION ON PARENTING PROGRAMMES143
communicate as a family (#22, +4), and learning how to reduce their child’s stress
(#16, +4).
In relation to the external or parent-focussed factors, individuals in this group also felt
that learning how to deal with conflict effectively (#9, +5), learning how to build their
own confidence as a parent (#7, +5), and learning to nurture their child’s
development (#19, +5) were all significant ‘active ingredients’ they would want to
see in a parenting group. Increasing knowledge of their child’s development (#18,
+3), learning how to problem solve difficult situations (#10, +3) and learning how to
set limits for my child (#21, +3) were all also rated highly.
While participants agreed strongly that the child’s wellbeing were central to the
success of a parenting programme, they were less concerned with the basic
practicalities surrounding the course. Participants strongly felt that the provision of
food and transportation were unnecessary to the ‘active ingredients’ in a parenting
programme where both items (#39 and #40) scored -6. They also agreed that learning
about healthy eating was not a pertinent items in a parenting group (#43, -5). Having
classes during the day were also ranked low (#29, -4) and participants in this group
felt that meeting the team running the group beforehand, doing homework activities
and having reminders about the sessions were not important (#48, -5; #25, -4; #26, -4,
respectively). Additionally, parents in this group did not value decreasing their own
awareness on the negatives in their lives as key to a successful parenting group (#46,
-5).
There were also a number of items that were ranked as less relevant in this factor. It
can be suggested that participants were indifferent towards them or felt them
irrelevant to the overall aims of the parenting group. In this group of
participants, the items typically fell around the theme of gaining support from
other group members, both
PARENTAL OPINION ON PARENTING PROGRAMMES34
inside and outside of the parenting workshops. Having buddy networks encouraged in
the group, to meet people like me in the group and seeking support when stressed
were all rated around the middle of the grid indicating a neutral response (#60, -1;
#27, -1:
#11, 0, respectively). In addition, participants ranked issues around the learning of
information or learning of skills related to their own wellbeing as less significant. For
example, learning mindfulness skills, learning about the parent-child bond, learning
to be aware of my feelings, and learning to control emotions were all rated as less
relevant to those on this factor (e.g. #6, 0; #12, +1; #58, -1; #2, +1, respectively).
PARENTAL OPINION ON PARENTING PROGRAMMES35
Figure 2. Factor array for factor one.
PARENTAL OPINION ON PARENTING PROGRAMMES36
Factor two: fix me first (see figure 3 for factor array; # =factor number from Table 3, + or- signifies where they placed the item onto the q-sort).
This factor array was understood through considering two defining sorts (see Table
1). Factor two had a rotated eigenvalue of 3.51 and explained 5% of the study
variance. Two participants were considered as the defining sorts on this factor.
Participants on this factor were male. Both had one child and both were co-
habiting. One of them earned more than £50,000 per year and both reported mental
health difficulties.
In contrast to factor one, participants on factor two agreed that parenting workshops
focussing on their own wellbeing and learning of skills to change their own behaviour
was most important. This factor and the statements associated with it were about the
parent feeling better able to parent if their own emotional needs were met first. Put
simply, they wanted to get support for managing their own feelings which would
enable them to parent their child/ren more effectively: the parent learning how to
improve their own emotions would improve their child’s wellbeing. They also felt
less reliant on the facilitator or other group members for this change indicated by
negative scores on the items around further communication outside of sessions.
The most highly polarizing q-sorts on this factor were around increasing their own
wellbeing. Specifically, the items of learning how to self soothe and being more
aware of their own body signals and sensations were important (#3, +6; #1, +6,
respectively). Learning how to control their own emotions and learning relaxation
skills were also rated as important (#2, +5; #5, +5, respectively). Additionally,
participants in this group also valued doing homework activities in order to
consolidate the skills (#25,
+5). Parents encapsulating this factor further rated learning mindfulness skills and
decreasing their awareness on the negatives in their lives as important (#6, +4; #46,
+4). In contrast to factor one, individuals in this group also felt that having
transportation provided was important (#40, +5).
PARENTAL OPINION ON PARENTING PROGRAMMES37
While participants agreed strongly that their own wellbeing was paramount to a
parenting programme, they did not agree that communication and support from the
facilitator/s and other parents was important. This suggests they were keen to learn
how to manage their own wellbeing without the support of others and keep the group
separate from their day-to-day lives. For example, participants felt that having
reminders about sessions (e.g. via text messages) were not vital aspects for a
parenting group (#26: -5). In addition, buddy networks being encouraged between
parents was not considered helpful (#60, -6) and having group discussion to learn
new skills was not valued (#35, -5). Furthermore, individuals in this group did not
consider collaborative working between facilitator/s and parents (#52, -5), protection
concerns being addressed (#57, -4), and promotion of a safe and supportive
environment (#42,
-4) as important in a parenting group.
Neutral items for these sorts indicated less value being placed on items relating to the
learning of new skills by their child/ren and wider family to help manage their
wellbeing. For example, learning how to encourage their children to problem solve
(#23, -1), learning about the parent-child bond (#12, 0), learning how to establish
family rules (#24, +1) and increasing their knowledge about their child’s
development (#18, +1) were all ranked neutrally in the array. Facilitator
characteristics were also considered less relevant with facilitators being non-
judgemental (#32, -1), facilitators listening (#33, -1) and facilitators being
approachable (#31, -2) ranked towards the neutral area.
Figure 3. Factor array for factor two
PARENTAL OPINION ON PARENTING PROGRAMMES38
PARENTAL OPINION ON PARENTING PROGRAMMES39
Factor three: nurture the nurturer (see figure 4 for factor array; # =factor number from Table 3, + or- signifies where they placed the item onto the q-sort).
For the purposes of this factor, one participant has been used as a defining sort. There
were five sorts that loaded significantly onto this factor, four of which were polarised.
It was felt that discussing the sort loading positively onto the factor would provide an
interesting exploration of the array. As such, the following results are discussed
according to this one defining sort. Factor three had a rotated eigenvalue of 5.61 and
explained 9% of the study variance. The defining sort in this factor was a female,
who was single, no reported mental health difficulties and with a low income
(<£10K).
When considering the statements in this factor and the defining sort associated with
the array, the theme of the parent wanting to be nurtured was apparent. A sense of
them feeling isolated and lonely was highlighted by both the statements (discussed in
more detail below) and the demographics of the participants defining the sort. For
example, a single mother on a low income may struggle to meet with others and gain
support from other networks. Supporting this idea, the most defining statements on
this factor were the promotion of a safe and supportive environment (#42, +6), the
facilitators being approachable (#31, +5), non-judgmental (#32, +5), listening (#33,
+4) and the facilitator having previous experience of working with parents (#53, +4).
Further practical issues were also ranked as important such as having day classes
(#29, +5) and the group being universal and open to all (#49, +4). In contrast to
factor one, parents in this group also rated learning about healthy eating (#43, +6)
and learning about healthy living (#44, +3). These statements all point towards
someone who values being ‘looked after’ in some way and having their emotional,
physical and health needs met by someone else: they want to be nurtured. It may be
that they are looking for a mentor to help them navigate raising a child or someone
who could potentially look after their child (e.g. providing the child with healthy
PARENTAL OPINION ON PARENTING PROGRAMMES40
eating and healthy living) as they feel enhancing their own wellbeing is less relevant
to them.
While the sort agreed strongly that being nurtured through the learning environment
and facilitator was important, they did not feel that learning skills for their own
wellbeing was as important. This is in contrast to factor one. For example, they
highlighted that learning to self soothe (#3, -6), learning how to reduce their own
stress (#15, -5), to learn skills to communicate as a family (#22, -5), to feel more
competent as a parent (#20, -4) and learning to deal with conflict effectively (#9, -6)
were not significant ingredients for them in a parenting group. Nor was it important
for the facilitator to be approachable (#31, -3). However, they did want them to be
knowledgeable (#34, 1). This makes sense in the context of what they feel is most
important as they want someone else to care for these needs. They do not want to
have to learn how to manage their own wellbeing they want a ‘mother’ figure to do
this for them.
Aspects in this factor that participants rated as neutral were typically issues around
learning specific skills to help manage their own and child/ren’s wellbeing. For
example, learning mindfulness skills (#6, -1), learning how to reduce their child’s
stress (#16, +1), learning relaxation skills (#5, +1) and learning communication
techniques (#47, +1) were all considered less relevant.
PARENTAL OPINION ON PARENTING PROGRAMMES41
PARENTAL OPINION ON PARENTING PROGRAMMES151
Figure 4. Factor array for factor three
PARENTAL OPINION ON PARENTING PROGRAMMES42
Discussion
The current study aimed explore, from a sample of parents, what their opinion was on
five specific aspects (facilitator characteristics, type of programme, model/content,
practical aspects and specific need) within five significant parenting
programmes/interventions TP programme (Sanders, 2008); the IYPT (Webster-
Stratton, 1984); and the PMTO (Forgatch et al., 2004). The interventions taken from
the literature review are the CWDC (Chronis et al. 2006); and guided self-help
cognitive behavioural therapy (CBT; Palmer et al., 2012) which were established
from a previous literature review and from a key government website on parenting
programmes/interventions (http://www.education.gov.uk/commissioning
toolkit/Programme/ParentsSearch).
Previous research highlighted above indicated some variability in parental views and
efficacy across these programmes and in relation to the five key aspects. In an attempt
to address these discrepancies, this study set out to discover what parents want from a
parenting programme in order for them to be best supported depending on their needs
and level of engagement. Following parental engagement with the task of sorting
items form the concourse, the results indicated three distinct factors. Factor one
highlighted value in learning a toolkit of skills to aid parenting. The second Factor
spoke to the idea of ‘fixing the parent first’, where the goal of attending was to stop
‘feeling’ bad as a parent. Factor three indicated the idea of ‘nurturing the
nurturer’, where the emphasis was on the parent wanting someone to care for
and comfort them [the parent], and provide guidance during the group.
Discussions of findings in the context of previous literature
Previous research has highlighted that parenting can be stressful (Deater-Deckard,
1998; Pottie & Ingram, 2008) and this stress can have a negative impact on children
PARENTAL OPINION ON PARENTING PROGRAMMES43
and young people’s wellbeing. Despite consensus over the impact of parenting stress,
there is some disagreement over how best to support individuals with the demands of
parenthood (Hill et al., 2007).
These findings are interesting in the context of previous literature which has
highlighted successful implementation of a number of parental programmes (e.g.
Sanders et al. 2014). These programmes have typically aimed to increase child
wellbeing with parental wellbeing as a secondary outcome (e.g. Kratochwill et al.,
2004; Hagen et al. 2010). They have largely focussed on providing a universal
approach to all parents and aim to teach them a set of skills to learn new parenting
techniques (e.g. Webster-Stratton, 1984; Hutchings et al., 2007; Scott et al., 2001).
Despite the success of these programmes, there is recent evidence indicating that the
programmes are still missing what parents really want and need from a group (e.g.
Hill et al., 2007). The results from the current study go some way to supporting
Hill and colleagues as it begins to highlight some variation in the needs of parents in
supporting them in a parenting programme. The vast majority of the participants
loaded on one factor. This array suggests, for this sample of parents, the current
parenting programmes would sufficiently meet their needs. However the other
factors suggest that there may be unmet needs for fathers and older single
parents. The following discussion sets out to explore these factors in more detail
with comparisons made to previous research. Each factor will be discussed
separately.
Factor one: toolkit for skills for parenting
In keeping with the intention of programmes to provide parenting skills training,
factor one suggests there is a clear demand for this skills training in how to
manage their child’s wellbeing and development. This is in line with existing
research and service
PARENTAL OPINION ON PARENTING PROGRAMMES44
PARENTAL OPINION ON PARENTING PROGRAMMES45
provision supporting a universal approach (see Sanders et al., 2014). The sorts that
created factor one also loaded most strongly onto statements associated with learning
parental skills to become a better parent and feel less stressed, with less emphasis on
the nurturing element of the group. This factor focussed on learning new parenting
skills and was consistent with a universal approach to recruitment of parents currently
promoted in a large number of parenting groups. The factor also highlighted some
parents felt their own emotional needs were also important. As such, this section
discusses these in turn, behavioural skills, parental wellbeing and the universal
approach.
Behavioural/parental skills
In terms of parenting skills, this factor supports a number of programmes already on
offer. For example, the standard TP programme incorporates the opportunity to learn
parenting skills (Sanders et al. 2000). This programme teaches parents 17 core skills,
ten of which are designed to promote the child/ren’s development and competence
and the other seven aim to decrease negative or unhelpful child behaviours. Factor
array one shows a number of sorts that relate to these core skills. For example, the
q-sorts that relate to children’s development and competence were: ‘to learn ways to
nurture my child’s development’, ‘learning how to build confidence in my children’,
‘to reduce my child’s stress’ and ‘to encourage my child to problem solve’. The
seven items in the TP programme that focus on reducing unwanted behaviours in
children are also supported in this factor with statements such as ‘learning how to
deal with conflict effectively’, learning how to change my child’s difficult
behaviour’ and ‘to learn skills to communicate as a family’.
Previous research has further indicated support for the behavioural skills approach
used by the TP programme (and other programmes discussed later in the study)
where
PARENTAL OPINION ON PARENTING PROGRAMMES46
Sanders and colleagues (2014) conducted a large scale meta-analysis and systematic
review. They found significant short and long-term effects for parents and their
children who had completed the TP programme for both children's social, emotional
and behavioural outcomes (d = 0.473), and parenting practices (d = 0.578).
Parental wellbeing skills
Although what parents have identified as important in factor one in the current study
are supported by current programmes on offer, there were some interesting statements
that suggest other motivating factors for attendance and completion. For example, a
number of statements ranked as important indicate the motivation for parents
attending may also be about learning how to be a better parent through changing
their own behaviour instead of their child’s. For example, the factor in this study
was made up of a high loadings on the statements ‘to learn how to build my
confidence as a parent’ and ‘to feel more competent as a parent’. As previously
mentioned, most parenting programmes focus on change in child outcomes
(emotional, behavioural, social etc.) as the main objective with parental change as
a secondary outcome. However, the statements highlighted above suggest some
parents may attend to learn skills to change their own behaviour first. This may be
important when promoting the groups to parents who want to focus on their own
behaviour (e.g. Akin & Gomi, 2017; Chronis et al., 2006).
Universal programme
This factor also provides a strong endorsement for the design of the Universal
parenting programme and clearly captures what many parents want. It could be
suggested from the number and varied demographics of participants who loaded onto
this factor that a universal approach is popular. The large majority of programmes
currently on offer fit this universal approach and want to prioritise behavioural skills
PARENTAL OPINION ON PARENTING PROGRAMMES47
to enhance parenting rather than engaging the adult in managing their own emotional
well-being.
Factor two: fix me first
Factor two highlighted a need for the group to be more adult orientated and wanting
the parent to feel better about themselves. The two defining sorts for this factor were
both men, first time parents, co-habiting and with self-reported mental health
difficulties. Key themes for discussion were threefold: (1) being first time parents; (2)
the role of mental health difficulties; and (3) mental health and parenting.
First time parent
In relation to being a first time parent it could be suggested they lacked confidence in
their parenting ability as they had no previous experience of being a parent (Kuo et
al., 2012). This may influence what they want from a group.
Mental health
Personal vulnerabilities may have a role to play in understanding the factor array. The
two sorts had self-reported mental health difficulties (depression and anxiety). These
fathers may have felt support with their emotional wellbeing (e.g. ‘learning to be
aware of my emotions’, ‘learning to control my emotions’ and ‘learning to self
soothe when experiencing difficult thoughts’) in a parenting programme was most
important. Previous research has shown that parents with specific needs value
programmes focusing on their wellbeing (e.g. Chronis et al., 2006). Research has
shown that a barrier to fathers attending programmes is concerns over content (e.g.
Bayley, Wallace
& Choudhry, 2014). It could be suggested that the current results show that the
fathers in this study wanted a programme focussing on how they could feel better as
a parent as opposed to learning behavioural skills.
Parenting and mental health
PARENTAL OPINION ON PARENTING PROGRAMMES48
Previous research has highlighted the significant association between parental
wellbeing and child mental health (e.g. Naerde et al, 2000). Programmes that
currently offer support for parents with mental health difficulties that specifically
focus on their emotional needs as a main objective are limited.
One such programme that is available is the Family Links Nurturing Programme
(Family Link research team, 2011). This programme aims to firstly help parents
understand their own emotional needs and secondly learn about positive parenting
practices. This programme postulates that parents with higher levels of self-esteem
and self-awareness are in a better position to respond to their child’s needs in a
positive and helpful way. This ultimately results in increased child and parental
wellbeing. Despite having promising ideas which support factor two in the
current study, the evidence base for this programme is poor.
Factor three: nurture the nurturer
Factor three was defined by gaining support from the group to parent more
effectively. They were not concerned with learning new skills (unlike factor one) or
about helping them to feel better in order to parent more effectively (unlike factor
two). The parent who loaded onto this factor wanted someone to mentor them and
have company from a group. Interestingly, the mother on this factor was an older,
single, first time mother, with low income. She reported no mental health problems.
These demographic characteristics that may be significant in understanding this
factor array and typically point towards the need for additional support. They have
been used to structure this section (single, age, and income).
Single
This mother may have limited support networks given that she is a single mother with
a low income. This may impact on her ability to seek support and reassurance.
PARENTAL OPINION ON PARENTING PROGRAMMES49
A single parent’s needs and concerns are likely to be different from that of a two
parent family. The former having the constant pressure and stress of the job of
raising children and no one to share day-to-day responsibilities or decision-making
with (e.g. McCubbin, 1989). Increased demand is likely to lead to increased stress
(e.g. Deater- Deckard, 1998; Pottie & Ingram, 2008) and with a large proportion of
parents parenting alone in the United Kingdom (UK; Office Of National
Statistics, 2015), having a parenting group dedicated to those ‘going it alone’ would
potentially improve parental and child wellbeing. Although, it is worth noting that
factor one had some single parents loading onto to it so further research into this
area is warranted to make a clear decision about this. There are online courses
for single parents (e.g. the confident parenting online course;
singleparents.org.uk) but there is currently no evidence-base to support their
effectiveness, despite sharing similar content to the face-to-face courses discussed
in this paper. Of course, single parents can attend any of the groups if they meet the
criteria but there are no groups that specifically recruit for just single parents.
Age
There may be an increasing stigma for older mothers who need support with
parenting in that they should be able to care for their child and themselves. At the
time of writing this document the author could not identify any research into
older parents and parenting programmes which may indicate a gap in the research.
However, it could be suggested that older parents may feel less able to attend
programmes due to this stigma. One statement to support this is ‘meeting people
like me in the group’. Perhaps a normalising experience is something older
parent’s value. Previous research has shown sharing and normalising of the parent
experience is helpful to parental and child wellbeing (Wilson et al., 2012).
PARENTAL OPINION ON PARENTING PROGRAMMES50
Income
Income may also play a part in the lack of support. It may be difficult to fund
activities to meet other parents. We also know that low economic status is linked to
decreased wellbeing in single mothers and increased behavioural problems in
their children (Jackson, Brooks-Gunn, Huang & Glassman, 2000). Increasing
support networks and utilising parenting programmes as a way of doing this may
help alleviate some of these difficulties for those on low incomes. Providing free
childcare has been shown to increase attendance and effectiveness of the
programmes and having venues close to individual’s homes to reduce financial
transport pressure may help (Wilson et al. 2012). Having childcare and evening
classes were both reported as relevant to this parent.
Confounding and non-significant q-sorts
Not only is it important to consider the q-sorts that were significant but it is also
noteworthy to address those that were confounding and non-significant. Although
they are not used in the final interpretation of the data, they potentially provide
additional information about parental views and opinions on parenting programmes. It
is beyond the scope of this study to consider the potential meaning behind the
confounding and non-significant q-sorts in the current data set. However, further
research considering these q-sorts in more detail may provide rich information about
these parents views on parenting programmes. For example, completing qualitative
interviews with the individuals would gather more information about their potentially
differing views about what they want from a parenting programme in comparison to
the current studies data set.
Summary from discussion
This study shows that parents believe the important aspects for programmes are the
kind of elements already provided by particular programmes (factor one: e.g. IYPT,
PMTO, and TP programme). These programmes have been proven to be effective in
terms of outcomes (e.g. Chronis et al., 2006; Wilson et al., 2012; Sanders, 2008).
PARENTAL OPINION ON PARENTING PROGRAMMES51
However, this study highlights that there may be minorities of parents who would
wish for different types of programmes than those that are currently available
(factor two and three).
Limitations
This study provides an interesting account of parental opinion on parenting groups.
However, additional demographic information could have allowed for more extensive
analysis (e.g. ethnicity, level of education). This data may help to consider additional
groups of parents who may require a particular focus or emphasis within a
programme. Utilising a different recruitment approach could increase this
demographic information as the personal contacts and snowballing method in the
current study potentially restricted gathering a range of demographic data.
To address more specific questions it would have been interesting to have gathered
specific data on attendance at parenting programmes. The inclusion criteria for this
study was that participants did not require or preclude parent’s attendance at a
programme to participate. Given the participants demographics in this study, it is
unlikely the participants had attended a programme (high income, married, low
mental health difficulties). This may have impacted on the findings. For example,
those who had already experienced a programme may have responded dependent
on the nature of their experience (good or bad). As such, the results may have been
informed by their previous experience and/or knowledge of how a programme
worked.
Future research and implications
It may be useful to complete a similar q-methodology study asking the children of
parents who have or might attend a programme what they would like their parents to
learn about and or change. As although research highlights that parental needs are not
being met (e.g. Hill et al., 2007) and that parental wellbeing is a secondary outcome
to child wellbeing (e.g. Sanders, 2008), what is unclear from this work is how the
PARENTAL OPINION ON PARENTING PROGRAMMES52
children perceive the benefits of their parents attending the programmes and what
they think their parents need assistance with. Understanding what children feel is
relevant would help address specific needs in more detail. This seems particularly
significant given that the programmes main aims are to increase child wellbeing.
Future research may also investigate opinion from other care givers to provide a
holistic approach to caring for children. This study focussed on parents but
information regarding step-parents, grandparents, foster carers, adoptive parents,
carers, guardians etc. would be interesting when addressing specific need and
demographics. This is
PARENTAL OPINION ON PARENTING PROGRAMMES53
particularly pertinent given the large number of Looked after children. Children in
need of adoption or fostering require a positive attachment experience (e.g.
Department of Health, 2015; Youngminds, 2014). Parenting programmes for these
individuals may provide a vital source of support and ensure the wellbeing of both the
child and parent are healthy.
It may also be beneficial to consider asking parents what they want from a parenting
programme at the outset of taking part in order to potentially adapt and individualise
current programmes on offer. This may increase engagement as parents may feel their
needs are being met and heard at the beginning.
Conclusion
The results of this research support the governments wish that services users have
access to a choice of evidence based interventions that will meet their needs by
exploring what and how much parents value what is currently offered by parenting
programmes (e.g. Department of Health, 2015; Youngminds, 2014). The creation of
evidence based interventions requires consultation and collaboration with Service
users. The results highlight the possible need to further develop some targeted
specific parenting programmes for fathers and single mothers as they appear to
report very different needs to those parents benefiting from the more ‘universal’
programmes. Future research is needed to further examine the needs of these
specific programmes and consideration of the views of fathers, those with mental
health difficulties, older and single mothers to develop understanding of parental
need in parenting programmes.
PARENTAL OPINION ON PARENTING PROGRAMMES54
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List of Appendices
Appendix A – Overview of programmes/interventions Appendix B – Clinical Psychology Review: Guidelines for AuthorsAppendix C – Q-sort statementsAppendix D – Screen shots of the online Q-sort study Appendix E – Favourable ethical approval Appendix F – Description of Q Methodology.
PARENTAL OPINION ON PARENTING PROGRAMMES59
Appendix A: Overview of programmes/interventions
Parenting programmes that target behaviour change:
The programmes described below all utilise Patterson’s coercion model of parenting
(1982) as there basis for teaching skills to change behaviour in the child.
Triple P Programme (Sanders, 2008):
The TP is a programme aims to provide parents with new techniques to manage their
child’s behaviour. Outcomes have shown it increases parent’s use of positive
parenting strategies, improves child behaviour, improves child wellbeing and
improves parental wellbeing (Sanders, 2008). However, there is evidence suggesting
its widespread use is unfounded as the improvements are not always reliable
(Wilson et al., 2012; discussed in more detail below). This programme can be
offered as an effective universal (open to all) or targeted (specific needs)
programme with varying durations (Wilson et al. 2012).
Incredible Years Parenting Training (Webster-Stratton, 1984).
The IYPT programme aims to teach parents to use positive parenting techniques (e.g.
positive reinforcement, praise, active encouragement) with outcomes showing
improved child and parental wellbeing, improved child behaviour and increased use
of positive parenting practices (Menting, De Castro & Matthys, 2013; mean effect
size of d = .27). The programme has shown positive results at a universal and
targeted level (Webster-Stratton, 1984).
Parent management training: Oregon Model (Forgatch, Bullock & Patterson, 2004).
The PMTO covers five areas of learning including skill encouragement, setting
limits, monitoring, problem solving and positive involvement. This programme can
be offered at four levels of intensity ranging from low to high need (oppositional
behaviour). It can be delivered in a group (14 weekly sessions) or individual format
(19-30 sessions for one hour). Effect sizes for the efficacy of the programme
PARENTAL OPINION ON PARENTING PROGRAMMES60
(discussed below) indicate variability, with both positive and little or no effect
(DeGarmo & Forgatch, 1999).
Parenting programmes targeting parent wellbeing:
Below, the CWDC and a guided self-help CBT course are outlined. These
programmes/interventions are more in line with Deater-Deckard’s model (1998) of
parenting where the parent’s appraisal of the situation affects change.
Coping with depression course
The CWDC is a psychoeducational intervention for individuals struggling with
unipolar depression showing positive effects (Lewinsohn, Antonuccio, Breckenridge
& Teri, 1984). The programme is 12 sessions teaching CBT coping techniques for
individuals including cognitive restructuring, behavioural activation and relaxation
techniques. Given the established links between parenting and mental health
(Bornstein, 2002), Chronis et al (2006) studied its effects for parents with depression.
Guided self-help cognitive behavioural therapy (CBT)
CBT guided self-help has been shown to improve wellbeing in those experiencing
anxiety and/or depression (Seekles et al., 2011). As such, Palmer et al (2012)
explored its use for mothers with depression using online support (‘living life to
the full’) or workbooks (overcoming anxiety/depression). Each group had support
from a psychological wellbeing practitioner (PWP) at the initial appointment, at
four weeks
PARENTAL OPINION ON PARENTING PROGRAMMES61
and at the end. At the end, nine participants completed in-depth interviews. The authors concluded that
guided self-help CBT for depressed mothers had a positive impact on the mother’s children and family’s
wellbeing (effect sizes not quoted).
PARENTAL OPINION ON PARENTING PROGRAMMES62
Appendix B.
Author guidelines for Children and Society taken from http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1099-0860/homepage/ForAuthors.html
CHILDREN & SOCIETY AUTHOR GUIDELINES
Sections1. Submission2. Aims and Scope3. Manuscript Categories and Requirements4. Preparing Your Submission5. Editorial Policies and Ethical Considerations6. Author Licensing7. Publication Process After Acceptance8. Post Publication9. Editorial Office Contact Details
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Children & Society embraces academic research, policy and practice in relation to the health, education and welfare of children from infancy through to adulthood. The journal informs all those who work with and for children, young people and their families by publishing innovative contributions on research and practice across a broad spectrum of topics, including: theories of childhood; children's everyday lives at home, school and in the community; children's culture, rights and participation; children's health and well-being; child protection, early intervention and prevention.
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Appendix C: Q-sort statements.
1. Learning to be aware of my body sensations/signals
2. Learning to control my emotions
3. To learn to self soothe when experiencing difficult thoughts and
feelings
4. To understand the link between thoughts and feelings
5. Learning relaxation skills to help manage feelings and situations
effectively
6. Learning mindfulness skills
7. Learning how to build my confidence as a parent
8. Learning how to build confidence in my child/ren
9. Learning how to deal with conflict effectively
10. Learning how to problem solve difficult situations
11. Learning how to seek support from others when I’m stressed.
12. Learning about the parent-child bond
13. Improving my self-esteem
14. Learning how to change my child’s difficult behaviour
15. To learn how to reduce my stress
16. To learn how to reduce my child’s stress
17. Learning about discipline methods
18. To increase my knowledge of my child’s development
19. To learn ways to nurture my child’s development
20. To feel more competent as a parent
21. To learn how to set limits for my child
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22. To learn skills to communicate as a family
23. To learn how to encourage my child to problem solve
24. To learn how to establish family rules
25. Doing homework activities to help me learn the skills from the group
26. Having reminders about sessions
27. To meet people like me in the group
28. Having evening classes
29. Having day classes
30. Having a childcare service when parents attend the group
31. Facilitators being approachable
32. Facilitators being non-judgemental
33. Facilitators listening
34. Facilitators being knowledgeable
35. Having group discussions to learn new skills
36. Practicing new techniques in the sessions
37. Communication outside of sessions for support/coaching (e.g. home
visits/texts, telephone)
38. Sessions are face-to-face
39. Food provided
40. Transportation provided
41. Parents have a workbook to use in and out of sessions
42. Promotion of a safe and supportive learning environment
43. Learning about healthy eating
44. Learning about healthy living (e.g. exercising)
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45. To understand how emotions such as stress and worry can negatively
affect physical and psychological health
46. Decreasing my awareness on the negatives in my life
47. Learning about different communication styles and how to
communicate effectively
48. Meeting the team running the group beforehand
49. The group being universal and open to all
50. The group being a targeted programme and open to specific groups of
parents
51. Having an overview of the programme before it starts
52. Collaborative working between the facilitator/s and parents
53. Facilitator having previous experience of working with parents and
children
54. Completion of measures before and after attending the group to assess
change
55. For parent goals to be considered whilst completing the group
56. For child goals to be considered whilst completing the group
57. Protection concerns are addressed (eg. child and parent)
58. Learning to be aware of my feelings
59. Learning how to increase my child’s performance at school
60. Buddy networks encouraged between parents
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Appendix D: Screen shots of the online Q-sort study.
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Appendix E: Favourable ethical approval.
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Appendix F: description of Q Methodology.
Q methodology is based on two main features: (1) the sorting of a collection of
statements or ideas prepared by the researcher along a subjective dimension, such as
'agree/disagree' or 'like/dislike' (Watts & Stenner, 2012) known as a ‘Q sorts’. This
method provides the researcher with an indication of what the participants view on
the topic being investigated are in a form that allows it to be fully compared
with the viewpoints of other participants. Owing to the Q-sorts inter-correlation, a
by-person factor analysis is used to compare patterns of responses between
participants. This provides data indicating what the shared understanding of the
concept being explored is. Using this method allowed for an exploratory
investigation into what parents consider the most helpful aspects in parenting
programmes are.