interventions with families: preparing the way for teaching parenting skills

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Journal of Family Therapy (1982) 4: 229-245 Interventions with families: preparing the way for teaching parenting skills Erica De’Ath The purpose of this paper is twofold. Firstly, to consider an ecological model of the system network of any one family, and the idea of intervention as education, prevention and support. A community approach of primary prevention, secondary prevention and administrative action is outlined. Secondly, briefly to consider whether the study of dysfunctional families and intervention with referred families has provided us with guidelines for necessary parenting skills for functioning family living; assumptions about whether such skills can be taught; and, at what stage of the family life cycle, in what context and by whom such enabling teaching takes place. Introduction A family’s inherent strengths and mental health are enhanced or reduced by their social, economic, ecological and political environment. It is accepted as a basic tenet of family therapy that an individual person and his behaviour does not exist in isolation but is influenced by, and in turn influences, other persons and other systems in the environment. Minuchin, for example, describes some of the elements in the ecology of a child,from his individual personality to his community, A child’s behaviour is caused by many factors. Some are ‘inside’ the child, like neurones, brains and glands, as well as memories, motivations, introjections, and drives. “Outside” the child are factors like his parents, his siblings, his family’s socio-economic status, his house, his school (teacher, peers and curriculum), his neighbourhood, his neighbourhood peergroup, the hue of his skin, television, and others. (Minuchin, 1970). If we understand an individual’s behaviour as a function of his member- ship of a group of others, primarily his family, then we should view the behaviour of any one familyas a function of other wider systems-not only the immediate community but also the economic, legal, medical, educational, political, social and communications system. We need to adopt an ecological model of the system of any one family, as indicated in Received December 1981; revised manuscript received March 1982. * National Children’s Bureau, 8 Wakley Street, London EC1. 229 0163-4445/82/030229+ 17$03.00/0 0 1982 The Association for Family Therapy

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Page 1: Interventions with families: preparing the way for teaching parenting skills

Journal of Family Therapy (1982) 4: 229-245

Interventions with families: preparing the way for teaching parenting skills

Erica De’Ath

The purpose of this paper is twofold. Firstly, to consider an ecological model of the system network of any one family, and the idea of intervention as education, prevention and support. A community approach of primary prevention, secondary prevention and administrative action is outlined. Secondly, briefly to consider whether the study of dysfunctional families and intervention with referred families has provided us with guidelines for necessary parenting skills for functioning family living; assumptions about whether such skills can be taught; and, at what stage of the family life cycle, in what context and by whom such enabling teaching takes place.

Introduction

A family’s inherent strengths and mental health are enhanced or reduced by their social, economic, ecological and political environment. It is accepted as a basic tenet of family therapy that an individual person and his behaviour does not exist in isolation but is influenced by, and in turn influences, other persons and other systems in the environment. Minuchin, for example, describes some of the elements in the ecology of a child, from his individual personality to his community,

A child’s behaviour is caused by many factors. Some are ‘inside’ the child, like neurones, brains and glands, as well as memories, motivations, introjections, and drives. “Outside” the child are factors like his parents, his siblings, his family’s socio-economic status, his house, his school (teacher, peers and curriculum), his neighbourhood, his neighbourhood peer group, the hue of his skin, television, and others. (Minuchin, 1970).

If we understand an individual’s behaviour as a function of his member- ship of a group of others, primarily his family, then we should view the behaviour of any one family as a function of other wider systems-not only the immediate community but also the economic, legal, medical, educational, political, social and communications system. We need to adopt an ecological model of the system of any one family, as indicated in

Received December 1981; revised manuscript received March 1982. * National Children’s Bureau, 8 Wakley Street, London EC1.

229 0163-4445/82/030229+ 17$03.00/0 0 1982 The Association for Family Therapy

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Figure 1 in their national, regional and local context. The reciprocal relations between the variety of systems can allow for a transactional approach to the provision of services to families. Intervention need no longer be an extraneous act, aimed at changing the pattern of behaviour in a particular family after an event, but can establish a framework for a continuous educative, preventive and supportive approach within the larger community (National Children’s Bureau, 1982).

Concern for the family

Over the last decade, a concerned interest in the ‘health’ of the family has been expressed through ministerial pronouncements, government

Commun~cat~ons system

nelghbourhood Immediate loco

f a c i l ~ t ~ e s .

Local agencies and ~nstltutlons eg.

Soclal welfare

Health care system

Figure 1 . An Ecological model of the system network of any one family. Dotted line indicates extent of normal involvement of family therapists beyond the family system.

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reports, conferences and research projects in the fields of health, education and social services, as well as in the media. The increasing divorce rate is seen as a threat to the institution of marriage, upon which much of our economic and social welfare legislation is based. The number of children in one-parent families is growing, an estimated 920 000 lone parents bringing up over 1 500 000 children (One Parent Families, 1980). So also, the number of children in care, ‘latchkey’ children, violence and crime in adolescence, schoolgirl pregnancies and the problem of child abuse. A recent estimate suggests that every week six children are killed by parents and 40 000 battered in a year (BBC, 1981).*

The development of a family approach in clinical and therapeutic work, and of family therapy as a more distinctive treatment model, has been welcomed as a move towards a more holistic understanding of the individual and the family. It has not, however, embraced the wider systems network of the family, except perhaps in a negotiating or col- laborative r81e with the school or with other agency workers (see dia- gram). The same ‘family’ approach by politicians, from the macro- system level, has generated heated discussion and debate together with expressed fears of the growth of state intervention as a means of social control. The media, meanwhile, proclaims a wide continuum of ex- treme viewpoints from decrying and naming individual social workers for not removing children ‘at risk’ from parents, by force if necessary, to expressing alarm at ‘a “commando group” of health and welfare profes- sionals invading the privacy of the castle that was once an Englishman’s home’ (Daily Telegraph, Mary Kenny, 1981).

In 1973, Sir Keith Joseph, then Secretary of State for Social Services, said ‘. . . there is little argument that the way families function is vital to the health of our society; and that there is a need for positive measures to remove obstacles and hindrances to effective parenting that confronts people at all levels of society’. In 1980, Patrick Jenkins, then Secretary of State for Social Services, declared that ‘every child deserves a proper family life’. What has not been stated is: what kind of measures are envisaged and how will they be implemented; who is able to define the constituents of a ‘proper family life’ and how can they be provided?

* Figure compiled by BBC TV for All Those Hard Luck Stories-At Risk, from information supplied by N.S.P.C.C., Home Office and other informed bodies.

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Intervention through education, prevention and support In 1979 a conference, sponsored jointly by the Department of Health and Social Security, the Department of Education and Science and the National Children’s Bureau, was held to discuss ‘what action can and should be taken by public authorities, voluntary organisations and others to raise the standards of parenting in this country’. It was suggested then that many parents fail, not so much because they do not know what good parenting is but, because they cannot cope with the multiplicity of external pressures and demands (social, environmental, financial, etc.) and because of the lack of a readily available informal system of support and advice which they could turn to during the various ‘stress’ points of family life without fear of being dubbed a failure or a problem case (Pugh, 1980).

Raising the level of health of any one family (physical, social and mental) and the standards of parenting in general involves preparing children and young people so that they are able to live adequate adult lives in today’s and tomorrow’s society. This means encouraging and enabling them to communicate, to establish and maintain satisfying personal relationships, to make informed choices, to be able to use their own resources, to know how to seek information and resources from others, to prepare prospective and actual parents for the realities of parenthood- the challenges and the chores, the happiness and the hard work, the twenty-four hour ‘coverage’ and responsibility for the physical, emotional, social and cognitive development of their children.

It seems to me that it is a legitimate goal to create a community programme for healthy family functioning, both at national and community level. Such intervention could be considered at three preventive levels, similar to that outlined by Gerald Caplan for a community approach to preventive psychiatry: primary prevention, secondary prevention, administrative action.

I . Primary Prevention - reducing risks to future families by increasing the skills and opportunities for healthy family functioning, and encouraging informal support networks to combat loneliness and isolation. This would lie in enhancing the level of knowledge and experience of those in the community before they became parents and at successive vulnerable family life-cycle stages. The aims would be:

(i) in schooZs-to equip all pupils with knowledge, skills, values and attitudes to help them exert and accept some responsibility for their present and future lives, when they may or may not

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choose to become parents. Education for personal competence and personal relationships and the development of social skills and life skills are currently being taught by some schools to some pupils-active tutorial work (Baldwin and Wells, 1981) and group work- life skills teaching programmes (Hopson and Scally, 1980). Some schools also offer the opportunity to combine courses in child development, family life studies and health education, through a co-ordinated curriculum. The I.L.E.A. course Child Development and the Family aims ‘to provide for the pupils a course in which, by studying family life and the pre-school child, they themselves may be helped to grow towards maturity and become responsible parents’.

(ii) in youth clubs and youth organizations-to give youngsters a continuing education for personal growth, competence and development by creating opportunities to consider and discuss their own needs, desires, life-styles, personal characteristics and potential. Youth clubs and services are often engaged in individual counselling but others actively promote discussion groups and role play sessions in local schools.

(iii) in antenatal services- to provide realistic information about pregnancy, childbirth and parenthood, and the opportunities for prospective mothers and fathers to meet and talk with other couples and actual parents about the experience of pregnancy and childbirth, and the practical issues of life with a new baby and the effect on the relationship of the parents (Clulow, 1979). The National Childbirth Trust has pioneered the creation of ante-natal groups, as informative, practical and supportive, with continuity as post-natal support groups when mothers are often feeling tired, isolated and inadequate. They are now planning ‘outreach’ workers for those mothers who do not come forward to join groups, often the younger, more isolated, and ‘at risk mother, in the hope of creating a ‘bare foot’ practice approach to ante-natal care and post-natal support. Some health centres are beginning to establish their own forms of group support, either by linking women through ante-natal clinics and classes, or by linking prospective parents with established local parents in the neighbourhood (e.g. Lisson Grove Health Centre, London).

(iv) Services for parents with infants and young children-to provide parents with sufficient social competence and informa- tion to enable them to have some measure of control over their

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own lives, to provide support for parents who feel depressed and isolated, to increase parenting skills, and to support and develop parents’ own self-confidence in making decisions about their children’s future. Midwives and health visitors have a pivotal role here to work alongside the parents encouraging their own development as new parents, to enlarge the social network of the family through linking with other mothers, with information on mother and toddler groups, drop-in centres, libraries, play-groups and the range of day care and groups for children. The Pre-School Playgroups Association (1980) has provided us with a model of intervention which is educative, preventive and supportive within the community ‘because playgroups are run by local parents, attended by local children, supported by locally-raised funds, they belong to their community in a very special way. They can act as a kind of extended family, filling the places of the widely-scattered relatives of today’s mobile families’.

(v) Community services f o r parents with school children -to offer informal advice on problems which may arise as children grow older (discipline, behaviour problems, developmental prob- lems, school issues and choices) and particular issues which arise with adolescent children (sex, drink, drugs, smoking, rules, money, clothes, hair styles etc.); to encourage parents to retain their own individuality as people and as a couple; to enable parents to ‘allow’ their children to leave home; to provide parents with sufficient information so they can understand and participate in educational and employment decisions. Although schools provide opportunities for parents to discuss educational and career issues, this area of the life- cycle seems to be the least catered for, except in terms of crisis work or counselling. Several religious groups are actively preparing material for parallel groups of parents and young- sters, and the Open University is designing a new programme for parents and teenagers as part of their Parenthood series.

It is an interesting reflection that the family appears to receive the least preventive support at this point in the family life-cycle- children in adolescence, parents at their mid-life point, grandparents becoming more dependent. ‘The family as a behaviour system stands intermediate between the individual and culture. It transmits through its adolescent members the disorders that characterise the social system’ (Ackerman,

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1970). Society is as ambivalent about the cultural and legal definitions of when an individual finally becomes an adult as it is wary about the problem of where informal support ends and intrusion into family privacy begins.

A family is not a static entity but is constantly evolving and developing through the life-cycle of its various members and through the variety of transactions with the numerous systems and networks that encompass it. Each stage of this life-cycle is characterized by different needs requiring certain necessary tasks to be performed if that individual is to pass competently through to the next stage.

11. Secondary prevention-reducing the duration and intensity of known cases of dysfunctional families and thereby reducing their prevalence in the community. This area of prevention is based primarily in the medical and social welfare services, through referrals to social workers, psychologists (clinical and educational), psychiatrists and probation officers. Such intervention is often directed towards enabling the individual, or the family, to cope with an environment that remains largely unchanged. However good the professionals, there will always be other client families to take the place of those whose ‘contract for treatment’ has ended.

Challenging the practices and priorities of social welfare and mental health policies; of the educational, financial and legal systems; and of the impact of work on families is a task too daunting for any single family worker. It is important therefore, that we should acknowledge those who try. Margaret Mead, from her extensive knowledge gained through anthropological investigations, concludes, ‘Experience has taught us that change can best be introduced not through centralised planning, but after a study of local needs’ (Mead, 1955). Those models of provision for local or special needs, and the knowledge and understandinggained, should be considered for wider application through administrative action. For example: The introduction of crisis intervention teams at Napsbury Hospital aiming to work with the family rather than accepting one member as patient, in the establishment of a community psychiatric service (Scott and Starr, 1981); the introduction of a child guidance team in regular meetings with all staff members of a secondary school, discussing how the teachers might handle disruptive children rather than send them to a special unit (Skynner, 1976); the establishment of a social worker in a deprived inner city primary school (Coventry Social Services, 1980) ; offering counselling and support services to all families

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with first offenders at the Juvenile Bureau (Family Welfare Association Annual Review, 1980); the establishment of a family conciliation service to support individuals and families in adapting to new circumstances after divorce (Bristol Courts Family Conciliation Service); exploring the dynamics of the overlapping areas of work and family (Renshaw, 1976); developing a ‘family’ approach to decision making in child care, access and custody cases (Bentovim and Gilmour, 1981).

There are many professionals who acknowledge the wider systems framework and attempt to incorporate an element of ‘preventing’ in their work as well as ‘after-the-fact’ curing, working in an educational rather than merely a clinical or administrative capacity. Alongside their case-work, social workers, psychologists and probation officers are providing, or acting as consultants to, mothers groups, parent support groups, divorce experience groups, ‘exchanging experiences’ groups, family groups and home visiting schemes. Some of these activities include opportunities to develop social skills, information on family rights and help with budgeting, as well as highlighting areas of child development and child management and have arisen in response to the needs of their clients, who may participate in them. There is also an awareness of the need to prevent possible ‘clients’ reaching their case loads. Many professionals see their r61e as facilitating others who are involved with families on a day to day basis- teachers, nursery staff, health centre staff, childminders and foster parents.

At the same time, there is evidence of a ‘moral panic’ over non- accidental injury cases and research indicates an increase in the number of care orders in respect of alleged child abuse, as well as in the number of Place of Safety Orders, which involves the compulsory emergency removal of children from their families (Packman, 1981). A recent research study from the Social Services Department, Barnet, which attempts to calculate the financial savings as a result of preventive child care work, is therefore particularly welcome. I . . . It seems to make sound financial sense as well as being sound social work practice, to invest a good deal of time, money and effort in I .T . , groupwork, child- minding support programmes and mother and toddler group program- mes to maximise these cost savings. Even if the success rate of these programmes in keeping children out of care were modest, heavy finan- cial costs can be avoided from any children prevented from having to be received into care’. (Pinniger, 1981). Another preventive project, from Coventry Social Services, involved placing a full-time social worker in a primary school in a deprived area, which already had a number of cases involving children in care and on supervision orders. Here the objective

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was ‘to develop the preventive service by intervening at an early age to strengthen the ability of families and children to cope with stress before disabling mechanisms are established which inhibit learning potential, which have socially unacceptable consequences (e.g. delinquency, truancy) or produce emotional or psychiatric disorders’ (Coventry Social Services, 1980).

The voluntary organizations, being freer than the statutory organiza- tions to pioneer new approaches, have always been well-placed to bridge the gap between provision and prevention, and to actively encourage self-help groups, informal support groups and volunteer schemes. There is a range of community groups, home visiting schemes and family centres, all attempting to help parents take greater control over their own lives and begin to enjoy and understand their children better. Those working with Family Service Units, Scope in Southampton (Poulton, 1980), Home-Start in Leicester (Harrison, 1981) and the London Family Groups (Knight, 1979) suggest that there are, in fact, very few ‘bad’ parents - just many who are lonely and overburdened. Scope provide a particularly good model of effective community self-help, with one full- time worker they are able to offer support to nearly 500 families through the network of parent-run groups. Many of the old residential children’s homes have now changed their usage and emphasis. Renamed as Family Centres some provide a local resource and community support (a drop-in approach), others offer specialized intervention and support using groups and counselling, while others may still reflect their original use and staffing and provide day care and nursery provision together with parental involvement and mothers support groups.

At the National Children’s Bureau we have details of almost 300 different examples of supportive schemes and services being provided by different agencies, from different disciplines, in different contexts. Unfortunately they are thinly and unevenly spread over the country and many are working in isolation rather than offering individual families a co-ordinated service. Since there are very few evaluation studies it is difficult to know to what extent such services are meeting their own objectives or the needs of families. The need to look at the wider system of the family, if only at the ‘agency network’ level is clearly documented from the other extreme by Win Roberts. Citing an example of a family who were concurrently involved with twelve professional workers, in addition to the family therapists: ‘As professional workers who are part of a complex system of helping agencies, the time has come for us to recognise the need for finding more effective ways of ensuring that we are not hindering rather than aiding families who came to us for help’

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(Roberts, 1979). A primary preventive approach could contribute to reducing the numbers seeking help. A community-based service could make it less likely for families to ‘collect’ agencies. The emphasis on community ‘health’ and community ‘help’ might also alleviate the additional risk of stigmatization that prevents so many families from seeking help until they have reached a crisis.

111. Administrative Action - reducing preventable stress by providing a sufficient and co-ordinated service of educative and supportive services (including financial) to assist families through the various stages of the evolving life-cycle. An approach based on an awareness of the ecological system of a family would acknowledge that families are subject to enormous environmental constraints (see Figure 1) and yet in turn, help to shape their own environments. The children of today are tomorrow’s adults, workers, citizens and parents.

Whilst a clear concensus on the objective of family services appears to be lacking, there is ample evidence that a co-ordinated preventive and supportive service is necessary, and the main problem seems to lie in the implementation. A recent discussion document produced jointly by Child Poverty Action Group and the National Council for Civil Liberties (1981) provides a critique of how present policies ‘hurt’ families, outlines a number of principles for the construction of a coherent family policy and also raises some fundamental questions about the relationship between state support for children and support for families through the wages system. Family Forum, a successor to the British Union of Family Organizations, hopes to provide a focus for the consideration of the relationship between the needs of families and the impact of policies on family life. The Study Commission on the Family intends to produce an annual ‘Family Policy Review’ as well as stimulating debates on family issues through its discussion papers.

Over the last six years there have been successive reports calling for administrative action and pointing to the importance of preparing young people for family life, and of the need to support parents in their parenting r61e.

Documents from the Department of Education and Science (1977, 1981) point to ‘the need for schools to co-operate with parents in preparing young people for adult human relationships’. The report of the Select Committee on violence in the family and par- ticularly the abuse of children by their parents, repeats the need for preparing both boys and girls for parenthood, and also recommends

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that the community at large be more aware of its responsibilities towards families with young children (D.H.S.S., 1978). The ‘Manifesto for change’ in the Times Educational Supplement (1981) stated that secondary education ‘gives insufficient time and attention to preparation for life as persons, workers, parents and citizens’. The Warnock report points out ‘Parents can be effective partners only if professionals take notice of what they say and how they express their needs, and treat their contribution as intrinsically important’ (Com- mittee of Enquiry, 1978). The Committee on Child Health Services (the Court Report, 1976) ‘We have found no better way to raise a child than to reinforce the ability of his parents to do so’. The Children’s Committee (1980) asks that society ensures ‘that parents are afforded access to help, advice and support in bringing up their children, not just to combat particular moments of severe and identifiable vulnerability, but also to deal with the common concerns of everyday life’. An intergovernmental conference on policies for children concludes: ‘Action to help families concerns all action by the government and its partners. It is multi-dimensional and must be all-embracing. It must be built into transport policy, housing policy, consumer policy and new uses of time also have to be promoted. We have to create a climate of conditions of life more propitious to the family. In that way our societieswillbeabetterplaceforchildrentolivein’(O.E.C.D., 1980). The Royal Society of Medicine (1981) sponsored a three day symposium on Priority f o r the Family.

Can parenting skills be taught?

A future paper will examine this question in more specific detail in terms of whether there is a basic core of parenting skills; the various modes of teaching and of intervention; and the possible context and stage of the life-cycle.

In this paper I am concerned with assumptions about whether, as family therapists, our knowledge of dysfunctional families has led to our developing an approach which could be interpreted as ‘educating’ our client families into more effective family functioning. Is this the same as teaching them how to be ‘good enough’ parents? Is our rBle to enable them to adapt and cope better with the reality in which they live, or to build on their ability and encourage them to change their situation? This

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is a very real dilemma when thinking of developing parent education programmes. As Haley (1976) points out:

Despite its humanitarian nature, the clinical field is also an important arm of social control in society. Governments pay therapists to quiet segments of the population and prevent them from making trouble. When the poor riot, mental health clinics proliferate in the slums. The ethical dilemma for many therapists is that they wish to help the poor and so welcome the government funds, they do not wish to be used by the establishment to keep the peace and prevent basic social change.

It has been stated by some that deficiencies of parenting are in large part to do with ignorance: ’. . . Many parents do not understand how to play, talk, read and generally communicate with their children and to interpret the various stages of development -mental, emotional, physical and social- through which all children go’ (D.H.S.S., 1974). If this is true, there is certainly a great deal of useful factual information that could be and is presented in schools, via television and films, through the many books and magazines, and through the numerous forms of parent groups previously mentioned. However, a recent assessment of parent education in the United States over the last twenty years still questions the validity of parent education (Harman and Brim, 1980). Parenting, however, is not just the application of knowledge.

What can family therapy and our studies of functional and dysfunc- tional families tell us about the dimensions of parenthood.

(1) Each family is different - ‘Each nuclear family evolves systematic ways of being a family: communicating, problem solving, meeting the members’ needs for affection and intimacy, resolving conflict, and dealing with loss and change’ (Lewis et al., 1976).

(2) The success of the coping systems of each family is related to the structural components of the family’s functioning- ‘The parental sub-system is the unit of the family that bears the main responsibility for guiding and nurturing the children . . . the family must have an executive system that can make decisions, particularly with regard to child rearing . . . the parental sub- system must have authority. A child must be able to experiment with growing up, knowing that the parental sub-system will set the limits of the permissible’ (Minuchin, 1977).

(3) Families can change their patterns of behaviour e.g. by ‘re- education of the family through guidance, re-organisation through a change in the patterns of family communication’ (Ackerman, 1966), by our highlighting strengths and resources

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within famiy members; by our supporting, encouraging and enabling each member; by re-examining rBles and rules within the family.

Any effective parenting skills teaching would, therefore, need to recog- nize:

the diversity of family life: social, economic, cultural, ethnic; the changing nature of the family: both parents working, parents unemployed, single parents, teenage parents; the parallel changes in the nature of parenting: isolation, loneliness, inexperience, need for day care services, lack of extended family, neighbourhood or familial support.

Families who are referred to therapists are usually in crisis or have been defined as not able to cope. There is a qualitative difference between acknowledging with a family that previous parenting has been inadequate, ineffective, or inappropriate, and attempting to teach parenting skills to those who are not yet parents or who wish to prepare for future developmental stages in their family. Is there a ‘critical’ time for learning parenting skills - do parents need a crisis to motivate them to learn or to change? Could parents learn from sequential teaching at the relevant family life stages? Virginia Satir (1978) outlines a series of major natural ‘crises’ or steps in family life: onset of parenthood (conception, pregnancy, birth); child starts to use intelligible speech; child makes official connection outside the home, namely school; child goes into adolescence; child seeking independence and leaving home.

If we accept that ‘parenthood itself is a developmental process’ (G.A.P. , 1973), then we should also accept the need for continuous education, guidance, and support for parents. A comprehensive family service would offer a range of schemes incorporating the aim of teaching or improving parenting skills, focusing on:

groups-where whole families, or individual family members can meet and share experiences in an informal way (e.g. mothers groups, family centres, drop-in centres); informal parent education groups in health centres or adult education institutes (Pre-School Playgroup Association courses, Family Life Education, WEA courses etc.); or, in specific self-help groups to share ways of tackling particular family problems or issues (OPUS, Gingerbread); family centres and clinics - where families could obtain casual advice and informal guidance from a recgonised agency without fear of ‘labelling’, as well as crisis intervention, clinical support and counselling;

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individual support - from factual advisory services, anonymous tele- phone counselling (Family Network), to particular counselling or befriending schemes (Home-Start, Big Friend Little Friend); distance learning-which can offer information and examples of the range of alternative forms of behaviour and activities through films, television, radio, books and magazines, as well as a vicarious sharing of feelings and experience.

The process of teaching is a crucial factor in the processs of learning: balancing what is desirable with what is possible; joining with the learner in . terms of cultural attitudes and values, language, thought and learning patterns. Parenting skills, as in other skills, can be taught in a variety of ways: discussion, observation, modelling, activities, rble-play, drama, experiential exercises, visual aids. There is a great need for systematic research and evaluation of current parent education groups and family support services. The important factors for success, as in much family therapy, will lie in:

( 1 ) recognizing the abilities of parents-personal strengths and resources, current level of knowledge, health and physical well- being, physical strength and size (important if looking at disci- plinary measures with adolescents);

(2) examining the structural determinants within the family- how many parents, how many children (encouraging parent-child interaction may be feasible with an intact small family, it is more difficult for a working mother with a large family);

(3) acknowledging the interpersonal and social controls - examining the influence of the extended family, friends and neighbours;

(4) considering cultural antecedents- where does authority lie in the family, what are the norms of male/female rbles;

(5) reviewing ecological and physical conditions- how people live influences their behaviour (a large house and garden allows for different parenting opportunities than inner-city overcrowded housing with no open space and an unsteady income);

(6) accepting the unconscious attitudes and emotions of parents, e.g. emotional attitudes to breastfeeding despite all the factual information on nutritional benefits.

The aims of such teaching would be primarily to assist parents in their parenting with the general goals of creating in the family: good physical and mental health, maximum conditions for cognitive growth, develop- ment of desired social skills and accepted norms of affective develop-

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ment. It would appear from the above that any potential programme would need to select from one of two basic areas in designing ‘parenting skills’ material: is the primary aim to teach specific child rearing tasks or to teach different groups of parents? What values will be used to select the teaching material, will they be made explicit? Will they allow for the different values of the educator, the parents and the children? The

Journal of Family Relations recently published a special issue on Family Life Education (1981) in an attempt to answer some of these questions.

The Committee on Child Health Services (1976) whilst advocating the very real need for ‘parenting’ skills to be improved, also outlined the difficulties in their implementation:

‘Even if there were an agreed body of knowledge about parenting to be transmitted (and there is not) and one could work on the assumption that knowledge always changes behaviour (which one cannot) it would still be necessary to bear in mind how much the interpersonal relationships and integrity of the parents affect their ability to be successful. So many previous well-meaning programmes aimed at changing behaviour for the benefit of health have fallen short of their objectives that we urge that any programme of education for parenthood should be based on principles rather than prescrip- tions.

Today’s children are already receiving their education in ‘parenting’ and in ‘parenthood’ from within their own family and through the families of their peers. Like the professionals, they see the pain and consequences of marital dissatisfaction, separation, divorce, alcoholism, isolation and depression, unemployment, but will they be any better able to prevent it happening in themselves or their own future families. Will they be any better educated to find the support, advice and help when they need it?

Conclusion

Heredity, culture, socio-economic class and personal experience all contribute to the process by which an infant is transformed into a particular individual child and adult. Specific child rearing practices can differ widely, not only from culture to culture but also from generation to generation within a single culture, and from parents to parents. The social environment in which a child is born and reared exerts a potent effect on the development of his personality; atmosphere and values will influence his assumptions and aspirations: the size and structure of his family are further individuating factors. There is a need for a co-ordinated preventive approach to promote ‘healthy’ family life and support the needs of parents throughout the life-cycle. Effective

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prevention and intervention lies in making the family systems approach, within an ecological framework, more widely known to all professions and disciplines and the whole range of government and local authority services. We should seek to implement administrative action statements, particularly on family policy and family impact. In our own community, we can seek to improve our own knowledge of schemes and services available for families and give professional support, advice and encouragement in the formation of links between agencies, disciplines, voluntary organizations and families.

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