Centre For Parent And Child Support Guys Hospital

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Centre For Parent And Child SupportGuys Hospital
It aint what you do, but the way that you do
it. The Family Partnership Model Hilton
Davis
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Plan
Background Need for a Theory of Helping Family
Partnership Model Training Programmes Applications
Research Evidence
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Service Concerns 1
High levels of psychological need. Insufficient
specialist services. Little promotional or
preventive work. Dissatisfaction with
services. Poor professional communication
. Failure to consider the whole child.
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Service Concerns 2
Neglect of whole family needs. Neglect of the
psychological and social. Low confidence in
dealing with psychosocial issues. Rarely select
for qualities and skills of helping. Lack of
training. Considerable stress in professionals. A
lack of skilled supervision.
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Theoretical Basis of Partnership Model
Davis H, Day C. Bidmead C (2002). Working in
Partnership with Parents The Parent Adviser
Model. London Harcourt Assessment.
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Family Partnership Model
Construction Processes
Partnership
Helper Qualities
Helper Skills
Process
Outcomes
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Intended Outcomes of Helping

Do no harm Help parents identify, clarify and
manage problems. Enable them, including problem
anticipation. Enable development and well-being
of children. Facilitate social support and
community development. Enable service
support. Compensate where necessary.
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The Helping Process

RELATIONSHIP EXPLORATION CLEAR
MODEL GOAL SETTING PLANNING
ACTION IMPLEMENTATION EVALUATION
END
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Partnership

Active participation/involvement Sharing of
complementary expertise Shared decision making
power, but parent led Agreed aims and
process Mutual respect and trust Open
communication Negotiation
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Essential Qualities Of The Helper
Respect unconditional positive regard
Genuineness Empathy Humility Quiet enthusiasm
Personal integrity
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Communication Skills Of Helpers
Concentration/Active listening Prompting and
exploration Empathic responding Summarizing
Enabling change Negotiating Problem solving
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Construing
All build construction system As model to
anticipate and adapt All have different
models Derived from previous experience Constantly
in process of clarifying and changing Interaction
determined by constructions of others
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Parent-child Interactive Cycle

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Family Partnership Training Manual
Davis H, Day C. Bidmead C (2002). The Parent
Adviser Training Manual. London Harcourt
Assessment
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Family Partnership Training Style
Designed on bases of Partnership
Model Reflects/demonstrates Partnership Model
Conceptual and skills focused Interactive
throughout Based upon Socratic questioning
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Family Partnership Training Structure
Two facilitators 12 Participants 10 half-day
sessions At weekly intervals
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Family Partnership Training Session
Assignment discussion Seminar to explore aspect
of model Skills Practice in groups of
three Assignment Reading and Observations
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Family Partnership Training Levels
Core Course 10 sessions Add-on modules 6
sessions Supervisor Course 10
sessions Facilitator Course 12 sessions Trainer
of Facilitator Course 10 sessions
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Family Partnership Model Applications
Childhood Disability Adult Disability SCBU
Follow-up for Very Low Birth Weight Childhood
Emotional Behavioural Problems Promotion of
Child Mental Health Prevention of Abuse and
Neglect School and Community Development
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Family Partnership Training Professions
Nurses Nursery, Primary Care, School
Therapists speech, physio, OT Community
Paediatricians Teachers All ages and special
needs Early Years and Child Care Social Care
SWs EWOs Parents
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Further Information
Davis, H. Tsiantis, J. (2005) The European
Early Promotion Project. International Journal
of Mental Health Promotion Special Issue, Volume
7.
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European Early Promotion Project
CYPRUS Dr A Paradisiotou, Mrs S Kyriakides,
Ms Y Hadjipanayi, Ms S Vizacou FINLAND Prof
T Tamminen, Dr K Puura, Dr M Turunen SERBIA
MONTENEGRO (formerly FRY) Prof V Ispanovic,
Dr N Rudic, Ms J Radosovljev, Ms T
Miladinavic GREECE Prof J Tsiantis, Prof T
Dragonas, Ms E Layiou-Lignos, Dr K
Papadopolou UK Prof H Davis, Prof A Cox,
Dr C Day, Ms R Roberts
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Review of Literature
These findings are sobering. In most of the
studies described, programs struggled to enroll,
engage and retain families. When program
benefits were demonstrated, they usually accrued
only to a subset of the families , they rarely
occurred for all of a programs goals, and the
benefits were often quite modest in
magnitude. Gomby, Culross Behrman (1999).
Home visiting recent program evaluations.
Future of Children, 9, 4-26.
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Service Design Specification 1
Based upon explicit theory (including
communication). Proactive and
non-stigmatising. Accessible to all
families. Universal surveillance via home
visiting. Integrated within existing primary
care structures. Coordinated with all other
services. Targeted to identified family need.
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Service Design Specification 2

Initiated in the antenatal period. Continues as
long as necessary. Family-centred, based on
parent-helper partnership. Strengths based to
build family resources. Staff trained to relate
and facilitate parent-infant interaction.
On-going skilled supervision for the workers.
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EEPP Service Structure
Universal promotional interview (4-6 weeks
before birth) Universal promotional interview
(4-6 weeks after birth) Health visitor judgment
about need (using Need Checklist) Continue to
visit those in need using Partnership Model
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Core Course Feedback
To what extent would you recommend the course to
other colleagues? (n275) Highly
recommend 187 68 Recommend 73 26.5 Not
sure 14 5.1 Unlikely to
recommend 1 0.4 Would not recommend
0 0

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Core Course Feedback
To what extent did you feel respected during the
training? (n275)  Very much so 199 72  A
lot 71 26 A little 5 2 Not at
all 0 0
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Effects of Training on Self-efficacy
Multidisciplinary group trained
(n26) Pre-training mean 55.2 (plt0.0001)
Post-training 29.4 15 items of 19 changed
significantly Controls waiting for training
(n15) no significant change over same
period No items changed significantly (Rus
hton Davis, 1992)
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Effects of Training on Empathy
 From Rushton and Davis (1992) using 9 point
scale Pre-training p Post-training Trained
(n26) 4.0 0.005 5.0 Untrained
(n15) 4.1 ns 4.1 (Effect
size0.50)
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EEPP Families In Need (UK)
HV Research Judgment
Judgment Intervention 62 (55) 77
(68) Comparison 25 (24) 73 (71)
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Frequency of Problems Rated by Trained and
Untrained Health Visitors
  Trained Untrained Mental health problems
(plt 0.001) 19 3   Marital discord (p 0.008)
23 6   Social isolation (plt 0.001) 30
4   Financial problems (plt 0.001) 19
1   Adverse life events (p 0.041) 15 6
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Accuracy Of Specific Need Identification
Intervention Comparison
Cyprus 55 67 Finland 61 68 Greece 78
32 Serbia 53 47 UK 66 32 Total
62 49
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Bangladeshi Mother Self-Esteem
PRE POST CHANGE P.A GROUP 46.4
(plt.01) 31.6 -14.8 (plt.005) CONTROLS 37.3
58.8 21.5 Effect size 1.05 0.25 small
0.5 medium 0.75 large
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Bangladeshi Mothers Social Support
PRE POST CHANGE P.A GROUP 3.3
(plt.005) 4.8 1.5 (plt.005) CONTR
OLS 4.1 3.9 -0.2
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Bangladeshi Children Griffiths Mental Age
PRE POST CHANGE PA GROUP 21.5
(plt.005) 27.4 5.9 (plt.05) CONTROLS 32.5
33.7 1.2 Effect size 0.30 Average
chronological ages 62 and 83 months
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Parenting Stress Index (Guys Study)
Pre Post Intervention 100.4 (p0.0001) 87
.7 Comparison 104.3 (p0.65) 102.9 Effect
Size 0.59 Clinical caseness cut off
90 See Davis Spurr (1998)
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Home Inventory Birth To Three Years Total
Score
PRE POST INTERVENTION 26.9 (p0.0001) 32.5
COMPARISON 28.1 (p0.15) 26.0 Effect
Size 1.04
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Child Behaviour Checklist (Guys Study)
Pre Post Intervention 70.5
(p0.0001) 59.5 Comparison 73.1
(p0.2) 68.8 Effect Size
0.79 Clinical caseness cut off
64 See Davis Spurr (1998)
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Avon Premature Infant Project (1998)

Mean Griffiths GQ scores For children with
birth-weights below 1251 grams Portage 100.5 Pa
rent Adviser 98.1 Controls 95.3 For children
with ultrascan evidence of lesions Portage 100.
4 Parent Adviser 99.0 Controls 93.1
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Outcomes HOME Inventory at 24mths
Inter. Comp. P ES Greece (5 of 7 scales
in predicted direction) Organization 5.3 4.6
0.001 0.72 Variety 3.6 3.1 0.02 0.48 UK (6
of 7 scales in predicted direction) Responsiveness
9.8 9.2 0.01 0.34 Play materials 8.5 8.2 0.02
0.28
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Other Interaction Measures at 24mths
Inter. Comp. P UK Quality of
relationship 0.9 1.1 0.06 Control
1.5 1.9 0.03 Involvement 66.5 65.3 0.08 S
ignificantly more change in Intervention
Group HOME Responsiveness (UK Finland) HOME
Organization (UK Greece) HOME Play Materials
(UK) HOME Total Score (UK, Finland Greece)

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Mothers Satisfaction with EEPP Service (Medians)
Intervention Comparison
p Cyprus 33 38 0.003 Finland
20.5 21 0.2 Greece 13 20
0.0002 Serbia 16 19 0.08 UK 20 25
0.03 Total 20.5 25 Average effect
size 0.4
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Bermondsey Study Mothers Feedback
How Parent Advisers made mothers feel about
themselves. Mean 3.04 (range 1.5 -
4.0) 4 Most positive
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Suffering
Suffering is not a question that demands an
answer it is not a problem that demands a
solution it is a mystery that demands a
presence. Anon.
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Further Information
www.cpcs.org.uk Centre for Parent and Child
Support, Guys Hospital Forthcoming Centre
conference The Family Partnership Model
Understanding the Processes of Helping Parents
and Children. 18th November, 2005