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Randomised feasibility trial of the helping families programme-modified: an intensive parenting intervention for parents affected by severe personality difficulties.
BMJ Open. 2020 02 06; 10(2):e033637.BO

Abstract

BACKGROUND

Specialist parenting intervention could improve coexistent parenting and child mental health difficulties of parents affected by severe personality difficulties.

OBJECTIVE

Conduct a feasibility trial of Helping Families Programme-Modified (HFP-M), a specialist parenting intervention.

DESIGN

Pragmatic, mixed-methods trial, 1:1 random allocation, assessing feasibility, intervention acceptability and outcome estimates.

SETTINGS

Two National Health Service health trusts and local authority children's social care.

PARTICIPANTS

Parents: (i) primary caregiver, (ii) 18 to 65 years, (iii) severe personality difficulties, (iv) proficient English and (v) capacity for consent. Child: (i) 3 to 11 years, (ii) living with index parent and (iii) significant emotional/behavioural difficulties.

INTERVENTION

HFP-M: 16-session home-based intervention using parenting and therapeutic engagement strategies. Usual care: standard care augmented by single psychoeducational parenting session.

OUTCOMES

Primary feasibility outcome: participant retention rate.

SECONDARY OUTCOMES

(i) rates of recruitment, eligibility and data completion, and (ii) rates of intervention acceptance, completion and alliance (Working Alliance Inventory-Short Revised). Primary clinical outcome: child behaviour (Eyberg Child Behaviour Inventory).

SECONDARY OUTCOMES

child mental health (Concerns About My Child, Child Behaviour Checklist-Internalising Scale), parenting (Arnold-O'Leary Parenting Scale, Kansas Parental Satisfaction Scale) and parent mental health (Symptom-Checklist-27). Quantitative data were collected blind to allocation.

RESULTS

Findings broadly supported non-diagnostic selection criterion. Of 48 participants recruited, 32 completed post-intervention measures at mean 42 weeks later. Participant retention exceeded a priori rate (HFP-M=18; Usual care=14; 66.7%, 95% CI 51.6% to 79.6%). HFP-M was acceptable, with delivery longer than planned. Usual care had lower alliance rating. Child and parenting outcome effects detected across trial arms with potential HFP-M advantage (effect size range: 0.0 to 1.3).

CONCLUSION

HFP-M is an acceptable and potentially effective specialist parenting intervention. A definitive trial is feasible, subject to consideration of recruitment and retention methods, intervention efficiency and comparator condition. Caution is required in interpretation of results due to reduced sample size. No serious adverse events reported.

TRIAL REGISTRATION NUMBER

ISRCTN14573230.

Authors+Show Affiliations

Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK crispin.1.day@kcl.ac.uk. Centre for Parent and Child Support, South London and Maudsley NHS Foundation Trust, London, UK.Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK.The Centre for Psychiatry, Imperial College, London, UK.McPin Foundation, London, UK.Centre for Parent and Child Support, South London and Maudsley NHS Foundation Trust, London, UK.King's Health Economics, P024 David Goldberg Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.King's Health Economics, P024 David Goldberg Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. Centre for Mental Health, Institute for Lifecourse Development, University of Greenwich, London, UK.Institute of Mental Health, University of Nottingham, Nottingham, UK.School of Psychology, University of Sussex, Brighton, UK.Department of Population Health Sciences, Centre for Academic Mental Health, University of Bristol, Bristol, UK.Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK.Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.Faculty of Education, PEDAL Research Centre, University of Cambridge, Cambridge, UK.Department of Mental Health, Middlesex University, London, UK.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32034024

Citation

Day, Crispin, et al. "Randomised Feasibility Trial of the Helping Families Programme-modified: an Intensive Parenting Intervention for Parents Affected By Severe Personality Difficulties." BMJ Open, vol. 10, no. 2, 2020, pp. e033637.
Day C, Briskman J, Crawford MJ, et al. Randomised feasibility trial of the helping families programme-modified: an intensive parenting intervention for parents affected by severe personality difficulties. BMJ Open. 2020;10(2):e033637.
Day, C., Briskman, J., Crawford, M. J., Foote, L., Harris, L., Boadu, J., McCrone, P., McMurran, M., Michelson, D., Moran, P., Mosse, L., Scott, S., Stahl, D., Ramchandani, P., & Weaver, T. (2020). Randomised feasibility trial of the helping families programme-modified: an intensive parenting intervention for parents affected by severe personality difficulties. BMJ Open, 10(2), e033637. https://doi.org/10.1136/bmjopen-2019-033637
Day C, et al. Randomised Feasibility Trial of the Helping Families Programme-modified: an Intensive Parenting Intervention for Parents Affected By Severe Personality Difficulties. BMJ Open. 2020 02 6;10(2):e033637. PubMed PMID: 32034024.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Randomised feasibility trial of the helping families programme-modified: an intensive parenting intervention for parents affected by severe personality difficulties. AU - Day,Crispin, AU - Briskman,Jackie, AU - Crawford,Mike J, AU - Foote,Lisa, AU - Harris,Lucy, AU - Boadu,Janet, AU - McCrone,Paul, AU - McMurran,Mary, AU - Michelson,Daniel, AU - Moran,Paul, AU - Mosse,Liberty, AU - Scott,Stephen, AU - Stahl,Daniel, AU - Ramchandani,Paul, AU - Weaver,Tim, Y1 - 2020/02/06/ PY - 2020/2/9/entrez PY - 2020/2/9/pubmed PY - 2021/2/16/medline KW - child & adolescent psychiatry KW - child behaviour KW - parenting KW - personality disorders SP - e033637 EP - e033637 JF - BMJ open JO - BMJ Open VL - 10 IS - 2 N2 - BACKGROUND: Specialist parenting intervention could improve coexistent parenting and child mental health difficulties of parents affected by severe personality difficulties. OBJECTIVE: Conduct a feasibility trial of Helping Families Programme-Modified (HFP-M), a specialist parenting intervention. DESIGN: Pragmatic, mixed-methods trial, 1:1 random allocation, assessing feasibility, intervention acceptability and outcome estimates. SETTINGS: Two National Health Service health trusts and local authority children's social care. PARTICIPANTS: Parents: (i) primary caregiver, (ii) 18 to 65 years, (iii) severe personality difficulties, (iv) proficient English and (v) capacity for consent. Child: (i) 3 to 11 years, (ii) living with index parent and (iii) significant emotional/behavioural difficulties. INTERVENTION: HFP-M: 16-session home-based intervention using parenting and therapeutic engagement strategies. Usual care: standard care augmented by single psychoeducational parenting session. OUTCOMES: Primary feasibility outcome: participant retention rate. SECONDARY OUTCOMES: (i) rates of recruitment, eligibility and data completion, and (ii) rates of intervention acceptance, completion and alliance (Working Alliance Inventory-Short Revised). Primary clinical outcome: child behaviour (Eyberg Child Behaviour Inventory). SECONDARY OUTCOMES: child mental health (Concerns About My Child, Child Behaviour Checklist-Internalising Scale), parenting (Arnold-O'Leary Parenting Scale, Kansas Parental Satisfaction Scale) and parent mental health (Symptom-Checklist-27). Quantitative data were collected blind to allocation. RESULTS: Findings broadly supported non-diagnostic selection criterion. Of 48 participants recruited, 32 completed post-intervention measures at mean 42 weeks later. Participant retention exceeded a priori rate (HFP-M=18; Usual care=14; 66.7%, 95% CI 51.6% to 79.6%). HFP-M was acceptable, with delivery longer than planned. Usual care had lower alliance rating. Child and parenting outcome effects detected across trial arms with potential HFP-M advantage (effect size range: 0.0 to 1.3). CONCLUSION: HFP-M is an acceptable and potentially effective specialist parenting intervention. A definitive trial is feasible, subject to consideration of recruitment and retention methods, intervention efficiency and comparator condition. Caution is required in interpretation of results due to reduced sample size. No serious adverse events reported. TRIAL REGISTRATION NUMBER: ISRCTN14573230. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/32034024/Randomised_feasibility_trial_of_the_helping_families_programme_modified:_an_intensive_parenting_intervention_for_parents_affected_by_severe_personality_difficulties_ L2 - https://bmjopen.bmj.com/lookup/pmidlookup?view=long&pmid=32034024 DB - PRIME DP - Unbound Medicine ER -