Peer-led parenting classes prove effective

New research shows that peer-led parenting classes are effective at improving parenting practices and children’s behavioural problems. The researchers, from the Institute of Psychiatry at King’s College London, suggest that peer-led parenting groups offer a less stigmatising and more accessible format than standard professionally-led programmes. This innovative approach to delivering effective parenting support may be particularly successful for helping the most vulnerable families in society.

Parenting styles are closely linked to children’s behavioural problems. Parenting interventions are recommended by the National Institute for Health and Clinical Excellence (NICE) and have been proven to be effective, but many families fail to receive effective help due to stigma and difficulties getting to services.

In this new study, published on bmj.com, researchers studied 116 families with children aged 2-11 years in Southwark, one of the most deprived boroughs in England. The parents were seeking help with managing their children’s behavioural problems, such as temper tantrums, defiance of household rules and fighting with siblings. Compared to a similar group of families that had yet to receive the intervention, the families who did take part in the peer-led intervention reported clinically and statistically significant improvements in positive parenting practices and children’s behavioural problems. 

Importantly, almost all of the parents (92%) who started the peer-led intervention completed it, and all parents reported good or excellent levels of user satisfaction. The researchers also found there was also a mild reduction in parental stress, although the difference was not significant. 

Dr Daniel Michelson, senior clinical research associate at the IoP at King’s and co-author of the paper says: ‘As well as comparing favourably with established parenting programmes in terms of clinical effectiveness, the peer-led intervention benefited from impressively high retention rates, outperforming many similar professionally-led programmes.’ 

The Empowering Parents, Empowering Communities (EPEC) intervention consisted of eight weekly, two hour group sessions aimed at improving participants’ parenting skills, relationships and interactions with their children. The parenting sessions involved information-sharing, group discussion, demonstration, role-play and home practice. The peer facilitators who were running these groups had all completed accredited training and received regular supervision. Child problems, parental stress, parenting competencies and user satisfaction were measured through questionnaires completed by the parents. 

Dr Crispin Day, lead author of the paper and Head of the Child and Adolescent Mental Heath Services Research Unit at the IoP at King’s says: ‘The most common reason children are referred to a mental health clinic is disruptive, aggressive and non-compliant behaviour, which can severely affect the quality of life for both the child and the family. If left untreated, this type of behaviour can develop into bullying, delinquency and more severe antisocial behaviour. Our findings suggest that EPEC is a successful way to deliver parenting support for some of the most vulnerable families in society.’

The authors suggest that more work is needed to determine the long-term effects of peer-led parenting support for individuals and communities. Future research is also needed to evaluate the cost-effectiveness of the programme, which may offer an economically viable method for improving access to evidence based parenting support for hard to reach families. 

Dr Day adds: 'Early indications are that the EPEC system is less costly and generally more efficient than professionally-led programmes because of the high demand and low drop-out of parents. Another important aspect is that EPEC relies on a manualised and clearly devised method for supporting parents, which has exciting potential to be replicated in other areas.' 

The authors of the paper thanked Caroline Adewole, Annika Jaramillo and Catherine Kearney for their assistance on the EPEC project; the peer facilitators and parents involved with the project; Stephen Rock and Stephen Tilki for their assistance with data collection; and Guy’s and St Thomas’ Charity and the London Borough of Southwark for funding. 

For full paper: Crispin, Day et al. ‘Evaluation of a peer led parenting intervention for disruptive behaviour problems in children: community based randomised controlled trial’ bmj.com (Tuesday 13th March 2012) doi: 10.1136/bmj.e1107

Peer-led parenting was also the discussion in this week’s BMJ Group podcast. The BMJ spoke to the co-authors of the paper and some of the mothers involved in the project.