Evaluation of an ICDP parenting programme for parents with teenagers
Report
|Published
The report evaluates a new version of a group-based guidance program for parents of teenagers, based on the International Child Development Programme (ICDP) and Tuning in to Teens (TinT). The primary method of learning is group reflection and the sharing of experiences among parents, following short teaching segments on how parents can strengthen their relationship with their teenagers.
Key message
- The report evaluates a new version of a group-based guidance program for parents of teenagers, based on the International Child Development Programme (ICDP) and Tuning in to Teens (TinT). The primary method of learning is group reflection and the sharing of experiences among parents, following short teaching segments on how parents can strengthen their relationship with their teenagers.
- ICDP Teens is intended as a universal health promotion measure (primary measure), but parents experiencing greater challenges with their teenagers are overrepresented in the guidance groups. If the goal is for the program to be used preventively, changes and increased efforts in broad recruitment strategies and marketing must be made.
- The parents who participated in our evaluation are very satisfied, both with their experience as participants and with the perceived usefulness of the program. They describe becoming more confident in their parenting role, being calmer in their relationship with the teenagers, and that the interaction and communication with the teenagers have improved. The changes persist a year after the program has concluded. The teenagers have little interest in the program, but they all agree that their parents seem calmer than before.
- The findings suggest that ICDP Teens has the potential to be experienced positively by all parents across cultural divides if the parents have lived in Norway for some time, and if the program facilitated a more in-depth thematization of culture and cultural differences in parenting norms.
- We observe variations in whether the guides are satisfied with the guidance material. ICDP guides play a central role in the implementation and execution of the program. They often initiate and introduce the program at their place of work. Maintaining their motivation and willingness to adopt the new version of ICDP Teens is important to ensure its long-term realization.
- We recommend changes to the guidance material to achieve better consistency between the program as it is designed and how it is implemented in the field. We recommend making the layout more flexible by changing the manual to a template, with several alternatives for teaching content, pedagogical strategies, tasks, and examples between which the guides can chose. The template should increase the cultural sensitivity of the program.
- Our study cannot answer whether ICDP Teens has a positive effect on teenagers, their parents, and their relationship. Reporting high satisfaction is very common in evaluation research and does not have a strong correlation with the actual effect of the program. Securing research-based evidence of ICDP Teens effects would require a (quasi-) experimental evaluation of the program.
Summary
Introduction
Parental guidance can strengthen the relationship between parents and children. A good relationship with parents is associated with better mental health and can limit the need for costly interventions later in life. The teenage years are increasingly recognized as an important time to invest resources, as the brain's maturation process during these years makes adolescents vulnerable, yet simultaneously receptive to learning and development. This report evaluates the piloting of a preventive guidance program for parents with teenagers. The program, here referred to as ICDP Teens, combines elements from the group- and reflection-based International Child Development Programme and Tuning in to Teens. ICDP Teens consists of 8 group sessions, where parents receive short segments of instruction but primarily exchange experiences with each other and reflect on their interaction with their teenagers. Our report describes the recruitment process; the experiences of parents and guides that have completed the program; to what extent the program suits the target group of parents with teenagers; and organizational barriers and facilitators for implementation. We describe the parents' experiences of the intervention's usefulness immediately following the final group session, and over time. We also share the perspectives of teenagers whose parent(s) have completed the program.
Methods
The evaluation is based on focus group interviews with parents from four guidance groups (a total of 29 parents), and questionnaires answered by 54 parents. We conducted in-depth interviews with 8 of the teenagers whose parents were in these groups. A smaller selection of parents and teenagers were interviewed again about a year after the last guidance session. In addition to this, we interviewed 14 guides who participated in the trial of ICDP Teens, and 28 guides responded to a questionnaire.
Results and Discussion
Recruitment: Just under half of the guides experience difficulties securing participants for their groups. The most common place of recruitment is through schools/after-school programs, and through the guides' contact with parents in various services. The drop-out rate is smallest among parents recruited through the guide's professional network, and there is almost no drop-out following the first group meeting. The majority of parents participate to counteract an escalation of identified problems with their teenagers. Nearly 80% are concerned about their teenagers. 61% of the parents answer that they knew little or nothing at all about the program prior to the first group meeting. Few inform their adolescents about the program, but almost all adolescents find out about it by chance. The teenagers show little interest in ICDP and know very little about the program. No one in our sample expresses negative feelings about their parents' participation.
Implementation: About half of the guides consider the training module to be sufficient. Those who disagree emphasize that elements integrated from the parental guidance program Tuning in to Teens are given too much attention compared to elements from Standard ICDP. Most of the guides use the manual flexibly and model the program to conform better with a previous variant of the intervention (standard ICDP). Less experienced guides are mostly positive to the new version of the program, but experienced guides prefer the Standard ICDP format. The more experienced guides would like the comprehension dialogue, where parents expand adolescents' understanding of the external world, to be included in the program. They would also prefer clearer emphasis on experience-based learning strategies. Less experienced guides are satisfied with the manualization of the program, while experienced guides want to retain the flexibility from standard ICDP. A clear majority find that ICDP Teens demonstrates far less cultural sensitivity than Standard ICDP.
The guides describe that ICDP Teens preserves aspects of Standard ICDP that support good group processes. Parents feel very positive about their interactions with other parents, and they describe a strong sense of community. About 95% agree/fully agree that they enjoyed group-based guidance; 92% that it was safe to share experiences. Approximately 85% are very satisfied with the guides' leadership of the group, and they describe the guides as non-judgmental and competent companions.
Parents and guides believe that the program is suitable regardless of differences in challenges faced by the adolescents. They also consider ICDP Teens to be appropriate across cultures if participants have had some time to adjust to Norway, and if the guide adjusts the material to better suit parents from collectivistic backgrounds. Guides working with interpreted minority groups find that the content does not always suit parents from countries with child-rearing norms that differ from Norwegian ones. Up to 100% of the parents agree/fully agree that the films and teaching segments were useful, and up to 90% respond the same about self-reflection and group tasks. Parents and guides agree that mindfulness was the least useful. Just over 80% of parents versus about 45% of guides agree/fully agree that role-playing was useful/worked well.
Utility: Parents are consistently satisfied with the guidance program as a whole. They are most satisfied with an increased awareness of their own reactions in interactions with the adolescents (about 90% agree/fully agree) and state that they are more capable of noticing the positive characteristics of the adolescents (about 90% agree/fully agree). Parents experience their role as parents to be less static and one-sided, and more dynamic. Those who equated their role as a parent with that of a boss now perceive themselves more as consultants and supporters for their teens. About 75% also agree/fully agree that they understand the adolescents better and more often seize the opportunity for contact. About 50% agree/fully agree that communication with the adolescents has improved; that they now have a closer relationship; and handle rejection better.
All parents and guides in our sample describe the group processes as safe and useful. We see no clear variations in the perceived utility of the program or group dynamics based on cultural background or variation in the type and level of the adolescent’s challenges. Parents highlight large parts of the program as important and useful, but especially learning about the connections between the different themes: For example, how one's own background affects interactions with the teenagers. Patterns of interaction matter for whether parents succeed in forming close relationships with the adolescents, which in turn enables parents to establish positive boundaries through negotiations with the teen. Parents report that they are now more empathetic and understanding of the adolescents' perspectives. They describe being attentive to the teen’s feelings and seizing the opportunity for contact or accepting rejection based on the teens perceived needs. Several parents believe they now have a closer relationship and communicate better with the teen - even if the conflict level remains the same. All describe being better able to stay calm in their interactions– to which the teenagers agree. Even so, the teenagers are not particularly interested in the program, and tend to forget that their parents have participated.
In qualitative data, parents highlight the benefits of taking an empathic rather than sympathetic approach to support their adolescents when they experience something difficult, and of staying calm in challenging interactions. Changes in the relationship are not obvious to the teenagers. They do, however, appreciate that their parents seem calmer and that they do not get angry or upset as quickly. Some mention that their parents seem more available for contact. The parents we followed up with about a year after the program still remember and draw benefits from ICDP related learning. When we remind teenagers of improvements in their parents’ behavior that they mentioned in the initial interview, most of them report that these changes have lasted. The teenagers have forgotten that the changes are associated with ICDP. Concrete changes in parents’ caring practices are not necessarily static and «lasting» but keep evolving and adjusting as the teenagers develop and mature.
Implementation: The parents perceive the guides to be personally suited for the role. The guides consistently have higher education qualifications, and have completed a bachelor’s degree at a minimum, within health, social, and community studies. 96% agree or fully agree that guiding groups of adolescent parents matches their competence and/or education.
Most of the guides feel that ICDP Teens lacks sufficient anchoring in municipalities and organizations. Many of them have initiated the implementation of the program at their workplace. A lot of work appears to be done without pay in addition to a full-time position. Guides consistently call for improvement of their working conditions and compensation, especially time reserved to attend to ICDP-related tasks. Almost none of the guides report incentives to invest professionally in ICDP, in terms of higher pay or increased opportunities for promotion. The findings also show that internal motivation is not enough to ensure long-term realization of the program: 36% of the guides are uncertain if they will continue as guides for ICDP Teens in the future, often because the program is not sufficiently prioritized by their organizations. The guides' internal motivation is crucial for the implementation of the program. And, for some guides, dissatisfaction with certain revisions in ICDP Teens (compared to Standard ICDP) seems to erode this motivation.
Conclusion and Recommendations
Many of the guides who participated in the pilot chose to integrate elements from Standard ICDP. For future evaluations, it is important that the program, as outlined in the manual and as actually implemented, align more closely. We primarily recommend adjusting the written material to match how the program is practiced in the field. This would make the program more consistent while motivating the guides to utilize the material. Our recommendation is to change the manual into a template with multiple options for different tasks, teaching content, and educational approaches that the guides can choose from.
Like standard ICDP, we suggest establishing an early and continuous focus on how cultural and experiential background affects care, and what experiences parents have related to a given topic before it is introduced. Furthermore, we recommend adjusting the written material and examples used to make the program more relevant across cultures. Ideally, the template will present different versions of tasks and examples, some of which are tailored to parents from more collectivist backgrounds.
To find out if the program has positive effects on parents, adolescents, and their relationship, research is needed that randomizes the timing of program entry and compares parents and adolescents who participate with a control group that has not completed the program, or that completes the program at a later stage.
If the goal is for the program to be used universally, a change in- and increased focus on recruitment strategies and marketing must be made. Currently, the program is implemented in line with proportional universalism: This means that the program is available to all, and that broad recruitment attempts are made, but that most parents who decide to participate experience greater than average difficulties with their teenagers. It could well be that this is a more cost-effective implementation than what would be achieved through universal recruitment.
