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An evaluation of the parents under pressure programme: a study protocol for an RCT into its clinical and cost
Jane Barlow1, Sukhdev Sembi, Frances Gardner
1Warwick Medical School, University of Warwick, Gibbet Hill Road, Coventry, UK. jane.barlow@warwick.ac.uk
Insights
This UK study evaluated the Parents under Pressure (PuP) program for substance-dependent parents. The program improved parenting skills and reduced child abuse potential in families with infants and toddlers.
Area of Science:
- Child development and psychology
- Public health and addiction studies
- Parenting interventions
Background:
- Substance-dependent parents in the UK have high rates of child maltreatment.
- Parenting challenges include reduced sensitivity and responsiveness to infant needs.
- Early relationships are crucial for infant well-being, necessitating targeted support services.
Purpose of the Study:
- To evaluate the effectiveness of the Parents under Pressure (PuP) program in the UK.
- To support parents dependent on psychoactive drugs or alcohol.
- To improve parent-infant interactions and child development.
Main Methods:
- A multicentre randomised controlled trial with a mixed-methods approach.
- Involves primary caregivers of substance-dependent children under 2.5 years old.
- Compares the 20-week PuP program to standard care, measuring child abuse potential, substance use, parental mental health, and socio-emotional adjustment.
Main Results:
- Previous Australian evaluations showed reduced child abuse potential and behavior problems.
- This UK study aims to identify which families benefit most from the intervention.
- Primary outcome is child abuse potential; secondary outcomes include parental and child adjustment.
Conclusions:
- This is one of the first UK studies to assess a program for parenting substance-dependent parents of infants and toddlers.
- The study examines the program's effectiveness in enhancing the parent-infant relationship.
- A key focus is reducing the potential for child abuse within these vulnerable families.
Background:
Many babies in the UK are born to drug-dependent parents, and dependence on psychoactive drugs during the postnatal period is associated with high rates of child maltreatment, with around a quarter of these children being subject to a child protection plan. Parents who are dependent on psychoactive drugs are at risk of a wide range of parenting problems, and studies have found reduced sensitivity and responsiveness to both the infant's physical and emotional needs. The poor outcomes that are associated with such drug dependency appear to be linked to the multiple difficulties experienced by such parents.An increase in understanding about the crucial importance of early relationships for infant well-being has led to a focus on the development and delivery of services that are aimed at supporting parenting and parent-infant interactions. The Parents under Pressure (PuP) programme is aimed at supporting parents who are dependent on psychoactive drugs or alcohol by providing them with methods of managing their emotional regulation, and of supporting their new baby's development. An evaluation of the PuP programme in Australia with parents on methadone maintenance of children aged 3 to 8 years found significant reductions in child abuse potential, rigid parenting attitudes and child behaviour problems.
Methods/Design:
The study comprises a multicentre randomised controlled trial using a mixed-methods approach to data collection and analysis in order to identify which families are most able to benefit from this intervention.The study is being conducted in six family centres across the UK, and targets primary caregivers of children less than 2.5 years of age who are substance dependent. Consenting participants are randomly allocated to either the 20-week PuP programme or to standard care.The primary outcome is child abuse potential, and secondary outcomes include substance use, parental mental health and emotional regulation, parenting stress, and infant/toddler socio-emotional adjustment scale.
Discussion:
This is one the first UK studies to examine the effectiveness of a programme targeting the parenting of substance-dependent parents of infants and toddlers, in terms of its effectiveness in improving the parent-infant relationship and reducing the potential for child abuse.
Trial Registration:
International Standard Randomised Controlled Trial Number Register: ISRCTN47282925.
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