What is this?

• Interventions were classified as individual family support programmes or group support programmes.
• Individual family support programmes use pre-visit planning and coaching. A coach helps parents to plan strategies for use during supervised contact with their children, offers support during the contact session and gives advice and support after the session.
• Group support programmes involve structured discussions for groups of parents of children looked after to discuss key issues such as positive parenting, anger management, developing self-esteem, grief and loss, learning through play, building children’s trust and confidence, and budgeting and finance. They are also designed to support self-reflection for parents.

How is it meant to work?

• Both individual support programmes and group support programmes are designed to improve the quality of contact between parents and children in the supervised contact environment by supporting parents in a non-judgemental and compassionate way.
• Individual support programmes are delivered to individual families, and may include carers. They are built on attachment theory, and focus on relationships. Building on attachment theory the intervention supports parents to become more reflective about their parenting and understand the importance of consistency in parenting. It also aims to give parents strategies to respond appropriately to their child’s behaviour.
• Some of the individual support programmes (e.g. Haight et al., 2005) also consider the feelings of grief and loss that parents who have a child removed from their care experience and highlight the importance of parents being offered emotional support to help manage these feelings.
• Group Support programmes are designed to improve parental outcomes and parent-child relationships. They do this through supporting parents to be honest about their previous parenting styles and to talk through feelings of stigma regarding the removal of their children in an empowering and supportive  environment.

What are the evaluated outcomes?

• Parental Outcomes
• Parent-Child Relationship

How effective is it?

Parental Outcomes
Individual family support and group support programmes had an inconclusive or mixed effect on parental outcomes. Overall there was some evidence suggesting these interventions may have the potential to improve parental outcomes such as resilience or shame, but findings were mixed. For example, Salveron et al. (2009) found that confidence and guilt did not change over time for parents in a structured therapeutic playgroup. This is based on low strength of evidence.

Parent-Child Relationships
Individual family support and group support programmes had an inconclusive or mixed effect on parent-child relationships. Overall there was some evidence suggesting these interventions may have the potential to improve parent-child relationships, however findings were mixed. For example, Haight et al. (2005) found that mothers in an individual family support intervention group were less engaged with their children than mothers in the comparison group. Again, this is based on low strength of evidence.

Where has it been studied?

This was an evaluation of 12 studies from the USA (6 studies), Australia (4 studies) and Canada (2 studies).

Who does it work for?

• The interventions evaluated in this study have focussed on children looked after and their parents. Some studies in this review included, support workers or foster carers.
• The target age for children was 0-16, although the range varied in some studies.

When, where and how does it work?

• The interventions were carried out in a range of locations, including community buildings and office spaces designed to look like a home environment.
• The majority of the interventions were delivered by experienced support staff; some of them included trained mental health professionals.
• The individual family support programmes involve coaching with individual families before, during and after the supervised contact visit to develop more effective and positive parenting strategies. When delivered in a single session to mothers, they found that mothers in the intervention group demonstrated more behavioural strategies to support the child at the end of a contact visit; however during observations these mothers appeared less engaged with their children when leaving at the end of a visit.
• The group support programmes involve structured group discussion between parents of children looked after, to promote greater self-reflection.
• The review did not explicitly state whether the interventions were more or less effective in different contexts.

What are the costs and benefits?

No economic analysis was offered in this review.

Case study

• The My Kids and Me programme is a pyshco-educational intervention created in Australia. The programme lasts seven weeks and is specifically designed for parents of children in care, to give them a safe space to reflect on their parenting.
• The intervention comprises structured discussions and activities delivered to small groups of parents by ‘parent educators’ (social workers or psychologists) in Sydney and Wollongong.
• The seven, two hour sessions, are titled as follows; 1. How Did We Get Here? 2. What’s it Like for You? 3. Looking After Yourself 4. Talking and Listening 5. The Legal System 6. What’s it Like for Your Kids? 7. Where to Now?
• Small, but positive, changes were reported as a result of this intervention. For example, increases in parent self-control, insight and positive thinking.

In summary...

• Bullen et al. provide a review of what limited evidence there is regarding interventions to improve the quality of supervised contact between looked after children and their families
• Limited evidence of effectiveness is available for the interventions evaluated, and the evidence that is available is of limited quality. There is a suggestion that both individual family support interventions and group support programmes could have a positive impact on parental outcomes and parent-child relationships, however the overall conclusions are that evidence is mixed or inconclusive
• There is more research needed in this area