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Children with acquired brain injury (ABI) are at significant risk of serious behavioural and social difficulties. The burgeoning growth of research documenting behavioural sequelae after paediatric ABI has not been met with a concomitant level of research aimed at treating the problem. The purpose of this paper is to investigate whether a manualised behavioural intervention support programme could reduce challenging behaviours in children with ABI and improve family-parental well-being and functioning.

A total of 61 parents (48 mothers and 13 fathers) of 48 children aged between three and 12 years with mild, moderate, or severe ABI received an ABI adapted “Signposts for Building Better Behaviour” programme (Hudson et al., 2001) in group-support (GS) or telephone-support (TS) format. Trained “Signposts” practitioners delivered the programme over a five-month period. The programme consisted of nine information booklets, a DVD, and workbook. All families completed pre-intervention and post-intervention evaluations.

On an average parents completed 7.92 out of a possible nine intervention sessions (range 7-9). Parents in both TS and GS formats reported significant reductions in challenging child behaviours irrespective of injury severity. They also reported significant reductions in dysfunctional parenting practices, stress and family burden.

Overall, the current research provides support for Signposts to be used with families of children with ABI in an attempt to ameliorate negative outcomes for family, parent, and child.

Where no psychosocial or interventional support is provided, children with acquired brain injury (ABI) are at significant risk of serious long-term behavioural and social difficulties. The purpose of this paper is to report the six- and 18-month long-term treatment effects of a family centred behavioural intervention to help families manage and prevent challenging behaviours in children following ABI.

In total, 31 parents were followed up at three time points (post-intervention, 6 and 18 months) after participating in an ABI adapted manualised “Signposts for Building Better Behaviour” programme (Hudson et al., 2003).

Attrition rates were highest amongst families caring for a child with mild ABI. The maintenance of treatment effects were detailed for those families who reported a reduction in challenging behaviour immediately post-intervention. There were no significant elevations in challenging child behaviour, maladaptive parenting, or family dysfunction for any participants over the long-term follow-up. Irrespective of injury severity, parents reported high levels of satisfaction and efficacy in the parenting role at 18 months post-intervention.

“Signposts” has further demonstrated its clinical viability by meeting the needs of parents who have a child with ABI in both the short- and longer-term.

Despite the importance of increasing engagement and minimising attrition and drop‐out in parenting interventions, there is a paucity of empirical evidence examining factors related to engagement and participation. The range of factors examined in relation to engagement is generally limited in scope and variety, focusing on variables of convenience rather than utilising a theoretically‐driven approach.The aim of this article is to review the factors related to parental engagement with interventions and to describe strategies and implications for improving engagement with parenting interventions. Several policy and practice implications are identified: (1) Poor parental engagement may threaten or compromise the capacity of parenting programmes to deliver valued outcomes. Viable engagement strategies need to be a core part of prevention and early intervention parenting programmes; (2) Agencies delivering parenting services need a proactive engagement strategy, which includes strategies to prevent drop‐out, as well as strategies to actively respond to parental disengagement; (3) Research is needed to test the efficacy and robustness of different engagement enhancement strategies. Empirical tests are needed to test the effectiveness of different engagement strategies in order to ensure that the most efficient, cost‐effective and efficacious approach is used in order to engage parents. Investment of research effort to improve parental engagement is likely to have a high yield in terms of programme efficiency, utility and cost effectiveness. We conclude that research examining how to improve engagement and decrease non‐completion is needed to strengthen the population level value of parenting programmes as preventive interventions.

This study examined the effectiveness of the Triple P‐Positive Parenting Program in a government child health service delivery context with Chinese parents in Hong Kong. Specifically, the study sought to identify pre‐intervention variables that might predict programme outcomes such as level of clinical improvement and programme completion. Participants were 661 parents of pre‐school and primary aged children participating in a group version of the Triple P‐Positive Parenting Program. There were significant decreases in disruptive child behaviours, levels of parenting stress, general stress and anxiety and an increase in parenting sense of competence. Greater change in reports of child behaviour problems was related to lower levels of family income, new immigrant family status, and higher pre‐intervention levels of parenting stress. The present study provides a profile of parents who are most likely to benefit from parent training programmes.

The purpose of this paper is to determine the preliminary clinical utility of a telephone-support format of the “Signposts” (Hudson et al., 2003) behavioural intervention programme to be used with a paediatric traumatic brain injury (TBI) population.

Nine families caring for a child with moderate or severe TBI, participated in a pilot study of a TBI adapted “Signposts for Building Better Behaviour” manualised programme. The programme is designed to help parents learn positive parenting skills and strategies that empower them to successfully manage their child's challenging behaviour post-TBI. The programme consists of seven core sessions and two supplemental sessions. Parents work through the sessions with an accompaniment of guiding information booklets, a DVD with scenes modelling positive parenting strategies, and a workbook containing written exercises. At the completion of each session parents receive a telephone-support call from a trained Signposts practitioner who provides assistance and feedback on programme content.

On average parents completed eight sessions (range seven to nine) and every family completed the seven core sessions. Participation in the telephone-support calls was high with 96 per cent of calls having been successfully received by families. All parents agreed that the telephone calls were a useful part of the programme and felt that the materials were helpful for managing challenging behaviour. Paired-samples t-tests showed significant reductions for challenging behaviour from pre- to post-intervention. Parenting practices also significantly improved over the course of the intervention. In general, parents rated a high level of consumer satisfaction with the Signposts programme and its content.

Overall, these preliminary findings support the potential clinical utility of a telephone-support version of the Signposts programme to improve parenting skills and to reduce challenging child behaviour following TBI. This study has provided the impetus for a larger clinical research trial to be conducted.

The purpose of the present chapter is to provide an overview of issues facing families of children and youths with emotional and behavioral disorders (EBD). We argue that although much is written about families of individuals with disabilities, comparatively little is known about families with children in this category. We suggest that the diversity of family contribution to the individual's EBD makes studying families of this population as a unitary group quite difficult. Despite the difficulty in adequately capturing families of individuals with EBD as a single unit, we describe what is known about (a) parental satisfaction with services for children with EBD, (b) issues affecting parental and family involvement in special education programming and decision-making, (c) the impact of a child with EBD upon siblings, and (d) interventions for EBD that involve families. We conclude by pointing to areas of need for additional research and noting that while educators are in a unique position to assist families of children with EBD, they are restrained by lack of adequate training, competing policy agenda, and constraints on the resources necessary to add this responsibility to the role of classroom teachers.

The present study examined the role of socio‐demographic and family risk factors as mediators or moderators of the success of parents undertaking a universal group parent training programme for young children. The results showed that parents' capacity to change dysfunctional parenting practices was not moderated by the child's gender, family income, family type, or pre‐intervention level of parental stress, but was partially mediated by changes in parental satisfaction and efficacy. Irrespective of their socio‐demographic background, parents who completed the Triple‐P Positive Parenting Programme were equally likely to succeed in changing their parenting practices. These findings suggest the robustness of intervention effects across a diverse range of parents.

The purpose of this paper is to describe the University of Exeter Family Interventions (FIs) training programme for the South West region which was commissioned as part of the NHS England Access and Waiting Times standards (A&WTS) initiative for early psychosis. This programme (10 taught days and 6 months of supervised practice) is designed to maximise implementation in practice.

The programme introduces students to a flexible, widely applicable FI approach which integrates cognitive behavioural/psycho-educational and systemic approaches. It refreshes and develops CBT-based psycho-social intervention skills, so that clinicians feel confident to use them in family sessions and integrate these with foundation level family therapy skills. The approach facilitates engagement, and it is designed so that every session is a “mini intervention”. This enables clinicians to offer standard NICE-concordant FI or a briefer intervention if this is sufficient to meet the particular needs of a family.

This paper provides details of the regional training programme and evaluates the first four training courses delivered to nine early intervention in psychosis teams. It considers how a combination of training a critical mass of staff in each service, ongoing supervision, regional events to maintain skills and motivation to deliver FI, and the national and regional auditing of FI as part of the A&WTS all contribute to clinical implementation.

The unique design of this programme maximises implementation in practice by virtue of its widely applicable integrated FI approach, the focus on ongoing skills development and by embedding it within regional and local service support structures.

This study examined the impact of a brief seminar series on positive parenting (Selected Triple P) on behavioural and emotional problems in pre‐adolescent children and on inter‐parental conflict, parenting style, relationship quality, parental adjustment and parental confidence. Two hundred and forty‐four parents with children aged four to seven years were assigned to one of three conditions: (a) partial exposure condition involving attendance at a single introductory seminar; (b) full exposure (attendance at all three seminars); or (c) a waitlist control group. Analyses were completed for the 109 participants for whom full data were obtained. There was a significant reduction in parental reports of problem child behaviour and dysfunctional parenting styles with the introductory seminar alone. However, exposure to all three seminars was associated with significant improvements in all dysfunctional parenting styles and in the level of inter‐parental conflict. There were no significant differences between conditions at post‐intervention on parental reports of depression, anxiety, stress, relationship quality or parental confidence. This study provides preliminary support for the efficacy of a brief universal parenting intervention in improving child behaviour and parenting variables associated with the development and maintenance of child conduct problems. The findings also offer preliminary support for the notion that positive outcomes for both parents and children can be achieved through the delivery of brief preventive parenting interventions that require minimal time commitments from parents.

While evidence-based parenting interventions (EBPIs) are proven effective at addressing numerous emotional and behavioral health challenges for children and youth, and reduce rates of child maltreatment, they are often not well implemented in the real-world settings. Even with the state-of-the art training, many practitioners do not deliver the intervention, or do so at a reduced capacity. The purpose of this paper is to examine system-contextual implementation factors that predict timely initiation of use of an EBPI (i.e. within the first six months following training). A secondary purpose is to document additional impacts of training.

Repeated measures were used to collect predictors and the dependent variable. The relationship between participant characteristics and use of the Triple P program was estimated using exact logistic regression.

The results from 37 practitioners across three communities indicated approximately 54 percent delivered the intervention with at least one family within the first six months following training. Practitioner self-efficacy immediately following training and general attitudes toward evidence-based practices were the most significant predictors of timely use of the model. The vast majority of practitioners, regardless of implementation status, generalized learning from the training to other aspects of their work.

Prospective examination of the predictive value of implementation factors helps to refine targeted approaches to support implementation.