Author: Coombes, Lindsey; Allen, Debby; McCall, Dominic
Date published: March 1, 2012
Early adolescence and school transition mean change on multiple levels for the young person. Illese changes include biological and cognitive growth, social development, and renegotiations of family relationships, especially the parentadolescent relationship (Steinberg and Silk, 2002). Furthermore, the secondary school environment for the young person at this time reflects a significant change compared to primary school, including a larger, more bureaucratic system with many more teachers, peers, and auricular choices (Hill and Chao, 2009). In the context of such changes and development, adolescents' academic performance often declines (Barber and Olsen, 2004), while at the same time, the long-term implications for educational and occupational attainment increase (Eccles and Harold, 1993).
The coming together of these developmental and contextual changes in early adolescence increases the risk dial young people may not reach their potential and heightens the need to identify sources of support during this time. Lack of parenting and family involvement may exacerbate existing behaviour problems and lead to academic failure (Dishion and McMahon, 1998).
There is an expanding body of research supporting die important role of parents, family and community in determining young people's academic success in school. For example, recent studies have shown that parental involvement in their children's learning positively affects the young person's performance at secondary school (Jeynes, 2007). Similarly, Spoth et al (2008) have emphasised the importance of family competence (ie, increased parenting skills, decreased young person substance related risk and increased school engagement) in influencing academic accomplishment Other researchers have also noted how the active involvement of parents, teachers, and community leaders who link community, school and family facilitates academic attainment (Spoth and Greenberg, 2005;FJiasetal, 2002).
Spoth et al (2008) note that much of the work in the area of parent, family and community support of young people to date has focused on what they call a 'deficit-to-deficit' model emphasising the influence of problematic family conditions on academic related issues, such as dropping out of school or the development of learning difficulties. Considerable evidence supports a model linking compromised key family management skills, such as low levels of parental monitoring, with childhood antisocial behaviour, academic failure, peer rejection and emotional distress (Webster-Stratton, 1993). Poor academic achievement is a risk factor for young people of all ages and is associated with a variety of health risk behaviours in adolescence, including substance misuse, depression, and violence (Hawkins, 1997). Conversely, family management skills together with parent-school involvement bolster school success, so interventions that target these two competencies will likely increase young people's school success and achievement.
Parent and family-mediated interventions that target parenting skills have been shown across multiple intervention studies to be the most effective method for reducing risk behaviour and preventing the development of later problem behaviour in adolescence (Connell et al, 2007). Although very few schoolbased, family-centered interventions directly target both parenting skills and academic achievement, some have been implemented successfully and have been shown to reduce problem behaviour. These programmes are typically conducted in groups, and outcomes include decreased growth of youth substance use and problem behaviour over time (Dishion and Andrews, 1995; Mason et al, 2003; Spoth et al, 2004). Programmes that add a tutoring, skill training, or academic component have been shown to increase student achievement and school bonding (Spoth et al, 2008).
Health visitors, school nurses and other professionals working in the community have an important role in providing ongoing support to families regarding young people during early adolescence. This may involve identifying problems and offering practical guidance and intervention when necessary. But there is another important role - some would argue more important - that community practitioners have and that is in the field of prevention. In this article an evidence-based, family orientated prevention programme will be discussed and a case study of its use within a school setting will be presented.
The Strengthening Families Programme (SFP)1 0-14 (UK)
The SFP10-14 (UK) is a seven-week prevention programme aimed at families with young people aged 10-14 years. It is appropriate for single parent, same sex, blended, or first-time nuclear families. The UK programme resulted from an adaptation undertaken by the Faculty of Health and Life Sciences at Oxford Brookes University (Alien et al, 2006). The impetus for this adaptation came following high-quality scientific research studies from Iowa in the USA that examined the effectiveness of the SFP10-14 (Spoth et al, 1998; Spoth et al, 2000; Spoth et al, 2001; Spoth et al, 2002; Spoth et al, 2006; Spoth et al, 2008). These studies have identified: significant intervention/control differences in initiation and current use of alcohol, tobacco and cannabis use; long-term reduction of adolescent aggressive and hostile behaviours; significant effects of the SFP10-14 on school engagement and school success; improved parenting skills and family competence. An evaluation study of the SFP10-14 (UK) in Barnsley, UK suggested that it was a useful tool in preventing young people's substance use, had a positive influence on the emotional health and well being of participating families, contributed to positive behaviour changes in young people and improved family functioning (Coombes et al, 2006). The SFP10-14 has been highlighted in an International Cochrane Collaboration systematic evidence review funded by the World Health Organisation (WHO) and the UK Alcohol Education and Research Council (AERC) (Foxcroft et al, 2003). The National Institute for Health and Clinical Excellence (NICE) has also highlighted the potential of the Strengthening Families FrogrammelO- 14 in their reports on alcohol misuse prevention and cancer prevention. A longitudinal randomised, controlled trial of the SFP10-14 (UK) started in Wales in 2009 with results expected in 20 1 4 (www.cardiff.ac.uk/socsi/research/ researchprojects/murphysubstancemisuse, html).
The SFP10-14 (UK) includes specific activities designed to:
* Help parents/caregivers learn nurturing skills that support their young people
* Teach parents/caregivers how to effectively discipline and guide their young people
* Give young people a healthy future orientation and an increased appréciation of their parents/carers
* Teach young people skills for dealing with stress and peer pressure.
The programme consists of seven core sessions delivered weekly, followed by an optional four booster sessions delivered six months to one year after the initial seven sessions. Parents/ carers and young people meet separately for the first hour and then spend the second hour together in family activities. Group size can range from eight to 13 families, for a total of 20 to 30 individuals. It is ideal if each young person can attend with two adults, either two parents/ carers or one parent/carer and another adult in the youth's life, such as a grandparent, aunt or uncle, or close family friend. A minimum of three trained group leaders is needed to deliver the programme: one to lead the parent/carer session and two to lead the young persons' session. In addition, including one to two helpers can assist the functioning of the programme especially in the case of families with more severe problems.
The content of the seven SFP10-14 (UK) sessions is summarised in Table 1.
Each parent session is based on a DVD presentation where narrators discuss session content followed by vignettes in which the concepts are acted out Young people have two DVD sessions in weeks 5 and 6 of the programme and families watch a DVD in weeks 3 and 6. In DVD sessions, when it is time for a group discussion or activity, the discussion questions or topics appear on the screen.
The targeted outcomes of the SFP10-14 (UK) are: increased parenting skills; improved family competency; improved social and normative behaviour; prevention of substance use/misuse; reduced youth aggressive and hostile behaviour; increased academic success. The programme achieves these outcomes by building the protective factors (eg, good stress management, positive future orientation, supportive family, positive parent-child affect, dear expectations, emotional management, interpersonal and social skills and peer refusal skills) and reducing risk factors (eg, challenging behaviour, poor communication, harsh discipline, parental monitoring, poor school performance) that are strongly related with die development of offending behaviour in young people in early adolescence.
The school focused on in this case study is a co-educational Sports College with 952 students aged 1 1-16 in the North of England, The school was designated an 'extended services' school following publication of Every Child Matters (DfES, 2004). Extended services in and around schools is the shared vision and commitment of the statutory, voluntary and community sectors to the wellbeing and achievement of children and young people. The aim of extended services is to raise standards and provide access to a range of core services: quality child care; swift and easy access to services for children, young people and families identified as requiring targeted support parenting support; study support; and community access to facilities such sports, arts, ? and adult learning. The school has a dedicated extended services manager, who has been involved in the delivery of the SFP10-14 (UK) for 10 years.
SFP10-14 (UK) practitioners come into school and co-facilitate the programme with teaching and support staff. Sometimes the school leads delivery of die programme and sometimes other agencies who have referred young people take die lead. On average the school runs one to two programmes a year usually during the day between lpm and 3pm. Running die programme this way has helped staff manage their time, and parents and carers have been able to attend the programme even if they are usually at work. The programme has also run in the early evenings previously. There is a dedicated venue in the school's Wellbeing Centre that is used for delivery of the SFP10-14 (UK).
The SFP10-14 (UK) is delivered as a targeted intervention by the school. Families are identified by the pastoral team within the school, or by agencies external to the school (eg, CAMHS, Educational Welfare Ofiicer) where an issue concerning a young person has been raised. The sorts of issues raised are summarised in Table 2.
The school attempts to engage with parents in a non-threatening, non-judgemental way so trusting relationships between all those involved with the programme can be developed. Families are invited to participate in the programme and the school provides pre-programme information about the SFPlO- 14 (UK) and what is involved Agencies referring families to die programme also plan an important role in marketing the SFP10-14 (UK) to families. Often agencies will arrange transport for families so that they can attend the programme. Refreshments are provided as part of the programme, which help families feel welcome and this has a dual role of providing a sodai occasion over the period the programme runs.
The Jones Family (not the family's real name)
Charlie (not his real name) lives at home with his mother who had been in a physically abusive relationship with Charlie's father for several years. Charlie's father is no longer living at home and Charlie has no contact with him. At school Charlie's teachers describe him as a bright, very intelligent boy. However, a number of issues have developed both at home and in school: Charlie has started to use cannabis and his relationship with his mother has deteriorated because of Charlie's anger and hostility. At school Charlie was considered the 'bad boy', a rebel, the class down. The extended services team at suggested that Charlie and his mother attend the SFP10-14 (UK).
As the SFP10-14 (UK) progressed the understanding of the presenting issues changed. Initially, it was thought that Charlie's drug use and anger/hostility were the result of a poor relationship between him and his mother. However, during the programme they showed that they had a very loving relationship. Because they had the opportunity to work together in family sessions and to see things from each other's point of view, it became dear that Charlie was angry at other things in his life (his disability, his experience of domestic violence) that had made him push his mother away. Charlie had very low self-esteem.
As they spent time together on the programme, Charlie's mother became aware how much Charlie cared about her. The family had fun together and Charlie began to change - SFP10-14 (UK) facilitators noticed that he started to smile. His mother made a conscious effort to praise him and in the family sessions they bom found shared values and worked together to sort problems out Charlie was calmer when with his mother and he stopped shouting at her, storming out, and slamming doors. Charlie thought his mother was saying, 'Don't do drugs' without understanding him or the pressures he was under. However, Charlie's mother explained to him that she was worried about what might happen to Charlie and how drugs could affect his future. She also said that the drugs changed Charlie and that Charlie was not 'the boy I love'. After attending the programme with his mother, Charlie seemed more calm both emotionally and behaviourally. His relationship with his mother had improved and both he and his mother were able to discuss issues that were causing concern.
Charlie's teachers reported there was a marked improvement in Charlie's attendance at school and in the quality of his schoohvork They felt that Charlie was beginning to fulfill the potential that he had. Charlie was no longer disruptive in class and there were fewer confrontations with teachers. Charlie's teachers felt that Charlie's mother had a better relationship with the school and that they were all working towards a common goal
Conclusion and implications
Community practitioners frequently work with families with young people experiencing early adolescence. The years from ages 10-14 are challenging for young people and have a significant effect on the young person's future attainment Prevention of problems and building resilience is essential for families during this period Interventions that build academic success are particularly important and parent and family-mediated interventions that target parenting skills have been shown across multiple intervention studies to be the most effective for reducing risk behaviour and preventing the development of later problem behaviour in adolescence. The SFP10-14 (UK) is a prevention programme with outcomes that demonstrate medium to long-term success in enhancing academic attainment in young people.
Community practitioners can contribute to the prevention of academic failure and its concomitants in a number of ways:
* By being aware of the main evidence-based parenting and family mediated interventions that families can access (eg, the Children's Workforce Development Council's commissioning toolkit (www.cwdcouncil. org.uk/working-with-parents-and-families/ commissioning-toolkit) and their different target populations, aims and approaches
* Be aware of the referral criteria for different evidence-based parenting and family mediated interventions, discuss these with facilitator and refer parents and families appropriately
* Participate in the delivery of evidence based parenting and family mediated interventions either as a helper (if the intervention allows this) or as a trained facilitator
* Support parents and young people before, during and after completion of an evidencebased parenting and family-mediated interventions building on the concepts and skills introduced in the programme.
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www.cardmtacuk/socsi/nsearch/researdiprojects/ murphysubstancemisuse.html [Accessed 3/10/11]
Lindsey Coombes MA PGCEA BA RGN RMN
Principal Lecturer, Oxford Brookes University
Debby Alien PhD
Principal Lecturer, Oxford Brookes University
Extended Services Manager, Holgate School, Barnsley