11 10 years on: developing and researching the Incredible Years programmes in Wales: Wednesday 17 th March 2010 Village Hotel, Cardiff Professor Judy Hutchings Bangor University and North West Wales NHS Trust Websites: (research) (practice)

2 Overview of presentation Small beginnings Reasons for choosing IY Successes The future

Implementation progress 2000 Parent leader training in North Wales 2002 Classroom Dina training in North Wales 2003 Funding for the Sure Start research trial 2005 Parenting Action Plan for Wales 2006 First WAG funded parent leader training across Wales 2008/9 Staff from all 22 Authorities in Wales trained in parent programme and delivered in all 22 Authorities 2010/11 Fifth year of WAG funding includes parent, child and teacher leader training 3

44 Why develop the Incredible Years programmes in Wales Over thirty years of research with high standards of evidence and long term follow-up Effective as clinical and preventive programmes Identified in every systematic review and by the US Office of Juvenile Justice and Delinquency Prevention as a model “Blueprint” programme for violence prevention. One of only 11 from 600 programmes that met the stringent criteria for evidence including tools for replication and effective implementation and independent replication One of only two parent programmes identified by NICE as effective for the treatment of conduct disorder Replications in Canada, Wales, England, Norway, Jamaica and Wales Parent programme is equally effective with caucasian, african, asian and spanish americans Research underway in Seattle, Wales, England, Ireland, Norway, Denmark, Portugal, Jamaica, Wales, etc.,

5 5 Teacher Programme 6 full day sessions held monthly Child Dinosaur treatment Programme: 6 children, weekly sessions Child Dinosaur Classroom Programme:3 year curriculum, 2 sessions per week, 30 weeks Fully revised ADVANCED Programme: 9 sessions helping adults communicate & problem solve The Incredible Years Programmes ***The School aged programme also has an additional four session unit on helping your child to do their best in school Fully revised School Aged BASIC Parent Programme: 12 sessions, years*** Fully revised Pre- School BASIC Parent Programme: 18 weekly sessions, 3 – 6 years School Readiness Programme: 4 pre-school sessions 2 – 4 years Infant (eight sessions) months toddler year olds (13 sessions) programmes

6 Key specific components of effective interventions that are incorporated into the IY programmes - new skills must be modelled and rehearsed - (non-violent) sanctions for negative behaviour and relationship building, praise and rewards - - practice or ‘homework’ - programmes should emphasise principles rather than prescribe techniques - must address difficulties in relationships or other problems - interventions work best when delivered early

7 Developmentally based Empirically validated Emphasis on therapeutic relationship: “collaborative process” Coping (vs. Mastery model) Videotaped modeling Role play & rehearsal Home assignments Group support Explores cognitions, behaviours, feelings Incredible Years Programme Methods

88 Fidelity in Incredible Years programmes Content – social learning theory Process – collaboration, individual goals, shared problem solving Access – transport, meals, child care, timing of groups etc.

99 How the IY programmes achieve implementation with fidelity detailed leader manuals videotapes books and materials for parents structured leader training, basic 3 day plus consultation days ongoing supervision a leader certification process a network of trainers and mentors

10 Replication studies have shown that the IY programmes do have the tools to enable them to work in practice if…… service providers fully equip staff with tools, materials, training and supervision the outcomes match those of the research trials

Current/future research Long term follow-up of Sure Start Nursery staff parenting project Toddler parenting project Evaluation of baby programme Evaluation of school readiness programme Small scale pull out Dina Lottery project Large scale RCT of Dina programme Birmingham Sure Start replication Economic evaluation of the toddler programme 11

Current IY team Judy Hutchings – Director Dr Tracey Bywater – Research Fellow Dilys Williams – Administrator Kath Chitty – Admin Assistant Nia Griffith – PhD student Kirsty Cooper PhD student Catrin Jones – PhD student Margiad Elen Williams – MRes student Nicole Gridley – Research assistant Joanna Charles – CEPhI PhD student A 12

WAG funded leader and service manager survey 2008 survey reports on first two years of WAG funding Responses from 206 group leaders and all 22 Service Managers All 22 Authorities have delivered the parent programme, 21 in 2007/8 All 22 Authorities are delivering the parent programme in 2008/9 Mean no. of parent groups per Authority in 2008/9 was seven, total 148 parent groups Gwynedd and Powys among the first in Wales to get started delivered 30 each in 2007/8 13

14 Conclusions from survey 14 WAG has had an excellent response to their funding with all Authorities making use of the training by delivering the progrmames Parents and group leaders are enthusiastic about the programmes As yet most services are concentrated on early prevention in high risk areas Further resources are needed to ensure that the work towards accreditation and mentorship continues 14

15 Other WAG support for the programmes 15 Provision of parent and teacher programme materials to all Authorities Welsh translation and provision of copies of IY parent and teacher books for all services Funding to research the toddler programme across Wales Support for our Annual conference and newsletter 15

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17 Conclusions from Wales It is possible to roll out an evidence based programme into diverse ‘real world’ services, to deliver it with high quality and good outcomes, and to improve the life chances of some of the most disadvantaged families in Wales Conclusions from Wales It is possible to roll out an evidence based programme into diverse ‘real world’ services, to deliver it with high quality and good outcomes, and to improve the life chances of some of the most disadvantaged families in Wales

Why have we been successful Staff like the programmes and see changes in the children/families with whom they work We collected evidence to show that the programmes work in Wales WAG recognised the evidence 18

19 But there is plenty more to do to ensure that children in Wales get the best start in life Diolch yn fawr Thank you