BANGLADESHI CHILDREN MENTAL AGE

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Preventing Child Mental Health Problems The
Family Partnership Model Professor Hilton
Davis Centre for Parent and Child Support SLAM
Kings College London
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Plan
Background to the work. Family Partnership
Model. European Early Promotion Project. Research
findings.
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Further Information
www.cpcs.org.uk Centre for Parent and Child
Support South London Maudsley NHS Foundation
Trust Guys Hospital Snowsfields London SE1
3SS Tel [phone] Email
info_at_cpcs.org.uk
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Family Partnership Model
Construction Processes
Partnership
Helper Qualities
Helper Skills
Process
Outcomes
Parent characteristics
Service context
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Intended Outcomes of Helping

Do no harm Help parents identify, clarify and
manage problems. Enable parents (including
problem anticipation). Enable development and
well-being of children. Facilitate social support
and community development. Enable service
support. Compensate where necessary. Improve the
quality of care.
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Family Partnership Model
Construction Processes
Partnership
Helper Qualities
Helper Skills
Process
Outcomes
Parent characteristics
Service context
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The Helping Process

RELATIONSHIP BUILDING EXPLORATION UNDERS
TANDING GOAL SETTING STRATEGY
PLANNING IMPLEMENTATION REVIEW

END
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Family Partnership Model
Construction Processes
Partnership
Helper Qualities
Helper Skills
Process
Outcomes
Parent characteristics
Service context
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Partnership

Working together with active participation/involve
ment Sharing decision making power Recognition of
complementary expertise and roles. Sharing and
agreeing aims and process of helping Negotiation
of disagreement Mutual trust and respect Openness
and honesty Clear communication
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Family Partnership Model
Construction Processes
Partnership
Helper Qualities
Helper Skills
Process
Outcomes
Parent characteristics
Service context
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Helper Interpersonal Skills
Attention/Active listening Prompting and
exploration Empathic responding Enthusing and
encouraging Enabling change in
ideas Negotiating Problem management
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Family Partnership Model
Construction Processes
Partnership
Helper Qualities
Helper Skills
Process
Outcomes
Parent characteristics
Service context
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Helper Qualities
Respect Genuineness Empathy Humility Quiet
enthusiasm Personal integrity Intellectual and
emotional attunement Technical expertise
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Family Partnership Model
Construction Processes
Partnership
Helper Qualities
Helper Skills
Process
Outcomes
Parent characteristics
Service context
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Parent Characteristics
Nature of problems Barriers to engagement Motivati
on to change Attitudes and beliefs about
services Expectations of outcome Socioeconomic
circumstances Culture
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Family Partnership Model
Construction Processes
Partnership
Helper Qualities
Helper Skills
Process
Outcomes
Parent characteristics
Service context
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Construing
All take in and process information for
meaning All construct a model of the world In
order to anticipate and adapt Model derives from
individual experience Unique to the
individual Not necessarily conscious or
verbal Constant process of testing, clarification
and change Social interaction determined by
constructions of others
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Family Partnership Model
Construction Processes
Partnership
Helper Qualities
Helper Skills
Process
Outcomes
Parent characteristics
Service context
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Service and Community Context
Support for staff Characteristics of
service Characteristics of population Geographical
characteristics
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Implications of Model
Personnel selection Training Management/supervisio
n Design of services Selection and training of
managers Service organization
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European Early Promotion Project
CYPRUS Dr A Paradisiotou, Mrs S Kyriakides, Ms
Y Hadjipanayi, Ms S Vizacou FINLAND Dr K
Puura, Prof T Tamminen, Dr M Turunen SERBIA
Prof V Ispanovic, Dr N Rudic, Ms J Radosovljev,
Ms T Miladinavic GREECE Prof J Tsiantis, Prof
T Dragonas, Ms E Layiou-Lignos, Dr K
Papadopolou UK Prof H Davis, Ms R Roberts,
Prof A Cox, Dr C Day
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EEPP Service Structure
Universal promotional interview (4-6 weeks
before birth) Universal promotional interview
(4-6 weeks after birth) Health visitor judgment
about need (using Need Checklist) Continue to
visit those in need using Partnership Model
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Antenatal Promotional Interview 1
Introduction Womans Feelings About
Pregnancy Expected Family Support Anticipated
Changes in Family Life/Relationships Self-percepti
ons of the Mother-to-be

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Antenatal Promotional Interview 2
Anticipations of Unborn Child Anticipation of
Delivery Anticipation of Feeding Finances and
Environment Life Events

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EEPP Indicators of Need 1
THE CHILD Premature/Small for Dates,
Physical Illness/Concern Constant
Crying PREGNANCY Unwanted, Other Concerns
(e.g. young mother) M-C RELATIONSHIP
Lack of Feeling for the Baby, Problems in
Interaction
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EEPP Indicators of Need 2
THE FAMILY Adversity in Mothers Childhood,
Marital Discord, Physical Illness,
Psychological Problems, 4 Children and
Isolation ENVIRONMENT Poverty/Debt,
Unemployment, Housing Problems, Overcrowding,
Environmental threat LIFE EVENTS Recent
Major Life Events
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EEPP Research Detail
Intervention families seen by trained
staff. Comparison families seen by untrained
staff. Evaluation by independent research
teams.   Families assessed at 8 weeks and 2
years. 430 families recruited into Intervention.
390 families in Comparison Group.
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EEPP Families In Need (UK)
HV Research Judgment
Judgment Intervention 62 (55) 77
(68) Comparison 25 (24) 73 (71)
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Frequency of Problems Rated by Trained and
Untrained Health Visitors
  Trained Untrained Mental health problems
(plt 0.001) 19 3   Marital discord (p 0.008)
23 6   Social isolation (plt 0.001) 30
4   Financial problems (plt 0.001) 19
1   Adverse life events (p 0.041) 15 6
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Accuracy Of Specific Need Identification
Intervention Comparison
Cyprus 55 67 Finland 61 68 Greece 78
32 Serbia 53 47 UK 66 32 Total
62 49
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Overall Effect Sizes
62 Positive 13 Zero 25
Negative
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Maternal Depression at 24 months
Inter. Comp. P ES Finland 10
(12.7) 17 (25) 0.03 0.22 Greece 2 (3.2)
6 (11.3) 0.04 0.15 (53-56
better)
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Outcomes Family Grid (Greece) 24mths
Inter. Comp. P ES Self-esteem 0.8
1.06 0.0001 0.69 Partner 0.9 1.29 0.004 0
.5 Child 0.5 0.61 0.02 0.49 (64-
70 better)
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Outcomes PS Index (Greece) 24mths
Inter. Comp. P ES Distress 20 25
0.02 0.51 Other scales in predicted direction
but not significant Overall ES 0.31
(58)
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Outcomes BSQ at 24mths
Inter. Comp. P Greece Eating 6.6
26.4 0.005 Peer 32.8 54.7 0.02 8 of 10
scales in predicted direction with ES
0.46 UK Depend. 17.3 27.1 0.046
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Bayley Scales at 24mths
Inter. Comp. P ES Greece Mental
88 82 0.006 0.58 Motor 96 92 0.24 0.18 Be
haviour 68 54 0.19 0.16 UK (No need
group) Mental 104 96 0.04 0.37 Motor 100 92
0.0009 0.64 Behaviour 80 60 0.09 0.27
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Outcomes HOME Inventory at 24mths
Inter. Comp. P ES Greece (5 of 7 scales
in predicted direction) Organization 5.3 4.6
0.001 0.72 Variety 3.6 3.1 0.02 0.48 UK (6
of 7 scales in predicted direction) Responsiveness
9.8 9.2 0.01 0.34 Play materials 8.5 8.2 0.02
0.28
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Other Interaction Measures at 24mths
Inter. Comp. P UK Quality of
relationship 0.9 1.1 0.06 Control
1.5 1.9 0.03 Involvement 66.5 65.3 0.08 G
reece Quality of relationship 0.7 1.0 0.02 Mater
nal sensitivity 0.8 0.6 0.03
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HOME Scores
More change found in Intervention Group from
perinatal period to 24 months (significant or
trend) Responsiveness (Finland
UK) Avoidance of Punishment (Finland) Organization
(Greece UK) Provision Play
Materials (Finland UK) Total Score (Finland,
Greece UK)
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Mothers Satisfaction with EEPP Service (Medians)
Intervention Comparison
p Cyprus 33 38 0.003 Finland
20.5 21 0.2 Greece 13 20
0.0002 Serbia 16 19 0.08 UK 20 25
0.03 Total 20.5 25 Average effect
size 0.4
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Parallel Processes Platinum Rule
Do unto others as you would have others do unto
others. Pawl (1994-95)
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Suffering
Suffering is not a question that demands an
answer it is not a problem that demands a
solution it is a mystery that demands a
presence. Anon.
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Further Information
www.cpcs.org.uk Centre for Parent and Child
Support South London Maudsley NHS Foundation
Trust Guys Hospital Snowsfields London SE1
3SS Tel [phone] Email
info_at_cpcs.org.uk