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Parent support: focused or wide-ranging?

The daunting statistics on the levels of alienation and health, social and educational failure within many of the UK’s disadvantaged communities emphasise the critical need for a fundamental cultural shift in the provision of parent support and child care. This leads to the question of whether it is more effective to continue with the present patchwork approach of professionals dealing separately with a family’s specific health, social or educational needs, or to offer instead a more basic integrated support service within which specific issues form part of a seamless whole, with professionals called in only to deal with more serious issues requiring skilled handling.

There are many parent support programmes and several parent support services in existence today in the UK. Most are focused on achieving specific goals. For example, speech therapy deals inter alia with solving language and articulation problems. Cognitive behavioural therapy aims to help parents cope with serious behavioural problems. Dietary advice aims to show how to improve the diets of children who are suffering from obesity or other nutrition-related difficulties. Other programmes exist to offer generalised social support and encouragement to parents.

In contrast, the parent support work of the Child Development Programmes - which include the recently introduced Parent and Child Empowerment Programme (the PCEmP) - uniquely endeavours to provide integrated parent support programmes that can deal with any of the child-rearing issues that concern parents, or which may have been identified by trained programme visitors.

While the empowerment goal lies at the core of these programmes, they are also holistic and integrated across all the key areas of development, in particular the health, social and educational fields.

Wide range of para-professional visitors

The new PCEmP programme has the advantage that it endeavours to recruit home visitors from a wide range of para-professional workers, including support staff from those three fields. When a programme team includes people from different key disciplines, visitors are more likely to broaden the focus of their work rather than narrowing it down to the speciality in which they were originally trained. This of course also requires that the training given to those staff should help them to become aware of the need to provide seamless support.

The importance of offering parents an integrated programme cannot be overstated. Support offered from a single disciplinary perspective can never meet all a child’s or parent’s needs; focusing simply on resolving a single parenting or child problem may seem to meet immediate needs, but inevitably the solutions are not necessarily integrated with the needs of the whole child, nor indeed related to the overall parenting of that child. This in turn means that solutions developed within that narrow focus cannot be as effective as those solutions which are developed to take into account all relevant areas of development.

Integrated approaches are also likely to be more effective in the long run. While a narrowly focused approach may require fewer home visits and therefore cost less, they are not likely to be as enduring as a ‘total’ solution, so that ultimately the latter is likely to prove more cost-effective. For example, a narrow focus on resolving behavioural problems is unlikely to devote time to encouraging parents to understand good nutrition and food preparation; yet there is much research to show that certain nutrients are crucially important in modifying behaviour, and ignoring that makes the task of behavioural resolution much more difficult. Likewise a narrow focus on helping parents to join a library and read or show books to their young children could require widening of the support to include, for example, encouraging parents to develop their own methods for dealing with hyperactive behaviour and other forms of inattention.

Official view on integration of family and children’s services

Today there is much official talk of ensuring integrated services for children and families, but most of the integration concerns senior figures in those services who share their collective views, rather than involving professional field staff, who are urged to collaborate with other services but not necessarily given appropriate multi-disciplinary training It is difficult to estimate how much effective integration can occur in that situation.

It is particularly importance that service integration should be at the heart of the work done by the huge number of Children’s Centres now being set up - a total of 3,500 is aimed at. Their biggest challenge will be to provide a high and effective level of integrated child care and parenting support services. To achieve that will mean that both the physical infrastructure and the training and staff insights will have to be adapted to meet this need. Children’s Centres are uniquely positioned to bring about an integration of these services and thus greatly improve their effectiveness. Whether the proposed parent support services will also be integrated, let alone empowering, has yet to be seen.

For the parent outreach work of Children’s Centres, the new PCEmP can play a key part by setting up integrated para-professional home visiting services (linked to the Children’s Centres) whose staff will be given the training and skills to provide parent support across a wide range of areas, including referral of families to the professionals within particular disciplines if the identified problems require more sophisticated support. The alternative is to invest ever more funds in expanding the already costly professional services, which by their nature are focused within particular disciplines; thus perpetuating the problem of services that may be too narrowly targeted to meet the parenting support needs, and which may also arouse issues of competing territorial claims.

A particular advantage of the PCEmP approach is that the para-professional programme visitors will be able to help parents become aware of the wider possibilities of their own (parental) work with their children. Parents often become locked into trying to deal with a particular problem area faced by their child; limited success in dealing with that problem can discourage parents from more general work with the children - leading to a kind of benign neglect that often leaves a troublesome child to itself. (This problem is particularly evident when a parent has lost control of a child’s social behaviours.) Helping parents to become more flexible in their approach to such issues, building on their strengths rather than remaining anchored in the problem area, can do a lot for parent morale apart from helping the parents to overcome their narrow focus on one or two problem areas.

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