According to research completed for my doctorate in Human Services Leadership and Organizational Management, the best-practice programs for kids with SED (*Serious Emotional Disturbance)
TEACH SKILLS TO PARENTS (PART I)
ARE PARENT-CENTERED (PART II)
Read the email series below. You may request my one-page overview of best practice programs for kids with SED or my full research paper by clicking below. —Dr. Michelle Alden, LPC
7/20/22 Parents Must be Taught to Cultivate Nurturing Environments Clossey and colleagues (2018), point out that…there is a great need for…more programs that work to improve problematic family patterns and children’s behavioral problems from a PARENT-based framework that teachesPARENTS to disrupt negative patterns and cultivate nurturing family environments. -Clossey, L., Simms, S., Hu, C., Hartzell, J., Duah, P., & Daniels, L. (2018). A pilot evaluation of the Rapid Response Program: A home based family therapy. Community Mental Health Journal, 54(3), 302-311
7/22/22 PARENTS Must be Taught the Skills The research from Cui et al. (2019) also pointed out that children with SED and behavioral problems tend to require more specific parenting skills and attention from the parents, resulting in what often appears to be indulgent parenting; however, in all reality, these parents are overwhelmed with concern for the well-being of the family and don’t have the tools needed to help with the challenges faced (Cui et al., 2019).
Along with the Cui (2019) study, other studies showed how poor parenting skills or parents who have no idea how to parent children with challenges, diminishes the mental health and well-being of the whole family (Bornstein et al., 2018). The Bornstein et al., study (2018) also linked parent practices and parenting needs to better or sometimes worse outcomes in children’s mental health, based solely on the parents’ thought process and learned parenting skills.
In other words, PARENTS who have or are TAUGHT SKILLS in handling children with challenges, can provide more positive social interactions and it gives PARENTS the ability to support their children through difficult mental health challenges. -Cui, M., Darling, C. A., Coccia, C., Fincham, F. D., & May, R. W. (2019). Indulgent parenting, helicopter parenting, and well-being of parents and emerging adults. Journal of Child and Family Studies, 28(3), 860-871. -Bornstein, M.H ; Putnick, D. L; Suwalsky, J. (2018). Parenting cognitions, parenting practices, child adjustments? The standard model. Development and Psychopathology, 30(2)
7/26/22 Critical to Children’s Mental Health In the McKee, Parent, Zachary, and Forehand’s pilot study (2018), PARENTS were taught mindfulness, emotional regulation, and social practices to help their child by being able to provide a healthy emotional atmosphere, supportive responses, and decrease negative interactions.
A higher level of PARENT involvement in parent-based programs and in supporting and training PARENTS to raise their children with SED, allows parents to be seen as critical in the child’s mental health and necessary in the overall well-being of the child and the family (Clossey et al., 2018). -McKee, L. G., Parent, J., Zachary, C. R., & Forehand, R. (2018). Mindful parenting and emotion socialization practices: Concurrent and longitudinal associations. Family Process, 57(3), 752-766 -Clossey, L., Simms, S., Hu, C., Hartzell, J., Duah, P., & Daniels, L. (2018). A pilot evaluation of the Rapid Response Program: A home based family therapy. Community Mental Health Journal, 54(3), 302-311
7/28/22 Dramatic Decline in Out-of-home Placements Just as the Clossey et al., study (2018) points out when child-care professionals help FAMILIES to rebuild, behavioral symptoms and out-of-home placements dramatically decline. -Clossey, L., Simms, S., Hu, C., Hartzell, J., Duah, P., & Daniels, L. (2018). A pilot evaluation of the Rapid Response Program: A home based family therapy. Community Mental Health Journal, 54(3), 302-311
8/2/22 Why Children Fail to Respond to Treatment “Why do children fail to respond to treatment?” Clossey et al., (2018) argue that a lower level of PARENT involvement and child-based programs are the answer to that pressing question. -Clossey, L., Simms, S., Hu, C., Hartzell, J., Duah, P., & Daniels, L. (2018). A pilot evaluation of the Rapid Response Program: A home based family therapy. Community Mental Health Journal, 54(3), 302-311
8/4/22 Address Family Unit Needs Community stakeholders, researchers, and providers can build informed community responses to children’s behaviors and mental health by addressing the unmet needs and breakdowns within the FAMILY UNIT… -Strand, R. C. W., & Eldevik, S. (2018). Improvements in problem behavior in a child with autism spectrum diagnosis through synthesized analysis and treatment: A replication in an EIBI home program. Behavioral Interventions, 33(1), 102-111.
8/9/22 PARENTS need Encouragement and Confidence Providers of intensive in-home programs need to approach families with the understanding that most often PARENTS of children with SED are anxious, overwhelmed, and hopeless; feeling isolated and needing encouragement and confidence to improve in their parenting (Tully et al., 2017). Tully, L. A., Piotrowska, P. J., Collins, D. A. J., Mairet, K. S., Hawes, D. J., Kimonis, E. R., Lenroot, R. K., Moul, C., Anderson, V., Frick, P. J., & Dadds, M. R. (2017). Study protocol: evaluation of an online, father-inclusive, universal parenting intervention to reduce child externalizing behaviors and improve parenting practices. BMC Psychology, 5(1), 21.
8/11/22 Parents Need Help Creating Structure and Connection The study by Clossey et al. (2018) points out that children with behavioral and emotional challenges have problems in flexibility, which is most often seen in the way they relate through adversity, tragedy, and changes, which in turn can create a breakdown in the family functioning. This study adds to the reasoning in the need to help PARENTS to create or recreate structure, organization, and connections within the family unit. -Clossey, L., Simms, S., Hu, C., Hartzell, J., Duah, P., & Daniels, L. (2018). A pilot evaluation of the Rapid Response Program: A home based family therapy. Community Mental Health Journal, 54(3), 302-311
8/16/22 Parent-as-the-Expert Model …we do know that (1) providing home-based support to the parents of children who are at risk for out-of-home placement, (2) supporting parents as they adapt to new ways of parenting children with challenges, and (3) helping people who suffer from anxiety, depression, and trauma-induced symptoms reduces the need for out of home placements, residential care and crisis management. -Bezeckzky et al., 2020; Hill & Everitt, 2018; Kiselev et al., 2017; Moffett et al., 2018 The developing literature confirms that when child care professionals move to a parent as the expert model, behavioral symptoms and out-of-home placements dramatically decline. -Clossey, L., Simms, S., Hu, C., Hartzell, J., Duah, P., & Daniels, L. (2018). A pilot evaluation of the Rapid Response Program: A home based family therapy. Community Mental Health Journal, 54(3), 302-311
8/18/22 Positive Outcomes! How? From early intervention to parent-centered programs that work in the home with teens, higher levels of parental mindfulness and effective strategies equal positive related outcomes for the child, the parents, and the family as a whole. -McKee, L. G., Parent, J., Zachary, C. R., & Forehand, R. (2018). Mindful parenting and emotion socialization practices: Concurrent and longitudinal associations. Family Process, 57(3), 752-766. https://doi.org/10.1111/famp.12329
8/23/22 Rebuild Families but How? Often the delivery of programs and services for children are moored in the professional as the expert model, however, research continues to show that better, more long-lasting results are likely if the paradigm shifts to models that promote the parents as the experts, while providers and professionals support the parents to rebuild their families, giving the parents tools to manage their child's behaviors. -Clossey, L., Simms, S., Hu, C., Hartzell, J., Duah, P., & Daniels, L. (2018). A pilot evaluation of the Rapid Response Program: A home based family therapy. Community Mental Health Journal, 54(3), 302-311 et al., 2018
8/25/22 Get BETTER outcomes Training and supporting PARENTS is not only good practice but also lends itself to better outcomes with longer-lasting results -Altafim et al., 2016; Bornstein et al., 2018; Blocher et al., 2017; Chacko et al., 2016; Clossey
8/30/22 In-home Key Elements for Success The research included common standards found in best practice programs for kids with SED:
a high number of hours spent in the home
ongoing parental involvement in training and practices
strong emphasis on teaching parents to create structure, develop inter-relational skills and crisis planning
teaching parents how to reduce aggression and violence
teaching parents regulation and de-escalation skills
providing supervision and safety
-Altafim et al., 2016; Bornstein et al., 2018; Blocher et al., 2017; Chacko et al., 2016; Clossey et al., 2018
9/1/22 Improvements Seen In numerous studies, significant improvements in parenting practices are linked to — improvements in child behaviors — overall mental health for parents and children — improved family functioning which in turn improves school and community involvement. -Altafim et al., 2016; Bezeczky et al., 2020; Chen et al., 2016; Dixon et al., 2018; Gan et al., 2019; Joussemet et al., 2018; McAloon & Lazarou, 2019; Moffett et al., 2018
9/6/22 Help AS Challenges Occur Furthermore, the majority of studies mentioned, continue to link skill-based parenting interventions to improved outcomes for the child and the family when providers work to increase positive parenting skills in the home as behavior and challenges are occurring. -Agner et al., 2020; Bornstein et al., 2018; Clossey et al., 2018; Dixon et al.,2108; Eun et al., 2018; Gan et al., 2019; Grindal et al., 2016; Huscroft-D’Angelo et al., 2018; Joussemet et al., 2018; Ng & de Colombani, 2015; Parladé et al., 2020; Pishva, 2017; Sampaio et al., 2017; Woolston et al., 2016; Yap et al., 2018.
PART II: The Need for PARENT-CENTERED Programs
9/8/22 A Needed Paradigm Shift Often the delivery of children’s mental health is anchored in a professional-as-the-expert model. Clossey et al., (2018) termed a "paradigm shift"; that is, to move away from providers and professionals as the experts, and away from providing services to children to resolve behavioral and emotional issues, to a parent model, where providers teach and support parents in raising their children and helping them to work through problems with their child. Shifting from a professional-as-expert model to parent-as-expert with the professionals working to support and guide parents is a paradigm shift that needs to be considered by children’s mental health providers. Clossey, L., Simms, S., Hu, C., Hartzell, J., Duah, P., & Daniels, L. (2018). A pilot evaluation of the Rapid Response Program: A home based family therapy. Community Mental Health Journal, 54(3), 302-311
9/13/22 When Parents Feel Unsupported Furthermore, the research shows that parents’ well-being is adversely affected when left out of the treatment interventions, children are placed outside the home, or when they feel unsupportedin parenting children with SED. -Cui et al, 2019; Eun et al., 2018; Karbasi Amel et al, 2018; Quetsch et al., 2018
9/15/22 Why are Kids Failing Treatment? One of the most pressing questions, according to the Clossey, Simms, Hu, Hartzell, Duah and Daniels pilot evaluation of the Rapid Response Program (2018), that must be asked of children’s mental health is, “why do children fail to respond to treatment?” The Clossey study (2018) points to low level of parent involvement and child-based programs as answers. -Clossey, L., Simms, S., Hu, C., Hartzell, J., Duah, P., & Daniels, L. (2018). A pilot evaluation of the Rapid Response Program: A home based family therapy. Community Mental Health Journal, 54(3), 302-311
9/20/22 Parents Need to Step into this Role We need to move away from the professional as the expert and for providers of in-home programs and family therapy to nurture the family relationship in collaboration with the parents. We need to promote parents to step into the role of accepting the responsibility for helping their children tackle life challenges—rather than professionals seeing children in clinics and agencies. -Clossey, L., Simms, S., Hu, C., Hartzell, J., Duah, P., & Daniels, L. (2018). A pilot evaluation of the Rapid Response Program: A home based family therapy. Community Mental Health Journal, 54(3), 302-311
9/22/22 A Shift from "Problematic Children" Behaviors... This shift in theoretical framework carries with it the goal to inspire providers to go into the homes and shift from a perspective of problematic children behaviors to influencing deeply entrenched family systems that are creating breakdowns in the parent’s ability to safely and effectively guide their children through challenges and access their own internal and community resources. -Clossey, L., Simms, S., Hu, C., Hartzell, J., Duah, P., & Daniels, L. (2018). A pilot evaluation of the Rapid Response Program: A home based family therapy. Community Mental Health Journal, 54(3), 302-311
9/27/22 The Parent's Role is Critical The research backs a higher level of parent involvement in parent-based programs as well as in supporting and training parents to raise their children with SED. It also makes a good argument for parents to be seen as critical in the child’s mental health and necessary in the overall well-being of the child and the family.
9/29/22 Parent-centered = Positive Outcomes From early intervention to parent-centered programs that work in the home with teens, higher levels of parental mindfulness and effective strategies equal positive related outcomes for the child, the parents, and the family as a whole. -McKee et al., 2018; Duncombe, 2018
10/4/22 The Focus: Teaching Parents Child care providers who focus on teaching parents, disrupt the family pattern of repeated, and less effective use of services, and instead; teach parents to access their own internal and community resources to manage their family challenges long after treatment. -Clossey et al., 2018
10/6/22 Parent-based Framework There is a great need for…more programs that work to improve problematic family patterns and children’s behavioral problems from a parent-based framework that teaches parents to disrupt negative patterns and cultivate nurturing family environments. -Clossey et al., 2018
10/11/22 Parents as Experts for their Child Research shows that moving parents into the position of experts on their child and in their family helps to nurture family relationships, improves problematic family patterns, produces longer-lasting benefits in reducing behavioral problems, and also improves parents’ mental health.