Archives: Intervention

Abstract

Delivery of the intervention

Family-based

Aim of the intervention

The intervention aims to improve child’s school readiness and to strengthen their social skills and interactive relations. The intervention supports parents and family in everyday life when the child starts the school.

Description of the intervention

FHille is a structured intervention for 5–6 years old children and their families, and it supports the child’s development and learning through play prior to school start. The intervention lies on development psychological theories and on research-based evidence, which shows that supporting parenthood strengthens the child’s development. FHille is provided for families, who are evaluated to potentially benefit from it, approximately a year before their child starts the school. Participation in the intervention is voluntary. Families are directed to the intervention through early childhood education or child health clinic, where appropriateness of FHille for the child is assessed. Intervention lasts 30 weeks and the families meet a FHille instructor every second week. Between the meetings families learn the FHille material and exercise daily. A suitable version of the intervention has also been developed for 4–5 years old children.

Availability of the intervention in Finland

Everyone interested in the intervention can participate in FHille-training in the municipalities, which deliver the intervention. Folkhälsan organizes the trainings. The Finnish FHille is based on the Hippy-program developed in Israel and HippHopp intervention developed in Denmark. Folkhälsan coordinates the piloting of the intervention in the municipalities. Currently pilots are ongoing in Ostrobothnia (Pohjanmaa), Southwest Finland (Varsinais-Suomi) and Uusimaa (Folkhälsan 2020). Intervention is offered in Swedish.

Research- and evidence-based efficacy of the intervention

There is abundant international research on Hippy-program and two high-quality RCT studies, which provide evidence of effectiveness for the intervention (Baker et al. 1998; Neoechea 2007). However, there is neither peer-reviewed research on FHille-intervention nor research-based evidence-based effectiveness in Finland.

Literature

Baker, A. J. L., Piotrkowski, C.S. & Brooks-Gunn, J. (1998). The effects of the home instruction program for preschool youngsters on children’s school performance at the end of the program and one year later. Early Childhood Research Quarterly 13(4), 571–586.

Folkhälsan. (2020). https://www.folkhalsan.fi/barn/foraldrar/forberedelse-for-skolstarten/

Necoechea, D. (2007). Children at-risk for poor school readiness: The effect of an early intervention home visiting program on children and parents. Dissertation abstracts international section A: Humanities and Social Sciences 68 (6-A), 2311.

Abstract

Introduction

Studies have shown that constant conflicts between parents have a negative impact on children’s well-being. The No Kids in the Middle method is used in divorces marked by conflict. The method aims to improve the safety of a life situation harmful to children by reducing the conflict between the parents, their negative and hostile attitudes towards each other and the disapproval of the former partner in the parents’ social network. (Visser & Van Lawick, 2021).

Research question

Does the No Kids in the Middle method have an impact on safeguarding the preconditions for the well-being of 4-18-year-old children in conflicted divorce situations in the Finnish context?

Data and Methods

The literature search was carried out using the Population, Concept, Context (PCC) search strategy typical for literature reviews with a focus on the question: What research has been conducted on the No Kids in the Middle method? The used search terms were: P = High conflict divorce families with children aged 4–18, C = No Kids in the Middle, C = healthcare, social welfare, third sector. The primary focus of interest of the literature search was on impact studies on the method, although studies using other research designs were also included. A systematic literature search was carried out in six databases: MEDLINE, APA PsycInfo, CINAHL, ERIC, Web of Science and Scopus databases and was complemented by a manual search.

Results

According to the assessment, the description and theoretical background of the No Kids in the Middle method were sufficient. The three articles found in the literature search were non-Nordic Dutch and British impact studies. No Finnish or Nordic impact studies were found on the No Kids Left in the Middle method, but according to an exploratory impact study carried out in the Netherlands (Lange et al., 2023), the preliminary results are promising. According to the study, parents are able to advance to parallel parenting, which involves fewer conflicts and disapproval of the social network than previously, even though the parents did not change their views of their ex-partner’s behaviour.

Overall assessment

There is little documented evidence (3/5) of the use of the No Kids in the Middle method in the Finnish context. While there is no evidence of the impacts of the method in Finland or the Nordic countries, according to an exploratory impact study carried out in the Netherlands (Lange et al., 2023), the preliminary results are promising. Further research is needed on the impacts of the method. The implementation readiness and support of the method from the perspective of the method is implemented in less than one third (3/10) of the areas.

Abstract

Introduction

Behavioural problems and disruptive behaviour burden both teachers and pupils. In the long term, problems related to pupils’ behaviour have a negative impact on the teaching and guidance provided by teachers to classes as well as on the learning and well-being of other pupils. If there are negative interaction models in the school environment that maintain and strengthen the student’s negative behaviour, behavioural problems may develop into more serious behavioural disorders. However, behavioural problems can be reduced and prevented by means of a schoolwide positive behavioural intervention in which all adults in the school commit to teaching and guiding social behaviour in mutually agreed ways.

Data and Methods

The literature search was carried out using the Population, Concept, Context (PCC) search strategy typical for literature reviews with the question: What research has been conducted on the Schoolwide Positive Behavioral Interventions and Supports model? (P = primary and secondary school pupils, C = Schoolwide Positive Behavioral Interventions and Supports (known as ProKoulu in Finland), C = school). The primary focus of the literature search was on impact studies. A systematic literature search was carried out in the following databases: MEDLINE, CINAHL, ERIC, APA PsycInfo, Web of Science and Scopus.

Results

Based on the literature search, 23 studies were included in the systematic review, of which six Nordic (Norwegian) impact studies were evaluated. The data of a yet-unpublished implementation research article from Finland were also used in the assessment. The remaining 17 studies (two meta-analyses, 14 impact studies from non-Nordic high-income countries and one Nordic implementation study) were examined qualitatively. The impact studies affecting the assessment examined the Norwegian PALS operating model, which corresponds to the Finnish ProKoulu model.

The results of qualitatively examined studies did not affect the overall assessment of the method, unlike the results of Nordic impact studies. According to the assessment, the Schoolwide Positive Behavioral Interventions and Supports model has a sufficient description and theoretical background. The model has positive impacts on pupils’ problem behaviour. Impacts were found both in the school environment and in the classroom. The model had a positive impact on pupils’ repeated problem behaviour over a period of three years since the launch of the model.

The extent of the impacts was moderate at most (pupils’ problem behaviour decreased in the classroom: d = 0.49, p = 0.034; d = 0.13, 95% confidence interval (CI) = (0.125–0.135) and d = 0.13, 95% CI = (0.126-0.133), pupils’ problem behaviour decreased in the school environment: d = 0.59, p = 0.011, d = 0.38, 95% CI = (0.375–0.385) and d = 0.25, 95% CI = (0.236–0.254) = 0.41, 95% CI = (0.406-0.414) and d = 0.02, 95% CI = (0.0190.021), behavioural correction increased: d = 0.09, 95% CI = (0.086–0.094) and d = 0.02, 95% LV = (0.019–0.021), number of pupils with behavioural problems decreased: d = 0.91, p = 0.004; pupils’ outward symptoms decreased: d = -0.79, 95% CI = (-1.27–(-0.31)).

No follow-up study has been conducted after the implementation of the method. The quality of the impact studies was good. The readiness to implement the Schoolwide Positive Behavioral Interventions and Supports model was achieved in seven out of nine areas. The Schoolwide Positive Behavioral Interventions and Supports model has the readiness for successful implementation.

Overall assessment

The method receives an overall score of 5(/5), i.e. there is strong documented evidence of the method in the Finnish context.

Abstract

Introduction

The parent-child relationship and parenting skills play a key role in a child’s well-being and development. The International Child Development Programme (ICDP) is a programme for parents and carers of children and young people of all ages that is mostly implemented as group activities and aims to reinforce good, positive interaction and the sensitivity and ability of carers to encounter children with respect and to strengthen the parent’s confidence in their parenthood, positively influence the parent’s perceptions of the child and support the child in being heard.

Research question

Does the International Child Development Programme (ICDP) have an impact on the parenting skills and parent-child relationship of 0–18-year-old children in the Finnish context?

Data and Methods

The literature search was carried out using the Population, Concept, Context (PCC) search strategy typical for literature reviews with a focus on the question: What research has been conducted on the International Child Development Programme (ICDP)? The used search terms were: P = parents of children and young people aged 0–18, C = International Child Development Programme, C = Parenting skills and parent-child relationship.

The primary focus of interest of the literature search was on impact studies related to the method, but studies using other research designs were also included. The systematic literature search was performed in the MEDLINE, APA PsycInfo, CINAHL, ERIC, Web of Science and Scopus databases and was complemented by a manual search.

Results

Based on the literature search, eight studies were included in the review. Six of these were Nordic impact studies which served as the basis for the impact assessment of the method. Additionally, two Nordic implementation studies were included. As the programme is not based on a clear manual, its description was assessed using various sources. For the target group, implementation, responses and a guide aimed at instructors, the programme description was assessed as “described but not sufficiently”.

On the other hand, the programme target phenomenon, objectives, means, key elements and flexibility, implementers and the materials aimed at the programme recipients were sufficiently described. The programme relies on many theories whose description was considered sufficient. The impact mechanisms of the programme are based on generally accepted theories explaining human behaviour. The studies found that the programme has positive impacts on some of the examined responses.

An article by Brekke and colleagues (2023) found that the programme had statistically significant positive effects on parents’ self-efficacy and emotional sensitivity in the area of emotion-regulating behaviour both immediately after participation in the ICDP and in a follow-up four months later. The impacts were minor in the four-month follow-up measurement (d = 0.20-0.23, NNT (NumberNeeded-to-Treat) = 7.69-8.93).

Overall assessment

There is moderate documented evidence (4/5) of the International Child Development Programme in the Finnish context. The implementation readiness of the programme was realised in six out of ten areas.

Abstract

Delivery of the intervention

Group

Aim of the intervention

The VOIKUKKIA peer group strengthens the parenthood in families, whose children are in custody or placement.

Description of the intervention

The VOIKUKKIA is a structured, peer group-based intervention, which is targeted at parents of children in custody or placement. The objective is to strengthen and empower the parenthood through peer support (Kivinen et al. 2012). Peer groups are steered by a peer instructor who has attained VOIKUKKIA-training. The instructors interview parents who are interested in the peer groups and evaluate the suitability of the parents in the group. Usually a social worker attends the group as well. The VOIKUKKIA-peer groups gather ten times. The VOIKUKKIA guidebook structures the meetings, but topics brought up by the parents are dealt with in the groups too. The parents, who have participated in the VOIKUKKIA-intervention, have the possibility to become trained peer instructors as experts by experience.

Availability of the intervention in Finland

Social and healthcare professionals working with child families can attain a training as a VOIKUKKIA-instructor and parents who have participated in the VOIKUKKIA-intervention can attain a training as a peer instructor. Instructor training is organized by Suomen Kasvatus- ja perheneuvontaliitto (Suomen Kasper Ry) together with Sininauhaliitto. There is no accurate information of the regional availability of this peer group intervention that has been developed in Finland.

Research- and evidence-based efficacy of the intervention

There is neither research-based evidence of the efficacy of the intervention nor peer reviewed research on it.

Literature

Kivinen, S., Hägglund, H. & Söderholm, P. (2012). VOIKUKKIA-vertaistukiryhmän perustaminen. Teoksessa: Kivinen, S., Hägglund, H., Söderholm, P. & Kujala, V. (toim.): VOIKUKKIA-vertaistukiryhmät. Opas sijoitettujen lasten vanhempien vertaistukiryhmien perustamiseen ja ohjaamiseen. Helsinki: Painotalo Repe Oy, 19–48.

Abstract

Delivery of the intervention

Group-based

Aim of the intervention

The aim of the Vertti-groups is to strengthen the parenthood and the psychosocial protective factors of the family. The intervention promotes positive interaction within the family and the child development and supports the daily functioning of the family.

Description of the intervention

The Vertti-group is a preventive group-based intervention, targeted at child families where a parent has mental health problems. The foundation of the Vertti-groups lies on the Beardsleen family intervention (Inkinen and Söderblom 2005) and they are one of the Effective Child & Family –interventions. The Effective Child & Family –interventions are based on child development research, respect of parent as an expert regarding their own child and the theory child development as a part of different development environments (Solantaus & Niemelä 2016). In the intervention the parents and children are appointed to their own peer groups, which meet ten times. During the meetings, both peer groups go through themes that have been determined in advance and themes arising from the participants’ own experiences. The groups work together, and each family is called to a closing interview 4 – 6 weeks after the intervention. The purpose of the closing interview is to evaluate the impacts of Vertti-group on the family’s daily life and to assess the need of further support.

Availability of the intervention in Finland

Vertti-instructor training is targeted at professionals working with children and families, especially for the social and health care professionals. The training is based on Vertti-manual (Inkinen & Söderblom 2005). Currently, the training is organized by only one trainer. In Finland, the intervention has been developed in a project of the Finfami Uusimaa ry. Vertti-groups have been organized mainly in the capital region.

Research- and evidence-based efficacy of the intervention

There is neither peer reviewed research nor research-based evidence of effectiveness for the intervention.

Literature

Inkinen, M. & Söderblom, B. (2005). Vertti – Lapset ja vanhemmat vertaisryhmässä, kun vanhemmilla on mielenterveyden ongelmia. Käsikirja ryhmänohjaajille. Profami Oy, Er-paino Lievestuore.

Solantaus, T. & Niemelä, M. (2016). Arki kantaa – kun se pannaan kantamaan. Perheterapia, 1, 21–33.

Abstract

Delivery of the intervention

Individual- / family-based

Aim of the intervention

The aim of the Holding Tight Treatment System is to support pregnant mothers and baby families with substance abuse problems to overcome the addiction. The treatment system strengthens parenthood and motherhood to guarantee safe growing environment for the baby.

Description of the intervention

Holding Tight Treatment System is targeted at pregrant mothers and baby families who have substance abuse problems. The treatment system lies on the attachment relationship and mentalization theories as well as on neurobiological research on the experiences of successful interactions of mothers with substance abuse problems with their babies (Suchman 2006). The treatment system is based on rehabilitative and reflexive approaches. The content of the treatment system is individually tailored to the situation of the pregnant mother and the baby, and different working methods are used accordingly. The treatment system comprises of the substance abuse rehabilitation and support for the early interaction and parenting at the mother and child homes and shelters. A group-based rehabilitation service, based on the Holding Tight Treatment System, has been developed for the mothers and baby families with substance abuse issues who are in the open care of the mother and baby homes and shelters.

Availability of the intervention in Finland

In-service training for the treatment system is provided for the employees of the mother and baby homes and shelters. Holding Tight Treatment System has been developed in Finland at the Federation of Mothers and Babies Homes and Shelters. The open care rehabilitation service, developed from the Holding Tight, is provided in certain Finnish Mother and Baby Homes and Shelters for the mothers and baby families who hold a municipal commitment to pay the rehabilitation.

Research- and evidence-based efficacy of the intervention

The Holding Tight Treatment System has been investigated in a prospective effectiveness study (Pajulo et al. 2011; Pajulo et al. 2012). Mentalization ability of the mothers who participated in the Treatment System (n = 34) increased during the rehabilitation but the sample size was small and many dropped out before the follow up. There is some evidence for the positive development of the mentalization ability during pregnancy and after child birth among the mothers who participated in the treatment system. In Finland, there are no effectiveness studies with a controlled study design on the Holding Tight Treatment System.

Literature

Pajulo, M., Pyykkönen, N., Kalland, M., Sinkkonen, J., Helenius, H. & Punamäki, R. L. (2011). Substance abusing mothers in residential treatment with their babies: Postnatal psychiatric symptomatology and its association with mother–child relationship and later need for child protection actions. Nordic Journal of Psychiatry 65(1), 65–73.

Pajulo, M., Pyykkönen, N., Kalland, M., Sinkkonen, J., Helenius, H., Punamäki, R. L. & Suchman, N. (2012). Substance‐ abusing mothers in residential treatment with their babies: importance of pre‐and postnatal maternal reflective functioning. Infant Mental Health Journal 33(1), 70–81.

Suchman, N., Pajulo, M. & Mayes, L. (2013) (toim.). Parenting and substance abuse, developmental approaches to intervention. Oxford University Press.

Abstract

Delivery of the intervention

Individual- / family-based

Aim of the intervention

The aim of the Swing baby family work is to support the early interaction between parents, and their baby and the development of securely attached relationship in the families with risk factors for the formation of it.

Description of the intervention

Swing baby family work is an intervention, which supports the early interaction in families with babies. The intervention lies on the attachment relationship theory, ecocultural theory and research-based knowledge about the harmful effects of the risk factors for early interaction on the child development. Swing baby family work is provided for families, which have psychosocial or physiological risk factors for the development of early interaction. Baby family work is conducted at home of the families, where support and instructions for parenting are provided. The Swing lasts for approximately a year and includes one meeting per week on average.

Availability of the intervention in Finland

Swing-baby family worker training is provided as an in-service training for the professionals of social and health care, education and sports. Training is organized by the Oulu polytechnic and Metropolia. Originally, Swing baby family work was developed in Finland as an early rehabilitation method for families of children with disabilities. Vamlas Foundation is responsible for the development of the program. Swing baby family work has been applied in Finland in the social and health care but there is no accurate information on the availability of the intervention.

Research- and evidence-based efficacy of the intervention

The effectiveness of the Swing baby family work on child development and interaction between mother and child has been examined in one Finnish study (Sajaniemi & Mitts 2004). The interaction between the mothers and babies, who participated in the baby family work (n = 39), developed positively compared to the control group (n = 19), but the small sample size weakened the reliability and interpretation of the results. Swing baby family work has little effect on the positive development of the attachment relationship between parent and child compared to the control group, which received support as usual.

Literature

Sajaniemi, N. & Mitts, T. (2004). Kiikku-vauvaperhetyön vaikutukset vanhemmuuteen ja lapsen kehitykseen. Erityispedagogiikan laitos, Helsingin yliopisto.

Abstract

Delivery of the intervention

Individual-based

Aim of the intervention

The intervention aims to strengthen foster children at school-related matters by providing early support and enhancing the child’s positive attitude towards school. The aim is to enhance the child’s strengths and to create a functioning network between the family, the school and the social workers.

Description of the intervention

SISUKAS– foster child at school is an early intervention targeted at children in the primary school age, who are in custody or in a long-term placement. The foundation of the intervention lies on research-based knowledge on the challenges that foster children face at school, and the adverse effects that these challenges can have on the development and psychosocial wellbeing of the child (Oraluoma & Välivaara 2016). In the SISUKAS–intervention, a regional and consultational multi-professional working team, including a social worker, a special education teacher and a psychologist, is established. The intervention begins when the consulting social worker contacts the child, the foster / biological parents, the school and the social worker responsible for the child’s matters. The multi-professional networking supports the child with any school-related matters at an early stage, enables timely informing and focuses on the child’s resources through a dialogue. In the SISUKAS, an individual learning plan is drafted for the child and its fulfillment is followed up. SISUKAShas been conducted also locally as a multi-professional method in cooperation of the social worker responsible for the child’s matters, a special education teacher and the school healthcare.

Availability of the intervention in Finland

SISUKAS-training is targeted at foster parents, foster care and education professionals. In Finland, Pesäpuu ry is responsible for the training. SISUKAS-training material is available in the internet. The SISUKASis based on the SkolFam-model developed in Sweden. In Finland, Pesäpuu ry has been responsible for the development of SISUKASin the Foster Child at School –project. It has been piloted in mid-Finland and parts of it have been piloted in Southern and Northern Savonia, Uusimaa, Satakunta, Varsinais-Suomi and Southern Ostrobothnia.

Research- and evidence-based efficacy of the intervention

Cognitive abilities of children who are in a family placement, have been studied in a Danish RCT-study, which focuses on systematic support provided to foster children (Eiberg, Andersen & Scavenius 2018) and in a Swedish quasi-experimental research on SkolFam (Durbeej & Gumpert 2016) and in a Finnish Pesäpuu ry study (Oraluoma & Välivaara 2016). There is some evidence of effectiveness of the SISUKAS, at least in terms of cognitive skills, which improved in the intervention group as compared to the control group.

Literature

Durbeej, N. & Gumpert, C. H. (2016) Effektutvärdering av arbetsmodellen Skolfam bland familjehemsplacerade barn i Sverige. Centrum för psykiatriforskning. Dnr 2016/01.

Eiberg, M. Andersen, L. K. & Scavenius, C. (2018). Skolestøtte til børn i familiepleje – delrapport I – Et effektstudie. VIVE – Viden til Velfærd Det Nationale Forsknings- og Analysecenter for Velfærd, København.

Oraluoma, E. & Välivaara, C. (2016). Sijoitetun lapsen koulunkäynnin tukeminen. SISUKAS-työskentelymallin vaikuttavuuden arviointi. Tutkimuksia 2/2016. Pesäpuu ry.

Abstract

Introduction

Good mental well-being is pivotal to a young person’s development, study performance and working life skills. Educational institutions play a key role in supporting the mental well-being of young people and are also required to strengthen the well-being of their students under the law. The Youth Compass method aims to support young people’s well-being skills, such as psychological flexibility and the skills this contains, and to prevent mental health problems. The method is fully web-based and can be used as part of the activities of educational institutions. It was originally developed for secondary school students, but it is also suitable for young people in the early stages of upper secondary education.

Data and Methods

The literature search was carried out using the Population, Concept, Context (PCC) search strategy typical for literature reviews with a focus on the question: What research has been conducted on the Youth Compass method? The used search terms were: P = young people, secondary school, upper secondary education, C = Youth Compass, C = school, home, healthcare. The primary focus of interest of the literature search was on impact studies related to the method, but studies using other research designs were also included. A systematic literature search was performed in the following databases: MEDLINE, APA PsycInfo, CINAHL, ERIC, Web of Science and Scopus databases and was complemented by a manual search.

Results

Based on the literature search, eight studies were included in the review. Five of these were Finnish impact studies which served as the basis for the impact assessment of the method. Three additional Finnish studies were included that did not assess the impact or implementation of the method. Based on the included studies and the methodological guide, the description and theoretical justification of the Youth Compass method are sufficient.

The method has been found to have positive effects on young people’s depression symptoms, anxiety symptoms, satisfaction with life, stress, academic flexibility and uncertainty related to career planning. It has also been found to increase the ability to make decisions on career choices. The impacts on responses were minor at most for young people attending secondary school (d = 0.03–0.48, NNT (Number-Needed-to-Treat) = 3.76–62.5).

The quality of the impact studies varied from satisfactory to good. The implementation readiness of the Young Compass was not sufficiently met based on the assessment of the used areas. The method is currently in national distribution on a stand-alone basis, i.e. those interested in the method can participate by registering on the website and studying it independently.

Overall assessment

The method receives an overall score of 4/5, i.e. there is moderate documented evidence of the method in the Finnish context. The overall assessment is based on impact studies in which the method was implemented on a web-based platform and through in-person and digital guidance.

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