Archives: Intervention

Abstract

Delivery of the intervention

Individual- / family-based

Aim of the intervention

The intervention aims to prevent and treat problems in the interaction between the child and the parents. The intervention strengthens the child’s experience of being accepted and understood.

Description of the intervention

Theraplay is an individual-based intervention and is targeted at families, where the child or the adolescent has developmental problems. Theraplay lies on the theories of attachment relationship and social learning as well as on the concepts of sensitivity, positive instructing and reflexivity (Mäkelä & Salo 2011). Beside the child and the adolescent, the parents are instructed in the intervention. The duration and the contents of the intervention are determined according to each family’s situation, comprising of 5-30 meetings with a Theraplay-worker. The meetings are filmed and the intervention begins with an evaluation phase (MIM-evaluation and the planning of delivery) and the parents are asked to attend to it. Theraplay may be delivered and applied in multiple ways with child families.

Availability of the intervention in Finland

Training for the intervention is provided by the Finnish Theraplay Association for the social and healthcare professionals. In addition to Theraplay-worker training, the Theraplay Association provides instructor and work supervisor training. Theraplay was developed in the 1960’s and the use and trainings of the intervention are in tight contact with the Theraplay Institute (USA). Theraplay is used in child and family services of the social and healthcare, private sector and organizations. The regional availability of the intervention varies across Finland.

Research- and evidence-based efficacy of the intervention

A German effectiveness study with a control group indicated positive changes in relation to the intervention in the following outcomes: shyness, over-adaptability and suspiciousness (part I) as well as shyness, attention problems, cooperation, adaptability and suspiciousness (part II) (Wettig 2011). The changes cannot be unambiguously explained by the intervention due to the natural development of the children as well as some limitations of the study. There is no Finnish peer reviewed effectiveness study on the intervention. Theraplay has some evidence of effectiveness in terms of reduced internalizing symptoms among the intervention group as compared to the control group.

Literature

Mäkelä, J. & Salo, S. (2011). Theraplay –vanhemman ja lapsen välinen vuorovaikutushoito lasten mielenterveysongelmissa. Duodecim 127, 29–39.

Wettig, H. H. G., Coleman, A. R. & Geider, F. J. (2011). Evaluating the effectiveness of theraplay in treating shy, socially withdrawn children. International Journal of Play Therapy, 20, 26–37.

Summary

Introduction

The Trappan method is aimed at children and young people aged 4–18 who have witnessed domestic violence in their family. Trappan helps the child to put their experiences of violence into words and process them. The aim of the method is to use discussions to reduce trauma symptoms related to experiences of domestic violence.

Research question

Does the Trappan method have evidence-based effectiveness in the Finnish context on reducing post-traumatic stress disorder (PTSD) symptoms and other psychiatric problems among children and young people who have witnessed domestic violence?

Data and methods

This study used the Population, Concept and Context (PCC) strategy to search for literature, which is a typical strategy in exploratory literature reviews. The search targeted the following question: What research has been done on the Trappan method? The keywords used were: P = Children and young people C = Trappan, stairs. Context was omitted to avoid an excessive restriction of the results of the search. The primary area of interest in the search was effectiveness studies carried out on the method, although studies carried out by using different frameworks were also included. A systematic search was carried out for the following six databases: MEDLINE, APA PsycInfo, CINAHL, ERIC, Web of Science and Scopus. In addition, a search for publications in Finnish was performed via the Finna.fi service.

Results

Trappan is well-documented, and the method’s mechanisms of action are based on a generally accepted theoretical basis. The implementation support included in the method is good from the perspective of training and implementation support, but the monitoring of the method could still be developed further. No peer-reviewed studies were found on the method in the literature search, but there is upcoming scoping research on the method.

Method assessment

Trappan receives a method assessment of 1/5, which means that the programme is well-documented and has a theoretical basis. There is no evidence of the effectiveness of the method, i.e. there is no data on the effectiveness of the method at this time.

Abstract

Delivery of the intervention

Group-based

Aim of the intervention

The intervention aims to strengthen positive interaction between parent and child, and parenting in everyday situations.

Description of the intervention

Stronger as a parent is a group-based early intervention for parents of 3–9 year-old children. The intervention is based on the modern attachment theory (Schore & Schore 2008) and the intervention strengthens the parent’s reflexive ability and positive perception of one’s own child. Stronger as a parent –group is not suited for parents, who are in an acute crisis related to their life situation. Peer groups gather eight times in group meetings to discuss and do exercises. Peer group instructor can use the instructor manual.

Availability of the intervention in Finland

Training for a Stronger as a parent –instructor is an additional training for social and health care professionals. The training is organized in Jyväksylä, but one can conduct peer groups by using the instructor manual even without the training. Intervention is based on a Finnish model of a coaching program, which targeted at parents of hyperactive children (Tasola & Lajunen 1997) and Stronger as a parent -manual (Korhonen & Holopainen 2015).

Intervention has been utilized in social and health care and in child and family services as an early intervention. Stronger as a parent groups have been organized in middle Finland.

Research- and evidence-based efficacy of the intervention

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

Literature

Korhonen, S. & Holopainen, L. (2015). Vanhempana vahvemmaksi – kohti myönteistä vuorovaikutusta. Kirja vanhemmuudesta ja sen tukemisesta. Jyväskylä: Grano Oy.

Schore, J. R. & Schore, A. N. (2008). Modern attachment theory: The central role of affect regulation in development and treatment. Clinical Social Work Journal, 36(1), 9–20.

Tasola, S. & Lajunen, K. (1997). Käsikirja ”Vanhempana vahvemmaksi – ylivilkkaiden ja keskittymättömien lasten vanhemmille tarkoitettu valmennusohjelma”. Uusittu painos. Jyväskylä: Kopijyvä Oy.

Summary

Introduction

The FHille programme is aimed at children aged four to six and families who are expected to benefit from additional support for the child’s school readiness. The programme provides families with tools for developing the child’s prerequisites for learning. The aim of the programme is to promote children’s wellbeing, development and prerequisites for learning through play and activities, interaction and reflection. The FHille programme aims to promote the child’s school readiness in the long term. The programme seeks to engage the parent’s participation in the way their child thinks and learns.

Research question

Does the FHille programme have evidence-based effectiveness in the Finnish context on strengthening the child’s self-esteem and social, cognitive and motor skills, or strengthening the child’s emotional and interpersonal skills? Secondly, does the FHille programme have evidence-based effectiveness with regard to engaging the parent’s active participation or the parent’s experience of being an important resource for the child?

Data and programmes

This study used the Population, Concept and Context (PCC) strategy to search for literature, which is a typical strategy in exploratory literature reviews. The search targeted the following question: What research has been done on the FHille programme? The keywords used were: P = parents and young children, C = FHille. Context was omitted to avoid an excessive restriction of the results of the search. The primary area of interest in the search was effectiveness studies carried out on the method, although studies carried out by using different frameworks were also included. A systematic search was carried out for the following six databases: MEDLINE, APA PsycInfo, CINAHL, ERIC, Web of Science and Scopus. In addition, a search for publications in Finnish was performed via the Finna.fi service.

Results

The FHille programme is primarily well-documented, and its mechanisms of action are based on one or more generally accepted theories or models that explain human behaviour or action. Implementation support for the FHille programme is realised for over half of the required items, i.e. the level of implementation support is satisfactory. No peer-reviewed studies were found on the programme in the literature search.

Method assessment

FHille is a well-documented method that has a theoretical foundation. It receives a method assessment of 1/5. There is no evidence of the effectiveness of the FHille programme, i.e. there is no data on the effectiveness of the method at this time.

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.

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