Supporting foster carers with the Incredible Years Parent Programme
There are over 4,000 looked after children (LAC) in Wales. These children often have a difficult start in life, move from foster home to foster home and are high users of health, social care and educational services. The UK government has recognised the need to improve training for foster parents to support the health, well-being and educational attainment of LAC (Tapsfield & Collier, 2005). Evidence based parenting programmes are both effective and cost-effective in helping children in conventional family circumstances with conduct disorder (CD) or challenging behaviour (Hutchings et al., 2007; Muntz et al., 2004; Edwards et al., 2007). The Welsh Assembly Government (2005) has recently endorsed the Incredible Years (IY) parent programme as effective and some adoption agencies are implementing the programme with prospective adoptive parents. Evidence has shown CD to have prevalence in LAC of over 37% (Tapsfield & Collier, 2005). Over the years staff in the North West Wales NHS Trust Child and Adolescent Mental Health Service have worked with many foster carers of referred children. These carers have found the programme helpful for themselves and their cared for children. Local authorities (Gwynedd, Anglesey and Conwy) have used the IY programme with foster carers as a training and support package and again carers have reported it to be useful. It has also been used successfully with parents whose children have been the subject of care orders and has contributed to decisions for children to be returned from foster care to their natural parent/s. Several other authorities are now considering making use of the programme, however, the programme has not been formally evaluated with foster carers. There is international evidence of the effectiveness of the programme and an evidence base in the UK from three randomised controlled trials, the Scott et al. trial (2001) and Gardner et al. trial (2006) with clinically-referred children, and Hutchings et al. (2007), in Wales, early intervention prevention trial with parents of children living in socially disadvantaged Sure Start areas at risk of developing conduct disorder. LAC have similar levels of conduct problems to these children and are four times more likely to have CD than children in the normal population (NICE, 2006).
Although little is known about the extent of health, social care and educational service use by LAC other than it is likely to be high and in addition to high fostering costs, national fostering agencies have recently highlighted the serious short fall in resources for fostering in the UK, estimated to be £748 million and £37.8 million for Wales. In advance of a large-scale trial of the IY parenting programme for foster parents and LAC, we set out to pilot the programme and identify the range of public and private sector services accessed by LAC and their carers in Wales. This provides the cost baseline for a larger trial in which several local Social Services Departments are interested in participating. We anticipate that this programme would be both effective and cost-effective in helping foster parents to support LAC short term and could possibly reduce future foster carer placement breakdown whilst contributing to the services offered to foster parents. The funding from WORD enabled a trial to test short-term effectiveness and acceptability of this programme to 46 foster carers in 3 North Wales authorities, the sample were allocated in a 2:1 ratio intervention to control.
There were significant improvements in the mean score for the intervention group as compared to the control group in child problem behaviou measures. Foster carers generally enjoyed the programme and welcomed the chance to attend a parent programme specifically run for them as a unique population. They felt more able to share than if they had attended a typical ‘parent’ group with a mix of carers and parents, due to confidentiality issues and the complex issues and legislation governing the care of LAC. It is clear from carer and leader feedback, and from behavioural outcome analyses that the programme was generally well received and beneficial to carers and their LAC in the short term. Both carers and leaders felt that there was a definite place for this programme, especially for new carers or prospective adoptive parents. New carers found the group to be particularly useful and supportive particularly if they had not had children of their own. With regard to cost data it is apparent that there is variability of available funds across Authorities, and some carers are offered more training and support than others and allowances paid to foster carers (British Association of Adoption and Fostering, 2008). However, our cost results are a ‘snapshot’ view of only three areas, which appear to spend more than the average Welsh Authority, so cannot be generalised across all 22 Welsh Authorities.
This research is in the process of being submitted in two papers, one regarding outcomes the other regarding costs.
Dr. T. Bywater as Primary Investigator and Lead Applicant, Prof. J. Hutchings, Dr. R. Tudor-Edwards, Dr. D. Daley and Dr. I. Russell as Co-applicants, Seow Tien Yeo and Pat Linck as Research Officers.