Out of the clinic and into the community

I was in a playground one day with my fractious four-year-old when I met another young mum with her son, who was a similar age. As we pushed our kids on the swings and got chatting, I became increasingly aware of how her frustration with her little boy grew. Nothing new there: I had sounded very similar just a few hours earlier at home. However, what was disturbing was that as things escalated between them, he put up his little arm to block her face shouting at him and she bit it, hard; out of sheer frustration and overwhelm.

I could absolutely empathise with how deeply frustrated she felt. Parenting is hard. As a young mum, I struggled too; and that was with a husband, with resources and with a career as a Clinical Child Psychologist. I had people I could turn to, whereas this young mum was isolated and alone. Without support or money, things can feel a whole lot tougher. Although I appreciated her struggle, I was also hugely concerned about the impact of the incident on her son and for his future. Through my work in the NHS, I regularly saw the overwhelmingly hard task many parents were faced with when the additional challenges of struggling with no money and no support were added to
the mix.

The risks of poverty

The research is unequivocal: children raised in poverty are many times more at risk of a whole host of social, behavioural and emotional problems than their wealthier counterparts (Scott et al., 2001). The stark reality is almost a third of children are now raised in poverty in the UK (JRF, 2023). So how can we, as psychologists, help and support parents in a climate of adversity and reduced community resources? The potential for parenting interventions to improve parenting and child cognitive and behavioral outcomes is well documented (Knerr et al., 2013; Furlong et al., 2012; Barlow et al., 2010), however, studies suggest parenting programmes delivered in more economically disadvantaged communities have poorer outcomes than those delivered in affluent areas (Lundahl, 2006).

Parents in deprived communities seem to have lower engagement and are more likely to relapse into prior behaviours after completion (Weissberg et al., 2003). Despite the poor outlook, research suggests that it is possible to engage people living in areas of social and economic deprivation if parenting programmes are attractive, well planned and well supported (Pote et al., 2019).

Creating a community

Shortly after my playground encounter with the young mum, I began to volunteer on a parenting course delivered to families on a housing estate in London. I was keen to see a successful community parenting programme in action with the hope of bringing back the learning to the estate near me where that young mum lived. I had run various parenting programmes in my NHS work and knew from the research that she needed more than clinical intervention. She needed support. She needed community. She was never going to attend a traditional parenting course two bus rides away run by people she didn't know.

On my first day of volunteering, what I witnessed marked the beginning of a shift in my thinking as a clinician. Marika, an experienced family worker and single mother herself, breezed into the room, scattering the flip chart and chairs that had been thoughtfully put out for us. She dragged a table into place, threw a tablecloth over it and put out a large pot of hot tea and flowers, arranging us and the programme booklets so we all sat together in a circle. I felt uncomfortable at first; how would the parents know we were there to help? When Marika started sharing her own examples of parenting as a single mother, I felt even more worried; all my clinical training was screaming that this was an inappropriate way to engage with the beneficiaries of the programme.

Unsurprisingly, what I saw was those mums, dads and grandparents instantly relax. They were not alone. The treats were passed around and with them the wisdom that was in the room. I was hooked. Imagine if we could see thousands of small groups like this meeting in every estate in the country: where parents meet, eat together, share the struggles and the joys of parenting and are gently guided through some robust, research-based material. This was when the idea for our charity was born.

Laughing, crying and learning together

After carrying out my doctoral research on why such a parenting programme is effective and how it impacted parents from the estate, Marika and I came together and co-founded Kids Matter; a charity that aims to reduce the impact of poverty on children through community-based programmes. We aim to improve outcomes for children raised in families struggling with adversity by improving relationships within the home, bolstering parents' wellbeing and support networks, and empowering parents to parent with confidence and care. Those early days of creating the charity whilst still piloting the parenting programme felt like laying the train tracks as an express train was bearing down on us. It was all new and yet so exciting to see the potential scale and reach of the work.

Our Kids Matter in Community programme is a six-module, skills-based, evidence-informed parenting programme underpinned by Social Learning Theory and Parenting Styles Theory. As a clinical psychologist, I have ensured that not only are we evidence-informed in all we do but that we follow the NICE guidelines for parenting interventions. From a delivery perspective we may look a little different to traditional parenting courses. If you were to join a group you would find what I found that first day volunteering with Marika: a peer volunteer facilitator and a helper (often a parent from the community) setting an informal and welcoming table laden with tea and cake, colourful booklets available as guides for the topics explored over each of the six weeks and a small group of 6-8 parents laughing and crying and learning together. Sharing the highs and lows of caring for children and ensuring the wisdom in the room is gently steered so mums, dads and carers feel heard, understood and valued whilst their infants are cared for in the crèche. Parents say things like, 'It was the ideal environment to just be.' Or, 'the facilitators, they were very good you know, they didn't judge.'

Crucially, as all groups are hyperlocal, relationships continue outside the room and persist for months and even years after, thus ending isolation. As a minimum, the groups are followed by a post-programme six-week social event and a booster follow-up session three months later. Facilitators are also trained and supported to signpost parents onto other interventions to meet needs beyond those met by the programme.

Volunteers are not clinicians so we don't just train and release people to run groups; we supervise and support them closely so we can be sure that parents are in safe hands and that the outcomes are positive.

What I've learned and where the future takes us

I now spend most of my time as the Executive Director for Kids Matter, building on those early pilots to running programmes in more than 60 locations with over 100 volunteers as well as in London prisons. Although I find myself in unfamiliar territory in the charity sector, my clinical work remains important; I continue to practice in a local school to keep me close to the children we are reaching and the application of theory, research and practice in all our training and programmes at Kids Matter is evident to anyone that is involved. We recently completed a piece of service evaluation research looking at data from almost 500 of our parents and the encouraging results were published last year; they showed improvements in parental self-efficacy and wellbeing with those improvements holding at the three-month booster mark. There is much to celebrate from our first five years.

Our training as psychologists is unique in that we set ourselves and others a high bar in terms of designing programmes that are effective and can show evidence of impact as well as being respectful and thoughtful. We also recognise that we are in the midst of a serious mental health crisis in children and those that are most at risk are those in the poorest families. We need more resources than can be provided by current statutory provision. Equipping and training the voluntary sector to deliver an effective, accessible, evidence-informed intervention holds promise as a viable, scalable option to meet this growing need in our country.

What I have learned on my own journey outside the clinic from being a frazzled young mum myself to leading a charity aiming to reduce the impact of poverty on children, is that we need one another as parents and carers. No one can do this well, alone. I believe if the mum I had met in the playground all those years ago had attended a Kids Matter group, she wouldn't have reached that breaking point and if she had, she would have had support and signposting available to her immediately.

I have also learned that nearly every parent out there loves their children. We all come to the task of parenting with some good instincts and ideas and every parent comes hindered with unwanted baggage. There is a lot of wisdom in our groups as well as a lot of pain and exhaustion. I for one am grateful to the friends and resources I clung to in those early years, and seeing parents blossom as they offer wisdom to others as well as receiving it is gratifying. The trajectory for their children is likely to be much more positive for them, and for future generations to come.

- Find more on Kids Matter.

References

Barlow, J., Smailagic, N., Ferriter, M., Bennett, C., & Jones, H. (2010). Group-based parent-training programmes for improving emotional and behavioural adjustment in children from birth to three years old. The Cochrane Database of Systematic Reviews, No. 3.

Baumrind, D. (1991). Effective parenting during the early adolescent transition. In P.A. Cowan P.A. and Hetherington E.M. (Eds), Advances in family research. Lawrence Erlbaum Associate, New Jersey, NJ, Vol. 2.

Esteban‐Serna, C., Eisenstadt, M., Gardner, E. & Liverpool, S. (2022). A preliminary evaluation of Kids Matter: A community‐based parenting intervention. Journal of Community Psychology. 

Furlong, M., McGilloway, S., Bywater, T.,  et al. (2012). Behavioural and cognitive-behavioural group-based parenting programmes for early-onset conduct problems in children aged 3 to 12 years. The Cochrane Database of Systematic Reviews, Vol. 2, No. 2.

Joseph Rowntree Foundation. (2023, January 25). UK Poverty 2023: The essential guide to understanding poverty in the UK. JRF. 

Knerr, W., Gardner, F. & Cluver, L. (2013). Improving Positive Parenting Skills and Reducing Harsh and Abusive Parenting in Low- and Middle-Income Countries: A Systematic Review. Prevention Science, Vol. 14, No. 4, 352-363.

Lundahl, B., Risser, H. J., & Lovejoy, M.C. (2006). A meta-analysis of parent training: Moderators and follow-up effects. Clinical Psychology Review, 26(1), 86-104.

Pote, I., Doubell, L., Brims, L. et al. (2019). Engaging Disadvantaged and vulnerable parents: An evidence review. Early Intervention Foundation, London.

Reyno, S.M. & McGrath, P.J. (2006). Predictors of parent training efficacy for child externalizing behavior problems – a meta‐analytic review. Journal of Child Psychology and Psychiatry, 47(1), 99-111.

Scott, S., Knapp, M., Henderson, J., & Maughan, B. (2001). Financial cost of social exclusion: Follow up study of antisocial children into adulthood. British Medical Journal, Vol. 323, No, 7306, 191-194.

Weissberg, R.P., Kumpfer, K.L. & Seligman, M.E.P. (2003). Prevention That Works for Children and Youth. The American Psychologist, 58(6-7), 425-432.

National Institute for Health and Care Excellence (NICE, 2013), Antisocial behaviour and conduct disorders in children and young people: recognition and management.