Nurtured Heart parenting intervention for child behavioural problems
Research type
Research Study
Full title
The Nurtured Heart Parenting Intervention for Children’s Behavioural Problems: A Single Case Design
IRAS ID
306642
Contact name
Nima Moghaddam
Contact email
Clinicaltrials.gov Identifier
Duration of Study in the UK
0 years, 11 months, 15 days
Research summary
Research Summary
Behavioural problems in children are common but can have long term impacts on the child and their family. Parent training programs are a recommended treatment approach for reducing behavioural problems in children. The Nurtured Heart Approach (NHA) is a parent training program that can be delivered in groups, one to one or as self-help intervention. There is little research on effectiveness of the NHA in any delivery format. The focus of this study is the NHA self-help workbook called “Transforming the Intense Child Workbook”. This study aims to find out if the NHA workbook changes the way parents think and behave, and if parents report any changes in their children’s behaviour following the intervention.
This research study will recruit parents/carers of children aged 3 to 11 years who have behavioural problems and are on a waiting list for National Health Service specialist children’s services (for example, Child and Adolescent Mental Health Services). The study will recruit participants across services in Lincolnshire and Nottinghamshire.
Participants will take part in three phases of the study. The first phase, called the baseline phase, will involve participants completing several questionnaires twice a week for a period of three weeks. The second phase, the six-week intervention phase, will involve participants reading a chapter of the workbook once a week and discussing this with a researcher. Participants will also complete the questionnaires once a week. The third and final phase, the follow-up phase, will involve participants completing the questionnaires once again and taking part in an interview to describe their experiences of the intervention.
The research is sponsored and funded by the University of Lincoln and is undertaken as part of the Trent Doctorate in Clinical Psychology. It is hoped that this research will increase understanding of the impact of the NHA workbook as a guided self-help intervention.
Summary of Results
The study aimed to explore whether the Nurtured Heart Approach workbook (Glasser, 2016) impacts parenting, how parents think and how children behave.
Five parents of children with behavioural problems were recruited from Child and Adolescent Mental Health Service (CAMHS) waiting lists. Parents completed questionnaires that measured parent-reported child behavioural problems, parenting practices and parental reflective functioning (the way a parent thinks about their child’s internal world). At the beginning and end of the study, parents also completed a questionnaire that measured parental wellbeing and identified the problems that affected them most about their child’s behaviour.Three parents completed the six-week intervention. Following the intervention, four parents completed an interview to share their experiences of the Nurtured Heart Approach workbook and guided phone calls. The results for the three parents who completed the intervention were mixed, with some individual differences across participants.
Overall, the Nurtured Heart Approach workbook did not appear to impact parent-reported child behavioural problems when measured using the questionnaire. However, parents did report a significant reduction in the problems that affected them most about their child’s behaviour. Parents also described a difference in their children’s behaviour in the post-intervention interview: all parents said that their children had ongoing behavioural problems, but these were less intense and less frequent compared to before the intervention.
The Nurtured Heart Approach workbook did not appear to impact parenting practices when measured using the questionnaire. However, all the parents reported a change in their parenting towards the referred child in the post-intervention interview.
The Nurtured Heart Approach did increase parental reflective functioning for all the participants. The increase in parental reflective functioning was significant and suggests that the Nurtured Heart Approach workbook helped parents to think in a different way about their child’s behaviour.
All parents reported an improvement in general wellbeing following the intervention. The participants reported positive experiences of the intervention. Parents valued the Nurtured Heart Approach workbook and particularly liked the way the workbook explained the rationale for the approach and provided examples as to how to apply the three stands. Similarly, parents found the guided phone calls helpful in applying the NHA to their child and increasing their confidence in putting the approach into practice. Parents said that the workbook combined with guided phone calls was important in making the intervention useful. A challenge for all the participants was finding time to read the workbook chapters and participate in the guided phone calls alongside parenting, work and life in general. Some of the parents found that the language in the workbook was hard to understand in some places and the guided phone calls were used to help make sense of parts of the workbook.
This research has helped us to understand more about the Nurtured Heart Approach workbook. In the future, more research is needed to support the findings, as this study had a small sample size. Future research would be helpful to explore whether the Nurtured Heart Approach workbook improves the relationship between parents and their children with behavioural problems.
REC name
East Midlands - Nottingham 1 Research Ethics Committee
REC reference
22/EM/0065
Date of REC Opinion
14 Mar 2022
REC opinion
Favourable Opinion