Nurtured Heart Parenting Intervention for Child Behavioural Problems

The Nurtured Heart Parenting Intervention for Children's Behavioural Problems: A Single Case Design

Behavioural problems are prevalent in children, yet the consequences can be significant for the child, family and wider society. Effective intervention is paramount in reducing the impact of childhood behavioural problems. The Nurtured Heart Approach (NHA; Glasser & Easley, 2016) is an atheoretical parenting intervention which aims to reduce childhood behavioural problems. Although used in clinical practice, there is little empirical research on the effectiveness of the NHA. The aims of the study were to examine whether the NHA reduced parent-reported child behavioural problems, reduced negative parenting practices, and increased parental reflective functioning.

The study used a multiple baseline single case design. Parents of children with behavioural problems were recruited from CAMHS waiting lists. The NHA was delivered in a guided self-help format, using the Transforming the Intense Child workbook (Glasser, 2016) and weekly phone calls. Data collection involved psychometric measures of parent-reported child behavioural problems, parenting practices and parental reflecting functioning. Measures were repeated throughout baseline and intervention phases. A follow-up four weeks after the intervention included final measure administration and a change interview. The data were graphed and visually analysed. Supplementary analysis included reliable and clinically significant change, Tau-U and percentage exceeding the median. Framework analysis was used to analyse the change interview.

Study Overview

• Status: Completed
• Conditions: Parent-Child Relations; Child Behavior Problem
• Intervention / Treatment: Behavioral: Transforming the Intense Child Workbook (Glasser, 2016)

• Study Type: Interventional
• Enrollment (Actual): 6
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United Kingdom
  • Lincolnshire
    • Lincoln, Lincolnshire, United Kingdom, LN5 7AT
      • University of Lincoln

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

Participants will be parents/carers of children who have been referred to National Health Service (NHS) children's services for behavioural problems. Participants will be recruited from waiting lists of NHS children's services at the two research sites in the East Midlands.

Inclusion criteria:

• The referred child is aged between three and eleven years old.
• The referred child is on a waiting list for an NHS children's service at the two research sites.
• The referred child's behavioural problems are one of the primary reasons for referral to the NHS service.
• The parent/carer identifies the referred child's behaviour as problematic.

Exclusion Criteria:

• The referred child has a diagnosis of developmental delay or learning disability.
• The family is current receiving active multi-agency involvement (e.g. social care, police or youth offending in addition to NHS services).
• The parent/carer is aged under 18.
• The parent/carer is unable to read or speak English fluently.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention arm; Participants receiving the intervention whilst on a waiting list for treatment as usual	Behavioral: Transforming the Intense Child Workbook (Glasser, 2016); The NHA was delivered in a guided self-help format, using the Transforming the Intense Child workbook (Glasser, 2016) and weekly phone calls.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Parent-reported Child Behavioural Problems	Results state the number of children for whom parents reported an improvement in behaviour using the Brief Problem Monitor (Achenbach et al., 2011).	Measure across the baseline phase (3 weeks), intervention phase (6 weeks) and follow up (one month post intervention)
Idiographic Measure of Parent-perceived Problems	Results state the number of children for whom parents reported an improvement on the ideographic goals set by parents. Measured using the PSYCHLOPS (Ainsworth et al., 2009)	Measured at the beginning of the baseline and follow up (one month post intervention)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Negative Parenting Practices	Parents whose negative parenting practices reduced, measured using the Multidimensional Assessment of Parenting Scale (Parent and Forehand, 2017)	Measure across the baseline phase (3 weeks), intervention phase (6 weeks) and follow up (one month post intervention)
Parental Reflective Functioning	Parents whose parental reflective function improved due to the intervention, measured using the Parental Reflective Functioning Questionnaire (Luyten et al., 2017)	Measure across the baseline phase (3 weeks), intervention phase (6 weeks) and follow up (one month post intervention)
Parental Wellbeing	Number of parents whose wellbeing improved when measured using the SWEMWBS (Tennanet et al., 2007).	Measured at the beginning of the baseline and follow up (one month post intervention)

Collaborators and Investigators

• Sponsor: University of Lincoln
• Investigators: Principal Investigator: Nima Moghaddam, University of Lincoln

Study record dates

Study Major Dates

• Study Start (Actual): June 27, 2022
• Primary Completion (Actual): February 28, 2023
• Study Completion (Actual): September 30, 2023

Study Registration Dates

• First Submitted: December 22, 2023
• First Submitted That Met QC Criteria: December 22, 2023
• First Posted (Actual): January 8, 2024

Study Record Updates

• Last Update Posted (Estimated): August 5, 2024
• Last Update Submitted That Met QC Criteria: February 20, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Keywords: guided self-help; parent training; child behavioural problems; Nurtured Heart Approach; single case design
• Additional Relevant MeSH Terms: Behavioral Symptoms; Problem Behavior
• Other Study ID Numbers: 22004

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No