Boingboing blogs from… the Resilience Forum!

How can young parents be supported to become more resilient and competent? – Jacqueline Barnes, Brighton Resilience Forum – Tuesday 21 February 2017

by Josh Cameron, Boingboinger

Approximately 25 people – who were a mixed audience of: various health, teaching/youth, social work and fostering practitioners; academics; parents; and Boingboing workers/volunteers – came to hear Professor Jacqueline Barnes speak at our second February Resilience Forum. She is a developmental psychologist and director of the Institute for the Study of Children, Families and Social Issues at Birkbeck, University of London. Jacqueline spoke about research into how young parents can be helped to be more resilient. She explained that key research in this field very much fits the ecological approach to resilience that we in Boingboing follow. Good parenting can help children avoid negative outcomes such as developmental delay, poor school achievement, attachment and mental health problems, behavioural issues and involvement with the criminal justice system.

Family Nurse Partnership (FNP) programmes in the USA, UK and Netherlands have aimed to help children at risk of adversities by providing support to young mothers and their partners. These approaches are ecological in that they pay attention to the family around the child and don’t only focus on the child’s behaviour and health. They also pay attention to developing community networks, and social and economic support for young parents.

The FNP programme was first developed by David Olds in the 1970s in the USA. He and colleagues thought waiting until a vulnerable child was three years old before offering them support was too late. So his FNP programme – based on ecological theory, attachment theory and self-efficacy – started to work with young mothers when they were pregnant. This involved individual support that aimed to improve parents’ self-sufficiency in a holistic manner – considering their environment, roles, friendships and relationships. Three Randomised Control Trials (RCTs – seen by many as the gold standard of research) in different states all showed very positive outcomes for children deemed to be at risk in terms of improved mothers’ health, greater father involvement, improvement in school readiness and reduced child injuries. Impressively, the biggest positive impacts occurred for the most vulnerable.

Inspired by such outcomes a version of the FNP was introduced in the UK in 2007. Initial evaluation and implementation studies suggested that it was promising in terms of building on personal strengths and helping young mothers focus on goals. However a RCT showed very limited positive outcomes. By contrast a similar RCT in the Netherlands around the same time did show significant positive outcomes. Jacqueline suggested that this might have been because the Dutch study was more targeted at young mothers facing multiple challenges. This certainly would be in line with Michael Rutter’s point that what supports resilience in vulnerable people may not necessarily be beneficial for those facing less or no adversity (he gives the example of adoption).

In 2009 Jacqueline led research into a group version of the FNP (gFNP). This followed the holistic principles of the FNP but it was delivered to groups of young mothers, partners and babies. Qualitative research showed that participants and the family nurse practitioners valued the opportunity for peer support, learning and interaction in a safe space. However, again, the linked RCT showed no significant differences in the primary outcomes compared to a control group offering the normal pre and post-natal support.

Jacqueline suggested that this may have been because the primary outcomes had been indicated by the research funders’ agenda, with a focus on issues of harm. A broader range of outcomes linked to peer support, empowering learning and social relationships, as suggested by the qualitative findings, may have produced different results. Indeed this is hinted at by the one significant positive finding that a greater proportion of people who attended these groups continued to breastfeed their babies. Another possibility may be that, despite some high profile criticisms, the ‘usual support’ provided in the UK is of a high standard (for example compared to the more limited support routinely provided in the USA).

There followed a lively discussion in pairs and then in the whole Forum related to issues of the benefits of breastfeeding and play with babies, the challenges of recruitment to research projects, and criticisms of academic journals for a tendency to prefer to publish studies with positive findings when – as we found out today – so much can be learnt from considering research which does not produce significant findings.