SCIE findings in relation to NIS programmes have been published

The SCIE has published their findings in relation to Models of care and care pathways to support the mental health and wellbeing of looked after children.

The NIS submitted evidence for five interventions; KEEP, TEND, RESuLT, AdOpt & TFCO.

Feedback across all NIS submissions was largely positive and reflected our commitment to both excellence and evidence in practice.

A summary of findings for the various programmes follows. You can also read the full report here.

KEEP 

•  Strong evidence from KEEP to suggest that interventions improved outcomes relating to parental sensitivity and quality of parenting compared to a control group. Two further submissions showed improved outcomes in these areas, but did not have a control group (Nurturing Attachments, TEND).
• KEEP showed improved outcomes for children in relation to a control group such as behaviour, emotional distress and prosocial behaviours.
• Views and experiences of carers were reported to be positive
•  Outcomes data were also provided for the KEEP programme (submission 45) and the pro forma describes improvements in outcomes such as child behaviour and carer stress. The submission also included a link to an evaluation commissioned through the Department for Education Innovation Programme. The evidence for this submission was rated as good (++).
• Baseline and follow-up data were collected from carers receiving KEEP training (submission 45) (n=59) and carers who did not (n=26). Taken together, the analysis of quantitative measures found that carers who completed the KEEP Standard showed significant improvements on the Parenting Scale while SDQs completed by those carers showed significant improvements on the sub-scale scores on their child’s emotional distress and prosocial behaviours compared with the control group.
• Interviews with carers (n=15) pointed to the positive effect the KEEP Standard (submission 45) had on their confidence and well-being as well as their ability to respond to challenging behaviours, which they felt benefited the child in placement and placement stability
• Examples in this cluster (including KEEP and TEND) are broadly aligned with recommendations from NICE guidance (PH28):
• ‘Foster care requires rehabilitative and therapeutic approaches and skills. Carers who feel supported by their social worker and have ready access to support services are better able to use these skills to encourage healthy relationships and provide a more secure base, and so reduce the risk of placement breakdown. These skills should also be reflected in the recruitment of foster carers and residential staff, and in the training and support they receive.’
• Also guideline on Attachment (NG26) recommends training and intervention for foster carers and adoptive parents, including attachment-based training for carers of preschool age children, and training in positive behaviour management and conflict resolution for parents of older children.

TEND 

• One intervention (TEND) showed improved outcomes for child development but did not have a control group.
• TEND also provided positive feedback from carers. There was no data on the views and experiences of children and young people.
• The TEND group based video coaching intervention (submission 48) collected outcomes data using a range of measure indicating that increased parental sensitivity, parental satisfaction and improved child development.
• The submission for TEND group-based video coaching (submission 48) included a link to an article that described feedback from carers and practitioners, with carers describing having been able to use what they learned to positive effect;
• Submission 48 is a group based, video coaching intervention (TEND) for foster-carers of infants and children aged 0-4 years in the pre-adoption period, based on ‘Serve and Return’, a US model. The central focus is on the relationship between carer and child as the vehicle to create healthy change and better outcomes;
• Qualitative feedback from facilitators involved in the TEND programme (submission 48) suggests that they perceived it to have a positive impact on carers, and on their own practice and learning.

Result

• ‘RESuLT received positive feedback from children and young people and staff in the residential homes’.
• ‘It seems possible that the young people’s social behaviour in the Intervention Homes showed more stability or improvement than for the young people in the Comparison Homes’.
• ‘Participants who attended the RESuLT training were very positive about all the elements of the course, such as cross-sectional participants, good facilitators, and the link between theory and practice.’

AdOpt

• ‘AdOpt includes an adoptive parent as facilitator, and the programme targets parents and children post legal order, a time when parents have historically received limited support and which is critical for future family cohesion, child development and wellbeing.’
• ‘The overall programme has been designed for adoptive parents to help facilitate parenting techniques and supports that address specific difficulties which adopted children may experience.’
• ‘The AdOpt parenting programme…was reported to have had a positive effect on child outcomes and parenting practices as well as parenting satisfaction.’
• ‘One parent commented about their experiences of being part of a network as appealing and invaluable: “I wanted to feel supported and learn something that would help. Being part of a community and being with people going through the same thing is really helpful.’

TFCO 

• ‘Carers and young people are supported by a team who work together to devise strategies to strengthen specific relational and developmental skills in the foster home, but also work on skills and strengths in other contexts such as education, or with the biological or extended family.’
• For TFCO-A and TFCO-P: ‘an overall improvement in global level of functioning in life… A sizable reduction in the occurrence of 7 out of 9 high risk behaviours’
• TFCO-P: ‘over 90% of children who complete TFCO-P remain in the same placement at 5 year follow-up.’ ‘Children who successfully complete TFCO-P have significant improvements in a wide range of behaviours between entry and exit from their placement’