In the first few weeks of March 2020, those working in family support services felt like they were caught in an impossible bind: how to minimise all personal contact with clients and professionals, while also meeting the growing need for parenting and relationship support.
Meanwhile, parents were coping with more emotional, behavioural and attention difficulties in primary school-aged children – with a greater proportion saying these had become clinically significant. Others reported increased parental conflict, teenagers challenging lockdown rules, and, for many parents, how working from home negatively impacted mental health, and also put a strain on relationships.
Demand for family support increased, while services faced practical problems: lack of access to buildings and resources, unfamiliar software/platforms, and making rapid, real-time changes to delivery methods. What we saw achieved by sites and practitioners delivering Triple P amid a period of such uncertainty was remarkable.
Learning from rapid change
To help practitioners to adapt Triple P interventions while still maintaining programme fidelity, we developed and distributed clinical guidelines. These were offered for each specific Triple P intervention, and also more generally, along with new Covid-19 guides, videos and tips to share with parents.
Practitioner training was offered via video conference, which meant people could continue to upskill even under lockdown restrictions.
Most importantly, we saw the Triple P community come together to share their experiences of expanding remote and online delivery of parenting and family support. Through nationwide webinars, practitioners and managers shared ideas, and lessons learned, with other sites who were experiencing similar issues.
There are five key lessons we’ve learned so far, thanks to contributions from services in Cambridgeshire, Dudley, Essex, Ealing, Gloucestershire, Nottingham, Sheffield, Tavistock Relationships (London) and others.
1. DIGITAL INEQUALITY IS REAL
Many sites have adapted well to digital delivery systems, finding that most clients could access these. But lack of WiFi and insufficient data for some families raised very real concerns about new inequalities exposed by the pandemic. Services have adapted by helping clients to find free WiFi, paying for data, and making the most of phones and services like WhatsApp, and even going back to posting out materials.
2. SCREENS – A MIXED BAG
Some practitioners were initially unsure about building rapport over video calls, but for many parents, sharing and engaging was actually easier from within the comfort of the family home. The issue of how to safeguard vulnerable parents when the practitioner isn’t in the same room still presents some challenges. An unexpected problem was the emergence of “screen fatigue”, which was a good reminder that self-care and having realistic expectations are important principles for practitioners and managers, as well as parents.
3. BENEFITS OF VIRTUAL DELIVERY
Not only were virtual sessions easier for parents to attend, they were easier to set up and “no-shows” decreased. More fathers took part, which helped further reduce parental conflict. Content could be delivered in timeslots that suited parents, and broken into smaller chunks if needed. Sessions catering for specific groups – such as Stepping Stones Triple P support for parents of children with additional needs, or those held in languages other than English – could be created more easily and sensitively, unhampered by geography, making these groups more effective and supportive.
4. ONLINE FILLED GAPS
More regions started offering our self-directed online programmes, whether via a universal public health approach, or via early help, intensive family support services, or to families referred to secondary care services, often as a wait-list intervention. In April, new Covid-19 specific modules were added to both Triple P Online and Teen Triple P Online. Data analysis found that demand for these programmes, for example, across London, Essex and Sheffield, almost tripled from March onwards. Compared with the previous months, pre-intervention screening for these programmes reported higher levels of parental stress and depression, as well as more behavioural and emotional problems in children and teenagers. There was also an increase in the number of parents who were looking for parenting support despite an absence of child behavioural or emotional issues on these measures.
5. MIXED SUPPORT IMPROVED OUTCOMES
Online programmes increased engagement from previously reluctant families. Combining online programmes with personal support often seemed to create more positive outcomes than caseworker support alone, even in intensive family support and edge-of-care settings. It also became easier to reach some vulnerable families.
In summary, no one would have wished for Covid-19, but our sector, like so many others, have worked hard to embrace technology and find the “silver lining”; meeting the needs of families during lockdown 2.0 and beyond will be a little easier because of what we’ve learned.
Triple P UK is responsible for dissemination of the Triple P – Positive Parenting Program® System throughout the UK and Ireland.
- Matt Buttery will be speaking at the CYP Now Early Help conference – Critical support to prevent a lost generation, 23-26 November
