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The Hexagon: An Exploration Tool
The Hexagon can be used as a planning tool to guide selection and evaluate potential programs and practice for use.
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Core Components
The Incredible Years® Preschool Basic Programme is a universal group-based prevention programme for parents of children ages 3-6 years with indicated behaviour symptoms. This programme is designed to be delivered as a universal programme over a 14-week duration but can also be delivered as a targeted programme for higher risk and treatment population (ADHD or ODD) parents with an increased dosage of 18-22 weeks in duration, each group sessions is 2 hours in length.
The programme is clearly operationalised with a comprehensive structured Leaders Manual and Leader Text in which the content of each session is fully described (session protocols) supported by 9 DVDs or USB, weekly home assignments and handouts and a parent book. The IY teaching methods of the sessions are collaborative and parent goal directed and include strategies such as: (1) video modelling (2) group discussion, problem solving and support (3) role play practice activities within sessions (4) home practice activities with children and (5) reading assignments. Parenting strategies and principles learned are tailored for use by parents to address their goals for themselves and their children.
Delivery of the programme requires two trained leaders and focuses on four core topics (1) Strengthening Children’s Social Skills, Emotional Regulation and School Readiness (2) Using Praise and Incentives to Encourage Cooperative Behaviour (3) Positive Discipline – Rules, Routines and Effective Limit Setting (4) Positive Discipline – Handling misbehaviour.
Fidelity
Incredible Years® provides a fidelity of implementation’ framework. The steps required to effectively replicate the programme and achieve good outcomes include use of (1) standardised intervention materials (2) parent training by accredited group leaders (3) weekly session protocols and participant evaluations (4) ongoing group leader supervision, consultation and support by IY coaches or mentors (5) fidelity monitoring using evidence-based measures and final summative evaluations and (6) agency organisational supports.
Modifiable Components
The programme is a universal programme however modifiable components clearly identified include:
Adjustment to the number of programme sessions depending on the target population whilst ensuring the minimum recommended sessions are achieved.
Pacing discussions and adjusting the number and relevance of vignettes shown tailoring these according to the knowledge, stress or depression levels of the parents and the developmental status of the children.
The Incredible Years® Home Coaching programme may be added as a supplement to the group parent programme for families who need more individualised assistance from leaders who coach parents to practice with their children. Or, for providing the complete programme at home for families who cannot attend parent groups. Additional training is required to deliver Home Coaching.
Support for Organisation / Practice
Incredible Years® Inc. is based in Seattle and offers a series of inter-locking evidence-based programmes targeting parents, teachers and children. The Incredible Years ® Preschool Basic Programme is one of a suite of Incredible Years® parenting and teacher programmes.
Implementation Support
Incredible Years® Inc. offers new sites/agencies considering use of any of the Incredible Years® programmes a consultation to answer questions and to discuss suitability of the selected programme for the intended population and implementation goals and needs. During this consultation, guidance relating to the importance of local data collection (baseline and follow-up), selecting the correct group leaders fit and, understanding the level of commitment and involvement needed to deliver the programme effectively is covered. Ongoing consultation or support is available at a cost of $210 per hour.
Incredible Years® Inc. provides agencies with a range of materials to support organisational readiness. These materials include an Administrator Packet & Brand License guide and agreement, an Agency Readiness Questionnaire, Administrator Implementation Pyramid, Fidelity Checklists, Cost Planning Spreadsheet and Evaluation questionnaires.
Licence Requirements
There is no licensing requirement to deliver the Incredible Years® Programmes. However, a Brand License Agreement is needed for use of Incredible Years® materials on web sites.
Start up Costs
Start-up costs include an upfront one-off purchase of the Preschool Basic Programme priced at $1,755.00 which includes 9 DVDs or USB stick, Leader’s Manual, Incredible Years Troubleshooting Guide for Parents, Collaborating with Parents to Reduce Children Behaviour Problems Book for Therapists, Wally Detective Books for Solving Problems, Parenting Pyramid Poster and Refrigerator Magnet. Additional Leader’s Manuals are available for purchase costing $90.00 plus shipping costs. Home coaching manuals are a supplemental material to the Basic Curriculum and are $85 per set.
The Preschool Basic Programme can also be purchased as a Spanish / English combination pack – cost provided upon request.
Group leader training held over 3 days in Seattle is a requirement costing $690 per person. Alternatively, training can also be hosted at the agency site for a cohort of between 15-25 participants with onsite trainer fees of $1730-2100 per day (plus travel, food and lodging costs). Consultation by phone or in person post training for new groups leaders is recommended and is available at $210 per hour.
Agencies will also need to budget for the cost of the parent book for each group leader and all parents who attend training. Cost for one book is $24.95 (bulk order discounts are available).
Building Staff Competency
Qualifications Required
Incredible Years® recommend that group leaders require a Masters degree as a minimum or a professional diploma in an appropriate field such as therapists and parent educators from psychology, social work, education, nursing and psychiatry and have experience working with parents and children and an educational background in child development.
Training Requirements
Group leader training is a requirement and is a 3-day training course. The 3-day Basic Training covers the Toddler Programme, Preschool Basic Programme, and Early School Age Programme and is delivered by certified/accredited mentors in Seattle or onsite to a cohort of 15-25 participants. An extra day of training is required for the home coaching version of the programme.
Supervision Requirements
Consultation and coaching of leaders is highly recommended by Incredible Years® Inc. although not a requirement. The process includes weekly peer review and self-evaluation of videotapes utilising process checklists, review of videotape feedback by an IY mentor, review of participant weekly evaluations, onsite consultations once or twice per year with an IY trainer and monthly telephone consultations.
Accreditation of group leaders is highly recommended to promote assurance of fidelity of programme delivery, although not a requirement unless the programme is being used as part of a research project. This process involves passing a video review of a session and submission of an application packet that includes weekly parent evaluations and session protocols for two groups. The cost of becoming accredited is $600 which includes detailed video reviews (up to 2) and a supervisory report. If additional video reviews are required, these are available at $105 per hour. Highly competent accredited group leaders may be identified for additional training to become an Incredible Years® Peer Coach in this programme, supporting new group leaders (this process incurs additional costs).
Theory of Change
The Incredible Years® Preschool Basic Programme is guided by cognitive social learning theory, modelling, attachment, development theories and research. Incredible Years® has an explicit parents programme logic model which describes the short-term outcomes as (1) Improved Parenting and Interpersonal Skills (2) Improved Child Behaviour at Home (3) Improved Child Behaviour at School. The programmes longer-term outcomes aim to achieve reduced youth antisocial behaviour.
Preschool: 3 to 5 years - Rating: 5
Research Design & Number of Studies
Two Randomised Controlled Trials, 1 Multi-Centre Controlled Trial and 1 Follow-Up of 2 RCTs were identified, all trials were conducted externally. These trial populations included children 3-6 years of age. The Follow-Up included only severe antisocial and high-risk children.
Outcomes Achieved
Compared to the control group, the following outcomes were observed:
Child Outcomes
Significantly reduced anti-social and hyperactive behaviour and increased self-control - maintained at follow-up in the intervention group. (Hutchings et al 2007; Scott, et al 2001 & 2014).
Significant improvements in child behaviour (Gardner et al 2006 & Scott et al 2001).
Significant improvements in child independent play (Gardner et al 2006).
Parent Outcomes
Significant improvements in parent-reported confidence and skill (Gardner et al 2006 & Scott et al 2014).
Ratio of praise to inappropriate commands increased threefold (Scott et al 2001).
Reduction in stress and depression levels and improvement in parent competencies (Hutchings et al 2007 & Scott et al 2014).
Key Reference
Gardner, F., Burton, J., & Klimes, I. (2006). Randomised controlled trial of a parenting intervention in the voluntary sector for reducing conduct problems: outcomes and mechanisms of change. Journal of Child Psychology and Psychiatry. 47(11). pp. 1123-1132.
Hutchings, J., Bywater, T., Daley, D., Gardner, F., Whitaker, C., Jones, K., Eames, C., & Edwards, R.T., (2007). Parenting intervention in Sure Start services for children at risk of developing conduct disorder: pragmatic randomised controlled trial. British Medical Journal (BMJ).
Scott, S., Spender, Q., Doolan, M., Jacobs, B., & Aspland, H. (2001) Multicentre controlled trial of parenting groups for childhood antisocial behaviour in clinical practice. British Medical Journal (BMJ). 323:194.
Scott, S., Briskman, J., & O’Connor, T. (2014). Early Prevention of Antisocial Personality: Long-Term Follow-Up of Two Randomized Controlled Trials Comparing Indicated and Selective Approaches. American Journal of Psychiatry . 171. pp. 649- 657.
Primary school: 6 to 12 years - Rating: 5
Research Design & Number of Studies
The best evidence for children aged 6-12 years includes two Randomised Controlled Trials (RCT) and 1 Follow-Up of 2 RCTs, all conducted externally to the programme developer. The Follow-Up included only severe antisocial and high-risk children. Data for children aged 6-12 years was not reported separately.
Outcomes Achieved
Compared to the control group, the following outcomes were observed:
Child Outcomes
Significantly reduced anti-social and hyperactive behaviour and increased self-control - maintained at follow-up (Scott, et al. 2001 & 2014).
Significant improvements in child behaviour (Scott, et al. 2001) maintained at 18 month follow-up (Gardner, et al. 2006).
Significant improvements in child independent play (Gardner, et al. 2006).
Parent Outcomes
Significant improvements in parent-reported confidence and skill (Gardner, et al. 2006 & Scott, et al. 2014).
Ratio of praise to inappropriate commands increased threefold. (Scott, et al. 2001).
Reduction in stress and depression levels and improvement in parent competencies. (Scott, et al. 2014).
Key Reference
Gardner, F., Burton, J., & Klimes, I. (2006). Randomised controlled trial of a parenting intervention in the voluntary sector for reducing conduct problems: outcomes and mechanisms of change. Journal of Child Psychology and Psychiatry. 47(11). pp. 1123-1132.
Scott, S., Spender, Q., Doolan, M., Jacobs, B., & Aspland, H. (2001) Multicentre controlled trial of parenting groups for childhood antisocial behaviour in clinical practice. British Medical Journal (BMJ). 323:194.
Scott, S., Briskman, J., & O’Connor, T. (2014). Early Prevention of Antisocial Personality: Long-Term Follow-Up of Two Randomized Controlled Trials Comparing Indicated and Selective Approaches. American Journal of Psychiatry . 171. pp. 649- 657.
Need
Comparable Population
The Incredible Years® Preschool Basic Programme is designed as a universal programme for all parents with children aged 3 – 6 years. Evidence of its effectiveness across Wales and England includes low-income children aged 3-6 years from socially disadvantaged areas including children with severe anti-social behaviour.
Is this comparable to the population you serve? Does your organisation have existing contacts with parents in this population? Are you likely to receive enough referrals for eligible families to populate a recurring programme of Incredible Years® Preschool Basic groups?
Desired Outcome
The Incredible Years® Preschool Basic Programme is a behaviour based preventative programme designed to help parents create a secure attachment with their child, reduce negative parenting interactions and prevent child problem behaviours arising. Are the improvements of children’s development, learning and mental health priority outcomes for your organisation?
Research has identified that the Incredible Years® Preschool Basic Programme has improved parental skills, confidence and parent-child interactions along with significantly reducing child problem behaviours including anti-social and hyperactive behaviours, increasing self-control and improving child independent play skills.
Do you have other existing initiatives that would be supportive of addressing this need and achieving these outcomes? Does helping parents create a secure attachment with their child, reduce negative interactions and prevent child problem behaviours arising align with the key values of your service?
Need Score
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Fit
Values
The Incredible Years® Preschool Basic Programme seeks to develop positive nurturing relationships between parents and their children and to help parents develop effective parenting strategies to prevent and deal with emotional and disruptive behaviours. The programme seeks to help parents develop positive support networks with family and community.
Does promoting a positive nurturing relationship between parents and children align with the key values of your service/organisation? Is helping parents develop a positive support network in your community a priority?
Priorities
The Incredible Years® Preschool Basic Programme has been developed as a prevention strategy for parents of children 3-6 years to promote optimal child development, nurturing of the parent child relationship and to prevent the development of child problem behaviours.
Is working with parents of young children aged 3-6 years in a prevention approach a current priority for your organisation? Is helping parents build confidence, develop positive parent-child interactions and relationships a current priority for your organisation? Is equipping parents with the necessary skills to positively parent a current priority for your organisation? Is helping parents understand their child’s behaviour a priority for your organisation?
Existing Initiatives
Does your service already provide prevention programmes aiming to improve child development and mental health outcomes? Does your area have practitioners trained in delivering the Incredible Years® Preschool Basic Programme? Do you have links with CAMHS, Adult Mental Health Services and Child Protection Services to refer onto if required?
Fit Score
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Capacity
Workforce
To deliver the Incredible Years® Preschool Basic Programme requires 2 trained leaders (training duration is 3 days) for 1 session per week for 18-20 weeks of the group including booster sessions. Additionally, leaders will require time for preparation and phone calls.
Do you have enough qualified practitioners available to commit to undertake training? Do you have enough qualified practitioners available to commit to delivering the full extent of this programme?
Technology Support
To implement the Incredible Years® Preschool Basic programme from a technology perspective requires a TV monitor or computer and DVD equipment.
Do you have access to adequate technology to support practitioners to effectively deliver the technological components of the programme?
Administrative Support
Administrative support is required to recruit parents, receive referrals, collect and report on evaluation data and feedback, print of materials along with co-ordinating and booking of venues, hospitality, transport and childcare.
Do you have enough administrative capacity and systems to meet these administrative needs? Do you have access to facilities to host the parent group? Are you able to provide childcare?
Financial Support
Start-up costs include purchase of the programme at $1750; and training for two practitioners ($690 pp in Seattle; or as part of a 15-25 person cohort on site $1730-2100 per day, plus travel and subsistence). Post training consultation is available at $210 per hour. If group leaders apply to become certified/accredited additional funding is required.
Ongoing costs include purchase of materials ($24.95 per parent) and the provision of a venue, hospitality, transport and childcare to deliver the programme.
Do you have the finances to pay for practitioners to attend the training and additional costs for group leader text, and manuals, consultations, coaching, mentoring and accreditation? Are you able to fund the recurring group delivery costs?
Capacity Score
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