Implementing child mental health interventions in service settings: lessons from three pragmatic randomised controlled trials in Wales
| Pages | 17-27 |
| Date | 12 April 2008 |
| Published date | 12 April 2008 |
| DOI | https://doi.org/10.1108/17466660200800009 |
| Author | Judy Hutchings,Tracey Bywater,Catrin Eames,Pam Martin |
| Subject Matter | Education,Health & social care,Sociology |
17
Journal of Children’s Services
Volume 3 Issue 2 September 2008
© Pavilion Journals (Brighton) Ltd
Abstract
This article reports on three pragmatic randomised controlled trials (RCTs) to help children at risk of
conduct disorder (CD): two involved the Incredible Years (IY) BASIC parent programme and the other
concerned the IY teacher programme. All three interventions took place in regular service settings in
North- and Mid-Wales. In all three studies, staff from the provider agency delivered the programme and
participated in RCT evaluations in which participants were randomly allocated to intervention or waiting-
list control conditions. After a brief introduction to research into the prevention or treatment of CD, and
the issues to be considered by services in selecting and delivering interventions, this article summarises
the structure, content and evidence base of the IY programmes. The three Welsh studies are briefly
described before exploring what factors contributed to service participation in the trials and the benefits
and lessons learned in undertaking them.
Key words
fidelity tools; intervention; collaborative planning; child behaviour; evidence-based services
1Professor,
School of
Psychology,
Bangor University
and North West
Wales NHS Trust
2Research
psychologist,
Bangor University
3School of
Psychology,
Bangor University
Introduction
Anti-social behaviour and conduct disorder (CD), its
clinical manifestation, is a large and growing problem
that absorbs an increasing proportion of state funds
on both sides of the Atlantic. These costs fall on a
variety of agencies, including health, education, social
care and the criminal justice system. As a result, the
issue is of growing political interest, prompting
recognition in the UK of the need to ensure that
publicly-funded services are being delivered
effectively and to start to specify the use of evidence-
based programmes (Parent Action Plan, 2005; Social
Exclusion Action Plan, 2006). This is manifested in
recent Government initiatives such as the Pathfinder
Early Intervention and Family Intervention Projects in
England, and Flying Start in Wales1.
One issue facing Government and service providers
is to determine what qualifies as effective. The vast
majority of high-quality randomised controlled trials
(RCTs) of interventions to prevent or reduce violence
and anti-social behaviour have been conducted in the
US (Mihalic et al, 2002). Even systematic reviews
undertaken in the UK find little, if any, sound UK
evidence (Woolfenden, Williams & Peat, 2001; Barlow &
Parsons, 2003; NICE, 2006). The difference in research
traditions between the US and the UK may result from
different political funding structures and priorities. In
Implementing child mental
health interventions in service
settings: lessons from three
pragmatic randomised
controlled trials in Wales
Judy Hutchings1, Tracey Bywater2, Catrin Eames3and Pam Martin3
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