Providing Strategies for Caregivers

According to leaders in child development, the first years of life matter because early experiences affect the architecture of the maturing brain. To create a strong foundation for healthy development, children need nurturing and predictable relationships with caregivers.

The Incredible Years, an evidence-based program, is helping parents around the world cope with the pressures of raising children. Developed by Carolyn Webster-Stratton, a clinical psychologist and nurse-practitioner in Washington, it provides a range of strategies for caregivers to help children regulate their emotions and improve their social skills.

The curriculum for parents focuses on play and positive involvement, praise and rewards, effective limit-setting and non-violent discipline. Participants attend two-hour sessions weekly for 12 to 16 weeks.

The preschool and school-aged Incredible Years Parent Training Programs are designed for families with children ages 3 to 12 who are exhibiting challenging behaviors and are at-risk for conduct problems. The training can also be used as a universal prevention program.

The short-term goal is to help kids get along better with peers and adults and do better academically. Long-term goals include preventing delinquency, drug abuse and violence.

By learning the most effective parenting approaches, I have reduced my child’s behavioral problems before it got out of control,” writes one father on the Incredible Years website. We have noticed significant changes in our child, both at home and… (in) his school.”

By learning the most effective parenting approaches, I have reduced my child’s behavioral problems before it got out of control.

Father in the Incredible Years program

Working to Ensure Fidelity

In North Carolina, a public-private collaborative called the Alliance for Evidence-Based Family Strengthening Programs is working to help local agencies bring The Incredible Years to more communities.

Three Alliance members — the N.C. Department of Social Services, the N.C. Division of Public Health and the N.C. Partnership for Children (“Smart Start”) — are supporting direct services. The Duke Endowment, along with additional money from DSS, is funding state-level infrastructure, or scaffolding,” which will help local agencies implement the Incredible Years program successfully.

That support includes hiring staff at Prevent Child Abuse North Carolina to help agencies with readiness assessments, planning, pre-service and in-service training, coaching, and technical help around evaluation and quality assurance.

In 2007, only one organization offered Incredible Years in North Carolina. By 2010, that number had expanded to 26 sites offering help to as many as 750 families. But instead of rushing to launch a program, agency leaders are taking time on the front end to determine if Incredible Years is the right fit. They’re using ongoing training and data collection to make sure they’re staying true to the fundamental tenets of the program.

Experts say the draw of evidence-based practices is compelling, but implementing them successfully in new locations requires the right components to assure appropriate service delivery and results. Without such scaffolding in place, it’s harder for evidence-based programs to work the way they were designed to work.

Nationally, more people are moving toward evidence-based program — but when it comes to funding infrastructure, there’s a huge lag,” says Sarah Currier, director of evidence-based programs at Prevent Child Abuse North Carolina. Here, through this public-private partnership, people have put a stake in the ground and said, We are going to do this right.’”

Some members of the Alliance are saying I can fund that piece’ and someone else is saying I can fund this piece,’ and they’re braiding it together to make it work,” Currier says. That kind of public-private partnership — where people are literally negotiating with each other about how they’re going to jointly accomplish goals — is unique.”

For its part, The Duke Endowment committed $9 million in 2008 – 2010 to help expand the use of The Incredible Years and several other proven, evidence-based interventions in North Carolina and South Carolina.

Through its Rural Church program area, the Endowment supported an Incredible Years site at Mount Pleasant United Methodist Church in Guilford County.

Finding the Right Tools

In Burlington, N.C., Renee Brown heard about the program through her grandchildren’s school. Now more than halfway through the 14-week training, she’s learning how to set clear limits at home.

As a result, her grandchildren are calmer. They’re learning to play together and express their feelings. They look forward to weekend rewards — such as going to the park or taking a family bike ride — to celebrate a good week.

My household has gone from constant shouting and anger, to more peaceful and loving,” Brown says. I really feel it will be one of the best things that ever happened in our lives.”

Here, through this public-private partnership, people have put a stake in the ground and said, We are going to do this right.’” 

Sarah Currier, Director of Evidence-Based Programs at Prevent Child Abuse North Carolina

The Incredible Years Results

The Duke Endowment defines evidence-based interventions as programs or approaches that have been evaluated with at least two randomized controlled trials and have been successfully replicated in real world” settings.

Six randomized control group evaluations and four independent replications by other researchers have shown that The Incredible Years is effective. According to the research the program can significantly:

  • Reduce aggressive and disruptive behavior and increase pro-social” behavior
  • Reduce conduct problems in children’s interactions with parents
  • Decrease the use of criticism, harsh discipline and negative commands
  • Increase effective limit-setting
  • Reduce parental depression and increase self-confidence
  • Increase positive family communication and problem-solving
  • Increase parental involvement with teachers and in the classroom

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