Young People in Focus

SECTION 1

1.2 Comparing the Five Models of Intervention

This section compares and contrasts the five models of intervention included in the IYPP Project which the Policy Research Bureau have summarised as follows:

1. Parallel Group Work

This intervention involves a teenagers group – ‘Avoiding Conflict with Adults’ - running at the same time as the parents group - ‘Living with Teenagers’ - and covering the same core elements. The two groups cover topics including improving communication, boundary setting and discipline methods, problem solving, conflict resolution and being a parent/teenager. The groups interact using a mixture of methods including discussion, role-play and video. Both parents and young people attend seven, 2-hour sessions. They are designed to run in parallel, or slightly staggered with parenting groups beginning first.

2. Family Group Conferencing (FGC)

Originating in New Zealand, this intervention brings together the family network in a meeting to decide on future action to support a young person where there are welfare, accommodation, child protection or youth justice issues which require resolution. The conference can include family, friends and other significant people in the life of the young person and/or the family as a whole, including professionals.  Where the FGC has been successful, it concludes when a plan has been developed and agreed. This particular project sought to expand the use of the FGC service beyond the parameters of Social Services to test its effectiveness in Education and Youth Justice.

3. Family Therapy

Family Therapy involves practitioners working with families either in their home or in an office setting. The aim of the family therapy intervention is to strengthen positive communication and relationship patterns between family members, and between family members and outside influences such as peers, school and the neighbourhood.  Issues identified and unhelpful patterns of behaviour become the subject of a problem solving approach to stimulate change. The intervention is delivered by paired family therapists. Families are offered 6 to 8 one-hour sessions. The objectives of the family therapy intervention include exploring with the family appropriate and effective parental discipline strategies, strengthening the family member’s capacity to communicate with each other and supporting family empowerment and capacity to direct change.  Factors such as family history, lifecycle events and triggers to offending are explored.

4. Individual parents and individual young people in parallel programmes

The emphasis of this programme is to undertake individual work with teenagers whilst covering core elements in tandem with their parents’ programme. The parent and young person are each assigned a different project worker but cover the same themes and issues during their individual sessions, with the parenting worker and young person’s worker liaising in between. Families are offered a 6 to 7 week programme. A mid-point and final review can be held involving workers, parent/s and young person to discuss progress and consolidate their achievements.

5. Family Skills Training for Parents and Young People

This programme has been developed in the USA and involves the whole family attending different group skills programmes and family sessions to practice skills learnt. The broad aim of the service is to reduce young people’s involvement in crime and prevent re-offending by providing integrated guidance and skills-based structured programmes for parents and young people. Families are offered a 12-week programme.  Parents and their children meet at the beginning of each session and then they spend time in their own groups, coming together for the final hour of the session. Parents’ sessions include behaviour management, communication skills and boundary setting. For young people the sessions include social skills training, communication, problem-solving and coping skills. The family sessions focus on increasing the co-operation of family members by problem-solving and communication skills training.

1.2.1 General overview

In some respects the models were very different, although they all involved the inclusion of young people in work with parents. Two sites worked with the young people in parallel with the parent(s) and three with the young person and parent(s) together. Two of the models were in essence process interventions, Family Group Conferences (FGC) and Family Therapy, whereas the others involved the delivery of programmes, Parallel Groups, Parallel Individual and Family Skills Training³. Two of the models were implemented within a Youth Offending Team (YOT), two within a local authority service agency and one within the voluntary sector.

1.2.2 Development phase

All of the project delivery sites involved with the IYPP Project were already offering work with parents and the IYPP Project was a development of that existing work. Even though this was the case, each delivery site had a development phase, which varied in length from three to six months, but all the delivery sites felt that they would have benefited from a longer development phase. One of the issues impacting upon this was that of recruitment. Anyone wishing to develop their service in a similar way would need to allow sufficient time for recruitment and development.

The Policy Research Bureau learnt from interviews with a project worker from each site that:

The majority of the project workers felt quite ‘rushed’ during the initial set up stages of the programme. Staff reported that they had to settle into their roles quite quickly and in an ideal world, if timescales had not been so tight, they would have liked more preparation time to plan and follow ideas through. Staff also emphasised that project set up and delivery could have been improved had they not had to focus on the two simultaneously, but rather focus on set up and then turn their attention to receiving referrals and providing a service. Only one intervention was fully operational before support from TSA began. On a programme delivery front, some project workers also felt that families needed longer to engage with the programme, suggesting that the timescale was ‘too rigid’.  Where follow-up strategies were not in place, workers suggested that projects make sure they prepare other resources to refer parents and young people onto after they had finished.

1.2.3 Referrals

The IYPP as a whole aimed to work with:

Parents and their children or young people (10–17 years), where parents have been assessed, or have identified themselves as requiring parenting support and the young people are involved in offending, anti-social behaviour or truancy.

The Policy Research Bureau found from their interviews with a project worker from each site that:

Each project had defined its aims and in the main these were similar across the five projects. It was evident that the referral process for each of the programmes was based on the young person’s needs or behaviour, although the programme was open to families. It would appear that the criteria for engagement with the IYPP Project were broad and on occasion rather vague. However; the main criterion for referral was virtually the same across all the projects and designed to cater for referrals aged 10 to 17 years. All the referrals were voluntary and tended to come from a range of statutory agencies (e.g. YOT, education, health, social services, etc.) most notably social services. It is worthwhile noting that nearly one in four young people were self-referred.

The IYPP Project proposal stated that ‘each of the five service delivery sites will be expected to deliver services to 24 families during the [IYPP Project] service delivery phase’.  It was evident that reaching this desired number was problematic for most of the projects:

Its been quite a challenge to keep families coming and engaged... it just involves such a commitment from the parent and young people, and the parent has to be committed to get the young person along, let alone bring themselves  (Frank)

It is worthwhile noting that project staff stated that they did not feel the need to change the referral criteria throughout the course of the evaluation period.  However; once projects had established themselves all but one found it necessary to make changes to their referral process.  The changes came about for a variety of reasons.  Firstly, in the early stages of operation when referrals were low, projects attempted to publicise their service provision more widely.  This resulted in one project in particular receiving more referrals than it could provide for. 

Another reason for changing the referral process was to ensure that the families who were referred were ‘appropriate’ to the specific projects. It was highlighted that initially projects did not undertake their own formal assessment to judge suitability of referral to the programme. Instead they would rely on the referring agency to undertake its formal assessment (e.g. ASSET used by the YOT). This might then be followed up by the project staff with an informal interview with the family. However; this method of working proved to be problematic because in some instances projects received referrals that did not entirely fall into the target population:

We were getting referrals that really weren’t appropriate for the programme.  We’d open a big can of worms and then it’d be like “what are we going to do with this?”  Sometimes the family clearly needed more support than we could offer on a parenting course... our role was just getting messy.  (Sunita)

According to some project staff, agencies making referrals to each of the five projects were not always aware of the project in terms of its target population, mode and medium of delivery, and content of intervention in the early stages of the operational phase. This resulted in either a lack of referrals or inappropriate referrals being made to the individual projects. In order to address such difficulties many projects embarked upon publicising their specific projects to potential referrers by way of publicity material (e.g. leaflets) or arranging events at which they could discuss the intervention with other agencies.    

1.2.4 Staffing and staff training

The minimum number of staff to implement the delivery varied from one in the case of Family Group Conferences (FGCs), two for Individual parallel work, Family Therapy and Parallel Groups and three in the case of Family Skills Training (FST).  

An issue to consider in the case of Family Therapy (FT), Family Group Conferences (FGCs) and Family Skills Training ( FST) is that these models require training in the methodology and the model can only be implemented and delivered by trained staff. For Parallel Groups (PG) and Individual Parallel work (IPW) the training element could involve training in a commercially purchased programme if this were the programme of choice. It is, however, perfectly plausible for a delivery site to develop their own programmes for these models. Inexperienced staff would benefit from facilitation skills training and in the case of Parallel Groups in co-facilitation and group work training. In some cases site delivery project staff delivered training to potential referrers, both internal and external to their own service, to raise their awareness of the model and thus ensure appropriate referrals

The Policy Research Bureau found that:

Staffing for one of the projects was problematic in the early phase of delivery. The project was faced with having to operate its intervention with only one of two anticipated staff members although it was not clear whether this was a funding issue or due to organisational factors such as references or contracts. Some projects also experienced high staff turnover - those who were responsible for co-ordinating the initial proposal moved on by the time the projects were being implemented.  This created a temporary void in knowledge about the rationale for the project, and resulted in inadequate handover instructions, particularly in relation to project design and set up.

However; in the main, staff reported coming to their posts having already been fully trained and equipped for their roles. Many stated that they did not receive further training as this was not necessary given that this was a familiar area of work. Only one project reported that it had to provide specific training on the intervention. This is because it was based on a U.S. model. In one instance however; the project worker felt that she was “learning on my own” as there had been ‘no time’ for official training from the outset.

Projects seemed to be able to cope well with the organisational aspects of their programmes, with only a small number of projects coming across difficulties in cases where they lacked support. The project workers we spoke to were responsible for managing the programme as well as working with the parents and young people, and some spoke of the challenge in balancing the two:

It’s difficult sometimes to balance the needs of the project and the needs of the families, but I think that’s a difficulty that project managers who are practitioners face wherever you go. (Sheila)

Where project workers felt that they did not have a good administrative system in place, this was seen to effect communication between staff. As one project worker advised:

don’t underestimate the time admin takes, ensure adequate admin support. (Neal)

1.2.5 Venues and programme resources

The issue of finding suitable venues was highlighted in several cases. In the Family Group Conference (FGC), Family Skills Training (FST) and Parallel Groups (PG) models, venues were needed to accommodate groups of people, which meant accessing suitable venues in the community. In the case of Family Skills Training (FST) this issue was compounded by the fact that there were two separate group sessions and joint sessions. Therefore a venue was needed that had at least one room large enough to accommodate both groups together in the family sessions. The delivery site implementing Family Therapy (FT) and Individual Parallel Work (IPW) delivered the model in clients’ homes. Individual Parallel Work (IPW), however, accessed alternative venues in some cases, as some of the young people felt more comfortable working outside of the home environment.

The Policy Research Bureau found that:

In terms of the medium of delivery, although a number of ‘off the shelf’ programmes for running such interventions exist, some projects reported difficulties in finding an existing model that fully met the needs of the parents and young people with whom they were working:

[We needed to] make it [the intervention] meaningful in our context because it’s a universal programme and we have a very much targeted client group.  And so that was one of the challenges was how we fit with our target group. (Frank)

This resulted in a ‘mix and match’ approach in which project workers often took elements of existing programmes and supplemented or modified the material to suit their clients’ needs. Furthermore a number of project staff stated how they needed to make changes to the duration of the intervention. Originally some interventions were planned to take place over 6 to 7 weeks, with one session a week.  However; this was seen to be unrealistic as there was too much material to cover during this time period:

It can be too short for the young people…because they’re telling us that it’s a shame that it’s ending, and I think we can also recognise that by the end of seven weeks that there is actually more work that can be done. (Louise)

1.2.6 Supervision of staff

Another key theme for all sites was that of staff supervision.  This was considered by the project delivery site staff to be so essential to the effective delivery of each model of intervention and to ensuring the delivery of effective services for clients, that a workshop was organised by TSA at one of the regular multi-site meetings to address the issue.  See Session 7 Staff Supervision in Section 4 Lessons Learned from Practice below.

All of the delivery sites had policies and procedures in place regarding staff supervision or line management. In most cases staff supervision was adapted to include new elements, such as clinical supervision, peer supervision, debriefing and consultation. In the case of FT, the therapist must receive some supervision from a trained Family Therapy (FT) Supervisor.

1.2.7 Time scales

The timescales for each model varied from seven weeks to six months. In particular, Family Group Conferences (FGCs) and Family Therapy (FT) were longer interventions. Both of these models of interventions are processes, rather than programmes (see footnote 3 for definitions) and so the length of the interventions was client led, rather than prescriptive. For Family Group Conferences (FGCs) the length of the intervention varied according to the review process. Typically, there is a review approximately three months after the Family Group Meeting, but further reviews may be undertaken, according to the individual need of the family. For Family Therapy (FT), the length of the process is determined by the individual need of the family. In the other three models, the time taken was easier to define, as the length of programmes determined this. In all these models, the time for each family was the programme length, plus home visits (1 or 2) to engage families prior to the intervention or to review progress at the end of the intervention. Sometimes, extra home visits were arranged if there were issues that needed addressing, which were unsuitable/inappropriate to address in the group setting or within the programme.

When working within the youth justice system with young people or parents on shorter statutory orders, the length of the intervention needs to be taken into account in planning.  Longer interventions, however, can continue on a voluntary basis once a statutory order is closed.

In the two models that involved parents in groups (Parallel Groups and Family Skills Training), both delivery sites felt that the process worked better if the parents’ sessions began before the young persons’ sessions. In both cases, the parents’ sessions started three weeks before the young persons’ sessions.  Both sites found that this allowed parents to ‘offload’, so that by the time the young people were involved, the parents were more ready to discuss their children and issues in a non-blaming way. In the case of Family Skills Training (FST) this issue was also pertinent when parents and young people were referred who had had no previous involvement with the service. Parents were then invited to three group sessions prior to the introduction of the Family Skills Training (FST) programme.

1.2.8 Management and partnership arrangements

From their interviews with a project worker from each site the Policy Research Bureau observed:

Almost all of the projects were run by single agencies which were the YOT, Social Services or a voluntary agency. One was run by a partnership of the two agencies. In addition, multi-agency Steering Groups were generally in place, but the extent to which these were thought to meet regularly and be active in driving the individual project’s development was variable. 

Across the IYPP Project there were both success stories in partnership working, and some that had proved to be less effective.  In the majority of cases successful partnership was achieved; however; some projects felt that their attempt to create/integrate themselves as part of an interagency team proved rather difficult.  One of the problems related to issues of confidentiality and information sharing within the partner agencies.  Representatives from different agencies were reluctant to share information with each other:

We’ve struggled with issues around confidentiality... you know, get a group of social workers and educational welfare officers together and they don’t always see eye to eye about how a child should be dealt with. (Sheila)

Difficulties around communication were also highlighted as detrimental to partnership working:

“you work very well with one agency, [then] somebody leaves from that agency and the communication has disappeared” (Sheila). 

In one case a number of teams had planned to form a partnership to implement and deliver the intervention but this did not materialise immediately. Consequently one team felt particularly pressurised as it believed that it had to carry the work forward, not least in terms of investment in resources. It wasn’t until much later that the partnership was established.

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