Emphasis on flexibility 
The trouble with many of these new approaches, however, was the tendency to assume that there was one right way to bring up children. That did not allow for the fact that children are different, parents are different and circumstances are different. The 'one-size-fits-all' approach does not recognise that each child comes into the world with its individual personality. Our goal in parenting, as many people increasingly see it, is to protect and nurture that individual identity as we socialise children to become responsible and co-operative adults. 
 
Family Caring Trust's approach
In developing Parenting Programmes, Family Caring Trust was able to benefit from studying the strengths and weaknesses of previous initiatives and to draw on the experience and research bases of a variety of psychological systems (see below). No one parenting model is espoused by the Trust. Like other forms of leadership, different parenting approaches appear to be appropriate according to individual circumstances, personalities, and child development stages. Parents, for example, might adopt quite a directive and supervisory role when introducing children to new skills or tasks, whereas they might adopt a more democratic and less directive role as their children grow in confidence and skill. 
 
Whose ideas?
Courses developed by the Trust are eclectic, then, not rigidly tied to any one system but drawing on Adlerian psychology (goals of misbehaviour, discipline through natural and logical consequences), Bowen Family Systems (emphasis on changing self, not others, growing in self-differentiation and becoming a more non-anxious presence, also on reinforcing change by withdrawing attention from the more symptomatic elements in the family system and focusing on the more influential elements), Reality Therapy (negotiating and conflict management within the family), Reevaluation Counselling (importance of parents working on their own childhood distresses and internalised oppression, value of tears, of play, and of expression of feelings), and Person-centred Counselling (active listening, expressing needs and feelings in "I" messages). 

The Trust has also drawn on the work of established researchers and writers, including Steve Biddulph, John Bowlby, Dolores Curran, Don Dinkmeyer, Rudolf Dreikurs, Gerard Egan, Eric Ericson, Edwin Friedman, R Forehand, John Gottman, Harvey Jackins, Gary McKay, Jean Piaget, Mary Pipher, Virginia Satir, Ron Taffel, Donald Winnicott, and Patty Wipfler. 

While there is a clear focus on improving communication within a family, there is also emphasis on change - changing the power basis and decision-making balance within the couple relationship and between parents and children. 
 
Developing an Adult Learning Tool 
These ideas are incorporated into a flexible programme which uses established principles of adult learning while emphasising "good enough parenting" that does not tend to create inappropriate guilt. There is a strong underlying emphasis in all the programmes on community development and empowering all individuals within a family to take increasing responsibility for themselves.
 
The programme is then tested extensively throughout Britain and Ireland with action research, using both quantitative and qualitative evaluation. This testing and consequent changing continues for at least two years in distinct phases. In the final phase, feedback from a variety of community organisations is incorporated - these have included the Pre-School Playgroups Association (now renamed the Pre-School Alliance), the Health Visitors Association, Barnardos, the Family Planning Association, the Mediation Network of Northern Ireland, Relate, the Trust for the Study of Adolescence, the Children's Society, Homestart, and mainstream Christian and Islamic faith community leaders with an interest in family concerns. 

Each course is also checked out with an expert on reading age to ensure simplicity and freedom from jargon; and with a philosopher who specialises in teaching children to think and form values: also with a number of psychologists, family therapists and a consultant psychiatrist to ensure that the process is a healthy, positive experience for all participants. 

Anti-discriminatory Policy
The Trust is anxious to be inclusive of all groups, particularly those which experience discrimination or marginalisation in the wider community. To this end, the language used in our materials is always inclusive, our course for couples is open to people in same-sex partnerships, our videos and the illustrations throughout our books include people from different social and ethnic backgrounds, people of colour and people with disabilities. We grant permission to adapt the materials free of charge to people who have visual or hearing challenges. And our materials are also available in many different languages for minority ethnic groups in Britain and Ireland. In the recruitment of staff and volunteers the Trust is an equal opportunities employer.

But What About Evaluation?  
It helps to be clear about what exactly we are judging or evaluating. We are not merely looking at how people's behaviour changed as a result of doing a course. Reduction in noise or conflict, for example, is not necessarily a good thing if it means that tensions are being pushed under the carpet and not dealt with. Similarly, getting a child to 'behave' now is much less important that freeing up a rigid family system to provide for growth and change in the future. Some helpful areas that an evaluator can look at immediately are: 
 
Evaluating the theoretical base
What are the underlying values of the course, and are they based on sound psychological research? Are the courses flexible and inclusive? Do they allow for different styles of parenting? In developing the courses, the Trust relied on major research bases (see 'Whose ideas?' above) which are acknowledged in the introduction to each of the course handbooks. 
 
Adult education methods 
Is there sufficient variety to accommodate quite different learning styles and educational backgrounds? This requirement explains the introduction of Case Studies, Skill Practice, Getting in Touch exercises, small group and dyad discussion, relaxation times, video input, opportunities for personal sharing, and short reading assignments (in simple jargon-free language). 
 
Community development 
Are parents valued and empowered to make their own decisions about parenting, or are they becoming overly dependant on professionals? Is there an opportunity for them to take a leadership role in their own self-help groups, or are they primarily in a "helped" role? Do they experience a lessening of isolation and guilt, and the increasing support of other parents? 
 
Ongoing support 
What provision is being made for follow-up, and how effective is it in reinforcing the new skills and the changes in parent-child interaction? Parents who repeated a course or who followed up one of our courses with another made longer-lasting gains. 
 
Changes in parent-child relationship/interaction 
How can we tell if a course is being effective? How do we measure changes in communication, in attitudes and in the power base within a family? When a mother comes back to the group and talks about how she involved the children in doing household chores, and what happened, or how she sat and listened instead of solving a problem, you know there is change in the interaction. But we also need to be cautious of parents' own self-reports - researchers have noted (including Patterson, Reid and Dishion, 1992) that what parents report about their interactions with their children does not always correspond with their observed behaviour. (For this reason, we have attempted to include teenagers as well as parents in the 'Parenting Teenagers' Programme.) And for the same reason we were happy for the BBC to install secret cameras (with parents' permission) to film parent-child interaction before, during, and after courses. The results were impressive as shown on the BBC1 programme, "Bringing Up Parents." 
Some of the more obvious changes we may want to look for in parents, then, (though these do not include vitally important long-term goals like supporting value-formation) are: 
 
Less exhaustion 
Offering children more choices 
Making fewer threats/ bribes/commands 
Less nagging and scolding 
Using a more assertive tone of voice 
Using more assertive body language(posture, eyes) 
Less isolation as a parent 
Encouraging more autonomy 
Using "I" messages 
Using active listening 
Managing conflict with more openness, justice and respect 
Showing openness to children's agenda 
Less inappropriate guilt 
More time spent listening 
Encouraging more responsibility for household tasks 
Withdrawing attention from unacceptable behaviour 
Paying positive attention when it is not demanded (e.g. at play) 
Changes in parental attitudes* 
Changes in children to be measured include responding to choices, 
     less unacceptable behaviour, more co-operation, involvement in
     household tasks, more or less family interaction, more autonomy...

Outside Evaluations
Prior to publication, all the Family Caring Trust courses were developed using action research, each over a two-year period, with continual modifications in the light of feedback from groups drawn from a variety of social and educational backgrounds in Britain and Ireland. Subsequent to publication, the 'Noughts to Sixes' course and the 'Fives to Fifteens' course were tested extensively throughout Britain and Ireland, and evaluated by a number of NHS Trusts and other bodies, for example by Herts Social Services, by Combined Health Care & Chesterton SRB Project (Anne Hobbs, 1999), by East Berkshire NHS (in co-operation with the Dept. of Community Studies at the University of Reading, Petford, 1997), by Lothian Primary Care NHS Trust (Byatt-Smith, McCombie & Barnes, 2000) by Barnardos South Lakeland Family Support Service (in co-operation with the University of Leeds School of Continuing Education, Frost & Ryden July 2001), and by the Down-Lisburn NHS Trust (in cooperation with the Dept of Psychology at the University of Ulster, Long, 2001).

All evaluations to date have been positive about the user-friendliness of the courses and the beneficial effects on the family life of participants. The Trust for the Study of Adolescence, in evaluating the use of Family Caring Trust's Parenting Teenagers' course by YMCA (Oct.2000) had this to say: "These materials were generally rated very highly and were particularly valued by people who had not run courses before, as the materials were structured and clear to follow. This is an important finding, as many materials currently being developed focus on other issues. The finding that the majority of these workers offering courses were positive about the materials they used is in many respects an unexpected and welcome finding."

Criticisms of the video input resulted in the production of revised videos, but updating videos on a continuous basis is a costly and unnecessary expense as a video is peripheral to the group dynamics which are at the heart of the learning process. There is continual updating of the accompanying books.

East Berkshire NHS/University of Reading
An evaluation of the use of the 0-6 and 5-15 Programmes was carried out in co-operation with the Dept of Community Studies at the University of Reading by Chris Petford, Parenting Project Co-ordinator for East Berkshire Community Trust. 33 health visitors and 10 school health sisters co-operated with the action research project involving 13 courses run within the project timeframe. The main findings were that the courses were effective in meeting parents' expectations and needs. Parents liked the fact that the courses were part of a universal service and thus not stigmatising. The referral through health visitors and school health sisters added to this acceptance of the 'normal.' Issues around time and creche facilities did cause problems, but both health visitors and school health sisters found that the courses provided an effective and valuable tool to help them in their health promotion role.

Down-Lisburn NHS Trust/University of Ulster
The results of the standardised tests used by the Dept of Psychology at the University of Ulster show a significant decrease in both clinical anxiety and depression in parents attending the 5-15 course. There was also an increase in coping strategies, parents shouted less, and they were calmer and had more energy by the end of a course. Further testing 3 and 9 months later confirmed that these changes were internalised by parents. One negative result, however, was that there was no significant change in how parents saw themselves or in their enjoyment of parenting. This is not surprising because, unlike the 0-6 and 'Parenting Teenagers' courses, there had been little emphasis in the 5-15s course on parents taking care of themselves. That emphasis on parents' own needs is now included in the revised Handbook, and the Planning section at the end of each session also now focuses on adults as well as on children.

University of Leeds/Barnardo's South Lakeland Family Support Service
The University of Leeds School of Continuing Education conducted an independent evaluation of the Barnardo's South Lakeland Family Support Service (which uses the Family Caring Trust courses) in 2001. The before and after surveys revealed a marked increase in parental confidence after completing a course, and this was also supported by qualitative responses. Parents reported improvement in their parenting and a reduction in stress. A strong recommendation was to make the provision of parenting support much more widespread and cost effective by providing training and support to new volunteers.

Validation
In January 2006 a new validation of the Family Caring Trust ‘Noughts to Sixes Parenting Programme’ was begun by two Chartered Child Psychologists, Dr Ion Wyness (West Lothian Primary Care Trust) & Dr Elise Kearney (NHS Lothian), beginning with questionnaires administered six weeks before and then immediately before a course (to rule out the possibility of the changes happening before the course began), and again at the end of the course and three months after the courses finished. The three short questionnaires were the Child Behaviour Checklist for ages 18 months to 5 years; The Parent Stress Index; and HAD – Hospital Anxiety & Depression Score.

Eight 6-week courses were run by trained facilitators between March and November 2006 – 80% Mums (4% Ethnic Minority) and 20% Dads. The last follow-up questionnaires were administered in Feb. ‘07, with analysis then done by Dr Wyness and Dr Kearney.

The final draft report was submitted to the Childcare Health & Development Journal in January 2008. The report states that “the FCT ‘Pram to Primary School’ parenting programme significantly reduced parenting stress and child behavioural difficulties. These positive effects were shown to have been maintained at three-month follow-up, and child behaviour problems continued to decrease. These results have important implications for practice. They demonstrate that Health Visitors can have a significant impact on parenting practices and improving children’s behaviour in the pre-school years. This is extremely important given the rising levels of children’s behavioural problems. The ‘0-6’ programme is a short intervention, which is relatively inexpensive to purchase and implement. With time and resource at a premium in services, this is an encouraging outcome for those working with parents in primary care.”

Caution naturally needs to be exercised in applying these results to the general population, and it would also be interesting to continue testing at six months and a year after completion of the courses, but it should be borne in mind that this course has already been popular for well over a decade throughout Britain and Ireland with parents from all socio-economic groups, and it is obvious from the research findings detailed above that the results of other evaluations confirm these findings.

Conclusion
The report continues, “The current research is very promising in that it suggests that the 0-6 programme is a cost effective and easily implemented programme for primary care workers, with the potential to be an effective intervention for increasing parental well-being and decreasing children’s behavioural problems in the area of primary care health promotion. It has also demonstrated an ability to significantly reduce parenting stress for parents experiencing stress within the clinical range.

Frances Byatt-Smyth, Parenting organiser with NHS Lothian co-ordinated the 2-year validation process. She comments “What was surprising was that nearly 50% of the parents in the study had parental stress even though the behaviours of their children would be classified as mild behavioural difficulties. The research confirms it is a great programme for prevention and reduction of mild child behavioural difficulties and parental stress. It is cost effective and shows that Health Visitors can have a significant impact on parenting practice and improved children's behaviour in the pre-school years.”

EVALUATION BY THE NATIONAL ACADEMY OF PARENTING PRACTITIONERS
The Pram to Primary Programme (also known as the ‘Noughts to Sixes’ Programme) and the Fives to Fifteens’ Programme have been graded by the researchers at the National Academy of Parenting Practitioners under four distinct categories:
1.) Evidence-based.
In the light of independent research both have been given a ‘2’ rating for their evidence base.  This is impressive by current UK standards – it is only given where positive change has been demonstrated through scientifically validated assessment methods collected at multiple points.  The only programmes that score higher tend to be the bigger (American or university-backed) bodies with the vast resources (usually hundreds of thousands of pounds) required to commission full randomised controlled research studies. 
2.) Training
‘Pram to Primary’ was awarded a ‘3’ rating for training and supervision, i.e., it has met almost all criteria for best practice.  Given our ethos of only working through other bodies, this was the most we could have expected.  All of our programmes have the same level of training and supervision to level 3 OCN.
3.) Appropriate Targets.  &  4.) Content and Approach.
In these two categories The Pram to Primary Programme and the ‘Fives to Fifteens’ Programme met all ‘best practice’ criteria and have been graded ‘4’ – the highest level possible. 

Doing Your Own Evaluation
It is very important to do your own evaluation of a course – to ask parents to take a few moments to fill in a questionnaire/enrolment form when they apply for a course, and again at the end of the course. The pre-course form can give you a better idea of their needs (and help to exclude parents who need to be referred on to other services for more intensive work). It can also build their expectations and help them get in touch with specific areas that they would like to work on. The end-of-course questionnaire helps parents to look back at the end of a course and it provides them with a measure of their success. This can validate their efforts and even reinforce their learning, and it gives you concrete evidence of change. If you go to ‘Questionnaires’ on the menu of this website, you can download excellent short tick-box questionnaires that have been adapted with permission from those used by Barnardos South Lakeland. There is no suggestion that you have to use the questionnaires from our website, but if you do design your own, please make sure that there is a consistency between the pre-course form and the end-of-course form, so that you are measuring the same things. Some health professionals also use the Parent Health Questionnaire (PHQ-9) or the Eyberg Child Behaviour Inventory. The Parenting Academy at King’s College hopes eventually to produce (in cooperation with programme developers like ourselves) some scientifically validated questionnaires for before and after.

A Practical Example of‘Before and After’
The feedback below demonstrates how useful all this can be. It is a good example of how before and after awareness-building can make your work more effective. In this case, the practitioners are describing their experience of running the ‘Parenting Teenagers’ course, but the process applies equally to any of our courses:

“At the first session of our Parenting Teenagers course my friend and I asked parents to write (anonymously) their concerns about their children. We then wrote the concerns as a huge(!) list on the flipchart. Then at the end of the course we had an extra session during which we showed the parents their list – and also gave them a list of all the skills (about 16!) which they had been learning on the course. We went through the list of problems, asking the parents to explain how they might tackle these issues by using skills from the list. We tackled some as a whole group but also gave the ‘grittier’ problems to small groups. The feedback from this session was particularly good – parents felt it had pulled everything together and refreshed their memories with a quick ‘check-list’ to which they could refer. They also felt encouraged that they now had the means to tackle what had seemed quite insurmountable problems at the course outset. So, many thanks! My friend and I love delivering the Parenting Teenagers course and are now offering it to all parents of Year 7 pupils as part of their welcome to Pilton Community College (where we are both based).”
Shirley Paterson & Sue Wearne, Pilton, Barnstaple.