This annual report - Taranaki District Health Board

teens/early twenties, their sense of efficacy as mothers, and the length and quality of theirrelationship with a romantic partner. The Memphis children showed significantly lowerrates of cigarette and alcohol use and depression and anxiety. The Denver mothers in theFNP programme were significantly more likely to wait longer before having a second childand to experience less domestic violence. For the Denver children overall there were nosignificant differences between the intervention and control groups but for the subsampleof children whose mothers had low psychological resources, the FNP children weresignificantly more likely to show improved intellectual and behavioural functioning.A large RCT of FNP is currently underway in the U.K. involving 1,645 women from 18 FNPsites [462]. The first results are expected in 2013. There have been several cost studies ofFNPs in the U.S. suggesting that these programmes return four to six dollars for everydollar invested [466]Family Foundations (3 ): A universal programme for expectant couplesFamily Foundations (FF) is for cohabiting couples expecting their first child. Couples attendfive weekly group sessions in the final three months of pregnancy where they learn how tosupport each other as parents after the baby is born. Six months after the birth the parentsreturn for four more weekly sessions to learn about communicating effectively as parentsand supporting their child’s development. The programme is based on research linkingimproved couple relationships to parental wellbeing and on research linking co-parentingbehaviours to children’s behaviour.The evidence for the effectiveness of Family Foundations comes from one RCT involving169 heterosexual middle class couples who were randomly assigned to receive FF pluschildbirth training or childbirth training only [467]. Assessments before and after theprogrammes indicated the following significant outcomes for the FF group: decreasedmaternal depression and anxiety, increased co-parenting support and increased infantsoothability. At twelve-month follow up (93% of mother and 88% if fathers participated) theFF group demonstrated reduced parental competition, reduced negative communication(mothers only) increased parental warmth and increased child self-soothing [468]. At ThreeYear follow up (85% of original mothers, 77% or original fathers) the FF group showedimproved co-parenting, reduced parental stress, improved child social competence for bothboys and girls, and reduced externalising and internalising behaviours, hyperactivity andaggression in boys only [469].New Beginnings (3 ): For Mothers and infants in prison with parent-childrelationship difficultiesIn this programme mothers, who may be depressed, anxious or have other mental healthissues, attend 12 weekly small group sessions, with their babies, at which they learn howto understand their baby’s needs and respond sensitively to them, and also reflect on theirown childhood and life experiences. The effectiveness of this programme has beendemonstrated in one cluster RCT carried out in seven mother-baby units within U.K.prisons [470]. Three units (88 others and babies) were randomly assigned to receive NewBeginnings while four units (75 mothers and babies) acted as a control group. The mothersin the New Beginnings group showed significant improvements in their sensitivity to theirchild and in their reflective functioning.Pathways Triple P (3 ): For parents on the child protection register or at risk ofmaltreating their childPathways Triple P is a level five intervention within the five-tiered Triple P system of care.There is on-going research and evaluation of various combinations of Triple Pinterventions in diverse settings and populations. A meta-analysis of 55 evaluations ofTriple P found that it had consistent positive effects for parents and children [471].Community-wide implementation of the entire Triple P system has been the subject of aRCT in the U.S. which suggests that it results in significant reductions in childmaltreatment [472]. An Australian cost-effectiveness study concluded that implementationof the entire five-tiered Triple P system on a population basis in Queensland would becost-effective for reducing the prevalence of conduct disorder (i.e. that it would save theIn-Depth Topic: Mental Health Issues in Children - 387