Evidence Based Parenting Training: What Is It and What's It Got To Do With CBT?

Children don't come with a manual, and parenting can be hard. What is evidence-based parenting training and how can it help? Dr Lucy Maddox interviews Sue Howson and Jane, about their experiences of delivering and receiving this intervention for parents of primary school aged children.    Show Notes and Transcript Sue and Jane both recommended this book: The Incredible Years (R): Trouble Shooting Guide for Parents of Children Aged 3-8 Years By Carolyn Webster-Stratton (Author) Sue also recommended this book: Helping the Noncompliant Child Family-Based Treatment for Oppositional Behaviour  Robert J. McMahon, Rex L.Forehand 2nd Edition Paperback (01 Sep 2005)  ISBN 978-1593852412 Websites http://www.incredibleyears.com/ https://theministryofparenting.com/ https://www.nurturingmindsconsultancy.co.uk/ For more on CBT the BABCP website is www.babcp.com Accredited therapists can be found at www.cbtregisteruk.com   Courses The courses where Sue works are available here, and there are similar courses around the country: https://www.reading.ac.uk/charliewaller/cwi-iapt.aspx   Photo by Markus Spiske on Unsplash This episode was edited by Eliza Lomas Transcript Lucy:   Hello and welcome to Let’s Talk About CBT, the podcast from the British Association for Behavioural and Cognitive Psychotherapies, BABCP. This podcast is all about CBT, what it is, what it’s not and how it can be useful. This episode is the last in the current series so we’ll be having a break for a bit, apart from a cheeky bonus episode, which is planned for a few months’ time so look out for that. Today, I’m finding out about evidence-based parenting training. This is a type of intervention for the parents of primary school aged children. It draws on similar principles to cognitive behavioural therapy about links between thoughts, feelings, behaviours and bodily sensations and ideas from social learning theory. It also draws some ideas from child development such as attachment theory and parenting styles. To understand more about all of this, I met with Sue Howson, parenting practitioner who works in child mental health services and Jane, a parent who has experienced the training herself. Jane:  My name is Jane and I’ve got a little boy called Jack who is seven and he’s in Year 3. Lucy:  And you’ve experienced evidence-based parenting training, is that right? Jane:  Yeah, I have. It’s something called the Incredible Years. And there was a really nice lady called Sue and my school put us in touch to form a group to kind of help me manage Jack a little bit more at home. Lucy:  So, your journey into it was that the school let you know about it? Jane:  Yeah. Basically, I was having a few issues with Jack at home and I think it was kind of impacting on school as well. So, I was working with the special needs coordinator and she, obviously, had me, Jack and my family in mind as someone who might benefit from working a little bit with Sue.  I was a bit nervous at first, you know, like professionals coming in, getting involved. But she was really nice and it was really beneficial. Lucy: Is it okay to ask what sort of difficulties you were having at home, sort of what was going on? Jane:  Yeah, I can tell you now because it’s all changed, it’s much better. Lucy:  Oh good, that’s great to hear. Jane:    I mean, Jack’s a lovely boy. He’s my eldest and he’s really nice and just a bit of a joy – he is now. But I think one of the main things that I was struggling with, with him, was kind of difficulties with falling asleep. In the evenings, he would always want me to fall asleep either next to him or in his bed and that was kind of impacting on our evening, mine and my husband’s quite a lot. And it was taking up a lot of time and I think evenings are quite hard because you’re so tired and you just want to go to bed. So, that was one of the issues. And the no sleep was impacting on all aspects of our family life, really. I would just be really tired all the time and quite short, and end up shouting at Jack when I just wanted him to go to sleep and he wouldn’t. And shouting wasn’t ideal and doesn’t help but I’d just get frustrated, really and I think quite a lot of us were quite unhappy. Lucy: That sounds super hard. Jane: Yeah. I mean, he is seven but he’d kind of throw a massive wobbly if he didn’t get what he wanted, like, I don’t know, like an extra biscuit or chocolate finger or something from the cupboard, he would just kind of lose it. And that was really hard to deal with, particularly when you’re tired. I know you shouldn’t but you always kind of end up giving in a little bit, don’t you, because you just want the easy life. And you know that you shouldn’t but… Sue: It’s really hard when you’re being shouted at or when you’re exhausted like that. Jane: And I’d also feel like the path of least resistance, like sometimes it just easier to give in, even though I knew that I shouldn’t. So, I guess those are the main issues, really, kind of thinking about his behaviour. And there were a few concerns from school in terms of his behaviour. Obviously, he was tired at school and maybe not doing as much as he could be schoolwork-wise. It was kind of impacting everything, really. So, that’s where Sue came in. Sue: My name’s Sue Howson and I am a parenting practitioner and I’ve worked in CAMHS for many years, background in social work. I’ve been working with children and families for years and years and years. But I also have a role of teaching practitioners at the University of Reading. Lucy: And do you teach practitioners about evidence-based parenting training? Sue: Yeah, absolutely. So, I have trainees coming from various different parts of the country to Reading University where we teach two really strong evidence-based parenting interventions where the practitioners become super equipped to go out into the community and offer the support that the parents need. Lucy: Fantastic. And this is all extremely topical because BABCP have recently launched the evidence-based parent training accreditation pathway. Sue: Yes, which means that the parent training pathway is now on par with the CBT pathway, which is hugely exciting for all those people out there that are actually during parent training and offering parenting interventions. It’s a really great way to get those skills and practices recognised. So yes, I’m really excited by that too. Lucy: Could you say a little bit about what evidence-based parent training is? Sue:  It is a practice that is based in social learning theory and really focuses on the attachment relationships and building the relationships between parent and child and building on parental self-confidence and self-efficacy and trying to equip the parent and skill up the parent to notice particular behaviours in a child and them then feeling confident in applying a particular technique or a particular method in the moment which will make a difference to – fingers crossed – to the outcome of that little interaction between parent and child. Lucy: When we’re talking about social learning theory, by that do you mean the way that we all learn from what we see around us? Sue: Yeah. It’s learned from our environment and the things we see around us. Lucy: So, it’s kind of providing parents and carers with a different model of how to do things. Sue: Yes. So, perhaps in their upbringing, they were brought up with one particular style of parenting and parent training offers, perhaps, a selection of different ideas on how they may choose to interact with their child that’s different from the way that they were brought up. Lucy: Which is very interesting, actually, isn’t it? Because, you know, it’s not something that’s taught in school, is it, parenting? So, it’s very much something that people do quite intuitively or in the way that they’ve been brought up or that their friends are doing it. So, there’s a lot of social influence involved, actually, isn’t there? Sue:  A huge amount of social influence. And quite often, in homes, both parents don’t do it the same way. So, just because you do it one way, your partner might do it in a different way and you may never have even discussed that until you reach a point where you’re having challenges with your child. So, you may end up having to think about things and being much more consistent. Especially with children with ADHD and autistic spectrum difficulties, the consistency element is really, really important. Lucy:  I asked Jane what she’d expected from evidence-based parenting training. Jane: Oh, I was a bit nervous and apprehensive to begin with because, you know, it’s bit embarrassing, isn’t it? You’re the one with the naughty kid that doesn’t do what they’re meant to. Sue kind of made me feel super relaxed from the start. She’s really approachable and just like normal, like not too expert, not using all these words that I didn’t understand. And she was quite relaxed so that kind of made me feel quite relaxed and let me feel comfortable to ask questions, even though they might have been silly or they might seem obvious. So, that was really nice in the beginning. I liked how she said things about the group rules, like intense confidentiality and respect and that made me feel like it was okay to share, really. Lucy: That sounds really important. Jane: Yeah. And I think one of the biggest things, obviously, apart from the actual strategies she gave me, was being able to meet other parents in a similar situation who had a child like mine. And we kind of set up a WhatsApp group after, which is really nice. Now Sue’s worked her magic, that kind of keeps us going. Like if you’re having a bad day, you can still speak to someone who knows. Lucy:  I asked Sue to talk us through what evidence-based parenting training involves and she said there are two methods. The first is the group process, which Jane did. This is usually two hours a week minimum for 12 to 14 weeks on the Incredible Years programme together with parents who are experiencing similar difficulties. Sue: The other offer would be an individual based programme, which we tend to offer for parents who find it hard to access the group. Or maybe they’ve tried a group before and it hasn’t necessarily worked. Or a parent that doesn’t feel quite ready or confident enough to go into a group so we would offer those parents a sort of one-to-one. Building a very similar model but the child is involved in those. So, the group one is just for parents but the individual programme, the child comes along to those sessions as well. Lucy: That’s great. And it’s lovely that it can be so flexible so it can be group or individual. That sounds really important. Sue: Both have been able to go remote now. That’s been quite a spectacular shift and I think that It’s gone down quite well for parents because it means they don’t have to organise childcare in order to be able to attend groups and things. You know, practitioners have been able to offer them in the evenings, perhaps when kids are in bed or at school, when parents aren’t working. So yeah, it’s gone down really well. Lucy: That’s fantastic. Yeah, that sounds really helpful. I was really curious about the sort of key skills and techniques that you teach in the evidence-based parent training. What are some of the topmost important skills do you think that get taught? Sue:  The first quarter of the programme, I would suggest, is focused on building that relationship. And that’s largely done through child-led play, spending time together. Jane: One of the things that we were asked to do was to set aside 15 minutes dedicated time each day to play with him. And I loved it and I felt like I learned loads about him in terms of some of the things he could do with play that I didn’t even know about because I was probably too busy doing the washing up, previously. Rather than me just getting frustrated and shouting. It really kind of built our relationship. Lucy:  That sounds really fun, actually, yeah. Jane:   Yeah, yeah, it’s nice to be a big kid rather than just be adult all the time. Lucy: Back to Sue. Sue: There’s a particular way of playing and it’s not just what you do, it’s the way that you do it. We particularly look at noticing what a child’s doing well. If you’ve got a child who is inattentive, for example, it might be very helpful for the parent to notice when that child is paying attention and focusing. Quickly jump in with praise to encourage that child to do it again. So, that’s the bit of social learning that we’re building on there. So, the child is paying attention, the parent notices the child is paying attention. The parent says, well done to child, so child is more likely to pay attention in that way again. Jane: Another thing that I learned was like the attention rule. So, it’s kind of drummed into us so what they always say is whichever behaviour you pay most attention to you will see more of and kind of flipping that on its head. So, thinking about what attention I was giving to Jack, whether it was positive or negative and trying to focus on the positives, really, which kind of gave me a little bit of perspective. I just felt as though he was really difficult all the time, whereas, actually, if took a step back and focused, I realised that he wasn’t and there were lots of really good things that he was doing that I didn’t always necessarily notice. Sue:  We also look at the ways of praising a child or rewarding a child. Quite often – and I’ve definitely been guilty of it myself – is putting a tag on a praise statement, for example. So, we might say, “Ooh, well done for tidying your bedroom. Why can’t you do that all of the time?” And that’s the tag. The tag there is, “Why can’t you do that all the time?” So, we’ve given with one had the praise, “Well done for tidying your bedroom.” But quite often as parents, we will take away the praise by adding that, “I wish you could do that all the time,” or, “Why can’t you be more like your brother?” Or we’ll add a something that actually negates the praise.  So, parents, by week five, six are really becoming conscious of the language that they use and how impactful that can be. And this really works well with the group of kids that I’ve talked about already because they’re quite selective with their listening, perhaps or they don’t really hear it all. So, it’s very powerful for kids to make sure that they’re genuinely hearing praise.  What else do we do? We then go on beyond praise and start thinking about our ability to remove that attention. So, we think about how we ignore a child. And quite often, parents will tell me, “Oh yeah, yeah, yeah, I ignore my children. I can ignore my children for five hours.” We’re not talking about not being with a child or the child being occupied very happily doing something else. We’re actually talking about an active removal of a parental attention, which is then when the child complies again, then the parent comes back and uses their attention in a particular way to reinforce the positive behaviour. Lucy:  When would a parent do that kind of taking the attention away? Would that be in response to something in particular? Sue:  Yeah, ignoring a particular behaviour. And we suggest that those are the behaviours that are annoying type behaviours. So, we’re talking about whingeing and whining and grumbling and answering back and nagging, you know, “Mummy, can I have a biscuit? Can I have a biscuit? Can I have a biscuit?” The parent has said no and that potentially could escalate between parent and child, where the child says, “You are the worst parent in the world. I hate you. It’s not fair.” But the parent needs to be ignoring that the whole way through. Kids are brilliant at this, absolutely brilliant, really clever at trying to get parental attention. So, they will up their behaviour. So, they may be saying, “Yeah, you’re the worst parent in the world. I don’t love you anymore. It’s not fair. Lucy down the road, she’s allowed to do this, that and the other.” Quite often, parents will snap at that point, therefore, no longer ignoring the negative behaviour that the child is presenting. So, the skill is for the parent to be able to keep a lid on it until the child has run out of energy in their negative behaviour. And when the child comes back down, that’s when we want parents to reengage with the child and respond in a positive way to the quiet, calm, polite behaviour that you hope your child is now exhibiting. Jane: Sue helped me, teaching me strategies to calm down, things like breathing techniques and stuff, obviously, for me and for him so that when he was on the verge of losing it, he could count to 10 or take some deep breaths. It wasn’t like I was just shutting the door and leaving him to lose his mind. And that really helps. I understand ignore sounds awful but I think it’s about, it’s like what you do and how you do it, rather than ignoring and leaving him to it. Because that’s not very nice. Sue: The idea of an ignore is only for the duration of the negative behaviour. So, if you think about the whingeing and whining for the biscuit, how long can a child continue to ask you for that biscuit? Five, 10 minutes, tops. You’re not leaving them in a room, you’re not walking out on them, you have just got to develop this sort of Teflon coating where you hear what they’re saying but you choose not to respond to it. But it’s the parent’s removal of attention that’s key. So, if a parent is actually leaving the room, then they’re not actively ignoring, they are doing something else. But an active ignore, which is what we’re talking about, the parent has to be very present because the moment the child has come back down that sort of angry curve, they come back down the other side. So, what you try to do if you wait for them to deescalate and then move on and get them involved in another task. Lucy:  I’m just thinking it’s sometimes really difficult to do, isn’t it, just as you describe that kind of… Sue:  Yeah. Lucy:  …snap. Just as things are escalating, particularly in a public situation. Or I guess if you feel that you’re worried that the child’s upset as well, it’s hard, isn’t it? Sue: Desperately hard, especially if you understand why your child is worried or you understand why your child is fearful, you know, if you’ve got an anxious child, for example. So, parents have to be able to work out which is a behaviour that they want to encourage or which is a behaviour that they want to see less of. And we spend a lot of time thinking about those things. Parents will say they’re very good at ignoring children but they quite often forget to reengage at the other end. So, the active ignore is a big step. Lucy:  I wanted to know from Jane how it felt to remove a tension in more difficult settings like in public. Jane: Because I had – well, script is the wrong word – but like a thing to follow, it kind of built my confidence in being able to do it. I think once he kind of learned where the boundaries were at home, it kind of like resolved itself a little bit when we were out in public because he knew from the beginning that it wasn’t going to wash and he was just going to get ignored. And flipping it on its head in terms of the negative tension, the positive tension, it just kind of got a bit easier because I felt a bit more confident and then I had the skills to cope. Lucy:  Another important aspect which Sue talked about is how we think about the language that we use when we talk to children. Sue: Quite often, we use a lot of negative commands, “Be careful.” It’s sort of an empty command, what does it actually mean? Whereas autistic spectrum children who probably need very, very clear communication, if they’re playing on a climbing frame, for example, “Be careful,” could be replaced with, “Hang onto the bars,” or, “Use both feet on the climbing frame,” really clear for children to know exactly what they should be doing. And it’s amazing when you tune in to that and you start listening to your friends and your relatives and things, you do realise that in everyday English, we use a huge number of negative commands for children. You listen to teachers in schools and they’re saying, “Don’t wriggle, don’t poke him next to you, don’t do this, don’t do that.” But what we should be saying is, “Please do, please do this, please do that,” because children quite often only hear the last word that comes out of our mouth. So, if we said, “Don’t run,” the only word they hear is run. Lucy:  Absolutely. And it’s also quite negative, isn’t it, if someone’s constantly telling you stuff not to do. I don’t know, it feels different in tone, doesn’t it to telling you stuff that they would like you to do. Sue: And when you set them off, in the same CBT-type model, you set them off with homework and home practice and things to do, when they come back the following week, they often say, “Well, the atmosphere in my house completely changed because we were focusing on positives, not negatives.” And again, it begins to shift what you notice as well. Jane:  It’s kind of a bit of a bugbear of mine and now I’ve realised it. Like, quite often, a lot of my friends and even my in-laws or my parents will say, “Oh, you’ve done really well, good boy, good boy.” And for me, it was like thinking about what that even was. Sue really helped me see the importance of being specific around the praise that you’re using. So, that kind of then links it to their behaviour rather than just being, “Oh yeah, that was really good.” So, specific praise for me was really important. I saw a really big impact on Jack’s behaviour when I was able to use really specific praise with him to, kind of, you know, highlight the good stuff that he’d been doing, like putting his plate in the dishwasher or calming down after an ignore, you know. Like when he was able to use his breathing strategies and then come back and then when we started to play, I’ve said, “Well done for calming down,” or that kind of stuff. So, the specific praise, brilliant. I think also, thinking about some of the phrases and the language that I use with him. So, if he’s really wanting something like, I don’t know, wanting loads of ice cream or something but he won’t eat his dinner, a little phrase like, “When you’ve eaten your dinner, then you can have your ice cream,” the when-then thing worked really well for me and made me think about the kind of words I was using and the impact that was having. Because, obviously, what I was doing before wasn’t helping. And I guess the other big thing for me that helped was the use of rewards. So, it helped me think about a specific target for Jack in terms of how we could get him to stay in his own bed. We used like Batman stickers when he was able to do it. Lucy:  That sounds nice. Jane: And then when he did it consistently for like five nights, we then went ten pin bowling, which was lovely. Sue:  Oh great. Jane:   Yeah. Everything just became a lot more positive, really. Lucy:  That sounds really powerful. Jane:  It was, actually, yeah. Lucy: Often, parents find that things like time out just aren’t necessary once praise and play and positive attention are in place. Sue: Absolutely, absolutely. And I don’t know whether you’ve noticed that while I’ve been talking to you, I keep doing this, I keep forming a sort of pyramid with my hands. And the fundamentals of the parent training is really about building that broad base at the bottom, which includes play and attending to a child and listening and problem solving. These are all the building blocks of a really strong relationship. And we’ve got praise in there and we’ve got rewards in there. And then as you move up the pyramid, you’ve got to start thinking about the other sort of techniques. We’ve got the children stuff at the bottom, you know, all the stuff that you can do with your children to build the relationship. And then you start thinking about the techniques that parents can apply to kind of modify behaviour. So, that’s when we start talking about ignoring or the language that we use, thinking about command statements and starting to put in boundaries. And then as you get to the tippy top of the pyramid, you’re thinking about time out and the use of consequences. But fingers crossed and a lot of periods experience this when they’re going through our programme, they start by saying, “I just want to hear about time out. I just want to hear about how to do it better.” We say, “Hey! No, no, no, we’re going to start at the bottom. We’re going to build that relationship.” And by the time we get to the point where we want to tell them about time out, they actually find that they don’t need to use time out as much as they did at the beginning because they have so many other effective strategies on managing behaviour and noticing different behaviours before we get to the top, before we get to the point where we may need to put in a consequence or a time out. Lucy: And the very, very end bit of that pyramid that you were describing, the time out is probably something that people kind of are really familiar with, actually, because it’s around because of programmes like Supernanny. Sue:  Yeah, you’re right and people love it on Supernanny, because she spends a lot of time talking about “naughty steps,” doesn’t she? Lucy:  There’s a lot of naughty steps in Supernanny. Is it the same in evidence-based parenting training or is it a bit different? Sue:  It’s similar but it does hang onto that idea of differential attention. So, you can’t just put a child on a naughty step or a naughty spot – and we wouldn’t necessarily use that phrase – we would encourage a parent to be removing their attention on purpose for a period of time. And that time is linked to age, which is very much similar to the Supernanny model. But one of the things that we would absolutely advocate is making sure that when the child has completed their moment of exclusion, the child comes back into the family activity in a calm state and they’re not expected to say sorry. They’re just expected to come back calm and quiet and you just move on with your activity. A lot of parents don’t necessarily like hearing the bit about not saying sorry. One of the ways I try to describe it is if you’ve ever had an argument yourself, you don’t immediately calm down. You’re not always receptive to apologising or hearing somebody else’s view. So, by asking a child to apologise in that moment, you either get a, “Ugh, sorry!” which doesn’t mean anything anyway or you will get a reignition of the fire, of the flames of the heat of that moment. So, it’s actually better to choose your moment to have that discussion, have that teaching element of your parental relationship when the child is calm or by modelling calm yourself or reminding them of what they do well, going back down that pyramid and through play. And the child will enjoy the attention they’re getting so much when they’re being played with in a particular and positive way versus the attention they get when they are simmering and smouldering. So, that’s the rationale. Lucy: It also sounds less shaming because there’s something tricky, isn’t there, about when any of us have been told off, that rush of shame that you get to begin with. I guess your kind of avoiding like really going over that by getting a child to go over things and say sorry. Sue: Yes, when they’ve thrown something at their brother and that’s why you’ve removed them from that scenario for a few minutes, they know that they shouldn’t have thrown that thing at their brother or they shouldn’t have kicked you or they shouldn’t have sworn at you. So, that’s the sort of step on from the ignore and ignore is in the moment hoping that the child can deescalate, wind themselves back in. But if you feel like they have gone beyond that, so there are some behaviours that we completely see as being completely unacceptable and those are the sort of violent behaviours, then that’s when we would put them into the total removal of parental attention, the sort of time out type space. And so, we do spend quite a bit of time thinking about parents’ thoughts and their physical emotion. So, we think about how cross they are when they’re ignoring or how wound up they are when they’re trying to do time out and we think about how they choose to behave, how they choose to respond to their child as a result of those thoughts and those feelings. So, we try to incorporate those three elements as best we can. Lucy: I was curious to know whether Jane used any of the techniques from the top of the pyramid like time out with her son. Jane: I don’t really feel as though we had to use it so much, I think mainly because of Jack’s age, he’s a bit bigger now. The ignore and the praise and the play and the positive attention and also building the relationship had the biggest impact. And like Sue talked quite a lot about your pyramid being upside down beforehand or properly ignoring, you know, with any like real idea of how to do it or what I was doing. Or maybe trying to put him on the step and then he wouldn’t and then it just all goes wrong. So, I was probably doing a lot of that at the beginning whilst trying to get through my day and not spending enough time with him and not doing the bottom stuff, which I think, obviously, is what for me has made the biggest difference. Lucy: But you were doing the best you could, weren’t you, at the time? Jane:   Yeah. Lucy:  Super hard. Jane:  I feel like they don’t come with a manual, do they? But that’s why the group kind of helped really. It gave me a bit of perspective like to stand back and think about things that are kind of happening on a day-to-day and what was going on for both of us, really. And also like a checklist in my head about what to do and when and that was amazing in terms of my confidence, really. Lucy:  I asked Sue what changes she saw from the start of the programme to the end. Sue: Yes, most parents want to come in and they really, really want to hear about these big time out, big guns approaches, potentially as a little bit of resistance to the idea of building a relationship. “Oh come on, come on, come on, let’s move on. I just want to hear about the big stuff. Why are we wasting our time on this little stuff? I just want to hear about the big stuff.” But by week three or four, they really do begin to see shifts in the way their children are responding to them and the tone in the house about noticing the positives rather than just looking at the negatives. So, we really see shift early on.  And like I say, by the end, fingers crossed, you would hope that parents are not needing… you know, they feel quite proud when we get to the sort of time out stage of the programme and they go, “Yeah, I get this but I don’t need it,” you know.  So, we do see big, big, big shifts through parents. And one of the things I love and one of the reasons I just keep going with this is because I see that confidence building in parents. And we have parents coming back and saying, “Yeah, we only talked about getting my child to bed but I now realise that if I just apply the same ideas and the same principles, I can use that with, ooh, getting him into school or encouraging him to do his homework.” So, there are all sorts. We are building skills which you then hope can be sort of expanded out and used in all sorts of settings. Lucy:   And it’s called evidence-based parent training. What is the evidence base like for it? Sue: The evidence base for both of the programmes that I’ve mentioned so helping the non-compliant child and in particular the Incredible Years, I mean, Incredible Years has had 25 years of research and has been developed over, I think it’s now delivered in 32 countries in 32 different languages to all sorts of different communities. And it isn’t prescriptive. Parents come along and you work with parents’ individual goals. So, each individual in that group will be working towards their own goal in that group but they’ll have the support of the leaders plus their colleagues in that group who will help them reach that goal. So, it’s sort of tailor made, if you like, to fit individuals who are going through similar things but individuals within a group. Or in the individual programme it’s even more tailor made by definition, I suppose. But yes, the shifts are huge and it doesn’t necessarily happen in two or three weeks. I think sometimes, parent training has been thought to be done to somebody. But you definitely have to have this sort of collaborative relationship, there’s no other word for it, but this joint working in order to reach the parents’ goals. So, I think that’s really important to get the outcomes that you want. If I was just telling somebody to do this, you know, “Go home tonight and do this,” that wouldn’t necessarily have the impact of exploring how it’s going to work in your house. And thinking about the parent, well, they know their children the best, don’t they? So, you work with whatever the parent is bringing to you and thinking about how these principles will apply in that instance. Lucy:   And what do you like about your role delivering evidence-based parenting training? Sue:  I like the fact that parents become much more confident in their parenting skill. I love the fact that they come in a little bit like sort of timid mice and go out like roaring lions with the confidence that they’ve got by the end. I think it changes the way they relate to their children, I think it changes the way they relate to each other as parents and I think it just changes atmospheres in households, which I think is really magical. Lucy:  I asked Jane if there was anything she didn’t like about the sessions and she had no bad things to say. So, I asked her what she enjoyed about it. Jane:   Learning about how to play properly, I think. With Jack, I’m not being like too directive. Like before I was like, “Jack, do this, do this, build your tower, build your train track like that, that’s wrong, dah, dah, dah,” and I didn’t realise how negative I was being. So yeah, I guess the most enjoyable bit for me was having that dedicated time to spend with Jack playing and watching him play and kind of getting to know him a bit more. Playing and building our relationship really was my favourite. Lucy:  And what sort of difference has it made? Jane:   I just think everyone’s a lot happier at home, which is great. I’m not shouting as much. Jack’s a lot happier because he’s not being shouted at. And the whole house is just a lot calmer and a lot happier and everyone is a lot more positive towards each other and it just makes the atmosphere a lot nicer. There’s a lot less whingeing and moaning and whining from all of us and nagging. (Laughs) And yeah, I feel like, because Jack’s now able to sleep in his own bed properly without me, it’s really had a positive impact on mine and my husband’s relationship because we actually get an evening together to watch Strictly Come Dancing or, I don’t know, something that’s not to do with the kids. So, that’s really helped. And I think also because Jack’s now sleeping better and things are happier at home, school is better as well, he’s not so tired. So, he’s able to focus a bit more and get on with his schoolwork a bit more. So, that’s the kind of feedback I’ve had from school, which is nice. Lucy:  It sounds like a really good result. Jane:  Oh yeah, I loved it, yeah, I loved it. It changed my life, anyway. I’d recommend it to anyone. And no matter how hard a problem seems, there will be someone else out there that’s got a problem like you. You’re not on your own and it’s okay to struggle. Pretty life changing, really. Lucy:  If you’re listening and you want to know more about how to access this sort of support, you can explore your local services online and check out Incredible Years groups in particular. You can also ask your GP who may refer you to Child and Adolescent Mental Health Services.  If you’ve got a child with a diagnosis with ADHD and you want this sort of support, you can ask, “Where can I access parent-based intervention?”  Thank you so much to both of my experts, Sue Howson and Jane. If you’d like more information on evidence-based parenting training, have a look at the show notes. And for any parents juggling home school and work at the moment, my thoughts are with you and I really hope you’re doing okay. For more on CBT in general and for a register of accredited therapists, check out BABCP.comand have a listen to our other podcast episodes for more on different types of CBT and the problems it can help with. There are quite a few episodes to do with children, including Shirley Reynolds on values-based activities in the pandemic and Maria Loades on helping children with loneliness during Covid-19. That’s all for now, take care. END OF AUDIO    

Om Podcasten

Let's Talk About CBT is a podcast about cognitive behavioural therapy: what it is, what it's not and how it can be useful. Dr Lucy Maddox interviews experts in the field including people who have experienced CBT for themselves.  A mix of interviews, myth-busting and CBT jargon explained, this accessible podcast is brought to you by the British Association of Behavioural and Cognitive Psychotherapies. www.babcp.com