Intervening effectively at home and in school to improve children’s social, emotional and behavioural outcomes: an evaluation of nurture group and attachment-based approaches

Assignment type: Thesis
Author: Larissa Cunningham
Submitted: June 2017

Abstract

Stable, caring relationships in early life are fundamental to children’s healthy development (National Scientific Council on the Developing Child, 2010). The importance of parent-child attachments is increasingly being emphasised within the wider socio-economic and political context (Meins, 2017), particularly in terms of policy development and intervention. As such, it is pragmatic and valuable to evaluate the effectiveness of interventions derived from attachment theory.

A systematic review of the literature was conducted to examine the efficacy of attachment-based interventions for biological parent-child dyads on children’s emotional, behavioural and relational outcomes. 15 of the 19 studies reviewed reported positive change for children in terms of enhanced attachment security, improved internal mental representations of themselves and their caregivers, increased responsiveness and communication with their caregivers and a reduction in externalising behaviours. However, a number of methodological limitations were identified. These included a lack of objectivity in the measures used and limited follow-up data on children’s outcomes. Accordingly, Educational Psychologists (EPs) should reflect carefully before recommending attachment-based interventions and ensure due consideration is given to other factors which may be impacting on children’s functioning, beyond their attachment style. Directions for future research include the use of longitudinal study designs and the use of more objective measures completed by a range of individuals. A review of qualitative studies as well as consideration of outcomes for parents would also enable an
increased understanding of the mechanisms by which attachment-based interventions may be working.

The empirical paper utilised a mixed-methods design to explore the impact of Nurture Group (NG) intervention on children’s social skills. NGs are a short-term, psychotherapeutic intervention which aim to provide reparative attachment experiences for children within an educational setting (Hughes and Schlӧsser, 2014). The social skills of 16 children (aged between 6 years and 9 years 9 months) were assessed through their verbal responses to hypothetical, challenging, social situations. Teachers also rated children’s social skills in problematic, social situations. The Parent-Child Relationship Scale (Pianta, 1992) was completed by parents to assess whether there were any benefits of NGs to the parent-child relationship. Measures were completed prior to children joining the NG and again 15 weeks later. Thematic analysis of six semi-structured interviews with children was conducted to explore their experiences and perceptions of NG intervention in relation to their social skills. Findings suggested that over time, children used significantly more socially appropriate responses. Teachers’ ratings of children’s social skills also improved, although this change fell just short of statistical significance. There was no change in parental perceptions of the parent-child relationship. Children’s own views of NGs suggested that they enjoyed attending and that NGs helped them improve their social skills. However, children also reported experiencing challenges engaging with peers outside of the NG, particularly on the playground. Implications for practice were highlighted, including the need to think about how practitioners can help to facilitate the generalisation of children’s developing skills beyond the NG context.

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