Parents Under Pressure

Module 1 - Assessment

The first module of the Parents under Pressure program focuses on obtaining information on the parent and the child/infant within the broader context of the current family and social situation. The information is based on standardised questionnaires, semi-structured clinical interview and direct observation.

The goal of the session is to obtain a clear picture of the family’s current concerns, strengths and areas of difficulty and to identify priority targets for change. As the PUP program assumes that difficulties in the parenting role are determined by problems across ecological domains, assessments are carried out across ecological domains. Specially the assessment addresses the psychological functioning of the parent, the parent-child relationship, marital and sibling relationships, and the social context of the family (level of stress and availability of support).

The information collected during the assessment forms the basis of the feedback session to the parent in session 2. In this feedback session, the therapist will help parents to acknowledge the impact of multi-problems across ecological domains on their parenting. Acknowledging that there are multiple influences, and that these are all important in becoming a more effective parent is a central rationale of the PUP program.

Assessing potential-to-change

An optional component of the PUP program is the assessment of potential-to-change. When working with parents with multiple problems, there is a high level of variation in the ability of the families to meet the needs of their children, and it must be acknowledged that, at times, there is an elevated risk that they may harm their children, and that the parents may not show improvement in their parenting practices, despite the intervention. This creates a dilemma for therapists working for high-risk families. On the one hand they want to help the families improve. On the other hand it is in the children’s best interests to acknowledge when a parent is unable to meet the needs of their children and are showing no response to an intervention. It is not uncommon for social services and/or the Children’s Courts to request information about a parent’s response to a parenting program.

The PUP program provides guidelines for the situation in which information on a high-risk parent’s response to the program is likely to be needed. When a parent’s likely response to the program is uncertain (e.g., where the problems are severe or where motivation is limited), it is recommended that the PUP program be viewed in the first instance as an assessment of potential to change rather than a “treatment program”. Specifically, each parent should be provided with the opportunity to demonstrate:-
1) a motivation to engage with the intervention, and
2) the ability to make some changes in their parenting practices.

Simple attendance in a parenting program is not sufficient to demonstrate improvements in the parent’s ability to meet their child’s needs. Where there are clear problems in parental functioning, parents must demonstrate a willingness to accept that change is necessary, a commitment to change, and the ability to make targeted changes. Together these provide evidence of meaningful change.

The potential-to-change model, then, is presented to parents involved with the PUP program as an opportunity to demonstrate targeted change and that the PUP program is being offered to help them achieve these goals. Further, it must be emphasised that the extent to which the targets for change are reached will be assessed.