Supporting couples across the transition to parenthood
Transition to parenthood - what works?
Generally, programs for new or soon-to-be parents aim to promote relationship skills and support, and realistic expectations of parenthood. In a meta-analysis2 of 142 studies, programs that addressed both couple relationship and parenting issues were shown to have positive impacts on couple, parenting and child development variables (Pinquart & Teubert, 2010). The interventions started either during pregnancy or following the birth of the child, and addressed a wide range of individual, couple, and child factors. Around two-thirds of the interventions were attended by at-risk families,3 however the majority of participants were mothers.4 Improved outcomes were noted for:
- parenting quality;
- actual or potential for child abuse/neglect;
- parental stress and psychological health;
- couple adjustment; and
- aspects of child development.
In combining the findings of the studies examined, Pinquart and Teubert (2010) identified the following optimal program characteristics:
- Interventions of 3 to 6 months duration appeared to be effective for promoting parenting quality and for child social development.
- Selective, targeted programs run by professionals were associated with positive/increased child mental health.
- Child cognitive development was positively impacted if parents attended an intervention with at least some postnatal sessions.
- Individual/couple programs were effective with respect to complex issues such as parent-child attachment.
- Group programs impacted health-promoting behaviours (for example, immunisation).
Overall the research suggests that programs that focus on both parenting skills and the couple relationship will provide the most optimal outcomes.
Findings across the range of factors examined in the meta-analysis were somewhat variable (but not contradictory). Some moderate to large effect sizes were found, but overall the effect sizes - while statistically significant - tended to be small to very small. However, as Pinquart and Teubert (2010) noted, small improvements such as those found for parenting quality, parental stress, and child cognitive and social development and mental health, can reflect meaningful improvements for participants. Even very small effects (such as those found for potential for child abuse/neglect) can have important implications for the lives of parents and their children. Findings from these kinds of combined analyses of programs, however, highlight the inherent tension for service providers trying to allocate resources across interventions with different proposed outcomes. For example, an organisation may wish to provide an intensive service for a small number of families considered to be at risk of child maltreatment (selective or targeted interventions). Alternatively, resources may be allocated to providing more general, information-based services to all families (universal interventions). These decisions are often influenced by funding agreements and associated outcome measurements.
One approach to resolving (or at least addressing) these tensions is suggested by the stepped approach outlined by Halford and Petch (2010) (and also implemented in the field of parenting education by the Triple P Parenting Program5). Halford and Petch (2010) noted that at present our ability to anticipate who might benefit most from support in becoming parents is limited. They suggested a graduated approach in which varying levels of information, support and skills training is offered, allowing providers to reach potentially large numbers of people and participants to choose the level of intervention that best suits their needs. The minimum level of intervention, perhaps comprising assessment of parenting strengths and challenges and providing information about adapting to being a parent, could be available to all couples. Progressively more intensive or involved interventions (for example, 2-hour seminars or 2-day group programs) focusing on specific issues and skills could be offered to couples who want further support, or who are identified as being at high risk of difficulties in becoming parents. Approaches such as this may help service providers think through the most efficient and effective way of distributing resources while achieving positive outcomes across a range of clients.
Transition to parenting programs in Australia
There is a limited number of programs/interventions that deal with both couple relationship and parenting practices across the transition to parenthood that are available in Australia for new or soon-to-be parents. Three of these have been evaluated and are outlined below.
- Couple CARE for Parents program - the program includes 6 units over 7 months, both pre- and postnatal, and includes baby care and parenting information as well as skills training in key relationship areas related to relationship quality. <www.psychology.sunysb.edu/ftrlab-/projects/ccp.php>
- Bringing Baby Home - a 2-day workshop that focuses on what to expect over the transition to parenthood, optimal child development and positive co-parenting, and strengthening couple friendship, intimacy and conflict regulation. <www.bbhonline.org>
- What Were We Thinking! Psycho-Educational Program for Parents (PEPP) - an early intervention program offered to parents soon after the birth of their first child to extend their knowledge and skills in managing infant needs and negotiating the new unpaid workload fairly, and improve the quality of the couple relationship by addressing adjustment to changes in the intimate relationship between partners after the birth of a baby. <www.whatwerewethinking.org.au>
2 A meta-analysis is a way of reviewing groups of studies. A statistic that quantifies the amount of change in particular variables is calculated and used to indicate whether the effect of a type of program (e.g., parenting competence, adolescent resilience) is small, medium or large. The larger the combined effect, the more effective the program.
3 “At risk” in the analyses reported here is indicated by the labelling of an intervention as universal or selective prevention of negative parenting behaviours. No further information regarding specific risk factors is provided.
4 This limits the generalisability of the findings. Directing programs at couples (rather than individuals) makes sense since this enables partners to create shared understandings and expectations of the issues facing them as a couple. They will also be exposed to the same information and [presumably] achieve similar levels of competence with respect to the challenges of becoming/being a parent (Halford & Petch, 2010).
5 More information about the Triple P program can be found at the Triple P website <www.triplep.net>