What does this project involve?
The Systemic Integrative Treatment (SIT) programme aims to use therapeutic support for parents and carers to reduce children and young people’s violence, crime, and anti-social behaviour. Delivered by the Brandon Centre for Counselling and Psychotherapy (BC), it provides a 12-month, bespoke intervention to the families of 10-14 year olds who are absent from school, displaying violent behaviour, misusing substances, or offending. Therapists provide 6 months of intensive support (2-3 times a week) to equip families with the tools and confidence to improve behaviour, before support tapers off and parents aim to independently implement new skills. Support draws form various therapeutic models, including CBT and family therapy.
Why did YEF fund this project?
As the YEF Toolkit explains, various therapeutic approaches including Multi-Systematic Therapy (MST) and Cognitive Behavioural Therapy (CBT) are associated with a positive impact on reducing serious youth violence. However, we only have a moderate level of confidence in these estimates, and further robust evaluation of these approaches in an English and Welsh context is required.
YEF, therefore, funded a feasibility and pilot evaluation of the SIT programme, an adaptation of MST. The feasibility study aimed to ascertain what factors supported or hindered delivery, examined recruitment, retention, and reach, and explored families’ and professionals’ perceptions of the intervention. The evaluation used interviews with six families and two referrers, a focus group with project staff, and analysed monitoring data collected by BC practitioners. Twenty-four families participated in SIT during the feasibility study, which ran from February 2020 to July 2021.
The pilot study then aimed to assess the potential improvements associated with SIT (as measured by outcomes including the Child Behaviour Check List, the Strengths and Difficulties Questionnaire and the SCORE 15 Index of Family Functioning and Change). It also aimed to describe the referral and screening process more fully, ascertain how many families completed the intervention, explore the potential for delivering SIT at a larger scale, and examine the implementation of the programme. It used interviews and focus groups with families and professionals, in addition to analysing project monitoring data. The pilot ran from December 2021 to April 2022. 49 families were supported by SIT and were considered within the pilot study. 53% of these families identified as White, 16% as Mixed, 10% as Black, 4% as Asian, and 6% as Other.
Both the feasibility and pilot studies were undertaken during the coronavirus pandemic, requiring both the delivery and evaluation teams to adapt to challenging circumstances.
|The feasibility study identified the flexibility of support and building trust with families as key enablers of the SIT programme. Referrals were considered appropriate, and referrers from NHS CAMHS were positive about the process. Twenty-four families were initially enrolled in the programme. After three months, 17 parents and carers of 14 children were continuing the intervention.|
|The six parents and carers interviewed in the feasibility study had positive perceptions of SIT. All would recommend it to other families. They commended the flexible and intensive nature of support and had more positive perceptions of BC compared to alternative services they had previously experienced.|
|Limitations in data collection prevented the evaluators from confidently commenting on the potential impact of SIT on children’s behavioural outcomes and family functioning. In the pilot phase, no more than 49% of parents provided data at any time point, while only very few children (6/49) completed any of the required measures. The evaluator is cautiously optimistic that the intervention was delivered as intended in the pilot study, despite modifications made due to the COVID-19 pandemic.|
|In the pilot study, as in the feasibility evaluation, all referrals were accepted, and 49 families were enrolled over the entire course of the feasibility and pilot studies. After six months, 73% of families were continuing with the intervention. This fell to 69% after nine months and 53% by 12 months. Although there were only a small number of families where the child was identified as Black, all five of these families had withdrawn from the intervention by nine months.|
|Several significant challenges would need to be resolved before proceeding to a randomised controlled trial, most notably, issues with outcome measure data collection.|
What will YEF do next?
Given the inconclusive nature of the findings at this stage, the SIT programme is not ready for a randomised controlled trial. YEF is, therefore, not currently planning on funding further evaluation of the programme.