Analysis: Parenting programmes - Hard-to-reach families

Progress in social inclusion depends on earning the trust of those who feel left out, and helping them find ways to take charge. Dr Carol Homden, chief executive of Coram, explains the charity's work in this direction.

Ten years ago, Coram, which is thought to be the oldest children's charity, established the Parents' Centre in the heart of London's King's Cross area.

For us, then as now, all children are children and all families are families. The notion that, in a land of universal education and health services, some are 'hard to reach' points to a fundamental issue in the access to services.

What is it that can cause that label? Might it be the mismatch between the hours worked by workers and the hours in which a family might find the moment to reach forwards? Or the fear that this will only be another failure, and so many fingers are already pointed? Suspicion of 'outsiders' or just plain exhaustion?

Undoubtedly there are those for whom support may and would make a huge difference, but only if parents (or so often a parent) can find the personal confidence, the network support or even a moment of crisis to lead them to approach the issue as they see it. What's more, for some the sheer scale of interventions is a frightening prospect.

In my own family, with a child who has complex special needs, there were, at one point, seven practitioners, all undertaking assessments and monitoring. Fortunately, one (and just one) approached the issues as if they had been seen before and gave us confidence there were things that they would share and that - if we worked at it - would improve family life and the prospects for our son.

And, however difficult, that is what it is all about. Everyone has a load to carry, and the vast majority of parents - no matter the circumstances and how many challenges they may seem to face - want the best for their children and a glimmer of hope to get them started.

Parents as teachers

Coram's new Born to Learn project works from that motivation to involve parents whose children aged one to three are 'at risk of learning failure'.

During home visits, project workers share ideas and activities to support the child's learning in up to six meetings. Even in the midst of all the other difficult things in their lives - housing instability, domestic violence, illness - it is the very focus on education and progress that enables the engagement.

Of course, the materials and approaches are well in evidence from the programme Parents as First Teachers (PAFT). This includes building on parents' strengths, focusing on relationships between parent and child, giving clear child developmental information to a parent (including recent brain research) that is adapted to their understanding, and sharing observations of the child.

We have seen delight on the face of our Bangladeshi parents and shared their pride.

This can be enough to start a snowball rolling downhill. If you think you can improve your child's capability by 50 per cent - when you found it so hard at school and have spent your life compensating for it - then how much more motivating is this than a special meeting about the problems being faced?

Cultural strengths

Strengthening Families, Strengthening Communities (Steele et al, 2000), which Coram has applied in partnership with the London Borough of Tower Hamlets, similarly focuses on strengths in families' cultural history and on passing these on to the children. We must recognise and explain the differences and the contradictions in the expectations of the English school system and the approaches of a childhood in Bangladesh, for example, the gap between presumed models of normality and the experiences of home life without stability. It is in these gaps that the children sit, finding their ways as best they can to their own future role as parents.

Enabling discussion of these things can lead to engagement in the neighbourhood. And when a group of parents create a PTA in their local school, you know there is a difference. At Coram we have also found that enabling local parents to work for as well as with us - being trained and supported - means that a new type of connection can be made, based on a shared context.

There have always been 'outreach' workers. This is essential, particularly for special needs and reaching across language barriers, but also for joining with parents in the home.

So what else is it that makes the difference, and what do colleagues tell us? For fathers in particular, the man's position might be seen to be elsewhere. In our work with fathers, under the Boys2MEN project, we have found a key to lie in participation and not compensation.

Feeling at home

The touchstone for families and for children has to be, 'how does it feel?' Gaining support is so much more likely if it can feel as natural as going to the supermarket (and the one which is close and convenient, at that), or helping the children settle into nursery. Who wants to feel they are waiting for triage in A&E, surrounded by others with issues that just might be more life-threatening, so that you start to doubt whether you are really going to be seen at all?

The ability to 'drop in' to see and to do, seeing video from the nursery day or finding music as a tool in fresh communication and relationship development, remains vital in unlocking engagement. And, if you are a teenager who has already tried so hard to adjust to being a young parent, you do just want to be with other teenagers, but only after you've had four phone calls to prompt you!

It is from the sense of ease and so often from place, that the confidence can be built to go further. At the Coram Parents' Centre, we have measured a 93 per cent attendance by parents at their first appointment with mental health services held in our campus, compared with 65 per cent of referrals made to a clinical setting. In every 100 referrals, that is 28 more opportunities to create a new chance of success.

The difference is not made by shaking a stick at the issue of inclusion, or by looking at statistics. It is made by stick-ability. As colleagues in nurseries, schools and children's centres across the country know, the trust upon which change is built has to be earned.


Coram Parents' Centre

- Community-based training in parenting and other skills

- Informal access to multi-agency services

- Services include outreach work, Young Parents Project, music therapy, childcare and drop-ins


- Group sessions to help vulnerable, challenging and hard-to-reach males make the transition from childhood to adulthood

Parents As First Teachers

- Trains professionals to work on a one-to-one basis with parents and children to support parents in their role

Strengthening Families, Strengthening Communities

- Parent programme to help families develop strong ethnic and cultural roots, positive parent-child relationships, self-esteem and social competence, and ability to access community resources

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