1 / 27

Implementation and experiences with The Incredible years in Norway

Implementation and experiences with The Incredible years in Norway. Professor Dr. Willy-Tore Mørch Faculty of health sciences. University of Tromsø Tallinn June 5th 2013. Levels of services. Treatment Diagnosed disorder , above clinical cut-off Indicated prevention

larue
Download Presentation

Implementation and experiences with The Incredible years in Norway

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Implementation and experiences with The Incredible years in Norway Professor Dr. Willy-Tore Mørch Faculty of health sciences. University of Tromsø Tallinn June 5th 2013

  2. Levels of services • Treatment Diagnoseddisorder, aboveclinicalcut-off • Indicatedprevention Symptomesofdisorders • Targetedprevention Presenceof risk factors • Universal prevention No known risk factors or symptomes

  3. Change in focusIncrease in program fidelity2008-2011

  4. Change of fucusIncrease in implementation2011 – 2016

  5. Agencies • Approx: 100 municipalities (Communityhealthcenters, social services, childprotection services • 25 outpatienceclinics (regional hospital specialistcervice) Parent program: 100 municipalities, 31 outpatientclinics Child program: 31 outpatientclinics, 10-15 municipalities School/kindergarten: Approx. 50 municipalities, 80 kindergartens, 40 schools (research)

  6. Funding • 100% Ministryofhealth. • 1,5 mill Euro pr year. • 500.000 Euro pr year (reserach) 2012-2015: Increase in funding to 1,7 mill Euro Maintenanceofresearchfunding Increase in implementation in collaborationwith PMTO Increase in thenumber om mentors and peer coaches.

  7. The incredible years: Parents, children, teachers Treatment and preventionDeveloped by Carolyn Webster-Stratton, Ph.D. The Incredible Years Training Series 10/00

  8. The incredible years program components in Norway Classrooms Management program Dinoraurschool In the classroom Small group Dinosaur school School age Program 6-12 Old Basic Closeddown Fall 2012 Universal prevention 3-6 Pre-school age Program 3-5 Baby and toddler Program 0-1 and 1-3

  9. The incredible years(preschool and school age) • How to play with your child • Emotional, social, consitence, academic coaching • The art of praise • Motivating children by reward • Positive, effective limit setting • Handling of behavior problems • Problem solving for children The Incredible Years Training Series 3/00

  10. Parent pyramide Rare Time out Ignore Reduce nagging Often Positive limit setting Enforce collaboration Praise and reward Building social competence Play: positive parent-child relations Emotional, social, consistence, academic coaching The Incredible Years Training Series 3/00

  11. The incredible yearsStrategies • Focus on cognition, emotions and behavior • Developmentally based • Empirically supported • The collaborative process • Promoting independence • Video clips • Role play and rehersals • Home assignments • Parent support The Incredible Years Training Series 3/00

  12. Parent involvement • In-depth interview • 10-14 parents in the groups • Partner support, different parent backgrounds • Day and evening groups • Weekly 2 hour meetings • Two group leaders • Buddy calls • Food • Baby-sitters • Transportation The Incredible Years Training Series 3/00

  13. The clinical RCT study Larsson, B., Fossum, S., Clifford, G., Drugli, M. B., Handegård, B. H., & Mørch, W-T. (2008). Treatment of oppositional defiant and conduct problems in young Norwegian children: results of a randomized controlled replication trial. European Child and Adolescent Psychiatry, Vol 18. (1) s. 42-52.

  14. Participants • 127 children 4-8 år • Screening with ECBI og Kiddie-sads • 4 assigment waves 2001-2003 • One year follow-up (2002-2004) • 5-6 year follow-up (2009/10)

  15. Results: behavior problems

  16. Results: parenting skills and stress

  17. Changes in diagnosis

  18. Results – Treatment dosage • Correlationbetweenpercentageofparticipation and change score on ECBI r = 0,18 (p > 0,05)

  19. Stability of ODD/CD diagnosis from 1 year FU to 5/6 year FU • 38.9 (21) of the participants at 5/6 years FU had not ODD/CD at 1 year FU or 5/6 year FU • The success children • 9.3% (5) had ODD/CD at both assessment points • The high risk children • 28.8% (15) had ODD/CD at 1 year FU, but not at 5/6 year FU • Delayed effect? • 24.1% (13) had not ODD/CD at 1 year FU, but with 5/6 års FU • The effect that disappeared?

  20. The universal prevention program • Reedtz, Mørch & Handegård, 2010 • Reedtz, Martinussen, Jørgensen, Handegård & Mørch, 2011

  21. An RCT from a normal population • Total of families volunteered=269 • 58 children (22%) excluded due to ECBI intensity score > 90% (clinical cut-off) • 22 families (10%) terminated their participation in the initial phase. • Pre-post and 1 yr. Follow-up • The relation building components of the IY parent program (Meeting 1-6)

  22. RCT from a normal populationparent and child characteristics • Full time occupation: 61% • Two-parent families: 80% • Bacheor or higher education: 78% • Children’s age from 2-8, mean age <4 • 112 (59%) boys, 77 (41%) girls • Mean ECBI score: 103,3 (SD=16,7) Mean Norwegian norms 93,0 (SD=23,6) Difference sign: <.001 • No differences between the participants and non-participants (attrition analysis)

  23. Effectsonbehavior problems, parenting skills and, parentssenseofcompetence

  24. Cost-effects IY in Norway • Starting point: 20-50% of xchildren with early debut develop problems in school, low education, low income, criminality and substance abuse. 10% are in prison. • Michael Parsonage (senior advisor for the departement of education in UK): Totale cost savings for children with early CD/ODD debut in a life perspective: £150.000. • Fra Knapp, McDaid & Parsonage. (2011). Mental health promotion and mental illness prevention: The economic case. Report. Department of Health, London • IY in Norway: Approx. 5000 children treated in the last 12 years. 60% sustainable successfull treatment (3000 children). DekningsgradContribution rate 0,083-0,092% of the children population • Make for basis: 10% successfull sustainable treatment (low estimate): £ 45 mill. savings for the society

  25. Cost-benefit analysis (march 2012) 15 %

  26. Cost-benefit – Let’s save some money! Save approx. 211 mio. euro per year with IY

  27. Thankyou for yourattention

More Related