Parenting Programmes

Referral Form

Please read the guidance notes on page 5 and 6 before completing the referral form. Please request only one service and complete the form in full.

1. Referrer Details
Name
Referring Agency
Self-Referral / Yes ☐No ☐
Agency Address
Telephone Number
Email Address
Date of Referral
2. Parents/Carers Details
Full Name / D.O.B / Address / Tel No / Course attendance required
3. Child/rens or Young Persons Details
CCM ID / Full Name / D.O.B / Address / Ethnicity / Crèche
4. Education details
Family member / Setting / Key Contact / Contact details
5. What service are you requesting? (please see guidance notes on page 5-6) Please only request one service /
  1. Parenting Programmes:
STOP ☐
PIT-STOP (one to one STOP) ☐
Strengthening Families Strengthening Communities ☐
Triple P ☐
Incredible Years (3- 10 years)☐
Incredible Years Babies (0-12 months) ☐
Mellow Babies(young mums only) ☐
Is this referral court ordered? ☐
Is this referral part of a Child Protection/Child in Need/Looked after Child Plan?☐
6. Reason for Referral
  • Safeguarding Concerns
  • Child Protection
  • Child in Need
  • Looked After Child
  • Historic/Current Situation
  • Substance Misuse
  • Domestic Abuse
  • Mental Ill-Health

7. Additional needs
  • Disabilities
  • Learning Needs
  • English as a second language

8. What does the parent hope to get out of attending the programme? (in parent’s own words)
9. Risk Assessment
(please explain any risk involved in supporting the family)
  • History of Violence
or Aggression (family/persons that cannot associate together)
  • Drug/Alcohol Misuse,
  • Family Pets
  • Non-Contact Order

10. Referrer signature

Signed
Date

11. Have the family agreed to the referral?

Yes ☐No ☐

Please return this form to:

Parenting Team

St Kilda Children’s Centre and Community Hub

90 Eastern Road

Romford

RM1 3QA

Email:

Telephone – 01708 432636

Guidance notes

Course name / STOP/ PIT-STOP
Description / Parenting programme for parents with children aged 10-16 year.
This programme focuses on empowering parents to have a greater understanding about the developmental process of their teenage child.
Sessions include; Praise and Encouragement, Setting Limits, Drugs and Alcohol Awareness, Conflict and Aggression Management, and Sex and Relationship Awareness.
Target group / Universal group work for parents and carers of children aged 10-16 years.
Delivery / 10 weeks, 2 hours per week.
Aims / Increase parental knowledge of their developing teenager, improve teenage behavior, support parent and teenager relationship and reduce family conflict.
Group size / 8 - 15
Facilitators / 2
Course name / Strengthening Families Strengthening Communities
Description / Culturally sensitive parenting programme for parents with children aged 3-18 years. Incorporating 5 main components; PositiveParenting, Enhancing Relationships, Community Engagement and Child Development- taking into account cultural/spiritual beliefs.
Sessions include; Domestic Violence Awareness, Drugs and Alcohol Awareness, Mental Health Awareness, Gangs Awareness and Exploring Challenging Behaviour.
Target group / Universal group work for parents of children and carers of 3-18 years old.
Delivery / 13 weeks, 3 hours per week.
Aims / Increase parental self-esteem, improve child/teenage behaviour, promote community networks, reduce family and community conflict.
Group size / 8 - 15
Facilitators / 2
Course name / Triple P
Description / Triple P gives parents simple and practical strategies to help them build strong, healthy relationships providing them with confidence to manage their children’s behaviour and prevent problems developing. For parents and carers with children aged 0- 16 years.
Target group / Universal group work for parents of children of 1-16 years old.
Delivery / 8 sessions
Aims / Increase confidence and self-esteem, empower parents to self-regulate and enable them to manage their children’s behaviour in different environments.
Group size / 8 -15
Facilitators / 2
Course name / Incredible Years
Description / Parenting sessions promoting child directed play, promoting language through play, increasing parent and child self-confidence, promoting praise and encouragement, establishing clear and predictable routines, positive discipline and effective limit setting and managing difficult behaviour.
Target group / Universal group work for parents and carers of children aged 2 -10 years.
Delivery / 13- 14 sessions
Aims / To strengthen parenting skills, increase parents confidence in promoting children’s social, emotional, physical and learning development.
Group size / 8 -15
Facilitators / 2
Course name / Incredible Years Babies (0-12months)
Description / The Incredible Years Parents and Babies Programme support parent and their babies. The programme consists of a 6 week programme focused on helping parents observe and communicate with their babies and learn ways to provide nurturing and responsive care including physical, tactile, and visual stimulation as well as verbal communication.
Target group / Parents with children aged between 0-12 months.
Delivery / 6 sessions
Aims / To support parentsto observe and read their babies cues and learn ways to provide nurturing and responsive care including physical, tactile, and visual stimulation as well as verbal communication.
Group size / 8-10
Facilitators / 2
Course name / Mellow Babies
Description / Comprehensive sessions for young parents to explore past relationships and experiences, support/knowledge around child development and routines. Supports positive attachment and improves child behaviors.
Target group / For young parents with children under 5 years.
Delivery / 12 weeks - 1 full day per week.
Aims / Address parental challenges to improve parental self-confidence and child attachment. Increase positive outcomes for young parents and their children.
Group size / 3 - 9
Facilitators / 2

1