Parenting: the Challenging Task of Modern World

Department of Social Work

Parenting: The Challenging Task of Modern World

A Critical Review of COPE (Community Parent Education Program)

Strengths and Weaknesses of COPE from the Point of View of Parents and Educators

Degree report 15 higher education credits

Spring 2008

Author:Sahar Kaleibari Notash

Supervisor: Anita Kihlström

Abstract

COPE is one of the state-based public parent education programscarried on in Sweden with an aim to prevent the behavioral problems of young children. This study is a qualitative research to examine the strengths and weaknesses of COPE from the point of view of parents and educators. The study has an intercultural perspective and intends to assess if the cognitive-behavioral education can lead to the empowerment of parents.Semi-structured interviewsare used to gather information. Empowerment and Cognitive-behavioral theories are used to analyze the findings of this study.

According to the findings, meeting other parents with the same problems and learning the behavioral means to create the desired behavior and extinguish the undesired onesare the first strong points of the program according to parents and educators. They also mentioned that gaining self confidence, self control and anger control, as well as learning to behave rationally and according to the correct models are the results of this education.

The most important barrier for the application of COPE is a cultural aspect. The Swedish society is not comfortable with the usage of material means of encouragement and punishment according to my informants. Low participation of parents both in the sessions and discussions is another problem.

Individual empowerment both for parents and educators are achieved in COPE according to the interviews. Parents reported beingmore secure and in control in relation to children after taking part in COPE. Despite my earlier experiences of family education programs in Iran, reports about social empowerment is lacking in the Swedish context. Meanwhile, parents and educators had some suggestions to improve the program most importantlyabout social empowerment of parents.

Key words: parent education, empowerment, parent views, educator views,cognitive-behavioral education, COPE.

Acknowledgment

I would like to thank the Department of Social Work in Göteborg University which prepared a rich ground for my study, and my supervisor Anita Kihlström who helped me in this degree report. Also, I am grateful to the kind cooperation of Astrid Tunås who helped me in gathering information for this report. I would like to thank my dear friends Reyhaneh and Arezou for their kind support and help. Finally, I thank all the informants who participated in my interviews and expressed their views.

SaharKaleibariNotash

Contents

Abstract

Acknowledgment

1. Introduction

1.1. The research subject: COPE

1.2 Problem Area and aim of the study

1.3. Research Questions.

1.4 Definitions

2. COPE

2.1 Background

2.2 The purpose of COPE

2.3 How COPE is implemented

3. Earlier researches about behavioral parent educational programs

3.1. Researches about the Behavioral Parent Education

3.2. Earlier Researches about empowerment of families

4. Theoretical framework

4.1. Empowerment

4.2. Cognitive-behavioral social work

5. Method

5.1 Design

5.2 Data collection

5.3 Data processing

5.4. Validity, Reliability and Generalizability

5.5. Ethical consideration.

6. Results and Analysis

6.1.Why parents need this program

6.2. Benefits and aims of the program:

6.3.Strengths of the program

6.4. Weaknesses of the program

6.5. Improvement of the program

6.6. Effects of cope on parents

6.7. Practical problems in implementation of program

6.8. Integration of the program to Swedish context

7. Discussion

References

Appendixs

1-Interview guide of “study of weakness and strength of COPE “

Educators’ version

Parents’ version

2-Informed Consent

1. Introduction

1.1. The research subject: COPE

Social Work with children and families is a specialized area of work in Sweden. The state began to have a stronger role in the family life by introducing new laws about children and women, providing public childcare facilities and emphasizing on dual earner model during the last century. Nuclear family is still the predominant form of family in Sweden, but there are many indicators which show that the situation of the nuclear families is moving towards instability. Facts like high divorce rate and reduction of fertility as well as introduction of other family patterns are changing the family system in Sweden (Therborn, 2004).

There are several different reasons for the importance of family education in Sweden which makes parent education one of the important areas of social work with families. One reason is that for most people, parenting can be a challenging task of adulthood. They may face a difficult situation in fulfilling this responsibility while this task is an opportunity for learning, growth, and development of them (Marienau C. and Segal J., 2006).Secondly, providing secure and favorable conditions during childhood and adolescence is one of the national public health policies of Sweden. Lastly, mental ill-health is one of the three most important public health issues in Sweden (Bremberg, S. 2003). General family education programs can prevent mental ill health in children.A study done in Canada shows that a significant number of children with behavior disorders do not get support. Ironically, children at greatest risk are more deprived from professional support. This is because they come from the poor socioeconomic strata, and their parents recognize their behavior problems late, and feel stigmatized if they seek assistance (Cunningham,Bremner and,Boyle, 1995). A general family education can cover all social strata including the neediest.

For children of families with disabilities, single parents, or those otherwise receiving long-term social assistance there is a higher risk of unfavourable development in many aspects including mental health. These parents might be at greater risk of early retirement for medical reasons or hospital care for mental problems. According to the Swedish medical authorities single parents with seriously impaired children are especially vulnerable when it comes to financial resources and health (The National Board of Health and Welfare, 2006).

One of the prevalent mental health problems is BMP (Behavior Management Problems). According to Axberg et al (2007), in Sweden BMPis common among children (4-12%). This problem is increasing and in long-term will result in poor psychosocial adjustment. Barlow and Stewart-Brown (2000) believes that behavior problems in children are an important social, educational, and health issue. They mention that the prevalence of these problems, their stability over time, their poor prognosis, and their costs to both individuals and the society, all point to the need for primary prevention and early effective interventions.

As a result of mentioned reasons, the Swedish government decided to use the parental support programs for prevention of mental illnesses based on the findings of one hundred different high quality studies whichproved the effectiveness of parent education. The parliament and government provide facilities for family education to help with the prevention of mental ill-health by appropriate regulations (Bremberg, S., 2003).

Researching about the implemented programs and theireffectiveness is one essential part of the program in order to correct the directions, content and methods of education. A lot of studies are done to assess the effect of the program on the behavior of the children and parents. It is also important to study and research the views of the partners who are participating in the programs and hear their voices and their assessments about their experience of participating in the program.Since COPE is a new program in Sweden, there is no research about its implementation. The only available sources are some reports of educators. So there is a need to study the program in the Swedish society. Also there is little information about the views of parents and educators about the program, and most of the researchers studied the effectiveness of the program on child behavior and parent-child relation according to the positivist ideas of reality. According to Gilbert(2003) individuals and groups construct their own version of reality. Therefore I want to examine the experiences of parents and educators who are participating in the program.

I have been engaged in family education in Iran for some years. Due to my previous studies in early childhood education, and my working experience in this field, I was interested to observe a similar program in Sweden. As aneducator, back home, I observed that all kind of family education has a great influence on parents, mostly mothers. They came to our center to know about their children and how to treat them. As soon as they get education about the family systems, child rights and other related subject, they start to seek their own rights. It seems parent education is a little sparkle which helps them to go ahead. They initiate their own study groups and try to help and support each other in a very patriarchal society. The knowledge and the skills they learn give them power in the family. The social network they participate in, on the other hand make the basis of their individual and social empowerment.

Also, my field placement period in the international master program gave me this opportunity to be in contact with the families and the educators of COPE (Community Parent Education Program). Social department office of Frölunda renders family education program since 2004.I participated in the program and obtained the educational material during my field placement. I decided to perform a study about COPE after being in contact with the families and the educators. I was more convinced about the importance of this study because all the previous studies were concentrated on the effectiveness of the program and views of the participants were generally ignored. There was a need to study the program from the point of view of parents and educators.

1.2 Problem Area and aim of the study

As mentioned the family education is a tool to enhance mental health. Many researchers studied the effectiveness of these programs, and most of them concluded that these programs are highly effective. There are a few researches about the point of view of parents and educators about the content, method and aims of these programs. The subjective role of the participants is ignored in the most of the studies. This research is going to achieve a deeper understanding about the implementation of these cognitive- behavioral programs. In other words, this study wants to look at the effectiveness of the program from the point of view of the practitioners and service users.

Every educational program has some weaknesses and strengths, whose recognition is a way to enrich them and bring in new possibilities to educate target group better. In this research the weaknesses and strengths of the program will be considered from the point of view of educators and parents to achieve a thorough understanding of the program characteristics. Empowerment theory will be used alongside the cognitive-behavioral theory to interpret the subjects’ ideas about the program and to find a new definition of effectiveness of the program.

1.3. Research Questions.

• What are the strengths of the COPE program from the point of view of the parents and the educators?
• What are the weaknesses of the COPE program from the point of view of the parents and educators?
• Can the behavioral education of COPE result in parents’ empowerment?

1.4 Definitions

The phrase "parent education program" is used here to refer to group-based programs with a standardized format aimed at enhancing parenting skills (Barlow and Stewart-Brown, 2000).

Attention-deficit/hyperactivity disorder (ADHD) is the most recent diagnostic label for children presenting with significant problems with attention, impulsiveness and over activity which is one of the most prevalent childhood psychiatric disorders (Barkley, 1998).

2. COPE

2.1 Background

In Sweden, family education programs implemented by the government are known as “Interaction programs”. They are the instruments of the government to support parents in two main areas: providing emotional development and creating boundaries for their children.These programs emphasize on collected experience of all the parents in the group. The programs are divided according to different age groups. In the age group of 2-9 years, the goal of programs is to reduce the risk of developing behavior problems. There are three main programs for this age group (2-9):De otroligaåren [The Incredible Years], Community Parent Education Program (COPE) and KOMET [COMET] (Bremberg, S., 2003).The programs include watching of movies, discussing problems, providing solutions for them and practicing the solutions.

COPE (Community Parent Education Program) is a family education program which is designed by Professor Charles E. Cunningham in McMaster University Faculty of Health Sciences in Canada. It is a large group version of individual family programs for families of children with ADHA which later have been implemented in mental health clinics (Barkley, 1998, p. 396). The program was introduced to Sweden as of year 2004 (Swedish COPE site).

In Sweden, COPE is implemented by National Institute of Public Health free of charge for all parents of children between 3-12 years old. It has facilities for free child care during the sessions of program. This program is implemented with some changes in content, order of the subjects and movies, and is used as a general family education program in different cities and different centers (National Institute of Public Health website).Most of the educators or leaders are social workers, preschool or school teachers and are educated directly by Charles E. Cunningham, the author of the program, or the private center of ‘Svenska COPE- Foreningen’ under the supervision of AgnetaHellstrom.

2.2 The purpose of COPE

According to Barkley (1998), parents of children with ADHD suffer from low self-esteem, a sense of lack of control over the child’s difficulties, and higher depression. Low regulated behavior of their children causes more controlling and less positive approach to child management. There are some groupspf parents for whom the rate of participation in intervention programs is lower. Younger, economically disadvantaged, socially isolated, depressed, immigrant parents, parents whom the official language of the country is their second language and are culturally different are least likely to enroll in and complete intervention programs. The same is true for parents of children with the most severe problems. On the other hand, studies shows that these groups come to community-based parenting courses more regularly.

Barkley (1998) showed that parent training improves child management skills, enhances parental confidence, reduces stress and improves family relationships. He believes that “Improving parenting skills is accompanied with less behavioral difficulties of children” (p. 394). COPE family education can be a good response to the needs of families who are in trouble or are at risk to be in trouble because of ADHD of the children. Also, COPE teaches self-control strategies, and the group provides a sense of universal parenting experiences with common problems. The group encourages supportive contacts and exchange of knowledge between the parents (Barkley, 1998). These are achieved with a low cost, single-leader program which uses community utilizations to help families.

When the parents find solutions by themselves in the groups, they show more commitment to the findings. They feel they own the solutions and alternative suggestions. This fact reduces their resistant for change, and helps them to implement the findings. Finding solutions is a life skill. This practice helps them to find individual solutions for their own special situations in the future. They also build skills for cooperative problem solving process (Barkley, 1998).

Providing group education for parents which are facing less severe problems gives more opportunity to help children with more severe problems. The fact that their families use clinical and professional help more frequently is a practical evidence for effectiveness of the program. COPE is an educational program which is based on social learning-based parenting programs, social-cognitive psychology, family systems theory, small-group interventions and larger-support-group models (Barkley, 1998). This is followed with a coping-modeling problem- solving approach.

According to Barkley(1998), leaders use modeling, role playing, goal setting, and self-monitored homework strategies to introduce new skills. ‘Social-Cognitive psychology’ tries to use attitude change models and it is assumed that optimal shifts in attitudes and behavior will be obtained when parents devise their own solutions and rationales.

2.3 How COPE is implemented

In order to increase the chances of parents’ participation in COPE, the program has predicted the possible causes for parents’ evasion from educational programs. According to Cunningham (1998), some barriers which may stop parents to go to parent education programs are difficulties for day-time attendance, extracurricular activities, travel time or transportation costs, and child care problems. These problems are solved in COPE by different hours for course, using neighborhood schools and facilities, free education and free child care facilities. The whole average 25 member of the group will be divided to five to seven sub-groups who can work together. Each group has a leader who is responsible for keeping members concentrated on tasks and writes the discussion of group and shares them with the large group. Each member must take the responsibilities of the leader in the subgroup.