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Initial transfer of Project Support from the US to Sweden: Feasibility and clinical aspects as viewed by counsellors and parents
Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).ORCID iD: 0000-0002-2368-3700
2022 (English)Doctoral thesis, comprehensive summary (Other academic)Alternative title
Initial överförbarhet av Project Support från USA till Sverige : Genomförbarhet och kliniska aspekter utifrån behandlare och föräldrars perspektiv (Swedish)
Abstract [en]

Project Support (PS) is a parenting programme developed and studied in the US for parents and children exposed to intimate partner violence (IPV) and for these children with subsequent behavioural problems. By examining feasibility aspects and using qualitative and quantitative methods, the study aimed to explore the transferability of PS to a new naturalistic context, i.e., Swedish social services. In the qualitative Study I, IPV-exposed mothers and counsellors who received/conducted PS were interviewed about their experiences. Study II explored whether the effects of PS in the US, i.e., reduced children’s psychological symptoms and improved parenting capacity among parents and children exposed to IPV, could be replicated in Sweden. Study III explored group and individual impacts of PS on parents regarding aspects of IPV, global psychiatric symptoms, and post-traumatic stress symptoms. Study IV is a qualitative follow-up study where counsellors were interviewed about how the PS work was or was not continued. 

The results indicate cultural differences between the US and Sweden in practising parenting skills though role-playing and in how to address and understand child misbehaviour, necessitating adaptation to Swedish values and norms. Results further indicate that PS is a promising intervention for Swedish IPV-exposed parents and their children with behavioural problems, leading to improved parental capacity and decreased child behavioural problems, supporting prior research in an American context. PS generally seems to improve parents’ psychiatric symptoms, but examining each individual revealed that most parents still had dysfunctional levels of symptoms post treatment. Maintenance and use of PS was inconsistent, due to lack of organisational support. 

The study indicates that PS can be further implemented and evaluated in Sweden, and stresses the importance of conducting feasibility studies when an intervention is to be transferred to a new context.

Abstract [en]

There is a need for new interventions for families exposed to intimate partner violence (IPV) in Sweden. Project Support (PS) has been chosen as one such intervention based on previous positive research conducted in the US addressing child behavioural problems and maternal needs. When transferring an intervention to a new context, its feasibility must first be evaluated. Building on aspects of feasibility, this dissertation examines the transferability of PS to social services and to families exposed to IPV in Sweden. 

The PS intervention was found to be promising for Swedish IPV-exposed families. In line with previous research, PS resulted in improved parenting capacity and reduced child behavioural problems. However, from a clinical perspective many parents had additional needs regarding psychiatric symptoms in the aftermath of IPV. Results indicate that PS needed cultural adaptations when being implemented in Sweden and that managerial support was important during this implementation. Taken together, the present results indicate that PS should be further implemented and evaluated in Sweden, highlighting the importance of conducting feasibility studies.

Place, publisher, year, edition, pages
Karlstads universitet, 2022. , p. 162
Series
Karlstad University Studies, ISSN 1403-8099 ; 2022:22
Keywords [en]
Intervention, Parenting programme, Intimate partner violence, Children’s behavioural problems, Feasibility study
National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:kau:diva-90423ISBN: 978-91-7867-295-0 (print)ISBN: 978-91-7867-306-3 (electronic)OAI: oai:DiVA.org:kau-90423DiVA, id: diva2:1669911
Public defence
2022-09-16, 11D257, Agardhsalen, Karlstad, 10:00 (Swedish)
Opponent
Supervisors
Funder
Swedish National Board of Health and WelfareRegion VärmlandAvailable from: 2022-08-26 Created: 2022-06-15 Last updated: 2022-12-12Bibliographically approved
List of papers
1. From doubt to trust: Swedish mothers' and counsellors' experience testing a parenting programme for mothers exposed to intimate partner violence whose children have developed behavioural problems
Open this publication in new window or tab >>From doubt to trust: Swedish mothers' and counsellors' experience testing a parenting programme for mothers exposed to intimate partner violence whose children have developed behavioural problems
2020 (English)In: Clinical Child Psychology and Psychiatry, ISSN 1359-1045, E-ISSN 1461-7021, article id 1359104520931569Article in journal (Refereed) Published
Abstract [en]

Many countries seek evidence-based interventions for children who have been exposed to domestic violence, and they frequently turn to interventions developed in the US and disseminated to Europe as a solution. Societal and cultural differences may, however, pose barriers to successful implementation. Project Support (PS), piloted in this study through social services agencies in Sweden, has shown positive effects in the US for families with children who have been exposed to intimate partner violence (IPV). The aim of this study was to investigate counselors' and caregivers' experiences when giving/receiving PS in Sweden. The study was based on interviews conducted with 11 mothers and 13 counselors with experience in the programme. A thematic analysis showed three themes (Initial doubts, Confidence from positive change, and Flexibility- challenge for the organization) and the study adds information about obstacles for implementation of PS in Sweden. Cultural and organizational differences between Sweden and the US in practice and child-rearing attitudes are highlighted, as well as the importance of making adjustments while maintaining treatment fidelity, and promoting the dissemination of the approach.

Place, publisher, year, edition, pages
Sage Publications, 2020
Keywords
Parenting programme, intimate partner violence, feasibility study, behavioral problem, qualitative study
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-79174 (URN)10.1177/1359104520931569 (DOI)000548574800001 ()32650670 (PubMedID)2-s2.0-85087788306 (Scopus ID)
Note

This publication is part of Helena Draxlers licentiate thesis Project Support i svensk socialtjänst. It has since changed publication type from manuscript to published article.

Available from: 2020-08-05 Created: 2020-08-05 Last updated: 2022-06-16Bibliographically approved
2. Replicability of effect when transferring a supportive programme for parents exposed to intimate partner violence and their children from the US to Sweden
Open this publication in new window or tab >>Replicability of effect when transferring a supportive programme for parents exposed to intimate partner violence and their children from the US to Sweden
2019 (English)In: Child Care in Practice, ISSN 1357-5279, E-ISSN 1476-489X, Vol. 25, no 4, p. 367-382Article in journal (Refereed) Published
Abstract [en]

Transferring an evidence-based parenting programme for parents exposed to intimate partner violence (IPV) and their children with emotional and behavioural problems reveals the extent to which cultural and social aspects can interfere with the programme’s effectiveness. Feasibility studies are of value in such circumstances, and the aim of the present feasibility study was to explore, on a small scale and in its natural context, whether the effects of the parenting programme, Project Support, were replicable when transferred to another country. In this study, the programme, which was originally designed for parents exposed to IPV and their children who had developed psychological symptoms in the United States, was evaluated in an equivalent population receiving Swedish social services. Parents (n = 35) self-assessed their parenting capacity and their children’s (n = 35) psychological symptoms. The results indicate that the parents improved their parenting capacity, and feelings of helplessness and fear regarding parenting their children decreased. Those feelings were also associated with the children’s psychological symptoms. The promising results are similar to the findings of previous research from the US, and further implementation and evaluation of Project Support in Sweden are indicated.

Place, publisher, year, edition, pages
Routledge, 2019
Keywords
Feasibility study, parenting, domestic violence, social work, children’s psychological symptoms
National Category
Psychology (excluding Applied Psychology)
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-70309 (URN)10.1080/13575279.2018.1463968 (DOI)
Note

This publication is part of Helena Draxlers licentiate thesis Project Support i svensk socialtjänst. It has since changed publication type from manuscript to published article.

Available from: 2018-11-27 Created: 2018-11-27 Last updated: 2022-06-16Bibliographically approved
3. Manuscript: Changes in psychiatric symptoms in Swedish mothers who take part in Project Support: An intervention for mothers exposed to IPV with children who have developed conduct problems
Open this publication in new window or tab >>Manuscript: Changes in psychiatric symptoms in Swedish mothers who take part in Project Support: An intervention for mothers exposed to IPV with children who have developed conduct problems
(English)Manuscript (preprint) (Other academic)
National Category
Psychology
Identifiers
urn:nbn:se:kau:diva-90424 (URN)
Available from: 2022-06-15 Created: 2022-06-15 Last updated: 2022-10-04Bibliographically approved
4. Manuscript: What does it take for an intervention to be more than a “flash in the pan”: A qualitative follow-up study of how Swedish social service counsellors experienced their Project Support work
Open this publication in new window or tab >>Manuscript: What does it take for an intervention to be more than a “flash in the pan”: A qualitative follow-up study of how Swedish social service counsellors experienced their Project Support work
(English)Manuscript (preprint) (Other academic)
National Category
Psychology
Identifiers
urn:nbn:se:kau:diva-90426 (URN)
Available from: 2022-06-15 Created: 2022-06-15 Last updated: 2022-10-04Bibliographically approved

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