The evaluation had high recruitment and retention rates, with social care teams and participants expressing positive views about the programme. However, there was no statistically significant evidence that the Lighthouse Parenting Programme produced better outcomes than those who received the usual children’s social care treatment. Further research is needed to fully understand the impact and effectiveness of the Lighthouse Parenting Programme in the children’s social care sector, however the report presents some interesting learnings for those that are delivering Lighthouse.
The Lighthouse Parenting Programme (LPP) is 20-week programme designed to to enhance parents’ capacity for curiosity about their child’s inner world, to help parents ‘see’ (understand) their children clearly; to help parents make sense of misunderstandings in their relationship with their child, and to equip parents to avoid harmful responses when misunderstandings occur, and to repair the relationship when ruptured. Lighthouse involves a process called mentalisation (the ability to think about thinking). Improving parental mentalisation has the potential for reducing the risk of children being maltreated. Lighthouse is designed for parents who are at risk of mistreating their children and preliminary studies of LLP (in the UK and abroad) have observed improvements in parents’ mentalisation capabilities. This study evaluated the extent to which LPP significantly reduces child maltreatment risk in the children’s social care (CSC) setting. This is the first Randomised Controlled Trial to examine the implementation and impact of the LPP in a CSC context.
LPP aims to prevent child maltreatment, by promoting sensitive caregiving in parents, using a mentalisation-based approach. The programme is designed to enhance parents’ capacity for curiosity about their child’s inner world, to help parents ‘see’ (understand) their children clearly; to help parents make sense of misunderstandings in their relationship with their child, and to equip parents to avoid harmful responses when misunderstandings occur, and to repair the relationship when ruptured.
The Supporting Parents Project (SPP) is a study aiming to evaluate the LPP in Children’s Social Care (CSC) for parents with children who are known to services. LPP is an adaptation of Mentalization-Based Treatment (MBT) and has been specifically developed for parents for whom there are serious parenting concerns. This project is a scale up of a pilot evaluation of LPP, which found it may be effective in improving parental confidence and sensitivity. LPP was developed in a specialist mental health/clinical service, delivered by specialist clinicians. This study aimed to explore the potential for CSC professionals to be trained in LPP and for it to be offered in a CSC setting, under specialist supervision, in order that it could be made more widely available to families.
The study used a randomised controlled trial (RCT) design to assess the impact and implementation of the Lighthouse Parenting programme in five local authority children’s social care sites in England. The sample included 110 eligible parents, as well as family support workers and social workers who were trained to deliver the LPP and supervised throughout the process. The primary outcomes were child abuse potential (defined as the risk of a parent physically abusing a child) and the child’s social care status, and secondary outcomes were parenting stress, epistemic trust (parents’ ability to trust communicated information about the social environment and relationships), child psychopathology, parental reflective functioning, and parenting representational risk (assessing any problems in how caregivers see their roles, as well as their relationship with their infant). Data was collected using baseline and follow-up questionnaires and interviews with participating parents, before and after they participated in the LPP. To assess the implementation process, focus groups, semi-structured interviews and a survey were carried out with local authority managers and intervention facilitators and clinical supervisors.
The study had high recruitment and retention rates, with social care teams and participants expressing positive views about the programme. However, there was no statistically significant evidence that the Lighthouse Parenting Programme produced better outcomes than those who received the usual children’s social care treatment.
There were mixed reports from parents on the benefits of LPP. The interviews highlighted that some parents found the LPP helpful in understanding their child’s perspective and managing their emotions, while others reported no personal changes. Just over half of the identified LPP participants were engaged with the programme, with 20% not attending any sessions. Participants also reported mixed experiences with group and online formats, with some preferring individual work and face-to-face interventions. Newly trained facilitators faced challenges in delivering the model for the first time and described needing time to embed their learning. Staff and managers expressed enthusiasm for the LPP to be scaled-up in their services and to other local authorities. However, within the duration of the study, only half of the sessions were delivered with fidelity, adhering to the Mentalisation Based Treatment (MBT) principles and the Lighthouse model.
Due to these limitations, the impact findings of this study relating to the effectiveness of LPP should be kept under review. In particular, as previous evaluations have focused on highly trained practitioners with backgrounds in mental health, adjustments to LPP training, supervision, and delivery may be needed for embedding the programme within children’s social care to ensure its effectiveness.
If providers choose to use the Lighthouse Parenting Programme, the key recommendations are that additional support and supervision is given to social care practitioners lacking prior therapeutic training. Further feasibility work is also recommended to better understand delivery, recruitment, and evidence of potential effectiveness. Additionally, involving service users in the development of the LPP programme could potentially improve its suitability to the CSC context and consider the specific needs and circumstances of target families.
Overall, practitioners express strong support for LPP, advocating for its future implementation. Post-trial, most participating local authorities continue LPP implementation, noting lasting positive impacts.
Further research is needed to fully understand the impact and effectiveness of the Lighthouse Parenting Programme in the children’s social care sector, however there are some interesting learnings from the study, for those that are delivering Lighthouse.
Further evaluation is needed to understand the effectiveness of LPP in a children’s social care sector. We recommend that a further study should consider:
Further research could also develop a better understanding of implementation issues, in order to better prepare for any future impact evaluation. This would include further examination of what the barriers and facilitators to implementation are, and what contexts best support delivery of the LPP. This would include attention to selection and suitability of families, including capacity to engage in a group programme, practical support to enable attendance and/or preliminary exploration of attitudes to working in an in-person or online setting.
Future implementation and research on the LPP should be co-developed with families receiving the program. Adequate time for co-development should be built into any future programme. This would be valuable for responding to some of the questions that arose from this study, such as the most suitable target groups, and the relative strengths and limitations of online versus in-person delivery.