Study of the Efficacy of the Pathways to Competence Groups with
Women Who Had Experienced Violence in the Home
Introduction
This report summarizes the results of two Pathways to Competence parenting groups
that were provided for women with children (ages 0 - 6) who had experienced abuse
by their partners and/or abuse as a child in their families of origin. The Pathways to
Competence parenting group has been used preventatively in early intervention
programs as well as with a number of at-risk groups including: parents of aggressive
and noncompliant preschoolers; abusive parents; single, teenage mothers; and parents
with unresolved loss and trauma. Some of the settings in which it has been used
include: Children's Mental Health Centres, Children's Aid Societies, School Boards,
Hospital settings, Family Service agencies, Parent Resource Centres, and private
practice. The program's Group Leader Manual is based on the book Pathways to
Competence: Encouraging the Social and Emotional Development of Young Children
and it provides specific instructions on providing the groups and handouts to be given
to group participants. The groups were delivered by Catholic Family Services Peel
Dufferin in partnership with the HEAL Network.
Description of the Pathways to Competence Groups
Goal of the Groups
The goal of the Pathways to Competence parenting group is to enhance the
development and behaviour of infants and young children.
Objectives
Objectives of the groups are to:
.
Enhance parents' knowledge of early child development and parenting in the early
years.
.
.
Increase parents' self-reflectivity and empathy for the child.
Increase understanding of the influence of their early family life on their current
parenting practices.
.
.
.
.
.
.
.
Encourage parents to develop positive attributions of their child and to reframe
negative ones.
Enhance parent-child interactions and parenting strategies.
Encourage parents to develop secure attachments and bonding with their child.
Encourage parents to develop emotion regulation and positive strategies to
encourage it in their children.
Provide parents with strategies to deal with their children's behavioural or
emotional difficulties and reduce any symptoms.
Enhance parents' and the child's self-esteem or view of self and others.
Enhance parents' sense of support.
.
.
Give parents a good experience that will encourage them to seek further counseling
or treatment if necessary.
Increase parents' sense of parenting competence.
Approaches to Achieving the Objectives
A number of approaches are used to be successful in achieving the objectives listed
above. These include:
.
The framework of the groups is based on providing information on some of the
capacities that are achieved in the first 6 years of life and which have been shown to
be critical in forming foundations for later development. The early years and the
capacities gained can be seen as the foundation of a house or the roots of a tree upon
which later development builds. If any of them is compromised later development
and behaviour can be affected. These capacities are outlined below:
.
.
.
.
.
.
.
.
.
Body control and a positive body image
Secure attachment
Play and imagination
Language and communication
Positive self-esteem
Self-regulation of behaviour, morality, and a conscience
Emotion regulation
Concentration, planning, and problem-solving
Social competence, empathy, and caring
.
Focusing initially on an overview of early development and temperament the group
provides information on the importance of the developmental capacities listed
above and provides information on how to develop them.
.
Encourages parents in the group to continually consider and wonder about what the
child is thinking about and why he or she is behaving in the way they are in order to
enhance self-reflectivity and empathy for the child.
.
Group members provide support for one another that helps parents feel less isolated
and more able to cope with parenting challenges. Meeting with parents who are
experiencing similar challenges (e.g. child with a behaviour problem, family
violence) can be particularly helpful.
.
Attributions of the children are discussed and related to their own experiences with
negative attributions and then reframed.
.
Research has shown that the way people are parented is one of the most influential
factors in determining how they will parent (Benoit & Parker, 1994). In the
Pathways to Competence program, parents are encouraged to discuss how a
particular developmental issue being discussed was dealt with as they were growing
up. How did their family communicate? How was problem-solving dealt with?
How nurturing were their parents? By discussing these issues parents learn how
their current parenting behavior and beliefs are influenced by their own history in
2
the family of origin. Such discussions can help parents gain insight into their
repeating patterns of behavior and enable them to begin to change maladaptive
intergenerational cycles of poor parenting.
.
A number of self-care activities and strategies to calm down when they become
stressed or triggered are provided which can be very helpful for parents with
unresolved loss and trauma.
.
A number of approaches to problem-solving around parenting dilemmas are
provided that can continue to be used by parents after the conclusion of the groups.
.
Parents' sense of parenting competence is enhanced by having their positive
parenting capacities reinforced. Changes can also take place as they gain insight
into their past, have new experiences in the group of being accepted, and practice
using the capacities they need to encourage in their children. Their children's sense
of self-esteem can be enhanced as parent-child interactions improve and parents
work to establish a secure attachment with them and learn strategies to enhance their
child's self-esteem.
.
Parents are provided with a number of strategies to help them overcome any
difficulties they may be having with regulating their own emotions around their
child.
.
Parents learn new ways to interact with their children in order to help them
overcome behaviour problems such as noncompliance and aggression. As well
parents are supported to interact with their children in ways that can enhance their
children's capacity for behavioural regulation.
Group Strategies for Achieving the Objectives
The program employs a number of strategies to enhance these competencies in parents
that include:
1) Didactic methods that provide information about normal development of the
various competencies and the principles of ways to encourage them.
2) Role playing around such issues as communication, negotiation and problemsolving, and encouraging emotion regulation in children.
3) Group discussion of the parents' own situations and parenting challenges.
4) Group exercises to encourage the capacities in parents.
5) Assigned homework exercises.
6) Use of videotaped interactions.
Group Session Structure
3
Although each step follows a similar structure it can also be varied according to the
experience of the group leaders and the composition of the group. Also, although the
structure of the group sessions will be similar the amount of information provided and
discussion allowed will vary significantly depending on the number of sessions (one or
two) that will be spent with each topic. In some situations parents may want to talk
about their own experiences growing up earlier in the session. Other groups may prefer
to start the group activities earlier than suggested above. It is helpful to conduct the
first group following this suggested order, however, in subsequent sessions the plan
could be varied in order to keep the interest and involvement of group members high.
Homework
Each week it is important to assign homework for the parents. Homework suggestions
include two different activities:
(1) Parenting
.
.
.
.
An activity to try with their child
A behavioral strategy to implement
Something for the parent to observe about their child
Reflections on their own families of origin
(2) Self care
.
A self-care activity
Many homework suggestions are contained in the manual or in the text "Pathways to
Competence". Parents should choose one activity related to parenting and one self-care
activity. If two sessions are used for one step homework should be assigned for both
weeks. Allowing parents the opportunity to practice skills with the chance for feedback
from leaders and peers will ensure a greater likelihood for parents to implement new
methods of parenting after the group is over. Changing their ways of interacting with
children requires parents to implement the strategies they learn in the group. After the
first meeting it is important to review the homework from the previous week at the
beginning of the session. Briefly review the key ideas and entertain questions. Give
group members the opportunity to help problems solve the issues the parents raise.
Practice with feedback is important to lead to permanent change in parenting behavior.
Be sensitive to those group members who found the assigned tasks difficult to carry out.
The group leaders will consistently encourage self-reflectivity and empathy for the child
during these discussions. For example, parents may have been asked to reframe some
"don'ts" to "dos" and would be asked to comment on how this made the child feel and
how they acted. Did they experience more understanding of their child? How did they
feel doing it? Each week a self care activity is suggested to encourage parents to lessen
the stress in their life especially concerning parenting. A list of self-care activities is
provided to the group however other activities to choose from can be generated by
members of the group. Parents pick a self-care activity each week to try and report on it
the following week. During self-care activities the discussion will focus on how helpful
the activity was and what they felt was important about it.
Setting the Stage
4
Each group topic in subsequent chapters contains suggestions on how to introduce a
new topic. It is important to capture the group's attention and engage them in a
discussion of the topic at the start of the session. This sets the stage for their
involvement in both receiving the information and problem solving the issues for their
family and child. It is important to remember that it is during this discussion that the
parent will evaluate if the next few hours that will be a worthwhile use of their time.
Discussion of Key Words
This section defines exactly what skills will be talked about in the evening. Most
parents do not know what attachment is or how expressive language is different from
receptive language. So explaining the topics in an interesting way is important to help
capture the group's interest. Visual or auditory props and having the parents describe
examples from their own children help pinpoint the kinds of behavior the discussion
will be centred around. For example, most group participants will have heard about selfesteem but further refinement of their understanding will be helpful.
Development of the Capacity
This section describes how the capacity develops in early life. Tables contain key
features at each stage of development. Highlighting a few of the key competencies
during a brief discussion helps parents understand that children are not born with all the
skills they need to demonstrate a capacity and indicates the importance of having age
appropriate expectations. Parents spend time reviewing the table and discussing where
their child might fit in the developmental sequence and what skills may be emerging as
their child develops.
Importance
of the Capacity Being Discussed
This section helps parents understand the importance of the capacity for their child and
how this capacity may have an impact on their child's life. It includes questions that
parents often wonder about like - what about sending their child to daycare - will he
still have a secure attachment? Why is it important for their child to have opportunities
for creative and fantasy play? Is it okay ifmy child has and imaginary friend? Is it
really important for their child to have good self esteem?
Any Important
Research about the Capacity
The text, 'Pathways to Competence' contains extensive reviews of the literature for
each capacity topic. The leaders of a group read the material pertaining to the evening's
topics and select some of the information that they think their group would find
particularly relevant. A brief description, in terms that are comprehensible for the
group, helps participants understand what is currently known about different aspects of
the capacity being discussed. This section may not be appropriate for all groups and
presenting the information in a way that the parents find interesting and answers their
questions is important. Group leaders can also add details in areas that are of particular
interest. A good knowledge of the text is helpful.
5
Parenting
Principles
and Techniques
The principles were developed based on a distillation of the current research findings
for each capacity. The principles specify general approaches to developing the capacity
in young children. There are handouts for parents that the group can review and
discuss. For a number of the capacities there is a resource video that reviews the
principles and gives visual examples of how parents can encourage the capacity in their
child. Parents discuss how they understand each principle and how they could
implement the concept with their child.
This part of the group includes lots of practical parenting ideas. Suggestions are given
both in the manual and the text. This is often the section where you find suggestions for
the homework part of the program. Some techniques can be practiced within the group
with participants taking different roles. These practice sessions set the stage for trying
the skills at home. Parents love the new ideas and if a safe secure environment has been
established the active participation can be fun and helpful to parents.
How It Was Dealt With in Their Family of Origin
This part of the session often plays a pivotal role in changing parents' thinking and
behavior. A key factor predicting how people will parent his how they were parented.
The manual poses several questions for parents to answer which will help them think
about the functioning of their families of origin and how the capacity was dealt with by
their own parents. The 'light' comes on when they see their own behavior mirrored in
the behavior of their parents. These activities are not put under one section but are
integrated across a number of areas that are considered most suitable. Some parents
may also discuss how their own difficult experiences have made them try not to repeat
that model of parenting with their own children. Group leaders should listen carefully to
make sure the parent is not over-compensating for their parents' behaviour and gently
point it out if that is the case.
Group Activities
Group activities are interspersed throughout the various principles to help with learning
throughout each of the steps in this manual. These activities include questionnaires and
activities that will help parents understand themselves, their parenting style and how to
help their child develop the different capacities. Activities are chosen that will work
best for the parents in each group. The choice of what activities to use will vary
according to the parents who will be attending, the particular issues they are dealing
with, the number of weeks assigned to each capacity, and how comfortable the group
leaders feel with a certain activity.
Other Discussion
groups
For each step group leaders introduce other important topics frequently raised by
parents about the developmental capacity being discussed. For example, under Emotion
Regulation some parents may want to discuss sibling rivalry and under Concentration,
Planning, and Problem-Solving they may want to find out more about ADHD. Under
each of the steps the more important topics are identified but the group leaders is
6
referred to Pathways to Competence for others. Topics for discussion should be selected
on the basis of the topics that the group is most interested in.
Home Work
Something is assigned each week that is geared to the needs of a particular group.
Metaphor for Development: The Tree
The tree is introduced in the first session as a visual cue and a metaphor to depict what
mothers are learning about parenting and development. At the end of each group
session parents will add the principles of parenting to the tree and the capacities will
gradually be added as roots of the tree.
The Current Study of the Efficacy of the Pathways to Competence Groups with
Women Who Had Experienced Violence in Their Homes
The Participants
Mothers who had experienced spousal abuse and/or historical childhood abuse with
children of ages between 0 - 6 were recruited through the HEAL network and the Peel
Children's Aid Society. Fourteen women began the program and there were 10
women who attended the groups consistently and for whom pre and post data are
available on most of the measures.
All women involved in the groups had one or more children. Mothers ranged in age
from 21 to 40 and the children from 3 months to 5 years.
Personal History
Eight of the mothers reported very difficult personal histories that included the
following:
Table 1: Mothers' Personal Histories
Difficult situations
Frequent moves
Separation or divorce of parents
Violence between their parents
Parents having affairs
Sexual abuse as a child or adolescent
Violence towards children by parents
Isolation or loneliness
Death of a parent/caregiver
Financial problems
Heated arguments between parents
Remarriage of parents
Mental health problems of parents
7
# of
women
2
5
5
3
5
4
7
3
4
4
1
2
2
1
Trouble with the law
Children running away
Attachment
Classification
Eight of the women initially reported themselves to be Dismissive and described
themselves as:
"I am somewhat uncomfortable being close to others. I find it difficult to trust them
completely, and difficult to allow myself to depend on them. I am nervous when
anyone gets too close, and often, others want me to be more intimate than I feel
comfortable being."
Three mothers following the group described themselves as being Secure or
Autonomous in relationships and felt they could trust again and were able to be
independent in managing their lives.
Method
Mothers attended a pre-group session during which they completed a number of
questionnaires and were videotaped playing with their child. The questionnaires and
videotaped interaction allowed for the collection of data that enabled evaluation of the
success of the parenting group in meeting the objectives set out below. Data from the
questionnaires and videotaping was collected again following the completion of the
groups. A 6 month follow up was also conducted and the mothers again completed
the questionnaires to determine if changes they made had endured.
Group Objectives
for the Current Study
The objectives of the Pathway to Competence group examined in this evaluation were
as follows:
1. Improve the parent-child interactions in the areas of:
.
.
.
.
.
Maternal sensitivity
Maternal structuring and intrusiveness
Maternal hostility
Child involvement
Child responsiveness
2. Enhance the self esteem of mothers
3. Enhance mothers' ability to be aware of their feelings and to be introspective
about them
4. Decrease maternal depression
5. Enhance mothers' sense of social support
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6. Decrease parenting stress in the areas of:
.
.
.
.
Parental distress
Parent-child dysfunction
Difficult child
Overall parenting stress
.~
It was hypothesized that as a result of the group mothers would improve in the areas
outlined above.
Tests and Measures
The variables assessed reflected the goals and objectives for the groups and tests and
measures were chosen to gather information on them. The tests and measures are
described below.
Demographic
Information
Demographic information such as their own personal history of being parented and
how they believed their child(ren) were affected by the family violence were collected
in the pre-test session. The mothers were also asked to rate them themselves on a 3item scale for quality of attachment. These were not expected to change as a result of
the groups. (However, changes in attachment style were described by three of the
mothers who at the pretest had described themselves as Dismissive. At the end of the
groups these three women described their style as Secure.)
Parent Satisfaction
In the follow-up session parents were asked for comments about the groups and what
they found most useful.
Pre and Post Test Measures
Emotional Availabilit
Scales-Infanc
The Emotional Availability Scales (Biringen, Robinson, & Emde, 1993) were
developed to fill the need for a measure of maternal sensitivity that could be used in
shorter observations than the more extensive measures developed by attachment
researchers. The scales provide specific behavioural descriptions of interactions that
are used with the coding. The Emotional Availability Scales have five dimensions that
are viewed as relationship variables. Each dimension has detailed behavioural
dimensions for coding. A minimum of 15 minutes of interaction is recommended in
order to obtain high reliability and validity. The maternal sensitivity scale assesses
how warm and positive the mother is with her child, her responsivity and acceptance
of her child's actions and verbalizations, how well she can resolve conflict, how
flexible and creative she is and how well she can time her actions to those of her
child's. The scale ranges from (1) Highly Insensitive to (9) Highly Sensitive.
Maternal structuring and Intrusiveness rates the mother's ability to set limits and
structure her child's play appropriately. The scale ranges from (1) Very Passive or
Very Intrusive to (5) Where the mother is actively involved in the play while letting
9
the child lead. Maternal Hostility scale assesses the mother covert and overt hostility
towards her child. The highest score (5) is given to a mother who if markedly hostile
physically, verbally and/or facially. Covert hostility is rated as 2 or 3, while no
hostility observed is rated as (1). The Child Responsiveness to Mother scale is
described as the child's sensitivity scale. Here the child's willingness to engage with
the mother in play is assessed, as well as the amount of pleasure the child is
displaying in his/her interactions with the mother. An Unresponsive child receives a
score of (1) and a Highly Responsive child receives the optimal score of (7). Finally,
the scale Child Involvement with the Mother rates how the child engages the mother in
play and attends to her. The Uninvolving Child (1) does not pay attention to the
mother at all, or if responding, does not elaborate or initiate exchanges with the
mother. The optimal rating (7) is given to the Highly Involving child where there is a
clear balance between autonomous play and seeking to involve the mother.
Four of the five scales have non-linear (non-continuous) clinical categories. There is a
cut-off between the main part of the scale and the highest score for every scale with
the exception of the Covert/Overt Hostility Scale. For Child Involvement and Child
Responsivity the highest score of 9 is considered to be "clinical" or non-optimal and 7
is considered to be the highest or most optimal score. In order to score the videos any
9s that were considered non-optimal in the scoring were converted to 0 and the other
scores were used. For the Structuring/Intrusiveness scale it was collapsed into a linear
scale from 1 to 5, where 5 is the optimal rating, 3 is inconsistent, and 1 is considered
non-optimal. The clinical rating of 9 becomes 1, 7 is transformed to 3, and 6 becomes
4.
The scales have been found to show consistency or reliability over time and to
correlate with other interactional measures and assessment of maternal risk (Biringen,
et aI., 1994; Oyen, 1996; Oyen, Landy, & Hilburn-Cobb, 2000: Rethazi, 1997).
The mother-child interactional videotapes were scored by a researcher trained to
reliability by the creator of the scales.
Rosenberg Self Esteem Scale (RSES)
The Rosenberg Self Esteem Scale (Rosenberg, 1965) consists of 10 items that assess
global positive and negative attitudes toward the self. Items are of the following type:
"I feel that I have a number of good qualities all in all"; "I am inclined to think I am a
failure". Subjects rate the questions on a 5-point Likert scale from (1=not at all
accurate to 5=completely accurate) the extent to which each statement is felt or
experienced. A total is computed by summing the ratings on all the items.
The possible scores on self-acceptance and self-worth range from (1) low self esteem
to (5) high self-esteem. High self-esteem signifies that the individual respects herself
and considers herself worthy of love. Low self-esteem reflects
both lack of self.
respect and feelings of inadequacy.
The Rosenberg Self Esteem Scale was standarised on a sample of 5,024 college
students with a internal consistency of .77. Concurrent validity has been established
by a demonstrated high relationship between low scores on the measure and depressed
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affect. Test-retest reliability of .61 over 7 months has been found. It is a strong
predictor of unwed pregnancy, drug use and depression.
Toronto Alexithymia Scale (TAS)
The Toronto Alexithymia Scale (Bagby, Parker, & Taylor, 1994) is a 20-item scale
which assesses the construct of Alexithymia, that is a reduced ability to accurately
identify subjective feelings, as well as reflect and communicate emotional experiences
and distress. Such a characteristic makes it more difficult to modulate emotional
experiences and to receive relevant interpersonal support. The scale has demonstrated
internal consistency of .76 as well as convergent and discriminant validity based on its
pattern of correlation with self-report measures of traits theoretically related and
unrelated to alexithymia. Cut-off scores have been set at >= 61 out of a possible 100
denoting Alexithymia and <=51 denoting non-Alexithymia. Intermediate scores range
between 52 and 60. High scores denoting Alexithymia have been found with parents
with unresolved loss and trauma (Martyn, 2002).
Center for Epidemiological Studies Depression Scale (CES-D)
The CES-D (Myers & Weissman, 1980) is a self-report measure of depressive
symptomatology. It has two major uses and is used for screening populations for the
incidence of depression and as short measure for research. It has 20 items that assess
the frequency and duration of symptoms associated with depression in the preceding
week. Scores range between 0 and 60. Scores of 16-20 indicate mild depression, 2130 moderate depression, and 31 or higher indicates severe depression.
Test-retest reliabilities between .48 and .50 after 3 months have been found. Strong
discriminant validity has been found in a number of studies. Concurrent and construct
validity has been found with correlations of.8 with other longer tests of depression
and other clinical measures.
Social Support Inventory (SSI)
The Social Support Inventory (Cutrona & Russell, 1987) assesses the mother's
subjective experience of reliable alliances, social integration, and opportunity for
nurturance and sense of support from family and friends. There are 6 items assessed
on a 4-point scale with 24 indicating a sense of high support. Test-retest reliability is
.92 and the test correlates with other social support measures and measures of the
individual's personal characteristics.
Parenting Stress Index-Short Form (PSI)
Parenting Stress Index-Short Form (Abiden, 1986) considers 3 factors that are added
together to give a total parenting stress score. These are: Parental Distress (items
signal parental distress coming from a variety of aspects of their experience), ParentChild Dysfunctional Interaction (items indicate the degree to which the parent derives
satisfaction from interaction with their child and how much the child meets their
expectations), and Difficult Child (items here are related to the child's temperament).
There are 12 items scored between 1 and 5 in each of the sub-scales to a total of 60,
with high scores indicating less stress. The total score is out of 180.
II
Test-retest reliabilities are high and vary from .84 for the total score and .78 for the
difficult child scale. Concurrent validity has been established by comparing the short
form with the long form of the scale that is well validated. The correlation was .94.
Results
Pre and Post Test Measures
Group One
On the pre and post-test measures mothers in Group One showed improvements
following the group on 11 out of 13 measures and of these 6 were significantly
different using t-tests.
Table 2: Pre and Post Test Means and the Significance of the Changes for Group 1
Measures
Emotional Availability Scales
Maternal Sensitivity
Maternal Intrusiveness/Structuring
Maternal Hostility
Child Involvement
Child Responsivity
Rosenberg Self Esteem Scale
Toronto Alexithymia Scale
CES-D
Social Support Inventory
Parenting Stress Index - Short Form
Personal Distress
Parent-Child Dysfunctional
Interaction
Difficult Child
Total Score
Pre-tests
Means
Post-test
means
Significance
5.20
4.10
1.50
5.00
4.00
36.80
53.60
22.20
18.60
7.20
4.80
1.30
7.00
5.20
38.00
47.00
18.80
18.40
+2.00*
+.70
-.20
+2.00*
+1.20
+1.20
-16.60**
-3.40*
-.20
40.40
50.60
47.2
48.60
+6.80*
-2.00
42.80
133.80
43.40
140.20
+.60
+6.40*
Statistically significant at the .05 level of significance
*
** Statistically significant at the .01 level of significance
As will be noticed mothers in Group One showed their most significant improvements
in reducing depression and the level of alexithymia. In interactions they showed
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improvements in maternal sensitivity and child involvement. Their level of parenting
stress and personal distress in their lives was also significantly reduced.
Group Two
On the pre and post-test measures mothers in Group Two showed improvements
following the groups on all of the measures and of these 8 were significantly different
using t-tests. See Table 2 below.
Table 3: Pre and Post Test Means and the Significance of the Changes for Group 2
Measures
Emotional Availability Scales
Maternal Sensitivity
Maternal Intrusiveness/Structuring
Maternal Hostility
Child Involvement
Child Responsivity
Rosenberg Self Esteem Scale
Toronto Alexithymia Scale
CES-D
Social Support Inventory
Parenting Stress Index - Short Form
Personal Distress
Parent-Child Dysfunctional
Interaction
Difficult Child
Total Score
Pre-tests
Means
Post-test
means
t tests
6.00
5.00
1.33
4.33
4.33
29.75
41.50
18.60
15.25
8.00
6.67
1.00
6.33
7.00
37.75
37.00
15.20
20.25
-5.0
-3.7
1.0
-4.0
-4.00
-4.08
1.71
.44
-2.2
.04*
.007**
.42
.22
.05*
.03*
.19
.02*
.05*
39.5
47.5
43.5
54.25
-.627
-2.38
.57
.05*
33.50
120.50
44.75
142.50
-2.67
-2.07
.05*
.13
Significance
* Statistically significant at the .05 level of significance
** Statistically significant at the .0 I level of significance
As will be noticed mothers showed statistically significant improvements in reducing
negative attributions of the child (Child Temperament) and parent-child conflict,
reducing their level of intrusiveness in interaction with their child and increasing their
sense of social support. The level of depression was significantly reduced and their
sense of self-esteem was significantly improved. As well their sensitivity in
interactions with their child and their child's responsiveness with their mothers was
also increased. All other measures improved although not statistically significant.
Parent Satisfaction
for Both Groups
Favourite Steps or Competencies
13
All the mothers expressed satisfaction with the groups and 6 would have liked them to
continue for longer or for there to be another follow-up group. The parents were asked
to rate the different steps in order of helpfulness. Three of the mothers rated all the
steps the same and excellent. The other mothers' favourite steps or group topics
varied. For example, one mother rated Self Esteem, Emotion Regulation, and
Morality highest and another rated Pretend Play and Attachment as the highest. As
one mother expressed it "All topics were extremely helpful and insightful, therefore
the categorization indicated, I think, is too restrictive. In fact if one of the topics was
missing it would be very disappointing and the program and the people attending it
would suffer." Another commented, "All the topics played an important role and if
anyone ofthem was missing the group would not have been as good."
Favourite Aspects of the Group Program
Mothers were also asked about the aspects or strategies used in the groups that they
found most useful. The group felt that all aspects of the group were important. The
four unique or important aspects of the Pathways to Competence groups were well
received, these were: Talking about how I was parented as I was growing up; group
exercises, principles of parenting, and information on my child's development.
Discussion with other parents was also highly valued.
Combining the Results from Group One with the Results of Group Two
In order to have a larger sample the results from both groups were combined to see
how successful the group was in improving the outcome measures using this slightly
larger sample of 10 mothers. See the Table 3 below for these results.
Table 4: Pre and Post Test Means and the Significance of the Changes for Groups I
and 2 Combined
I
Measures
Emotional Availability Scales
Maternal Sensitivity
Maternal Intrusiveness/structuring
Maternal Hostility
Child Involvement
Child Responsivity
Rosenberg Self Esteem Scale
Toronto Alexithymia Scale
CES-D
Social Support Inventory
Parenting Stress Index - Short Form
Personal Distress
Parent-Child Dysfunctional
Interaction
Pre-tests
Means
Post-test
means
t tests
5.50
4.50
1.75
5.13
4.75
33.38
48.22
25.11
17.00
7.63
5.50
1.25
6.75
6.75
39.50
41.22
18.67
19.22
-6.07
-3.7
-7.6
-3.53
-4.7
-4.34
2.07
2.87
-1.49
.001 **
.007**
.47
.01*
.002 **
.003**
.05*
.02*
1.47
40.00
47.5
46.11
54.25
-.627
-2.25
.57
.05*
14
Significance
38.66
127.88
Difficult Child
Total Score
44.67
144.11
.05*
.01**
-2.10
-2.99
When the results are combined three additional measures improved significantly and
the level of significance of those that improved was much higher.
Post and 6 Month Follow Up for Groups 1 and 2 Combined
In order to assess if the changes made in groups I and 2 were maintained 6 months
after the groups had concluded further testing using the paper and pencil tests was
completed. These results are shown in Table 4 below.
Table 5: Post and Post-Post Test Means and the Significance of the Changes
for Groups I and 2 Combined
Measures
Rosenberg Self Esteem Scale
Toronto Alexithymia Scale
CES-D
Social Support Inventory
Parenting Stress Index - Short Form
Personal Distress
Parent-Child Dysfunctional
Interaction
Difficult Child
Total Score
Posttests
Means
Postpost test
means
t tests
Significance
36.67
42.00
21.00
22.33
41.00
45.00
14.67
16.33
1.42
.66
1.61
2.27
.29
.58
.25
.15
44.33
52.60
41.67
52.00
.32
1.59
.78
.25
44.00
142.67
42.33
127.33
.26
1.09
.82
.39
As is shown in this table there were no statistically significant changes from
immediately after the groups were completed to 6 months later. This indicates that the
positive changes made by the mothers were maintained. It should also be noted that
although the changes were not statistically significant the mothers continued to show
improvements 6 months later in the areas of reduction of depression, personal distress,
negative interactions with their child, and in levels of parenting stress. There were
also some improvements in mother's self esteem. The only measure, on which there
was some deterioration, although it was not statistically significant, was with sense of
social support. This may have occurred because they were missing the support of the
other women and the group leaders. These results indicate that the changes found
were enduring and the group continued to be a positive influence on these mothers
and their children 6 months after the completion of the groups.
Conclusions and Recommendations
15
The results of the evaluation of the Pathways to Competence groups are very
encouraging. Significant effects were found on pre- and post-tests for a number of the
variables targeted by the group intervention with almost all measures showing
improvements.
When the results of the first group and the second group were combined the
improvements in the measures was even more significant. Similarly, when the groups
were followed up 6 months later the results indicated that almost all the improvements
were maintained and in some areas the mothers continued to improve.
The results suggest as well that an emphasis on the resolution of the mothers' very
difficult experiences both as they were growing up and in their partner relationships
can be very effective in improving a number of the parent characteristics. Parent
satisfaction with the groups was also very high and there was very little drop-out or
non-attendance once mothers became involved in the groups.
Of course the number of participants was small even with the combined groups and
below the optimal number of 30 suggested for evaluation studies making analysis of
the data difficult. Consequently the results must be taken with some caution although
the strengthening of the findings with two groups is very encouraging. The Pathways
to Competence program shows significant promise as a parenting group for women
who have experienced violence in their relationships. It could also be used
preventatively to enhance the sense of competence of women who have grown up in
violent situations and to enhance their parenting interactions with their children and
consequently the developmental outcomes of their children.
16
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17