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The Incredible Years After 10 years in Norway A prevention and treatment program for children with conduct problems Developed by Carolyn Webster-Stratton, Ph.D. The Incredible Years Training Series. 23.09.2009. De utrolige årenes programserie. Program for personale i skoler og barnehager.
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The Incredible Years After 10 years in Norway A prevention and treatment program for children with conduct problems Developed by Carolyn Webster-Stratton, Ph.D. The Incredible Years Training Series 23.09.2009
De utrolige årenes programserie Program for personale i skoler og barnehager Program for barn 3-8 år: Dinosaurus- skolen i klasserommet/ barnehagen Program for barn 3-8 år: Dinosaurus- skolen i smågruppe Program for foreldre til barn i alderen 4-12 år ”Advanced” Program for foreldre til barn i alderen 6-12 år (ny!) Program for foreldre til barn i alderen 4-8 år ”Basic” Program for foreldre til barn i alderen 3-6 år (ny!) Program for foreldre til barn i alderen 0-3 år
Agencies in Norway North Norway: Alta kommune, BUP Alta, Nordreisa kommune, BUP Tromsø, BUP Midt-Troms (Finnsnes), BUP Nord-Troms (Storslett), Tromsø kommune, Vågan kommune, BUP Gravdal Mid Norway: Trondheim kommune (alle 4 bydeler), BUPTrondheim, Verdal kommune, Levanger kommune, Melhus kommune, BUP Kristiansund, Kristiansund kommune, Averøy kommune, Frei kommune , Inderøy kommune, Surnadal kommune, Innherred kommune, Verdal kommune Vest Norway: Bergen kommune, BUP Fana, BUP Sentrum, BUP Nordhordland, Fjell kommune, Sogndal kommune, Odda kommune, Stavanger kommune, BUP Stavanger, Strand kommune, Randaberg kommune, Time kommune, Årstad familiesenter, Bufetat region vest, BUP Sogndal, Odda kommune, Klepp kommune, BUP haugesund, Sandnes kommune, BUP Sandnes South/East Norway: Holmestrand kommune, BUP Bærum, BUP Søndre Nordstrand, BUP Nydalen/AMT, Forus/Kirkens bymisjon/Nanna Maries hjem, Arendal SSHF, Gjerdrum kommune, Nøtterøy kommune, Nittedal kommune, Ski kommune, Sørum kommune, BUP Elverum, BUP Kongsvinger, Hamar kommune, Lillehammer kommune, Sørum kommune, Ringsaker kommune, Hole kommune, Røyken kommune, Sarpsborg kommune, Skien kommune, Bleiker behandlingssenter
Trainers and Mentors 2010 Trainers: 2 (Incl. one clinical mentor) Tromsø 1, Trondheim (clinical trainer) 1 Parent mentors: 8 Trondheim: 2 Tromsø: 2 Bergen: 2 Stavanger: 2 Dinosaurmentors: 3 (4) Trondheim: 1 (2) Tromsø: 2 Teacher training mentors: 2 Tromsø: 2
IY office. OrganizationAt Center for child and adolescent mental health
Budget 2010 2008 – 2010: Implementation and running costs: £ 660.000 pr year Research: £ 330.000 pr year
Program fidelity questionnaire 2008How many groups?Alternativer Prosent Verdi 1 1 11,5 % 10 2 2 23,0 % 20 3 3 14,9 % 13 4 4 14,9 % 13 5 5 4,6 % 4 6 Flere enn fem,31,0 % 27
Program fidelity questionnaire 2008Are you certified? Prosent Verdi 1 Ja 22,7 % 20 2 Nei 77,3 % 68
Program fidelityundersøkelsen 2008Have you enough time to run groups? (40% position) Prosent Verdi 1 Ja 69,4 % 59 2 Nei 30,6 % 26
Program fidelity undersøklesen 2008How many percent of your position can you use for IY?1 20% 25,6 % 22 2 30% 16,3 % 14 3 40% 46,5 % 40 4 Mer en 40%, 11,6 % 10
Program fidelity undersøkelsen 2008Do you offer the IY program in full dosageAlternativer Prosent Verdi 1 Ja 97,6 % 81 2 Nei 2,4 % 2
Program fidelity undersøkelsen 2008 Do you offer the parent program in full dosage?Alternativer Prosent Verdi 1 Ja 98,6 % 73 2 Nei 1,4 % 1
Program fidelity undersøkelsen 2008Do you offer Dinosaur school in full dosage??Alternativer Prosent Verdi 1 Ja 35,3 % 6 2 Nei 64,7 % 11
Program fidelity undersøkelsen 2008Do you offer the teacher program in full dosage?Alternativer Prosent Verdi 1 Ja 61,5 % 16 2 Nei 38,5 % 10
Violation of contracts Increasing tendency of violation of contracts Causes: • The payment system in the specialist services (lower charge per hour for group treatment, lower charge for work with parents and teachers • Agency limbo • Resistance against evidens based treatments • IY as a supplement – not as the main selection of treatment • Psycho-social treatment is not psychotherapy – lower prestige among psychologists and psychiatrists • Unfamiliar with the demands of quality in evidens based treatments.
Consequences for the IY in Norway • Reduced parts of positions for the IY groupleaders • Rejects use of baby sitters, food, transportation (program fidelity demands) • Groupleaders not allowed to participate in supervision • Certification fails to appear or is postponed • Long pauses in group delivery and slow death of the program • Pressure for reduction of dosage. • Pressure for including clients outside the target group • Selection of not evidence based treatments
Consequences for children aand families • Less children access to evidence based treatment • The quality of the IY belittles
Consequences for the health services in Norway • The quality of the prevention and treatment services reduces • Less children get early intervention • More criminality and substance abuse
I ask questions about the possibility to maintain high quality of mental health servces under the present circumstances It is essential that the economical framework for the use of evidence based treatment and prevention programs, both in the community settings and specialist services, are analysed and adapted.
BUT IT HAS BEEN FUN AND IT STILL IS