> Togetherness research
Togetherness research
Togetherness (previously known as the Solihull Approach) has a rich mixture of both quantitative and qualitative studies carried out by independent teams across the UK and by the Togetherness team.
All research by the Togetherness team has been published in peer reviewed journals. Some studies are small, and some are large, but all vary from significant to extremely significant. There are no non-significant studies. Therefore, given the range of studies and the fact that all have produced significant results, it is likely that the research supports practitioners’ and parents’ experience; Togetherness works.
All populations referenced in the research studies are ‘whoever turns up for the services’. There is no selection of subjects, and participants are the usual range of people that practitioners work with. This is important for demonstrating the universality of the approach – some academic studies rigorously select the participants to be included, so that it can be argued that they do not reflect the population that practitioners work with. Most research to date has been carried out in the UK, so it could be said that the research does reflect the British population. However, studies from Pakistan, Iceland and Sweden suggest that the model also applies across cultures.
Research, with citation, abstract and link to the study, are clustered under headings to aid retrieval.
> Workforce development: impact of training on practice and outcomes
> Workforce development: impact on student health visitors and midwives
> Workforce development: international studies
> Understanding your child: from toddler to teenager. Parenting group face-to-face
> Schools
> Antenatal group face-to-face
> Postnatal group face-to-face
> Online parenting pathway: Understanding your child: toddler to teenager
> Online antenatal pathway: Understanding pregnancy, labour, birth and your baby
> Online postnatal pathway: Understanding your baby
Workforce development: Impact of training on practice and outcomes
Hart, K. (2023). Beating the blues. Nursery World, (12), 39–41.
How can early years settings support staff’s mental health and wellbeing? Karen Hart speaks to some managers about the methods they use to look after their teams ‘The Solihull Approach (see tools and resources) is a big part of the setting’s ethos… The Solihull Approach supports mental health and wellbeing in parents’
Fox, J., & Archard, P. J. (2020). Models of practice in infant mental health: Response to Gordon et al. (2020). Journal of Child and Adolescent Psychiatric Nursing, 33(4), 248–249.
Bakshi, R., Coulter, S., & Cutler, D. (2019). 48 The Solihull Approach: An evaluation of staff training on understanding and supporting relationships and emotional communication in a paediatric hospital setting.
The Solihull Approach (SA) is an integrated model of relationships based on three theoretical concepts: containment, reciprocity and behaviour management. These concepts are well established in psychoanalytical and behavioural models and child development research. The approach was originally developed between Child Psychotherapy, Clinical Psychology and Health Visiting in Solihull. It provides professionals with a common framework for understanding emotions and behaviour in relational terms. The SA aims to support professionals in their work with complex patients and families through a lens of understanding themselves and their peers, teams and the wider systems. It enables professionals to consider what they need to support their own emotional wellbeing in a way that means they are able to offer the best possible care to families.
The SA has been widely used and evidenced in its effectiveness by both the NHS and voluntary sector groups in the UK and internationally. This evaluation explored the application of the SA in a paediatric hospital setting, as this was a new context for the model.
This pilot study evaluated the effectiveness and relevance of the SA training at GOSH and considered whether it supported staff to better understand their patients‘ emotional needs and communications.
A mixed-method design combining both quantitative measures and qualitative interviews was used to assess the impact of the SA Foundation training in the Psychological Therapies service. This pilot study evaluated training participants’ understanding and confidence at three time points: pre-training, post-training and six months post-training. We include the results of initial qualitative interviews conducted with staff trained using the model at GOSH.
These are initial results and a test of the method before we cascade the training. They suggest the approach is viewed as relevant by training participants and that it has helpful applications in the care of complex children.
Leonard, R. A., Grant, A., Söderström, K., & Hales, L. (2019). How health visitors can impact perinatal mental health. Journal of Parent and Family Mental Health, 4(2), 1010.
Maternal mental illness is a growing public health concern. The impact of mental illness during the perinatal period (during pregnancy or up to one year after giving birth) can be significant not only for mothers but also for their children, partners and wider family. Health visitors (qualified nurses or midwives who have undertaken specialist training in community public health) are in a unique position during the perinatal period to support mothers and their families. However, the type of support and its frequency in health visiting can vary. In addition, there is limited research that considers what factors may enable or hinder health visitors’ family-focused practice. This issue brief provides an overview of current health visiting practice in maternal mental health, places family-focused practice within the context of health visiting and outlines future research developments.
Vasilopoulou, E., Afzal, A., Murphy, K., & Thompson, C. (2017). The Solihull Approach: Pros and cons. Community Practitioner, 90(5), 40–42.
The study explored the experiences of two professions (Health visitors and CAMHS staff) using the Solihull Approach, revealing the benefits and challenges. A team from NHS Fife is using a qualitative service evaluation. Four main themes emerged: impact on practice, challenges when using the SA, training improvements and post-training support.
Benefits included enhanced practitioner reflection, greater focus on parents’ and children’s feelings and an increased awareness of the family’s readiness in therapy. Quote ‘I think it gives us a model so that we can really relate some of what we are saying to our mums, and it gives us a structure to what we are saying. It gives that theoretical underpinning to things that we do’.
Challenges included time stress and workload constraints in implementing the approach. IT was difficult to keep a balance between containing the parents’ emotions and delivering session content, especially during group work. Gaining supervision could be influenced by time and workload constraints, and practitioners can have different views on supervision.
Cutler, D. (2017). Reciprocity in the training relationship. Organisational Life.
The concept of reciprocity was used by Brazelton (1974) to describe the second-by-second patterns of interaction he found when looking at parent-infant relationships. This article explores how my colleagues and I have used the idea to think about the process of offering training in the Solihull Approach and the relationship that is set up between the facilitators and the participants of that training.
Kerr, C., Jessiman, E., & Davidson, P. (2016). Aspiring to change young people’s lives through universal staff training: Embedding the Solihull Approach in the early years. Educational Psychology in Scotland, 17(2), 7–11.
Fairtlough, A. (2016). City of London and Goldsmiths Knowledge Transfer Programme (KTP) Solihull Approach (SA) Research: Interim and Final Reports. Copy available on request to author.
This document reports on research undertaken as part of the Knowledge Transfer Programme between the City of London and Goldsmiths University. It evaluates the effectiveness and impact of training in the Solihull Approach to working with children and families from the perspective of a sample of parents, practitioners and managers.
Hassett, A. (2015). Evaluation of the Solihull Approach in Kent: Drawing conclusions from the data [Project report].
- The Solihull Approach is both a theoretical framework and a comprehensive resource pack developed by practitioners for practitioners. It is designed to be used as a brief intervention and is supported by a comprehensive resource pack which contains evidence-based information for practitioners, carers and young people. This framework has been rolled out across Kent County. Data from various sources has been collected over several years and has been summarised to offer some comment on the efficacy of the training.
- Using a training evaluation framework developed by Kirkpatrick (1998), various levels of impact were assessed, including participant views of the training, perceptions of change in their behaviour and impact on outcomes for children and families.
- The course feedback shows a high level of satisfaction with the training in terms of content, framework and delivery. A survey of participants 1 year after the courses revealed that over 90% were using the skills, making use of the resources and felt more confident. However, 40% were experiencing difficulties in accessing the practice development sessions.
- An evaluation of outcomes for children and families was undertaken using pre- and post-work assessment measures. Despite the challenges encountered using measures in a frontline setting, the data does suggest that there were positive outcomes for those children and their families who worked with a Solihull Approach-trained practitioner. The Strengths and Difficulties Questionnaire, both Parent and Child versions, indicated that there were significant differences. The BAI also indicated that parents’ anxiety levels had improved. It is important to bear in mind that these are only indicative, as the number of participants was small.
- Parent interviews also indicate that, based on their descriptions of what was helpful, practitioners were making use of the model.
- Data from 2 qualitative research studies indicate the positive impact of the training. A mixed-methods study exploring and evaluating frontline education practitioners’ experiences of The School Years Solihull Approach training within a multi-agency context revealed that the training has the potential to facilitate multi-agency working and enhance training practices within universal children’s services more generally. The second study looked at the experiences of Solihull Approach-trained school and community nurses in using the Solihull Approach in their school drop-in sessions. The study also explored the experiences of pupils who have attended drop-ins with Solihull Approach-trained nurses. This study revealed that participants were using the framework and that young people found these drop-ins useful.
- Taking the data as a whole, it would appear that the Solihull Approach training is having both a positive impact on the practitioners being trained as well as on the young people and families they are working with.
Lee, P., & Mee, C. (2015). The Tameside and Glossop Early Attachment Service: Meeting the emotional needs of parents and their babies. Community Practitioner, 88(8), 31–35.
Parent-infant emotional health is probably one of the most complex arenas in which mental health, maternity and health visiting services operate. This critical period can be emotionally charged, not only for the infant but also for the parent. While most parents essentially get it right, severe ruptures in the parent-infant relationship can occur and can have serious consequences. This paper describes a comprehensive and cost-effective parent-infant mental health service based on a psychodynamic model. The service aims to meet the needs of all parents, from those with a high level of need through to universal provision. Strategic and theoretical underpinnings of the service model are described.
Brigham, L., Smith, A., Quarter, B. B., & Hill, A. (2014). Implementing the Solihull Approach. The Open University in the North.
This evaluative study makes a range of recommendations related to minimising barriers and maximising the benefits of embedding the Solihull Approach more consistently across the health and social care workforce. A key concern is that a superficial understanding of the Solihull Approach and formulaic application could lead to fragmentation across occupational groups, with behaviour management strategies being implemented in a more professionally driven, top-down way outside the framework of a developing therapeutic relationship with families. This would impact the key benefit at the heart of the Solihull Approach, i.e. developing family resilience. Ongoing refresher training and mandatory Solihull supervision sessions are necessary to enable practitioners to have a deeper understanding of the Solihull Approach and the central importance of a partnership approach and promotion of reflective parenting.
Dread, C., Lumsden, V., & Bourne, J. (2014). Using practitioners’ feedback to contribute to organisational development in health visiting. Community Practitioner, 87(12), 30–33.
This paper presents the findings of a survey of practitioners within a health visiting service. This service was an Early Implementer site for the Health Visitor Implementation Plan. The survey was administered in the context of training all practitioners in the Solihull Approach. It aimed to gather information from practitioners about factors they thought could help them do their work with families more effectively. Practitioners’ responses were analysed using thematic analysis. The principal needs identified were: more knowledge, skills and training; increased time to support families; increased supervision and support; and improved communication and partnership working. Practitioners’ needs identified through the analysis were subsequently taken into account during the development of the service.
Brigham, L., & Smith, A. (2014). Implementing the Solihull Approach: A study of how the Solihull Approach is embedded in the day-to-day practice of health practitioners. The Open University in the North.
The recommendations above are based on a detailed analysis of the findings from this collaborative piece of work and are focused on minimising barriers and maximising the benefits of embedding the Solihull Approach more consistently across the whole health and social care workforce. It is recognised that many may already be in place or in the early stages of being implemented.
A key concern is that a superficial understanding of the Solihull Approach and formulaic application could lead to fragmentation across occupational groups, with behaviour management strategies being implemented in a more professionally driven top-down way outside the framework of a developing therapeutic relationship with families. This would impact the key benefit at the heart of the Solihull Approach, i.e. developing family resilience. Ongoing refresher training and mandatory Solihull supervision sessions are necessary to enable practitioners to have a deeper understanding of the Solihull Approach and the central importance of a ‘partnership approach’ and promotion of ‘reflective parenting’. The main resistance to this is perceptions of time input, and the corollary is the ‘quick fix’ approach, which can, in fact, be more time-consuming in the long term. The benefits of holistic practice and potential efficiencies in the use of time need to be stressed in both training and supervision.
To address this concern, ongoing effective leadership and management are essential, with key individuals tasked with taking a strategic plan forward in order to achieve a critical mass of practitioners across professional boundaries, with an in-depth understanding and level of skills to fully embed the Solihull Approach. One of the risks identified is that with reorganisation and changing personnel, the momentum becomes lost and embedding the Solihull Approach becomes fragmented both in terms of its holistic philosophy and inter-professional potential.
Lumsden, V., & Sarankin, M. (2014). The process of consultation to a health visiting team based on the Solihull Approach: A critical reflection. Community Practitioner, 87(10), 34–36.
A critical reflection of the process of consultation offered by a child and adolescent mental health service (CAMHS). The Solihull Approach was used for understanding the consultation process, and the concepts of containment and reciprocity were explored within this context. Further integration of the Solihull Approach in practice was supported by consultation.
Moore, T., Adams, M., & Pratt, R. (2013). A service evaluation on the Solihull Approach training and practice. Community Practitioner, 86(5), 26–27.
A substantial amount of research has provided evidence for the effectiveness of the Solihull Approach with Health Visitors. This study provides evidence for the effectiveness of the Solihull Approach with other groups of practitioners. The present study developed Ottmann’s themes into an 18-item questionnaire. This measure was then administered to a large and varied sample of SA-trained professionals. Scores were compared across Health Visitors and family support workers. The two groups described the SA training as useful to their work with clients as well as within their multidisciplinary teams. Participants identified the crucial role of managerial support, supervision and consultation in implementing the training in practice. Results are discussed in relation to the SA theory.
McAtamney, R. (2011). Health visitors’ perceptions of their role in assessing parent-infant relationships. Community Practitioner, 84(8).
The assessment of parent-infant relationships is an important process in safeguarding and promoting the health of children. There is compelling evidence of the importance of early attachment on the infant’s neurological and emotional development. Health visitors are uniquely well placed to identify problems in the parent-infant relationship and to help improve its quality. This study explored health visitors’ perceptions of their role in assessing and supporting parent-infant relationships and their views of their own educational needs. Semi-structured interviews were conducted with a purposive sample of six experienced health visitors. Health visitors used multiple sources of information in assessing parent-child relationships, including direct observation of behaviour, assessment of known risk factors, knowledge of norms and ‘intuition’. Strategies to support the parent-infant relationship included parenting support at home, listening support, encouraging parenting group attendance and referral to other support agencies. Health visitors reported a lack of training in parent-infant relationships. General agreement is required nationally and locally on educational and clinical experience prerequisites for this aspect of the health visitor role. Reduced client contact, as well as a lack of training in and use of specific ‘relationship assessment’ tools, may affect this. The Solihull Approach to mental health may be useful for informing future health visitor training and practice.
Hassett, A. (2011). Evaluation of the Solihull Approach in Kent: Drawing conclusions from the data.
The data does suggest that there were positive outcomes for those children and their families who worked with a Solihull Approach-trained practitioner and that the training has the potential to facilitate multi-agency working and enhance training practices within universal children’s services more generally.
Essex, R., & Jennings, J. (2011). Positive relationships: Parenting-time together. Nursery World.
A home-visiting programme is improving the parent-child relationship through play, explain its developers, Rebecca Essex and Julia Jennings. ‘The function of the professional delivering the Solihull Approach may be to contain the anxiety and overwhelming feelings of the parents, enabling them to think more clearly’.
Stefanopoulou, E., Coker, S., Greenshields, M., & Pratt, R. (2011). Health visitor views on consultation using the Solihull Approach: A grounded theory study. Community Practitioner, 84(7).
- Explored health visitors’ experiences of consultation in relation to their clinical practice, experience of their work and its impact on the wider service using the Solihull Approach Model as a framework for the consultation.
- The study also explored health visitors’ experience of using the Solihull Approach in their work with families.
- Identified recurring themes and highlighted the vital role of consultation in health visitor’s demanding work with families.
Lawrence, V. (2007). The Solihull Approach in Northamptonshire: A school years impact evaluation.
Report available upon request.
Maunders, H., Giles, D., & Douglas, H. (2007). Mothers’ perceptions of community health professional support. Community Practitioner, 80(4), 24–29.
- A qualitative study aimed to explore mothers’ experiences of the support they received from community health professionals.
- Every third mother was selected from the database.
- All mothers interviewed had been supported by health visitors who used the Solihull Approach.
- Findings explore concepts of trust, expertise and understanding within the working relationship.
- Results address mothers’ need for reliability, and preference for professionals who understood women’s beliefs about what it means to be a ‘good mother’.
Cullen, M. A., & Lindsay, G. (2006). Sure Start Chelmsley Wood: Report of the local evaluation 2005–06. Centre for Educational Development, Appraisal and Research, University of Warwick.
Milford, R., Kleve, L., Lea, J., & Greenwood, R. (2006). A pilot evaluation study of the Solihull Approach. Community Practitioner, 79(11), 358–362.
Assessing the effectiveness of the Solihull Approach compared to standard health visiting practice. Used quantitative methods to assess the effectiveness of the Solihull Approach:
- Used experimental (Solihull Approach) and control group (Standard Health Visiting Practice)
- Results showed a statistically significant decrease in distress and parental perception of child difficulty, in favour of the experimental group.
- A greater reduction in overall stress levels in the experimental group
- Views of Solihull Approach-trained health visitors more closely matched parents’ views of problems than the control group
- Similar results to Douglas and Brennan 2004
- The outcome of the study suggested that the Solihull Approach may be more effective than standard health visiting in addressing behaviour problems in young children.
Lintern, J. (2005). Follow-up evaluation of Solihull Approach training delivered by local trainers in Middlesbrough.
Report available upon request.
Whitehead, R., & Douglas, H. (2005). A qualitative evaluation of health visitors using the Solihull Approach. Community Practitioner, 78(1), 20–23.
Four health visitors used grounded theory to expand on the themes of clinical practice, feelings about work and the wider service.
- Focus more on emotions
- More reflective and improved consistency
- Increased job satisfaction
- Improved referrals to and from HVs
- Improved relations with other professionals
Lowenhoff, C. (2004). Practice development: Training professionals in primary care to manage emotional and behavioural problems in children. Work Based Learning in Primary Care, 2, 97–101.
- Over 18 months – over 100 health and social care professionals, including health visitors, nursery nurses, school nurses, Sure Start workers and school counsellors.
- Attended 8-day training programmes.
- Each participant
- observe a child to gain an insight into the meaning behind behaviour and ways children express their feelings, without words.
- opportunity for each participant to present a child and family who are experiencing a particular behaviour problem, e.g. feeding difficulties, sleeping problems, toileting problems, attachment disorder, or any other behaviours of concern, for consideration by the group in the company of clinicians from CAMHS.
Evaluation forms – With only one or two exceptions, all the participants rated the course very highly, commenting on the comprehensive content, excellent facilitation, interesting range of outside speakers, informative handouts, useful case vignettes, video examples and practical advice and opportunities for sharing ideas, frustrations and good practice.
Comments included:
– Nursery nurse stating she had learnt more about children’s behaviour in two days of Solihull training than she had in her entire training to date
– The school nurse said she felt more confident in her ability to manage emotional and behavioural problems in children
– Health visitors report that training changed their way of thinking about children
Evaluations have demonstrated significant improvements in a range of outcomes for both children and families without having to invest in major new resources, apart from the initial expense of providing the training
40 staff trained in the first year attended a single ‘evaluation and update’ day, to reflect on the impact of the Solihull training on their practice.
Douglas, H., & Brennan, A. (2004). Containment, reciprocity and behaviour management: Preliminary evaluation of a brief early intervention (the Solihull Approach) for families with infants and young children. The International Journal of Infant Observation, 7(1), 89–107.
- Overall decrease in parental anxiety of 66%
- Significant reduction in anxiety relating to problem
- Significant decrease in problem severity
Douglas, H., & Ginty, M. (2001). The Solihull Approach: Changes in health visiting practice. Community Practitioner, 74(6), 222–224.
Survey of Solihull-based Health Visitors after receiving Foundation training.
- Impacted on practice of 88% of health visitors
- Improved consistency of approach
- No increase in overall time for assessment and intervention
- Increase in job satisfaction and confidence in own skills
Workforce development: Impact on student health visitors and midwives
Anderson, G., & Lawther, L. (2024). Solihull Approach training in undergraduate midwifery education: A pilot study. British Journal of Midwifery, 32(11), 592–599.
Background/Aims: To date, Solihull training for midwives in Northern Ireland has been facilitated as continuing professional development; however, incorporating Solihull Approach Antenatal Foundation Training in undergraduate midwifery education has been recommended. The aim of this pilot study was to evaluate the provision of this training for undergraduate midwifery students.
Methods: This mixed-method evaluation study used pre- and post-test questionnaires with a purposive sample of 24 final year midwifery students. The data were analysed using descriptive statistics with thematic analysis of free text comments.
Results: Four themes emerged: perceived benefits in clinical practice; increased knowledge and confidence; increased recognition of the public health role of the midwife; and integration and timing of the training.
Conclusions: The innovative initiative was positively evaluated and considered an enhancement to current education provision. However, the initiative would have been welcomed earlier in the education programme.
Hollinshead, J., & Stirling, L. (2014). A conceptual curriculum framework designed to ensure quality student health visitor training in practice. Community Practitioner, 87(7).
This paper describes the challenges faced by a trust in England following the introduction of the Health Visitor Implementation Plan. Two practice education facilitators designed a conceptual curriculum framework to ensure quality student health visitor education in practice. This curriculum complements the excellent academic course already delivered by the University. A justification is provided for the design of the curriculum framework, including a rationale for the introduction of specific training sessions. Student and practice teacher feedback demonstrates the success of the introduction of this programme to ensure the development of student health visitors fit for practice. The conclusion places emphasis on the importance of continuous evaluation of the training programme to meet the needs of the students and the service. ‘The principles of the Solihull Approach were introduced as the foundation for supporting this practice. The sessions concentrated on supporting families with behaviour and health issues, which if left unaddressed could have detrimental effects upon the child and family. The Solihull Approach was introduced to enable effective partnership working between professionals and families.’
Workforce development: International studies
Bryggman, M., Berger, E., Bäck-Pettersson, S., & Olsson-Tall, M. (2025). Specialist nurses’ experiences of working with parental support in each and every encounter, according to an evidence-based model in child healthcare. Open Journal of Nursing, 15(3), 198–210.
Aim: To explore specialist nurses’ experiences of working with the evidence-based Solihull Approach in Child Healthcare.
Background: In recent decades, changes in living conditions and lifestyles have affected child healthcare, shifting the focus towards children’s mental health. Today’s parents increasingly seek knowledge and information about their children’s emotional needs and development. Research in Child Healthcare indicates a growing need for support in parenting and strengthening the parent-child relationship.
Design and Method: The interview study used a qualitative approach, and a qualitative method was employed for content analysis. The request for participation was sent to a strategic sample of specialist nurses who had participated in the SA training program; the majority (n = 14) were interviewed. The COREQ checklist was used in this study.
Results: The analysis reveals an overarching theme, four categories, and 13 subcategories that illustrate how the training affected the nurses’ attitudes, values, and working methods. They have gained increased awareness of the relationship between parents and children, focusing on facilitating dialogue and individualized care.
Conclusion: The study shows that the Solihull Approach significantly enhances specialist nurses’ competencies in Child Healthcare, resulting in a more person-centred and relationship-oriented approach with parents and children.
Relevance to Clinical Practice: The study revealed that specialist nurses focused more on the impact and quality of interactions between parents and children. Their ability to observe these interactions enabled them to work with parental support. Patient or Public
Contribution: This educational effort enhances how nurses collaborate with parental support, emphasizing the child’s perspective during each visit to Child Healthcare centres.
Gísladóttir, G. R. (2025). Reynsla ráðgjafa Bergsins Headspace af Solihull-aðferðinni.” Umhygð, gangvæmni og atferlismótun í verki” (Doctoral dissertation). (Gísladóttir, G. R. “Bergid Headspace counselors’ experience with the Solihull Approach).
The aim of this study was to explore how professional counsellors at Bergið Headspace experienced the use of the Solihull Approach in their work with children and adolescents. The research was based on a qualitative methodology, using semi-structured interviews with counsellors who apply the approach in their daily practice. Data was analysed using thematic analysis. The findings revealed that the Solihull Approach was not perceived as a stand-alone intervention but rather as a professional attitude and framework that promotes safety, connection, and professionalism in practice. Training and regular supervision were found to be key factors in maintaining the approach and strengthening professional confidence. The approach was considered to help counsellors create trust, emotional safety, and space for young people to process difficult experiences. The study concludes that the Solihull Approach can enhance relationship-based and early intervention services within low-threshold settings. The knowledge gained from this research has practical relevance for professionals and policymakers in developing strategies for child and youth services that focus on empathy, reflection, and professional security in relationships.
Lee, V. W. W., & Newman, L. K. (2018). A model for the provision of integrated perinatal and infant mental health services in regional settings. Australasian Psychiatry, 26(5), 531–533.
Objective: This paper aims to describe current approaches in Victoria to the development of perinatal and infant mental health services in regional areas.
Method: The paper outlines the significance of perinatal mental disorder for maternal wellbeing and impact on infant development, and describes the model of care at the Agnes Unit.
Results: The Agnes Unit has been established as a residential therapeutic unit offering short-term treatment that focuses on promoting parental mental health, parenting sensitivity and the parent-infant relationship.
Conclusions: A coordinated and integrated approach with a focus on early intervention is needed to deliver perinatal and infant mental health services. Services need to focus on the infant and parent-infant relationship in addition to parental mental health.
Thome, M., Douglas, H., Morozova, T., & Dovbnya, S. (2007). Training health professionals cross-culturally in promoting infant and parent mental health by the Solihull Approach. Journal of Reproductive and Infant Psychology, 25(3), 250.
Report available upon request.
Understanding your child: from toddler to teenager. Parenting group face-to-face
Hill, B., Boscoe, A., & de Lange, B. (2021). Solihull Approach groups for Orthodox Jewish mothers. Community Practitioner, 94(1), 44–47.
The London borough of Hackney contains the largest Orthodox Jewish (OJ) community in the UK. (Staetsky and Boyd, 2015). Working with Koach Parenting and the OJ community, First Steps Community CAMHS adapted the Solihull Approach parenting group to be inclusive of Jewish cultural values and religious aspects of parenting. The adapted groups have been piloted since 2014. This paper aims to evaluate whether incorporating spiritual and cultural aspects of parenting enabled accessibility while retaining efficacy. Fifty-one mothers accepted a place in the groups, with 90% completing the 10-week course over a five-year period. They were asked to complete self-report measures assessing the parent-child relationship (MORS-SF), parental mental health (DASS-21), and to set and rate a parenting goal at baseline and completion. Findings showed a statistically significant increase in warmth, a reduction in parental depression, anxiety and stress, and progress towards parenting goals. Data suggests the Solihull Approach can be adapted to meet the cultural and religious needs of the OJ community.
Douglas, H., & Johnson, R. (2019). The Solihull Approach 10-week programme: A randomised controlled trial. Community Practitioner, 92(7), 45–47.
Researchers evaluated the manualised Solihull Approach group ‘Understanding your child’s behaviour’ (UYCB), a 10-week course available universally to a population of parents/carers of children aged 0 to 19 years.
Three self-report measures were used at two time-points – pre- and post-intervention – measuring child behaviour, parental emotional health and child-parent relationship.
Participants’ responses in the intervention group were compared with waiting-list controls, after controlling for pre-test scores, by analysis of covariance, as per protocol.
The results show that, compared with not attending, attendance at the Solihull Approach group resulted in improvements in: child prosocial behaviour and conduct problems; parental anxiety and stress, and the parent-child relationship (increase in closeness, decrease in conflict), in a cohort that can be considered characteristic of the UK population in terms of ethnicity and those typically attending such groups (majority female). Furthermore, the impact on closeness in the parent-child relationship and parental stress showed highly statistically significant results, with a 99.995% probability that these could not have occurred by chance.
Baladi, R., Johnson, R., & Law, G. (2018). Strengthening child-parent relationships. Community Practitioner, 91(11), 45–47.
Researchers undertook a review of the ‘Understanding your child’s behaviour’ programme amongst parents with children aged 0-18 years with some degree of behavioural difficulty.
- 46 groups in 2 West Midlands cities over 14 months
- 119 parents
- Mean age of children: 5.07 years
- 17% were reported by parents as having an ‘additional need’
- Questionnaires completed pre, post, and at 3-month follow-up
- Parental wellbeing significantly improved, and parents reported significant improvements in their own depression, anxiety and stress between pre- and post-measures.
- Improvements in the child-parent relationship.
- Improvements in the child’s behaviour and emotional functioning.
- Smaller number of parent responses in follow-up (n=35)
The study shows that after the conclusion of the group, there is evidence for the maintenance.
Appleton, R., Douglas, H., & Rheeston, M. (2016). Taking part in ‘Understanding Your Child’s Behaviour’ and positive changes for parents. Community Practitioner, 89(2), 42–48.
The Solihull Approach’s Understanding Your Child’s Behaviour (UYCB) is a 10-session group for parents run by facilitators in their local area. Previous studies have shown that parents enjoy taking part in the group, and that UYCB can reduce problematic behaviours in children. Building on this research, the present study evaluated whether UYCB programmes run more recently in the UK were rated positively by parents, and what positive changes were reported by parents. Both quantitative and qualitative data were analysed from 105 parents who took part in 18 different UYCB groups between 2012 and 2015. The results of this analysis showed that 90 per cent of parents found the group a great place to relax and share experiences, 93 per cent rated the group as ‘great’ for helping them understand their child, and 92 per cent gave a ‘great’ rating for helping them identify changes. In addition to this, content analysis showed that 47 per cent of parents reported having a better relationship with their child after taking part, 42 per cent said they were more confident, and importantly, six per cent reported a significant positive change in their lives generally as a direct result of UYCB.
Vella, L., Butterworth, R., Johnson, R., & Urquhart Law, G. (2015). Parents’ experiences of being in the Solihull Approach parenting group, ‘Understanding Your Child’s Behaviour’: An interpretative phenomenological analysis. Child: Care, Health and Development, 41(6), 882–894.
Background Empirical evidence suggests that the Solihull Approach parenting group, ‘Understanding Your Child’s Behaviour’ (UYCB), can improve child behaviour and parental wellbeing. However, little is known about parents’ in-depth experience of participating in the UYCB programme. This study provides an in-depth qualitative evaluation of UYCB, focusing on possible moderating factors and mechanisms of change that may inform programme development. Method: Ten parents (eight mothers and two fathers), recruited from seven UYCB groups across two locations, were interviewed within 7 weeks of completing the group and again 10 months later. Data were analysed using interpretative phenomenological analysis. Results: Four themes were identified: ‘Two Tiers of Satisfaction’, ‘Development as a Parent’, ‘Improved Self-belief’ and ‘The “Matthew Effect”’. In summary, the majority of parents were immensely satisfied at both completion and follow-up: they valued an experience of containment and social support and perceived improvement in specific child difficulties, their experience of parenting, their confidence and their coping. Most parents appeared to have developed more reflective and empathic parenting styles, with self-reported improved behaviour management. The theoretical material was well-received, although some struggled with technical language. Positive outcomes appeared to be maintained, even reinforced, at follow-up, and were associated with having few initial child difficulties, perceiving improvement at completion and persevering with the recommendations. Two participants, whose children had the most severe difficulties, perceived deterioration and felt that the group was insufficient for their level of difficulties. Conclusion: Through in-depth analysis of parental experiences, UYCB appears to achieve its aims and communicate well its theoretical principles, although change may also occur through processes common to other group programmes (e.g. social support). Recommendations, stemming from the experiences of these parents, include simplified language, separate groups for parents with complex needs, greater emphasis on the importance of perseverance, and additional support for parents who
appear to be struggling to make changes.
Norman, L. (2013). Delivering Solihull Approach training in Pakistan. Community Practitioner, 86(8), 42–43.
The author narrates how she delivered the Solihull Approach to parenting and parent/child relationship program in Pakistan in 2012. She describes the three sets of training she conducted in Islamabad, Abpara and Rawalpindi. The author concludes that the Solihull Parenting course, Understanding Your Child’s Behaviour, gave 52 women the opportunity to assess their parenting and how it can affect their children’s future.
Dolan, A. (2013). “I’ve learnt what a dad should do”: The interaction of masculine and fathering identities among men who attended a ‘Dads Only’ parenting programme. Sociology, 48(4), 812–828.
The article is based on qualitative research with men who voluntarily attended a ‘dads only’ parenting programme (Solihull Approach Understanding your child). It explores men’s motivations to attend a parenting group. In addition, it demonstrates challenges relating to masculine identity that fathers face, in particular in seeking support regarding their children. In relation to masculinity, it emphasises how aspects of masculinity can shape men’s limited knowledge relating to the needs of their children and their capabilities as ‘involved’ fathers. Although they gained a sense of mastery over childcare, the ways in which men care for their children are context-dependent, and fathering may clash with certain masculine ideals.
Cabral, J. (2013). The value of evaluating parenting groups: A new researcher’s perspective on methods and results. Community Practitioner, 86(6), 30–33.
The aim of this research project was to evaluate the impact of the Solihull Approach Understanding Your Child’s Behaviour (UYCB) parenting groups on the participants’ parenting practice and their reported behaviour of their children. Validated tools that met both the Solihull Child and Adolescent Mental Health Service (CAMHS) and academic requirements were used to establish what changes, if any, in parenting practice and children’s behaviour (as perceived by the parent) occur following attendance of a UYCB programme. Results indicated significant increases in self-esteem and parenting sense of competence; improvement in the parental locus of control; a decrease in hyperactivity and conduct problems, and an increase in pro-social behaviour, as measured by the ‘Strengths and Difficulties’ questionnaire. The qualitative and quantitative findings corroborated each other, demonstrating the impact and effectiveness of the programme and supporting anecdotal feedback of the success of UYCB parenting groups.
Johnson, R., & Wilson, H. (2012). Parents’ evaluation of ‘Understanding Your Child’s Behaviour’, a parenting group based on the Solihull Approach. Community Practitioner, 85(5), 29–33.
137 parents completed feedback questionnaires on their experience of each of the 10 sessions of the group. The results show that parents found UYCB highly satisfactory as measured by a simple, non-literacy-based evaluation form. 98% of people felt that the group helped them relax and share experiences. The results showed that understanding comes before change. And both increase over 10 sessions. This fits with social learning theory, which states that we learn from others in different ways; it takes a bit of time for us to change our parenting. 10 sessions for most people.
Bateson, K., Delaney, J., & Pybus, R. (2008). Meeting expectations: The pilot evaluation of the Solihull Approach parenting group. Community Practitioner, 81, 28–31.
- Child Behaviour Checklist – For children under 3 years – There was a significant difference between pre- and post-externalising behaviour, p-value = 0.026 (i.e. reduction in conduct and behaviour problems at the end of the course)
- For children over 4 years – There was a significant difference in all measures, p-value = <0.001 (apart from internalising behaviour)
- Beck’s Anxiety Inventory Score – Highly significant difference between pre and post measures, p-value = <0.001
- Strengths and Difficulties Questionnaire – Highly significant difference in the total score and Conduct domain of the SDQ questionnaire between pre- and post-interventions among the 4-year-olds or older children. Total score p-value = <0.001
- Conclusion – Both parental anxiety and child behavioural problems improved significantly over the course of the 10-week group. There is an interesting relationship between changes in the CBCL and changes in the BAI, in that there is a significant positive correlation between some changes in CBCL and BAI.
Neurodivergence
Williams, L., & Newell, R. (2012). The use of the Solihull Approach with children with complex neurodevelopmental difficulties and sleep problems: A case study. British Journal of Learning Disabilities.
The following article introduces the Solihull Approach, a structured framework for intervention work with families (Douglas, Solihull resource pack; the first five years. Cambridge: Jill Rogers Associates, 2001) and aims to demonstrate the usefulness of this approach in working with school-age children with complex neurodevelopmental difficulties in a community Child and Adolescent Mental Health Service (CAMHS) setting. More specifically, it aims to show the efficacy of this approach in intervening with sleep problems, which are prevalent amongst children with learning disabilities. The authors hope to achieve these aims through the use of the qualitative case study method, which allows for a rich account of the intervention and therefore facilitates a detailed understanding of the psychological phenomena and processes involved in the approach (Dallos & Smith, Clin Psychol Forum 2008; 182, 18). The three theoretical concepts central to the Solihull Approach – containment, reciprocity and behaviour management – are used to describe the intervention, which resulted in a positive outcome. Implications for clinical practice and future research directions are discussed.
Foster care and adoption
Harris-Waller, J., Bangerh, P., & Douglas, H. (2018). An evaluation of the Solihull Approach foster carer course. Practice.
This is an evaluation focusing on the effectiveness of the Solihull Approach foster carer training group programme ‘Understanding your foster child’. Four groups were run, of 12 weekly sessions with a total of 56 foster carers. All foster carers who attended completed both pre- and post-measures; however, incomplete data sets were removed, so in total, 27 data sets were analysed. Four questionnaires were used: Parental Stress Index Short Form (PSI-SF), Strengths and Difficulties Questionnaire (SDQ), Carer Questionnaire and the Children’s Expression of Feelings in Relationships (CEFR). Statistical analyses identified that after the group, there were significant increases in foster carers’ ratings of their understanding of their children’s difficulties; their understanding of why foster children behaved the way they did; their feeling of having the required skills to manage difficulties; alongside significant decreases in their ratings of foster children’s hyperactivity and attentional behaviour difficulties.
Madigan, S., Paton, K., & Mackett, N. (2017). The Springfield Project service: Evaluation of a Solihull Approach course for foster carers. Adoption & Fostering, 41(3), 254–267.
Many young people in care have experienced trauma. The emotional and behavioural issues that often ensue, along with foster carers’ varying levels of confidence and skills, are cited as the main reasons for placement disruption. Placement breakdown can represent a further trauma for young people and is also highly costly for local authorities. The need for interventions to develop foster carers’ competence and confidence in understanding and managing foster children’s behaviour is therefore significant. The Solihull Approach (SA) promotes the parent and child relationship by emphasising the need for emotional containment and a reciprocal relationship so as to form a framework for thinking about, understanding and effectively managing behaviour. The ‘Solihull Approach course for foster carers: understanding your foster child’s behaviour’ is a 12-week programme tailored to the demands of this task. It has been run within the Springfield Project in Fife, Scotland, for the past four years. In the reported study, 83 participants completed evaluation forms. A thematic analysis of their replies revealed that the most important things learned were: taking a step back; understanding the effects of trauma; reciprocity; communication and play; containment (of my child); understanding my child; and the ability to offload when full up. The course helped participants to better understand their foster child by clarifying the nature of the relationship and their role, understanding the impact of the child’s early experiences and appreciating that she or he is not to blame. Participants took from the course: increased understanding, being part of the group, staying calm and thinking before they act, feeling more confident, and looking after themselves and seeking containment. Pre- and post-Child Behaviour Checklist (CBCL) questionnaires were collected from 34 carers with children in the six to 18 age group and 13 looking after children aged one-and-a-half to five years. Paired samples t-tests revealed no statistically significant difference in pre- and post-scores in either the six- to 18-year-olds (t (33) = 1.6, p = 0.114) or the one-and-a-half- to five-year-olds (t (12) = 2, p = 0.069). Possible reasons for this and its implications are explored. However, the identified qualitative themes suggest that the aims of the training are being met. There was a strong overall sense that foster carers found the course helpful and informative, suggesting that it could represent a valuable intervention for promoting placement security.
Brown, S. (2014). Clinical update: A small service evaluation of a Solihull Approach foster carer training group pilot study. Practice: Social Work in Action, 26(1), 37–52.
A pilot service evaluation of a foster carer training group programme for ‘Understanding your foster child’s behaviour-supporting foster carer/child relationships’ was conducted in a community setting. A total of 16 foster carers completed the programme, delivered over 12 sessions. Several scales were employed: short form Parental Stress Index, Carer Questionnaire and Strengths and Difficulties Questionnaire (SDQ). Following qualitative and quantitative analysis, there was a significant decrease in the carers’ ratings of their child’s hyperactivity and attentional disorders and a trend towards a decrease in the behavioural difficulties of their child, as rated by the carer. These positive behavioural changes suggest this is a promising programme. Implications for the Solihull Approach are discussed, alongside future recommendations.
Schools
Derry, C. (2009). The Solihull Approach: Its use by school and community nurses in school drop-in sessions (Doctoral dissertation).
This study looks at the experiences of Solihull Approach-trained school and community nurses, asking if and how they use the Solihull Approach in their school drop-in sessions. The study also explores the experiences of pupils who have attended drop-ins with Solihull Approach-trained nurses. The Solihull Approach is a psychotherapeutic and behavioural model for professionals working with children and their families. It provides a framework for practice and advocates the use of three key elements with children and their families: containment, reciprocity and behaviour management. This study used semi-structured interviews with nurses and pupils. It was found through thematic analysis (Braun and Clarke, 2006) of the transcripts that school and community nurses use two of the main elements of the Solihull Approach: containment and reciprocity in their drop-in work. It was found that nurses used containment prior to Solihull Approach training, although naming the process is itself suggested as helpful. Although nurses report not using reciprocity in their drop-ins, their descriptions of their behaviour and pupils’ accounts of the sessions indicate nurses use reciprocity in their drop-in sessions. It was found that nurses do not think reciprocity is relevant to their drop-in work, but it is relevant in the home, particularly to the parent and child relationship. Additionally, the findings indicate what pupils value about drop-in sessions; privacy and confidentiality are paramount to them. The implications of these findings for training in and development of the Solihull Approach are discussed, while methodological issues arising from the research paradigm are explored. The distinctive and original contribution of the research is described, and recommendations for future research are presented.
Hassett, A., & Appleton, R. (2016). Understanding your pupil’s behaviour: A pilot study from two schools in Kent.
The Solihull Approach was developed to help frontline workers be more effective in their work, as they are in the ideal position to intervene early in any potential emotional or behavioural difficulty for a child. The Solihull Approach has been developed for both early years practitioners and those working with young people in their school years. The theoretical model has been developed from three concepts: containment, reciprocity, and behaviour management, taken from psychotherapeutic, child development and behavioural models, respectively. A new programme specifically for schools, Understanding Your Pupils’ Behaviour, has been developed.
At present, most of the evaluation and research has been on the 0-5-year work with Health Visitors. Further work needs to look at the effectiveness of this in the school years and in other settings outside of the health sector. The piloting of the Solihull Approach in a school setting to help school staff better understand their pupils’ behaviour provides an ideal opportunity to assess the impact of the approach in this setting.
A mixed-method design combining both quantitative measures and qualitative interviews was used to assess the impact of the training. The study focuses on 2 primary schools, an experimental school that received the training and another matched control school. Data was collected pre-training and 6 months after the final training session. The teacher variables measured included anxiety, burnout, compassion satisfaction, fatigue, self-concept and teacher efficacy. Interviews with 7 school staff who have received the training were undertaken.
Quantitative statistical analysis found that six months after training, teachers in School A showed a statistically significant increase in satisfaction with their helping role, self-esteem, and teacher efficacy scores, as well as a decrease in feeling burnt out/stressed. The teachers at School B who did not receive the training only showed an improvement in teacher efficacy over the period.
Qualitative thematic analysis found that overall, the teachers found that the following aspects were useful: that they were offered a framework that underpinned all aspects of the work they do; focus on the relationships not only with pupils, but teachers, support staff and parents as well; and the focus on well-being and its link with learning.
Antenatal group face-to-face
Douglas, H., & Bateson, K. (2017). A service evaluation of the Solihull Approach Antenatal Parenting Group: Integrating childbirth information with support for the fetal-parent relationship. Evidence Based Midwifery, 15(1), 15–19.
This study evaluates the new Solihull Approach antenatal course ‘Understanding pregnancy, labour, birth and your baby’. The course integrates traditional antenatal information with an emphasis on relationships. Three validated questionnaires and two multiple choice questions assessed issues such as pregnancy–related anxiety, feelings of attachment to the baby, intent to breastfeed, intent to stop smoking and general anxiety and depression. There was a total of 105 participants with 26 fathers and 34 mothers completing all questions (=60).
Results indicated that both mothers’ and fathers’ feelings of attachment increased, mothers’ anxieties relating to pregnancy, labour and birth decreased, and mothers’ intention to breastfeed increased. Intention to stop smoking and general anxiety did not change for mothers or fathers.
Results indicate the possibility of using the opportunity of antenatal classes to connect parents with their baby before birth, given the importance of relationships for the development of the baby into childhood and across the lifecycle.
Fagan, E., Land, S., Meadows, Z., Raza, M., Gavin, J., & Douglas, H. (2016). Midwives’ experience of delivering the Solihull Approach antenatal group. International Journal of Birth and Parent Education, v4, 31.
The article includes midwives’ description of running Solihull Approach Parenting Groups, who attend the groups, the strengths of the Solihull Approach, what parents like and future developments.
Douglas, H. (2016). The Solihull Approach antenatal parenting group: Understanding pregnancy, labour, birth and your baby. International Journal of Birth and Parent Education, v4, 29–31.
The article describes the Solihull Approach in relation to the antenatal parenting face-to-face group and online course. It also outlines the unpublished study Bateson and Appleton (2012), Summary of Antenatal Groups Pilot – Evaluation and the submitted study Bateson and Douglas (2016), a service evaluation of the Solihull Approach Antenatal Parenting Group.
Breastfeeding support
Tan, M., Rheeston, M., & Douglas, H. (2017). Using the Solihull Approach in breastfeeding support groups: Maternal perceptions. British Journal of Midwifery, 25(12), 765–773.
The aim of the study was to formally explore maternal perceptions of this peer support breastfeeding service.
UK breastfeeding rates are among the lowest in the world, so it is necessary to understand what makes breastfeeding support successful. Anecdotal reports of a West Midlands breastfeeding support group noted the benefits of using a psychosocial model, the Solihull Approach, in their staff training.
Subgroup sampling resulted in nine semi-structured interviews, which were then analysed with thematic analysis. The Solihull Approach helped to create safe spaces, both literally (between supporters and mothers) and figuratively (atmosphere of trust and acceptance in the venues). It also ensured tailored informational and emotional support, which sustained the mothers’ attendance at the group.
Breastfeeding support groups can gain in consistency from being underpinned by a model: the Solihull Approach would be a promising candidate, as its influence can be helpful to the emotional wellbeing and breastfeeding outcomes of all mothers, regardless of their socioeconomic background.
Thelwell, E., Rheeston, M., & Douglas, H. (2017). Exploring breastfeeding peer supporters’ experiences of using the Solihull Approach model. British Journal of Midwifery, 25(10), 639–646.
The aim of the study was to gain insight into breastfeeding peer supporters’ experiences of using the Solihull Approach. The study also sought to identify factors that might contribute to improving the service.
The Solihull Approach is a model designed to support professionals, offering breastfeeding peer supporters and an opportunity to think about their work. A qualitative study was undertaken with three voluntary and four paid peer supporters using a thematic analysis with an inductive approach. Three key themes emerged: motivation to volunteer, their experience of peer supporter training and their experience of putting this training into practice.
The conclusion of the study was that several benefits were highlighted when incorporating the Solihull Approach into peer professionals’ practice, including increased confidence levels and improved team communication, as well as positive outcomes for their personal lives.
Postnatal group face-to-face
Walker, L. (2014). Evaluation of the Solihull Approach postnatal parenting group in Islington
22 parents attended across four groups, three universal and one targeted. All parents moved positively towards their goals. In addition, 16 parents completed pre- and post-measures, with increases in confidence about parenting and confidence in understanding their baby’s communications.
Online parenting pathway: Understanding your child: toddler to teenager
Johnson, R. (2018). Improvements in parenting achieved with innovative online programme: Preliminary evaluation of ‘Understanding Your Child – Online’ (UYC-OL) – A Solihull Approach course for parents and carers. Educational and Child Psychology, 35(1), 40–50.
The evaluation of ‘Understanding Your Child – Online’ (UYC-OL) was a between-subjects, repeated-measures design. The scores of 115 self-referred parents/carers were compared before and after completing Understanding Your Child – Online (UYC-OL) between 2013-15 on the Child-Parent Relationship Scale (CPRS). Paired samples t-tests were performed, and Cohen’s d was used to determine effect sizes. The results showed highly statistically significant improvements. Closeness within the parent-child relationship significantly increased (p=<0.0001), whilst conflict significantly decreased (p=<0.0001). Effect sizes were large (d =0.61 and 0.78, respectively). The Solihull Approach online course appears to offer an effective option for enhancing universal parent-child relationships. The implication is that it should be included in population-based strategies for increasing resilience, reducing the impact of adverse Childhood Experiences (ACEs) and closing the attainment gap.
Online antenatal pathway: Understanding pregnancy, labour, birth and your baby
Shahid, A., & Johnson, R. (2018). Evaluation of an online course ‘Understanding pregnancy, labour, birth and your baby’ by the Solihull Approach. Evidence Based Midwifery, 16(3), 101–106.
This study examined the impact of the Solihull Approach online antenatal course on participants’ attitudes towards pregnancy, labour and birth, and their feelings towards their babies.
139 participants completed self-report measures, designed for the purposes of the study, before and after completing all nine modules of the Solihull Approach online antenatal course ‘Understanding pregnancy, labour, birth and your baby’. Participants showed a reduction in anxiety towards pregnancy and birth (p=<.0001), felt closer to the baby (p=<.0001), and showed increased intention to breastfeed (p=<.001) after completing the online course. This study indicates that online antenatal education shows promise, with the potential to reach a wider population than traditional classes. Furthermore, with the addition of a focus on the parent-infant relationship, as well as traditional content, such courses may contribute to the emotional health and wellbeing of parents and babies after the birth. It is suggested that this could help reduce the need for parenting interventions in future for problems in childhood.
Online postnatal pathway: Understanding your baby
Sanchez Egana, R., & Douglas, H. (2023). Effectiveness of a static web-based postnatal parenting programme: Solihull Approach’s ‘Understanding your baby’. Community Practitioner.
Researchers evaluated the effectiveness of the web-based postnatal parenting intervention titled ‘Understanding your baby’ – a postnatal parenting programme designed for parents and caregivers of infants aged from 0 to 12 months.
Data were collected from a non-clinical sample of 2313 parents and caregivers in the UK.
Before and after the participants completed the online course, the Karitane Parenting Confidence Scale (KPCK) was used to assess their parental self-efficacy levels. A paired–samples t-test was used to compare pre- and post- course measure scores.
The online version of the postnatal parenting programme demonstrated statistically significant improvements in 14 of 15 items of the KPCS, providing promising evidence of its effectiveness.
The statistical comparison revealed a significant difference between the total mean scores per subject at the start of the course (36.2, SD= 8.3) and after its completion (39.3, SD= 7.2, p= <.000). Moreover, participants showed positive attitudes towards this course.
The results provided promising evidence regarding the effectiveness of ‘Understanding Your Baby’ Solihull Approach’s online parenting programme.
Adults with learning difficulties
Neilson, T. (2022). Adapting the Solihull Approach for staff caring for adults with learning disabilities and/or autism: Evaluation of a pilot programme. Learning Disability Practice, 25(1).
The Solihull Approach is a model that has been used successfully to provide training for health and social care practitioners who support children and families, and is based on the concepts of containment, reciprocity and behaviour management. This article describes a pilot project in which the two-day Solihull Approach foundation course was adapted for practitioners who care for adults with learning disabilities and/or autism. The aim was to enhance their understanding of the behaviour that challenges in this population.
A total of 11 participants completed the pilot programme. To evaluate the adapted training programme, the participants were asked to complete a questionnaire before and after the course, and their responses were then compared. The trainers also recorded participants’ feedback continuously throughout the programme and summarised this in a reflective account.
The findings of this service evaluation suggest that the Solihull Approach is transferable to the training of staff who support adults with learning disabilities and/or autism. However, several areas for further development were identified, and a larger-scale evaluation is warranted.
Phenomenological
Williams, E. (2016). Newly qualified health visitor: Containment and reciprocity. Journal of Health Visiting, 4(3), 124.
Emma Williams explains how being introduced to the Solihull Approach as part of her Trust’s training programme was a lightbulb moment in her work with families.
Bains, S. (2015). A carer’s journey. Community Practitioner, 88(12), 10–11.
Dougan, A. (2015). A new learning experience. Journal of Health Visiting, 3(1), 56.
When Amanda Dougan learnt about parenting support as part of her SCPHN course, it inspired her to reflect on her own experiences as a mother of two children.
Rogers, E. (2014). Lessons in parenting. Children & Young People Now, (14), 22–25.
Many people believe all parents would benefit from some kind of training. Emily Rogers, mother of two young children, records her experiences of a 10-session parenting course and explores the concept of universal classes for every family.
Best Practice
Department of Health and Social Care. (2026). Healthy Child Programme.
Report available upon request.
Barlow, J. (2016). Improving relationships in the perinatal period: What works? International Journal of Birth & Parent Education, (Suppl 1), 1–8. (AIMH UK Best Practice Guidance No. 1).
Published articles
Douglas, H. (2011). The Solihull Approach: A whole school approach. Journal of Educational Psychotherapy, 18, 53–58.
Report available upon request.
Douglas, H. (2010). Supporting emotional health and wellbeing: The Solihull Approach. Community Practitioner, 83(8), 22–25.
The quality of the early relationship is an important factor in the development of emotional wellbeing. Yet in the UK, we do not integrate support for the relationship between the baby and parents into antenatal parentcraft. Neither do we provide enough focus on the relationship in the basic and post-qualification training or support for practitioners to integrate working with the relationship into their practice. The Solihull Approach provides one model for working with the relationship between parents and the child and between the parents and the practitioner. It integrates concepts from disparate academic fields that can focus a practitioner’s work on supporting the relationship between parents and baby or child, whether individual or in a parenting group.
Douglas, H., Delaney, J., Cabral, J., & Rheeston, M. (2009). Supporting parenting: The Solihull Approach. Healthcare, Counselling and Psychotherapy Journal, 9(3), 17–21.
Report available upon request.
Douglas, H., & Rheeston, M. (2009). The Solihull Approach: An integrative model across agencies. In J. Barlow & P. O. Svanberg (Eds.), Keeping baby in mind. Routledge.
Douglas, H. (2007). Containment and reciprocity: Integrating psychoanalytic theory and child development research for work with children. Routledge.
Report available upon request.
Adams, C. (2005). Health visitors and adult mental health: The future begins here. Community Practitioner, 78(11), 389–391.
Douglas, H. (1999). The Solihull Approach: Helping health visitors to help families with young children. Young Minds, 40, 19–20.
Report available upon request.