Family SMILES: interim evaluation report What works in supporting children who have a parent with mental health problems

Practitioner talking to childrenParental mental health problems are a common feature in child protection investigations. Family SMILES (Simplifying Mental Illness plus Life Enhancement Skills) is an NSPCC service, which works with parents and children to reduce the risk of harm.

Family SMILES is a group work intervention programme for children aged 8 to 13 years who have a parent with a mental health problem. The programme also includes individual sessions for the parent with the mental health problem and joint work with the parent and child. It aims to improve children’s self-esteem, resilience and life skills; to help parents understand the impact of their mental health problem on their child; and to improve protective parenting skills.

Our interim evaluation report gives findings from questionnaires completed before and after the programme. It also includes interviews with some of the children and parents who took part. This is part of the Impact and evidence series.

Authors: Rachel Cass and Prakash Fernandes
Published: 2014

Our interim findings provide promising evidence that Family SMILES can help parents understand and reduce the impact of their mental health problems on their children.

  • Children reported increased self-esteem and less serious emotional and behavioural problems.
  • Parents reported increased self-esteem and lower levels of distress and unhappiness. This should help improve protective parenting skills.
  • Children found the group sessions helped them understand that mental health problems are common.
  • Children valued meeting others in the same situation and wanted to be able to continue this peer support after the programme finished.
  • Both parents and children appreciated the opportunity to talk more openly about mental health issues, the impact on the family and to find some solutions. They felt it would work even better if the whole family could be involved (so also the other parent and siblings younger than 8 or older than 13).
  • Some parents continued to struggle to cope with their mental health problems and weren’t able to accept the impact of their mental illness on their children’s behaviour.

This evaluation highlights the difficulties that families have talking about mental health problems and understanding their impact on family life and children’s well-being. The Family SMILES service may be bridging a gap between adult mental health and children’s services by creating a safe space for parents and children to explore these issues.

Further evaluation will provide more insight into whether these changes were sustained in the longer term, as well as findings from a comparison group who have not received the service. This will also include interviews with practitioners delivering the programme, and the agencies who referred families to the service.

Acknowledgements  5
Key findings: young person's version  6
Key findings  7
Executive Summary  8
Main report  12
Introduction  12
Background and methodology  12
Increasing self-esteem  18
Decreasing children’s emotional and behavioural problems  23
Enhancing protective parenting  27
Improving family communication about mental health  38
Conclusion  41
Bibliography  43
Appendices  45

Please cite as: Cass, R. and Fernandes, P. (2014) Evaluation of Family SMILES: interim report. London: NSPCC.

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