News

In research conducted by North London Foundation Trust a new, personalised one-to-one support programme for children with conduct problems is delivering results where standard approaches have fallen short. Designed for vulnerable families who have not been reached by existing services, the programme achieved attendance rates of over 70% and produced strong, sustained improvements in children's behaviour – improvements that continued to grow over time.

Conduct problems go beyond occasional difficult behaviour. Children affected may struggle to follow rules, have angry outbursts, and face exclusion from school. Without effective support, these difficulties often persist into adulthood, affecting life chances and wellbeing for years.

The recommended treatment is for parents to join parenting groups such as Incredible Years or Triple P, which can be very effective, but not for everyone. Some children's conduct problems continue after parents finish these groups, and some parents are unable to attend at all. For these families, options have historically been limited.

A major investment in understanding what works

Led by Dr Rob Senior at North London Foundation Trust, with partners including King's College London and the Maudsley, this six-year programme secured over £2 million from the NIHR, with additional funding from NHS England. The study had two parts: first, exploring parents' experiences of parenting groups; second, testing personalised support for families with children aged 4 to 9 with behavioural difficulties who had either not attended standard groups or had not seen improvements after doing so.

Designing for those who need it most

What sets this research apart is its ecological, systemic approach: considering the child in relation to their family, housing, economic pressures and wider social factors, rather than focusing on parenting alone. The programme was delivered by therapists in family homes or a venue of the parents' choosing, deliberately removing practical barriers to access. It was grounded in the science of behaviour change and co-created with families to ensure it worked for those who had rarely had positive experiences with services before.

Parents and carers were central from the outset, providing feedback on what helped, guiding the study, and informing how findings could be shared and implemented.

Compelling results

Parents attended over 70% of sessions, significantly higher than in typical local authority or CAMHS parenting programmes. Both programmes led to clear improvements in children's behaviour, with results continuing to strengthen by 32 weeks. There were also improvements in attention, concentration and emotional regulation, suggesting the support addresses underlying difficulties, not just behaviour.

The online option also proved highly effective. Despite being less intensive and delivered remotely, it achieved strong results at a lower cost to the NHS, suggesting a combined, tailored approach may work best.

What mattered to families

A separate qualitative study identified three key themes: the importance of choice over timing, frequency and delivery format; the value of a trusting relationship with the therapist; and the benefit of looking beyond parenting to consider the wider family context.

Parents particularly valued something often missing from standard services: a thorough assessment and genuine insight into the reasons behind their child's behaviour. For families who had often felt judged or dismissed, this respectful, curious approach was a significant and welcome departure.

What comes next

The flexibility and relatively low cost of this approach make it well suited to integration into existing pathways. Online delivery could extend reach to areas with limited specialist provision, while home-based delivery removes barriers that prevent many families engaging with centre-based services. Early intervention could also reduce long-term difficulties, aligning with the NHS's broader shift towards prevention.

Next steps include developing referral pathways and practitioner training. For children who have experienced adversity and exclusion, this research offers powerful evidence that when services are built around families rather than the other way round, transformative change is possible.