The Incredible YearsAfter 10 years in NorwayA 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 forpersonale iskoler og

barnehager

Program for barn 3-8 år:Dinosaurus-

skoleni smågruppe

Program for barn 3-8 år:Dinosaurus-

skoleni klasserommet/

barnehagen

Program forforeldre til

barn i alderen0-3 år

Program forforeldre til

barn i alderen3-6 år (ny!)

Program forforeldre til

barn i alderen4-8 år

”Basic”

Program forforeldre til

barn i alderen6-12 år (ny!)

Program forforeldre til

barn i alderen4-12 år

”Advanced”

Agencies in NorwayNorth 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

ChairWilly-Tore Mørch

Anne-Kari Johnsen Teacher program

Lin Kristin Bjørk Akselsen(vikar for Andrea Jennerwein)

Parent Program Dinosaur school

Merete AasheimParent programDinosaur school

Ministry of Health

The mentors

Outpatient mental health clinicsParent program and

Small group Dina

Special education centers, Health stations, Family centersTeacher program, parent program, Dinosaur school in the classroom,

Children adolescent and family agencyFamily shelter and family centers)

Parent program and small group Dina

IY programs for parents, school and kindergarten

and children

RBUP NorthCenter for child and adolescent mental healh

IY OfficeChair IY Norway

Professor and trainer Willy-Tore Mørch

Research IYungsinn.uit.no

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 Verdi1 1 11,5 % 102 2 23,0 % 203 3 14,9 % 134 4 14,9 % 135 5 4,6 % 4

6 Flere enn fem,31,0 % 27

Program fidelity questionnaire 2008Are you certified?

Prosent Verdi1 Ja 22,7 % 202 Nei 77,3 % 68

Program fidelity undersøkelsen 2008Have you enough time to run groups? (40% position)

Prosent Verdi1 Ja 69,4 % 592 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 % 143 40% 46,5 % 404 Mer en 40%, 11,6 % 10

Program fidelity undersøkelsen 2008Do you offer the IY program in full dosage

Alternativer Prosent Verdi 1 Ja 97,6 % 812 Nei 2,4 % 2

Program fidelity undersøkelsen 2008 Do you offer the parent program in full dosage?

Alternativer Prosent Verdi 1 Ja 98,6 % 732 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 Verdi1 Ja 61,5 % 162 Nei 38,5 % 10

Violation of contracts

Increasing tendency of violation of contractsCauses:• 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