Effectiveness of Solution-Focused Consultations on Parent Stress and Competence

Participants

In response to flyers describing an opportunity to participate in a research study on the effectiveness of a two-session consultation experience, 45 parents voluntarily contacted a local parent education nonprofit organization. Approximately 82% (n = 36) of these participants were female, 93% (n = 42) were White, and 71% (n = 32) were married. Parents’ ages ranged from 24 to 49 years, with a mean age of 32.2. Parents reported having 1 (n = 11), 2 (n = 21), 3 (n = 8), or 4 (n = 2) children. Children’s ages ranged from 18 months to 18 years, with a mean of 8.3 years.

The Consultation Model and Consultants

The consultation approach used in this study was based on previously published principles and practices (Sommers-Flanagan, 2007; Sommers-Flanagan & Sommers-Flanagan, 2011). Generally, the model is described as solution focused, with a strong emphasis on person-centered or parent-centered principles. Specifically, the model is consistent with theoretical foundations of solution-focused counseling, including:

a consistent focus on parent strengths and solutions instead of problems;

Consultants were trained to stay positive and validating in their interactions with parents and to spend the first half of the session primarily listening and the second half of the session offering concrete advice or homework assignments, emphasizing mutuality of purpose. In an effort to reduce parent stress and increase parent perceptions of competence, the approach focused on (a) showing empathy for parenting challenges, (b) affirming previous parenting efforts, and (c) guiding parents toward constructive and effective solutions. Consultants were advised to use no more than one or two personal self-disclosures during each session (see Sommers-Flanagan & Sommers-Flanagan, 2011 for additional details on this solution-focused and person-/parent-centered approach).

Initial and second session consultations were conducted either by the first author (male) and a graduate student (n = 19), by graduate students in counselor education working in pairs (n = 18), by the first author alone (n = 1) or by a single licensed female practitioner (n = 7). Four different graduate students were trained to provide consultations (one White male, two White females, and one Japanese female). Of the 45 initial sessions, a male consultant primarily or exclusively led 21 sessions and a female consultant primarily or exclusively led 24 sessions. The first author developed the consultation model and all graduate students had at least 3 hr of training, plus the experience of observing or “sitting in” on at least one session with the first author. The licensed practitioner worked at the agency and had received a single, 3-hr training.

Procedure

All parents who contacted the agency about the research opportunity and expressed interest in an appointment were scheduled for an initial appointment within 2 weeks. Immediately prior to Session 1, parents completed registration and consent forms (as approved by the Institutional Review Board at the University of Montana), the Parenting Stress Index–Short Form (PSI-SF) (Abidin, 1995), the Parenting Sense of Competence (PSOC) scale (Johnston & Mash, 1989), an additional 17-item parenting questionnaire that was included for experimental purposes, and turned these materials in to the consultant. At the end of Session 1, parents were provided a photocopy of the consultant’s recommendations and a second consultation appointment was scheduled from 3 to 15 weeks after the initial session (depending on parent preference and consultant availability).

At the end of the second session, parents were given a stamped envelope with the Parenting Practices Questionnaire (PPQ), PSI, PSOC, and a satisfaction questionnaire and were instructed to take the questionnaires home, complete them, and mail them back to the agency office within a week of their consultation. A US$10 bill was included in the envelope to encourage a higher return rate.

Instrumentation

Pre- and posttest measures used in this study included the PSI-SF, PSOC scale, PPQ, and a satisfaction inventory (SI). These measures were selected because they are relatively brief, unobtrusive, and focus on variables central to the parenting consultation intervention goals.

Quantitative Findings

Within-group analyses of pre-post consultations for PSI-SF scores were calculated using paired sample t-tests. There were statistically significant findings for all subscales in the hypothesized directions (see Table 1).

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Table 1.

Pre-Consultation Versus Post-Consultation PSI Ratings.

Scale	Pre-Consult	Post-Consult	t	p
Defensive responsiveness	17.33	15.78	2.23	0.035*
Parent distress	27.85	25.63	2.39	0.024*
Parent–child dysfunction	23.07	21.33	2.1	0.046*
Difficult child	34.11	31.22	2.68	0.012*
Total PSI	86.85	79.59	3.5	0.002**

Note. Items were rated on 5-point Likert scales ranging from 1 (strongly agree) to 5 (strongly disagree). All comparisons were two-tailed, paired sample t tests (df = 26). PSI-SF = parenting stress index–short form.

*Statistically significant at p < 0.05. **Statistically significant at p < 0.01.

Paired sample t-tests were also used to evaluate pre- and post-consultation differences on the PSOC. On the Satisfaction subscale of the PSOC there was a trend toward statistical significance t(23) = −2.019, p = 0.055). On the Efficacy subscale there was a statistically significant difference t(23) = −2.963, p = 0.007). Pre-post changes for Total PSOC scores were also statistically significant t(23) = −3.218, p = 0.004).

Twenty-seven parents responded to the Likert-type satisfaction questions about their 2-session parenting consultation experience. Mean scores on these questions indicated parents felt positive about the quality of the consultations, were highly satisfied, viewed the consultations as having a positive effect on their relationship with their children, and would be likely to schedule another appointment in the future. Results are summarized in Table 2.

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Table 2.

Consultation Satisfaction Ratings.

Item	M	SD	n
1. How would you rate the overall quality of services you received?	1.23	0.424	27
2. How satisfied are you with the help you received?	1.23	0.424	27
3. Did the consult help improve your relationship with your child?	1.77	0.622	27
4. If you need help again, would you schedule another consultation?	1.38	0.694	27

Note. Items were rated on 5-point Likert scales ranging from 1 (Excellent) to 5 (Very Poor) on item 1, 1 (Very Satisfied) to 5 (Very Dissatisfied) on item 2, 1 (Yes, it helped a great deal) to 5 (No, it seemed to make things worse) on item 3, and 1 (Definitely) to 5 (Definitely Not) on item 4. M = mean; SD = standard deviation.

Qualitative Findings

The final 3 items (i.e., 5, 6, and 7) on the parent SI were designed to elicit qualitative responses from parent participants. Item 5 asked parents to list “helpful” consultant behaviors, item 6 asked for examples of “unhelpful” consultant behaviors, and item 7 asked about “any further feedback” pertaining to the consultation.

In response to item 5, 21 out of 29 parents wrote examples of positive consultant behaviors. These responses ranged in length and specificity. Some respondents were very brief, noting the helpfulness of “Concrete suggestions” and “Making a list for me to refer to.” Other respondents were more detailed. For example, one parent wrote:

[The] consultant listened well, made accurate assessments and provided specific suggestions—suggestions included help in communicating more effectively to my child that, as a parent, I am in charge, and help handling argumentativeness and defiance and help for me to see effective ways of giving my child more choice and responsibility.

Only 12 parents wrote something in the section on “unhelpful” consultant behaviors. Out of these 12, 10 noted that they did not have any negative feedback by either writing “Nothing” or something positive. Overall, there were two references to negative consultant behaviors. One parent was critical of the consultants’ use of self-disclosure or self-referencing:

Some comparisons with the consultant’s own personal experience didn’t pertain well to ours—and we weren’t sure if this tactic was as effective—or perhaps it could be used less.

Another parent noted that “A couple” of the consultant’s suggestions were less helpful. She wrote:

A couple of suggestions (to have a race and “I bet you can’t…”) weren’t right for my son because he doesn’t yet engage with competition (unless a toy or attention is involved or other kids). However, these were minor suggestions in a list of useful/helpful options.

On item 7, 12 parents made additional positive comments about their consultation experience. One parent specifically articulated the advantage of private consultations over group classes:

I really appreciated having a private consultation. I attend free group programs when offered to the public, but the private consult was 10 times more effective in its specificity. Thanks!

Another parent who was struggling with co-parenting articulated many potential dimensions of a consultation experience. She wrote:

[He] suggested contact with counselors, teachers, co-parent, [and was] informative and encouraging, cited resources to refer to in the community. I’d definitely refer anyone, as I found it helpful. I received reinforcement on the positive constructive ways I’m dealing with my children. Consultant was friendly, easy going, approachable, honest, kind, understanding, non-judgmental, professional, and patient.

Overall, the qualitative parent responses included 33 separate positive comments and 2 comments that had a negative or critical tone. Two raters conducted a content analysis of the positive qualitative comments. This analysis revealed: (a) 24 mentions of being provided specific helpful suggestions, (b) 7 comments pertaining to being listened to, respected, and accepted, (c) 5 references to obtaining a sense of reassurance from the consultant(s), (d) 6 comments about gaining a new perspective during the consultation, and (e) 6 comments that were generally positive (e.g., “the consult was very helpful”). Percentage agreement between the two raters was 80.4%.

Applications

Despite limitations of this study, we believe the results have significant implications for community-based professionals who work with parents. Specifically, this study is the second in a series suggesting that a relatively straightforward, positive, and brief consultation intervention can have positive effects on parent stress and parenting self-efficacy. This finding is important because although many family therapy practitioners work directly with parents, there are few community-based and empirically supported models directly linked to positive parenting outcomes and high parent satisfaction. The brief solution-focused model used in this study is flexible and can be integrated into family therapy practices ranging from individual play therapy to therapy with adolescents and to stand-alone parent only interventions (Post, Ceballos, & Penn, 2012; Sommers-Flanagan & Sommers-Flanagan, 2011). Findings from this study suggest that parents who receive this positive approach are likely to feel less stress, more competent, and satisfied with their consultation experience.

Results from this study are especially important given the evidence of deleterious effects of parental stress on children’s health. For example, a national study found that 13% of children live in households with at least one parent experiencing high parental stress and that parents with high parental stress had higher rates of seeking emergency medical care for their children than those with lower parental stress (Raphael, Zhang, Liu, & Giardino, 2010). Given direct costs of parental stress on children, families, and society, the possibility that a brief and positive intervention has the potential to significantly reduce stress and increase self-efficacy is a boon to mental health, community, and school-based professionals as well as parents. In many ways, it does not matter that participants may be experiencing a placebo effect or inaccurately attributing their positive outcomes to the consultation rather than the passing of time. This intervention is of minimal expense, burden, and stigma to parents. It is also an approach that can be learned relatively quickly and is well within the practice domain of many different community, mental health, and human services professionals. Consequently, although determining if this intervention is the active ingredient in reducing parental stress and increasing self-efficacy is important and worthy of additional research, providing low cost, parenting consultation services through various community settings is likely to benefit parents and families who choose to participate. Overall, we find the possibility that helping professionals can confidently inform parents that, if they are feeling stressed and ineffective, 2 h of their time and money may significantly reduce their stress and increase their confidence is very exciting news.