The importance of evidence-based commissioning in relationship support

Published in Blog by Andrew Balfour on July 13th 2023

Following the publication of an evidence review by the Early Intervention Foundation in 2016 – What works to enhance interparental relationships and improve children’s outcomes – which found that frequent, intense and poorly resolved parental conflict puts the life chances and mental health of children at risk - the Government introduced the Reducing Parental Conflict programme.

This programme sought to test eight separate interventions – on parental couples still together as well as those who had separated – to see what impact they had on reducing conflict and improving children’s mental health and wellbeing.

Four areas of the country were chosen for this programme, which was essentially a research pilot. A number of the interventions were categorised as being for parental conflict of moderate intensity, while the remainder – including mentalization-based therapy for parents, an intervention which Tavistock Relationships helped to develop – were categorised as being for conflict of high intensity.

During the four-year programme, which received £50 million in funding, 71% of parents assessed for the programme were assessed, using psychometric measures developed by DWP researchers, and found to be in need of interventions to address high levels of conflict.

Interim evaluations of the programme, published by the Department for Work and Pensions (the department in charge of the programme), showed that mentalisation-based therapy “had the widest appeal (with the most referrals and starts to the intervention). Providers suggested that this might be because it is closest to what parents might expect from an intervention about parental conflict (whereas the scope of other interventions is wider, focusing on other elements of home life, rather than solely on the interparental relationship).”

In 2022, the four year testing period for the eight interventions came to an end, and the Government opted to make funding available to all local authorities to purchase training and/or interventions to address interparental conflict among the parents with whom they work.

In order now to derive the maximum benefit from the public money which has been spent on testing the eight interventions, the Government should work to ensure that commissioning decisions by local authorities are made with reference to the findings from the evaluation of the programme.

For while some parents may only need a relatively light touch intervention, we know that the Reducing Parental Conflict provided strong evidence of the prevalence of high levels of conflict among parental couples, which shows that high intensity interventions are badly needed by significant numbers of parents.

Prime Minister Rishi Sunak said in his first speech in 2023 that “strong supportive families make for more stable communities and happier individuals.” Ensuring that commissioning decisions by local authorities are made with reference to the findings from the evaluation of the Reducing Parental Conflict programme would not only help those with the lowest wellbeing scores in the country, but also the physical and mental wellbeing of the wider public and future generations of children.

The quality of our relationships has significant consequences for our own lives and for those around us and there is a great deal of evidence linking physical and mental health and wellbeing to the state of our relationships. In fact, a long-running Harvard study of adult life found that ‘investing in your relationships with other people is the thing that will make you happiest and keeps you healthiest’.

As well as significantly affecting our overall wellbeing and life satisfaction, the quality of our relationships has extensive economic implications. Partners with better mental health are likely to be more productive, generating personal income, benefits to employers, increased taxes and reduced welfare payments.

What needs to happen now?

In 2022, the Children’s Commissioner, Dame Rachel de Souza’s Family Review urged Government to be “unashamed about wanting to support and strengthen families”. This long-awaited and significant opportunity to embed relationship support in the heart of family services has not yet been picked up and acted upon.

Tavistock Relationships is an internationally recognised organisation committed to providing world class training for clinicians, developing and delivering evidence-based therapies for couples and far-reaching partnership programmes with Adult and Children’s Health services. We are calling for:

• the Government to require all local authorities to commission evidence-based interventions, such as those found to be effective through the Reducing Parental Conflict programme;
• the Government to increase funding for the relationship support sector as part of developing a wide-ranging strategic vision for the future of relationship support in the UK;
• the Government to ensure relationship support services are widely available and accessible before, during and after separation and divorce, so that parents can be the best parents they can be and to minimise distress for the children affected.
• to effectively address children’s mental health, the Government should trial the introduction of couple therapists, or practitioners with experience of working with couples, into child and adolescent mental health services;
• a review of funding streams for Family Hub services to ensure the most effective interventions in reducing parental conflict are delivered through the localised hubs; and
• specific training in understanding and identifying relationship issues in the context of depression to be provided to every mental health professional carrying out assessments in NHS Talking Therapies services.

Further information

For more information about Tavistock Relationships work with local authorities, Family Hubs and the NHS, This email address is being protected from spambots. You need JavaScript enabled to view it..

For more information about Tavistock Relationships Couple Therapy for Depression work, This email address is being protected from spambots. You need JavaScript enabled to view it..