Behavioural problems are prevalent in children, yet the consequences can be significant for the child, family and wider society. Effective intervention is paramount in reducing the impact of childhood behavioural problems. The Nurtured Heart Approach (NHA; Glasser & Easley, 2016) is an atheoretical parenting intervention which aims to reduce childhood behavioural problems. Although used in clinical practice, there is little empirical research on the effectiveness of the NHA. The aims of the study were to examine whether the NHA reduced parent-reported child behavioural problems, reduced negative parenting practices, and increased parental reflective functioning.

The study used a multiple baseline single case design. Parents of children with behavioural problems were recruited from CAMHS waiting lists. The NHA was delivered in a guided self-help format, using the Transforming the Intense Child workbook (Glasser, 2016) and weekly phone calls. Data collection involved psychometric measures of parent-reported child behavioural problems, parenting practices and parental reflecting functioning. Measures were repeated throughout baseline and intervention phases. A follow-up four weeks after the intervention included final measure administration and a change interview. The data were graphed and visually analysed. Supplementary analysis included reliable and clinically significant change, Tau-U and percentage exceeding the median. Framework analysis was used to analyse the change interview.

Inclusion Criteria:

Participants will be parents/carers of children who have been referred to National Health Service (NHS) children's services for behavioural problems. Participants will be recruited from waiting lists of NHS children's services at the two research sites in the East Midlands.

Inclusion criteria:

• The referred child is aged between three and eleven years old.
• The referred child is on a waiting list for an NHS children's service at the two research sites.
• The referred child's behavioural problems are one of the primary reasons for referral to the NHS service.
• The parent/carer identifies the referred child's behaviour as problematic.

Exclusion Criteria:

• The referred child has a diagnosis of developmental delay or learning disability.
• The family is current receiving active multi-agency involvement (e.g. social care, police or youth offending in addition to NHS services).
• The parent/carer is aged under 18.
• The parent/carer is unable to read or speak English fluently.

The data collection preiod - 4 months

The study included no observational element, meaning there is no measure of the extent to which parents were using the NHA in interactions with their children. The study also highlights the limitations of measures used for the variables of interest e.g. the BPM has limited items related to externalizing behaviour but alternative measures were not appropriate for a single case design. The limitations of the measures require the results to be interpreted in the context of these shortcomings.