Relationship Support Interventions Evaluation - Gov.uk
Transcript Of Relationship Support Interventions Evaluation - Gov.uk
Relationship Support Interventions Evaluation
Research report January 2014
Tavistock Institute of Human Relations National Foundation for Educational Research Thomas Coram Research Unit Qa Research
Contents
List of figures
7
List of tables
8
Acknowledgments
10
Executive summary
11
1. Background
21
1.1. Policy context and background to the study
21
1.1.1. Supporting families and couple relationships
21
1.1.2. Previous research
23
1.1.3. Evaluating relationship support
24
1.2. Report structure
25
2. Aims and methodology
27
2.1. Aims and objectives of the study
27
2.2. Methodology
27
2.3. Literature review
28
2.4. Quantitative surveys
29
2.4.1. Survey design
29
2.4.2. Final survey sample
30
2.4.3. Research instruments
31
2.4.4. Analysis of quantitative data
32
2.4.5. Limitations of survey designs
33
2.5. Provider visits and qualitative interviews
35
2.6. Value for money (VfM) analysis
36
3. Marriage preparation
38
3.1. Description of services: FOCCUS© and Preparing Together
38
2
3.2. Characteristics of survey participants
39
3.3. Accessing marriage preparation
41
3.4. Satisfaction with marriage preparation
42
3.5. What difference does Marriage Preparation make?
45
3.5.1. Change over time – relationship quality, well-being and communication 45
3.5.2. Change over time – other outcomes
48
3.6. Encouraging access to relationship support
51
3.6.1. Likelihood of accessing other support
51
3.6.2. Encouraging others to access marriage preparation
54
3.7. Conclusions
55
4. Relationship education for new parents
57
4.1. Description of Let’s Stick Together (LST)
57
4.2. Characteristics of LST participants
59
4.3. Satisfaction with LST sessions received
60
4.4. Level of recall of key messages
61
4.5. Change over time
63
4.5.1. Change in well-being, relationship quality and communication
63
4.5.2. Other changes
66
4.6. Encouraging access to relationship support
69
4.6.1. How to encourage others to attend
70
4.6.2. Would making it compulsory work?
70
4.6.3. Has receiving LST changed their attitude to future support?
71
4.7. Conclusions
72
5. Couple counselling
73
5.1. Introduction
74
3
5.2. Overall findings
74
5.2.1. Using couple counselling
74
5.2.2. Satisfaction with the service
75
5.2.3. Outcomes
76
5.3. Relate couple counselling
77
5.3.1. Characteristics of the Relate survey sample
78
5.3.2. Reasons for attending couple counselling
79
5.3.3. How serious were reasons seen to be and for how long?
80
5.3.4. Were couples hoping to save their relationship?
81
5.3.5. Accessing relationship counselling
82
5.3.6. Satisfaction with support received
84
5.3.7. Changes in relationship quality, well-being and communication
86
5.3.8. Change over time – other outcomes
88
5.4. Marriage Care couple counselling
90
5.4.1. Characteristics of the Marriage Care survey sample
91
5.4.2. Reasons for attending couple counselling
91
5.4.3. How serious were the reasons seen to be and for how long?
93
5.4.4. Were couples hoping to save their relationship?
94
5.4.5. Accessing relationship counselling
94
5.4.6. Satisfaction with support received
97
5.4.7. Changes in relationship quality, well-being and communication
99
5.4.8. Change over time – other outcomes
102
5.5. The Tavistock Centre for Couple Relationships (TCCR) couple counselling 104
5.5.1. Reasons for attending couple counselling
106
5.5.2. Accessing relationship counselling
108
4
5.5.3. Satisfaction with support received
110
5.5.4. Outcomes
113
5.6. The Asian Family Counselling Service (AFCS) couple counselling
114
5.6.1. Reasons for attending couple counselling
115
5.6.2. Accessing relationship counselling
116
5.6.3. Satisfaction with support received
118
5.6.4. Outcomes
121
5.7. Encouraging access to relationship counselling
123
5.7.1. Attitudes towards future support
123
5.7.2. Factors discouraging access to relationship counselling
126
5.7.3. The cost of counselling
128
5.7.4. Encouraging the take-up of couple counselling
130
5.8. Conclusions
132
6. Value for money (VfM) analysis
133
6.1. A ‘best estimate’ approach
133
6.2. Approach to estimating benefits
134
6.3. Valuing changes in DAS-7
136
6.4. Valuing changes in WEMWBS
138
6.5. Approach to estimating costs
139
6.6. Sensitivity analysis
140
6.7. Relate couple counselling cost-benefit analysis
141
6.8. Marriage Care couple counselling cost-benefit analysis
145
6.9. FOCCUS Marriage Preparation cost-benefit analysis
147
6.10. Conclusions
150
5
7. Conclusions and lessons learned
151
7.1. Change over time
151
7.1.1. Well-being relationship quality and communication
151
7.1.2. Awareness and likelihood of using relationship strengthening behaviours 152
7.1.3. Changes in attitudes towards accessing relationship support in future 153
7.1.4. Limitations of study
154
7.2. Value for Money
155
7.3. Encouraging access to relationship support
155
7.4. Recommendations
158
7.5. Concluding statement
159
Bibliography
160
Appendix 1: Choice of standardised scales
164
Appendix 2: Summary of bespoke questions used in three surveys
170
Appendix 3: Details of couple counselling model
173
Appendix 4: Couple counselling sample details
179
Appendix 5: Qualitative interviews sample details
180
Appendix 6: Literature findings
186
Appendix 7: Methodology technical annex
214
6
List of figures
Figure 1 Expectations of usefulness and relevance of marriage preparation ..................41 Figure 2 Satisfaction with support received ....................................................................43 Figure 3 Satisfaction with different types of support received .........................................44 Figure 4 Preparing Together case study.........................................................................47 Figure 5 FOCCUS case study ........................................................................................51 Figure 6 Likelihood of seeking support from another organisation ..................................52 Figure 7 How would you rate the sessions overall? ........................................................60 Figure 8 Can you remember the three main themes of LST? .........................................61 Figure 9 Perceived changes to own views and relationship behaviour ...........................66 Figure 10 LST case study...............................................................................................67 Figure 11 How likely would you be to attend a course like LST in the future? .................71 Figure 12 How serious do you consider those problems and issues to be? ....................80 Figure 13 Satisfaction with support received ..................................................................84 Figure 14 Relate case study ...........................................................................................88 Figure 15 Has counselling helped you understand your relationship better? ..................89 Figure 16 How serious do you consider those problems and issues to be? ....................93 Figure 17 How satisfied are you with the Marriage Care couple counselling?.................97 Figure 18 Marriage Care case study............................................................................102 Figure 19 Has counselling helped you understand your relationship better? ................ 103 Figure 20 TCCR case study .........................................................................................112 Figure 21 The AFCS Case Study .................................................................................119 Figure 22 Linking survey results to monetary outcomes ............................................... 135 Figure 23 Cost conceptual model ................................................................................. 140
7
List of tables
Table 1 Pre- and post-survey response rates .................................................................30 Table 2 Change over time for three validated scales – Preparing Together....................45 Table 3 Change over time for three validated scales – FOCCUS ...................................48 Table 4 Perceived impact on views and behaviour .........................................................49 Table 5 Perceived impact on skills and techniques.........................................................50 Table 6 Change in mean scores for validated scales......................................................63 Table 7 Main issues identified by Relate clients attending couple counselling ................79 Table 8 Change over time for three validated scales – Relate ........................................86 Table 9 Main issues identified by Marriage Care clients attending couple counselling ....92 Table 10 Change over time for three validated scales – Marriage Care........................100 Table 11 Key assumptions and sources .......................................................................135 Table 12 Baseline DAS-7 scores according to couple status five years on ...................136 Table 13 Costs of relationship breakdown ....................................................................137 Table 14 Relate couple counselling costs.....................................................................142 Table 15 Relate couple counselling revenue ................................................................143 Table 16 Relate couple counselling cost-benefit analysis .............................................144 Table 17 Relate couple counselling sensitivity analysis ................................................144 Table 18 Marriage Care couple counselling costs ........................................................ 145 Table 19 Marriage Care couple counselling revenue ....................................................146 Table 20 Marriage Care couple counselling cost-benefit analysis.................................147 Table 21 Marriage Care couple counselling sensitivity analysis....................................147 Table 22 FOCCUS costs ..............................................................................................148 Table 23 FOCCUS revenue..........................................................................................148 Table 24 FOCCUS cost-benefit analysis ......................................................................149
8
Table 25 FOCCUS sensitivity analysis .........................................................................149 Table 26 Comparison of sample characteristics and Relate clients ..............................179 Table 27 Comparison of sample characteristics and Marriage Care clients ..................179 Table 28 Let’s Stick Together sample characteristics ...................................................180 Table 29 Marriage preparation sample characteristics..................................................181 Table 30 Relate couple counselling sample characteristics ..........................................182 Table 31 Marriage Care couple counselling sample characteristics..............................183 Table 32 TCCR couple counselling sample characteristics ..........................................184 Table 33 AFCS couple counselling sample characteristics ...........................................185
9
Acknowledgments
Our thanks go primarily to the staff and clients of all the relationship support interventions included in the study. Without their co-operation and willingness to share with us information, thoughts, ideas and feelings we would not have been able to produce this report. We have been generously and patiently supported by members of our Steering Group, and we remain very grateful for their input. Staff at the Department for Education (DfE) have been unfailingly helpful, and we have been especially appreciative of the way in which Afia Hassan has managed the project. The evaluation was conducted by the Tavistock Institute of Human Relations (TIHR) in partnership with the National Foundation for Educational Research (NFER), Qa Research and the Thomas Coram Research Unit (TCRU). The main responsibility rested with Judy Corlyon and Thomas Spielhofer (TIHR), Ben Durbin (NFER), Becky Gulc and Julie Wrigley (Qa Research) and Marjorie Smith (TCRU). The report was written by Thomas Spielhofer, Judy Corlyon, Laura Stock and Matthew Gieve (TIHR), Ben Durbin (NFER) and Marjorie Smith (TCRU) but it would not have been possible without the significant help of David Drabble and many other colleagues at TIHR, Katie Hollingworth at TCRU and Adam Rabiasz and Simon Rutt at NFER.
Suggested citation: Spielhofer, T., Corlyon, J., Durbin, B., Smith, M., Stock, L. and Gieve, M. (2014). Relationship Support Interventions Evaluation. Department for Education.
10
Research report January 2014
Tavistock Institute of Human Relations National Foundation for Educational Research Thomas Coram Research Unit Qa Research
Contents
List of figures
7
List of tables
8
Acknowledgments
10
Executive summary
11
1. Background
21
1.1. Policy context and background to the study
21
1.1.1. Supporting families and couple relationships
21
1.1.2. Previous research
23
1.1.3. Evaluating relationship support
24
1.2. Report structure
25
2. Aims and methodology
27
2.1. Aims and objectives of the study
27
2.2. Methodology
27
2.3. Literature review
28
2.4. Quantitative surveys
29
2.4.1. Survey design
29
2.4.2. Final survey sample
30
2.4.3. Research instruments
31
2.4.4. Analysis of quantitative data
32
2.4.5. Limitations of survey designs
33
2.5. Provider visits and qualitative interviews
35
2.6. Value for money (VfM) analysis
36
3. Marriage preparation
38
3.1. Description of services: FOCCUS© and Preparing Together
38
2
3.2. Characteristics of survey participants
39
3.3. Accessing marriage preparation
41
3.4. Satisfaction with marriage preparation
42
3.5. What difference does Marriage Preparation make?
45
3.5.1. Change over time – relationship quality, well-being and communication 45
3.5.2. Change over time – other outcomes
48
3.6. Encouraging access to relationship support
51
3.6.1. Likelihood of accessing other support
51
3.6.2. Encouraging others to access marriage preparation
54
3.7. Conclusions
55
4. Relationship education for new parents
57
4.1. Description of Let’s Stick Together (LST)
57
4.2. Characteristics of LST participants
59
4.3. Satisfaction with LST sessions received
60
4.4. Level of recall of key messages
61
4.5. Change over time
63
4.5.1. Change in well-being, relationship quality and communication
63
4.5.2. Other changes
66
4.6. Encouraging access to relationship support
69
4.6.1. How to encourage others to attend
70
4.6.2. Would making it compulsory work?
70
4.6.3. Has receiving LST changed their attitude to future support?
71
4.7. Conclusions
72
5. Couple counselling
73
5.1. Introduction
74
3
5.2. Overall findings
74
5.2.1. Using couple counselling
74
5.2.2. Satisfaction with the service
75
5.2.3. Outcomes
76
5.3. Relate couple counselling
77
5.3.1. Characteristics of the Relate survey sample
78
5.3.2. Reasons for attending couple counselling
79
5.3.3. How serious were reasons seen to be and for how long?
80
5.3.4. Were couples hoping to save their relationship?
81
5.3.5. Accessing relationship counselling
82
5.3.6. Satisfaction with support received
84
5.3.7. Changes in relationship quality, well-being and communication
86
5.3.8. Change over time – other outcomes
88
5.4. Marriage Care couple counselling
90
5.4.1. Characteristics of the Marriage Care survey sample
91
5.4.2. Reasons for attending couple counselling
91
5.4.3. How serious were the reasons seen to be and for how long?
93
5.4.4. Were couples hoping to save their relationship?
94
5.4.5. Accessing relationship counselling
94
5.4.6. Satisfaction with support received
97
5.4.7. Changes in relationship quality, well-being and communication
99
5.4.8. Change over time – other outcomes
102
5.5. The Tavistock Centre for Couple Relationships (TCCR) couple counselling 104
5.5.1. Reasons for attending couple counselling
106
5.5.2. Accessing relationship counselling
108
4
5.5.3. Satisfaction with support received
110
5.5.4. Outcomes
113
5.6. The Asian Family Counselling Service (AFCS) couple counselling
114
5.6.1. Reasons for attending couple counselling
115
5.6.2. Accessing relationship counselling
116
5.6.3. Satisfaction with support received
118
5.6.4. Outcomes
121
5.7. Encouraging access to relationship counselling
123
5.7.1. Attitudes towards future support
123
5.7.2. Factors discouraging access to relationship counselling
126
5.7.3. The cost of counselling
128
5.7.4. Encouraging the take-up of couple counselling
130
5.8. Conclusions
132
6. Value for money (VfM) analysis
133
6.1. A ‘best estimate’ approach
133
6.2. Approach to estimating benefits
134
6.3. Valuing changes in DAS-7
136
6.4. Valuing changes in WEMWBS
138
6.5. Approach to estimating costs
139
6.6. Sensitivity analysis
140
6.7. Relate couple counselling cost-benefit analysis
141
6.8. Marriage Care couple counselling cost-benefit analysis
145
6.9. FOCCUS Marriage Preparation cost-benefit analysis
147
6.10. Conclusions
150
5
7. Conclusions and lessons learned
151
7.1. Change over time
151
7.1.1. Well-being relationship quality and communication
151
7.1.2. Awareness and likelihood of using relationship strengthening behaviours 152
7.1.3. Changes in attitudes towards accessing relationship support in future 153
7.1.4. Limitations of study
154
7.2. Value for Money
155
7.3. Encouraging access to relationship support
155
7.4. Recommendations
158
7.5. Concluding statement
159
Bibliography
160
Appendix 1: Choice of standardised scales
164
Appendix 2: Summary of bespoke questions used in three surveys
170
Appendix 3: Details of couple counselling model
173
Appendix 4: Couple counselling sample details
179
Appendix 5: Qualitative interviews sample details
180
Appendix 6: Literature findings
186
Appendix 7: Methodology technical annex
214
6
List of figures
Figure 1 Expectations of usefulness and relevance of marriage preparation ..................41 Figure 2 Satisfaction with support received ....................................................................43 Figure 3 Satisfaction with different types of support received .........................................44 Figure 4 Preparing Together case study.........................................................................47 Figure 5 FOCCUS case study ........................................................................................51 Figure 6 Likelihood of seeking support from another organisation ..................................52 Figure 7 How would you rate the sessions overall? ........................................................60 Figure 8 Can you remember the three main themes of LST? .........................................61 Figure 9 Perceived changes to own views and relationship behaviour ...........................66 Figure 10 LST case study...............................................................................................67 Figure 11 How likely would you be to attend a course like LST in the future? .................71 Figure 12 How serious do you consider those problems and issues to be? ....................80 Figure 13 Satisfaction with support received ..................................................................84 Figure 14 Relate case study ...........................................................................................88 Figure 15 Has counselling helped you understand your relationship better? ..................89 Figure 16 How serious do you consider those problems and issues to be? ....................93 Figure 17 How satisfied are you with the Marriage Care couple counselling?.................97 Figure 18 Marriage Care case study............................................................................102 Figure 19 Has counselling helped you understand your relationship better? ................ 103 Figure 20 TCCR case study .........................................................................................112 Figure 21 The AFCS Case Study .................................................................................119 Figure 22 Linking survey results to monetary outcomes ............................................... 135 Figure 23 Cost conceptual model ................................................................................. 140
7
List of tables
Table 1 Pre- and post-survey response rates .................................................................30 Table 2 Change over time for three validated scales – Preparing Together....................45 Table 3 Change over time for three validated scales – FOCCUS ...................................48 Table 4 Perceived impact on views and behaviour .........................................................49 Table 5 Perceived impact on skills and techniques.........................................................50 Table 6 Change in mean scores for validated scales......................................................63 Table 7 Main issues identified by Relate clients attending couple counselling ................79 Table 8 Change over time for three validated scales – Relate ........................................86 Table 9 Main issues identified by Marriage Care clients attending couple counselling ....92 Table 10 Change over time for three validated scales – Marriage Care........................100 Table 11 Key assumptions and sources .......................................................................135 Table 12 Baseline DAS-7 scores according to couple status five years on ...................136 Table 13 Costs of relationship breakdown ....................................................................137 Table 14 Relate couple counselling costs.....................................................................142 Table 15 Relate couple counselling revenue ................................................................143 Table 16 Relate couple counselling cost-benefit analysis .............................................144 Table 17 Relate couple counselling sensitivity analysis ................................................144 Table 18 Marriage Care couple counselling costs ........................................................ 145 Table 19 Marriage Care couple counselling revenue ....................................................146 Table 20 Marriage Care couple counselling cost-benefit analysis.................................147 Table 21 Marriage Care couple counselling sensitivity analysis....................................147 Table 22 FOCCUS costs ..............................................................................................148 Table 23 FOCCUS revenue..........................................................................................148 Table 24 FOCCUS cost-benefit analysis ......................................................................149
8
Table 25 FOCCUS sensitivity analysis .........................................................................149 Table 26 Comparison of sample characteristics and Relate clients ..............................179 Table 27 Comparison of sample characteristics and Marriage Care clients ..................179 Table 28 Let’s Stick Together sample characteristics ...................................................180 Table 29 Marriage preparation sample characteristics..................................................181 Table 30 Relate couple counselling sample characteristics ..........................................182 Table 31 Marriage Care couple counselling sample characteristics..............................183 Table 32 TCCR couple counselling sample characteristics ..........................................184 Table 33 AFCS couple counselling sample characteristics ...........................................185
9
Acknowledgments
Our thanks go primarily to the staff and clients of all the relationship support interventions included in the study. Without their co-operation and willingness to share with us information, thoughts, ideas and feelings we would not have been able to produce this report. We have been generously and patiently supported by members of our Steering Group, and we remain very grateful for their input. Staff at the Department for Education (DfE) have been unfailingly helpful, and we have been especially appreciative of the way in which Afia Hassan has managed the project. The evaluation was conducted by the Tavistock Institute of Human Relations (TIHR) in partnership with the National Foundation for Educational Research (NFER), Qa Research and the Thomas Coram Research Unit (TCRU). The main responsibility rested with Judy Corlyon and Thomas Spielhofer (TIHR), Ben Durbin (NFER), Becky Gulc and Julie Wrigley (Qa Research) and Marjorie Smith (TCRU). The report was written by Thomas Spielhofer, Judy Corlyon, Laura Stock and Matthew Gieve (TIHR), Ben Durbin (NFER) and Marjorie Smith (TCRU) but it would not have been possible without the significant help of David Drabble and many other colleagues at TIHR, Katie Hollingworth at TCRU and Adam Rabiasz and Simon Rutt at NFER.
Suggested citation: Spielhofer, T., Corlyon, J., Durbin, B., Smith, M., Stock, L. and Gieve, M. (2014). Relationship Support Interventions Evaluation. Department for Education.
10