Group-based parenting programs are an effective intervention for improving children’s emotional and behavioural functioning (Barlow et al., 2016). Emotion-focused parenting programs specifically aim to facilitate children’s emotional competence by helping parents understand how their past experiences influence their current parenting, improve their own emotional competence and emotional communication, develop strategies for responding to their children’s emotions, and learn how to facilitate children’s emotional competence (Havighurst et al., 2020). Tuning in to Kids (TIK; Havighurst & Harley, 2007) is an emotion-focused parenting program that has demonstrated efficacy and effectiveness in improving children’s emotion regulation and parents’ supportive responding to children’s emotions, while also decreasing children’s behavioural difficulties and parents’ unsupportive responding (Havighurst et al., 2010; Havighurst et al., 2013; Wilson et al., 2012).
Parenting programs, such as TIK, are mostly attended by mothers and have low rates of father enrolment, yet evidence suggests that families may obtain superior outcomes when parents participate in programs together rather than individually (e.g., Casey et al., 2017; Cowan et al., 2009).
When parents attend sessions together, they have opportunities to improve their coparenting relationship. The coparenting relationship occurs between adults who are actively engaged in raising a child (McHale et al., 2019) and specifically relates to how parents work together to manage childrearing tasks and responsibilities (McHale & Irace, 2011; McHale & Negrini, 2018). Feinberg’s (2003) framework describes the coparenting relationship in terms of how parents support each other; whether there is agreement on childrearing decisions regarding discipline, education, emotional needs; how decisions are made about dividing tasks, labour, and responsibilities; as well as joint management of family relations, including how family members ought to behave and communicate (Feinberg, 2003). Most researchers emphasise the coparenting dimensions of support and undermining (Belsky et al., 1996; Mangelsdorf et al., 2011; McHale, 1995). Supportive coparenting describes how coparents value and respect each other’s parenting, and work collaboratively and cooperatively together (e.g., Feinberg, 2003; Margolin et al., 2001; McHale, 1995; Van Egeren & Hawkins, 2004). Undermining coparenting describes the extent to which one or both coparents belittle, criticise, interrupt, and disparage each other’s parenting (e.g., Belsky et al., 1996; Feinberg, 2003; Van Egeren & Hawkins, 2004). The way in which parents work together influences child adjustment (Teubert & Pinquart, 2010), the parent-child relationship (Feinberg & Kan, 2008; Teubert & Pinquart, 2010), parenting practices (Bonds and Gondoli (2007); Margolin et al., 2001; Morrill et al., 2010), and parental emotional availability (Sturge-Apple et al., 2006). A meta-analysis by Teubert and Pinquart (2010) revealed that high levels of cooperation and agreement, and low levels of conflict in the coparent relationship are associated with improved child social functioning, and reduced internalising and externalising symptoms. Notably, the association between child outcomes and coparenting remained significant after controlling for individual parenting practices and the marital relationship (Teubert & Pinquart, 2010). When the coparenting relationship is working effectively, it provides the family with predictability, stability, and security (Minuchin, 1974; McHale et al., 2000). Given the impact of the coparent relationship on family functioning, promoting supportive coparenting through parenting programs may lead to additional improvements in parenting practices and child wellbeing.
Majority of group-based parenting programs specifically focus on the parenting practices of individual parents without addressing the coparenting relationship (Eira Nunes et al., 2021). Eira Nunes and colleagues (2021) recently conducted a meta-analysis to examine the efficacy of coparenting programs, which were delivered in a variety of formats (e.g., group, couple sessions, home visit). Findings revealed coparenting programs have a significant, small effect on the quality of the coparenting relationship, positive parenting, and parents’ stress. The Supportive Fathers Involvement program is an example of group-based coparenting program that highlights the utility of including both parents in sessions. Cowan et al. (2009) evaluated the efficacy of Supporting Fathers Involvement by conducting a randomised trial with three conditions: 16-week program for fathers (i.e., mothers only attended twice), 16-week program for couples, and a low-dose comparison group (i.e., one information meeting). In this study, “couples” referred to the biological parents who were raising a child together, regardless of their relationship status (e.g., married, cohabiting, living separately, divorced). Results at 18-months follow-up showed that compared with parents in the comparison group, parents in the intervention groups (i.e., father and couple programs) reported increased father involvement with their children and no increase in child behavioural problems. Notably, the couple program provided the additional benefit of reducing parenting stress and maintaining relationship satisfaction, while relationship satisfaction declined in the father-group and comparison group. Additionally, results from a trial of the United Kingdom version of the program (Parents as Partners; Casey et al., 2017) indicated that parents who began the program with poorer communication and relationship quality improved their relationship satisfaction, reduced conflict about child-rearing, and decreased violent problem solving after attending sessions together. Parents also reported improvements in their children’s emotional and behavioural difficulties (Casey et al., 2017). Research suggests that children benefit when parents work together collaboratively and cooperatively (e.g., McHale et al., 2019) and use similar supportive parenting approaches (Martin et al., 2007; Meteyer & Perry‐Jenkins 2009). Furthermore, it appears parents are willing to attend programs together, with Patterson et al. (2005) reporting that parents believed the Webster-Stratton Parenting Programme would have been more effective if they were able to attend sessions with their partner, as it would enable more consistent parenting at home.
Several challenges may arise when one parent from a two-parent family attends a parenting program. Firstly, the parent who attends the program is responsible for conveying the program information to the other parent. In some circumstances, the information learnt at the parenting program may not be effectively communicated to the other parent. One factor that may compromise this information exchange is inhibitory maternal gatekeeping, in which a mother limits and restricts the other parent’s involvement with their children and criticises their parenting efforts (Stevenson et al., 2014; Talbot & McHale, 2004). Regarding inhibitory gatekeeping, Hauser (2012) found that maternal gatekeeping can involve mothers controlling parenting decisions and access to information, while also dictating the parenting approach that must be adopted without consultation with the other parent. Although withholding information is often not malicious or intentional, mothers’ reluctance to share information with the other parent may be due to beliefs that the information is only relevant to the maternal parenting role and a sense of pride and indispensability that is obtained when withholding information (Hauser, 2012).Given maternal gatekeeping and low levels of father participation in parenting programs, fathers may develop dependence and reliance on mothers for parenting advice because they do not have access to information. As such, the way in which the information from parenting programs is communicated can impact fathers’ ability to make changes to their own parenting practices. Furthermore, fathers’ perceptions of their parenting abilities are highly influenced by mothers’ attitudes about paternal competence and involvement, whereas mothers do not seem as effected by their coparents’ opinions (Van Egeren & Hawkins, 2004). This means that if mothers share the information from the parenting programs but are critical of fathers’ attempts to use new parenting strategies, fathers’ self-efficacy may be compromised (Stevenson et al., 2014; Talbot & McHale, 2004). Encouraging both parents to attend parenting programs may mitigate inhibitory gatekeeping, as parents learn the information at the same time and can practice the skills together. Alternatively, the attending parent may be undermined by the non-attending parent when they attempt to implement the new practices at home. Undermining can result in low skill enactment, as the parent who attended the program struggles to effectively integrate the new knowledge and skills into the family home. Tavassolie and colleagues (2016) suggest that parents may be able to work together more collaboratively and reduce interparental conflict when they are aware of their own parenting preferences and understand these may differ from the other parent’s approach. By attending parenting programs together, parents can become more aligned in their parenting goals.
Evidence shows that emotion-focused parenting program, such as TIK, can benefit families by improving parenting and children’s emotional competence and behaviour (e.g., Barlow et al., 2016; Duncombe et al., 2016). However, program effectiveness may be limited as mothers are more likely to attend parenting programs than fathers, and they typically attend alone (Panter‐Brick et al., 2014). This may lead to problems in two-parent families, including disagreement about parenting and differences in parenting choices. Two parents attending a parenting program together may facilitate for a more holistic approach to family functioning, compared to one member of the coparenting subsystem attending alone (McHale & Negrini, 2018). Given this, TIK-Together, an extension of TIK, was designed to specifically involve coparents (Ambrosi et al., 2022). TIK-Together aims to enhance parents’ emotion socialisation practices (i.e., increase emotion coaching, decrease emotion dismissing), and improve how coparents work together when responding to their children’s emotions (i.e., coparenting children’s emotions; Ambrosi et al., 2022). As TIK-Together is a new program, this study focuses on the next stage of intervention development and evaluation, which involves piloting the program to assess feasibility (Hateley-Browne et al., 2019; Moore et al., 2015).
The United Kingdom Medical Research Council framework for developing and evaluating complex interventions (Craig et al., 2008; Skivington et al., 2021) presents four phases: developing the intervention, assessing intervention feasibility, evaluating intervention effectiveness/efficacy, and increasing the impact and uptake of the intervention. The process of intervention evaluation is iterative and dynamic, often moving through cycles of obtaining feedback from stakeholders and generating solutions to identified problems. As TIK-Together is newly adapted, it is important to assess the feasibility of the intervention by piloting the program. The United Kingdom Medical Research Council guidelines (Skivington et al., 2021) emphasise the importance of engaging stakeholders throughout program development and evaluation, particularly when piloting new or adapted programs. Engaging stakeholders in program evaluation is crucial as it increases the likelihood of successful future implementation (Skivington et al., 2021). Stakeholders, such as facilitators who deliver parenting programs, can provide valuable insight about program feasibility and implementation (Moore et al., 2015; O’Cathain et al., 2019), given their professional experience in program delivery and knowledge about their community. As facilitators are responsible for choosing and delivering parenting interventions to their communities (i.e., disseminating parenting programs), it is particularly important to understand their perspectives (Skivington et al., 2021). A key aim in the feasibility phase of intervention development is gauging intervention acceptability and appropriateness (O’Cathain et al., 2019; Sekhon & Francis, 2018).
Proctor and colleagues (2011), acceptability is the extent to which stakeholders perceive aspects of a program (e.g., content, complexity, delivery) as agreeable, palatable, and satisfactory. In addition, Sekhon and Francis (2018) developed a theoretical framework outlining the multiple components of acceptability which includes, but is not limited to, affective attitude, burden, and perceived effectiveness. Affective attitude refers to how facilitators feel about the intervention, while burden relates to the perceived amount of effort required to deliver the intervention. Perceived effectiveness is the extent to which facilitators believe the program has achieved its intended purpose. Furthermore, Proctor et al. conceptualised appropriateness as the perceived fit, relevance, or compatibility of a program to a specific setting or consumer. These outcomes are often assessed using a combination of qualitative and quantitative research methods, such as stakeholder interviews (e.g., Hateley-Browne et al., 2019; Moore et al., 2015) and quantitative questionnaires (e.g., Weiner et al., 2017).
The Current Research
We investigated the feasibility of TIK-Together, an emotion-focused coparenting program, from the perspective of facilitators as stakeholders. This research was nested within a pilot study of TIK-Together, using a sample of Australian coparents with children aged 3 to 10 years old. We used a mixed-methods approach to examine facilitators’ perceptions of the acceptability (affective attitude, burden, perceived effectiveness) and the appropriateness of TIK-Together. As such, the research question addressed in this study is: do facilitators perceive TIK-Together as an acceptable and appropriate program for their communities?
Method
Design
We used a convergent mixed-methods design with an intervention framework (see Creswell et al., 2009; Fetters et al., 2013). Qualitative and quantitative data were concurrently collected from facilitators after delivering TIK-Together. The qualitative component of the study was guided by a critical realist approach and an experiential orientation to reflexive thematic analysis. A key assumption of a critical realist approach is that participants’ responses reflect their realities, and are influenced by their own culture, language, and social context (e.g., Maxwell, 2012; Willig, 2013). In the current study, a critical realist approach enabled exploration of facilitators’ experiences delivering TIK-Together and their perceptions of program acceptability and appropriateness, while also considering the continuous influence of contextual factors. Notably, this approach assumed that facilitators’ responses reflected their own reality, and the experiences and realities of parents attending the program may be different.
Participants
Participants were 15 facilitators (14 females; 1 male) from family and community services across the Australian states of Victoria, New South Wales, and Western Australia. Eight facilitators completed program delivery (two facilitators delivered the program twice), and six facilitators started program delivery but ended the program early due to low parent numbers. All facilitators had completed high school and gained higher qualifications, including: 13.3% Certificate-IV (e.g., group facilitation, community and child services), 6.7% diploma (e.g., social sciences), 13.3% bachelor degree (e.g., education, social work), 13.3% graduate diploma/certificate (e.g., counselling, psychology studies), 53.3% post-graduate degree (e.g., clinical psychology, counselling psychology, child and family health nursing). All facilitators had experience delivering TIK or Tuning in to Teens group programs prior to study involvement. On average, these facilitators had previously delivered six of these programs (M = 6.00; SD = 4.30; Md = 4.50, range = 14). All facilitators who had previously delivered a TIK program reported delivering the program to groups that included a mixture of individual parents and coparents at least once. Most facilitators (80%, n = 12) had experience delivering other group-based parenting programs, including: Bringing up Great Kids, Dads Tuning in to Kids, Tuning in to Toddlers, Circle of Security, and 1-2-3 Magic and Emotion Coaching. Facilitators had a mean average of 6.13 years of experience delivering parenting programs (SD = 5.81, Md = 3.92, range = 19).
Procedure
Initially, ethics approval was granted by the University of South Australia Human Research Ethics Committee (protocol number: 200983) and the study was submitted to the Australian New Zealand Clinical Trials Registry (ACTRN12618000504213). To begin the research, family and community services that had previously delivered TIK were contacted via phone and email to invite them to participate in the pilot study. Information about the study was also emailed to facilitators who had completed the TIK Facilitator Training and were on the mailing list. The first author (CA) met with services and facilitators who were interested in participating to discuss the program and logistics of delivery (e.g., recruitment, staffing). Service providers set the date, time, and location for TIK-Together groups, and chose two facilitators to deliver the program. The facilitators provided informed consent before participating in the research, as they were provided with an information sheet and discussed their involvement with researchers prior to program delivery.
Parent recruitment was conducted in suburbs surrounding each service provider, with information flyers distributed at educational facilities (e.g., schools, preschools, and kindergartens), libraries, community groups, via social media, on service providers’ websites, and through service providers’ email distribution lists. Before recruiting parents in Victorian government schools, ethics approval was obtained from Department of Training and Education Victoria (protocol number: 2018_003637). Parents were also directed to the study by internal referrals from participating services and external referrals via health care professionals (e.g., paediatricians, social workers).
Before delivering TIK-Together, facilitators completed an online questionnaire about their training and previous program delivery experience. Upon program completion, facilitators responded to an online questionnaire about their experience delivering TIK-Together. Facilitators also had the option to participate in audio-recorded, semi-structured phone interviews to discuss program feedback. In addition to informed consent at the commencement of the study, CA obtained verbal informed consent prior to recording interviews. A semi-structured interview method was chosen instead of structured and unstructured interview methods as it allows for a reflexive interview process, in which the interviewer can ask follow-up and probing questions to obtain rich data (Adams, 2015). Interviews were approximately 45–60 minutes long, depending on facilitator responses. Transcription was completed on Express Scribe and transferred to NVivo for analysis. Interviews were transcribed using the complete transcription method. The transcripts were sent to facilitators to review; however, no facilitators made changes to their responses.
Intervention: TIK-T
TIK-Together is a version of TIK that was adapted to address the coparenting relationship (Ambrosi et al., 2022). TIK-Together takes a family systems approach to emotion socialisation by encouraging coparent involvement. TIK-Together aims to provide a supportive space for coparents to have constructive conversations about their current parenting and how TIK-Together concepts could be integrated into their family life. TIK-Together was designed for parents to attend sessions together, contrasting with the original program that only requires one parent to attend. The adapted program extended the number of sessions of the original program (original: six sessions, adapted: eight sessions), by incorporating new coparenting activities and content. The new content aimed to increase support and cooperation in the coparenting relationship, specifically when coparents work together to respond to their children’s emotions. TIK-Together content included: psychoeducation about the coparenting relationship and how it influences children’s wellbeing; a group discussion normalising the strengths and challenges of parenting together; increased focus on meta-emotion philosophy to help parents reflect on how their childhood experiences influence their parenting practices and coparenting relationship; coparent dyad discussions about similarities and differences in how coparents respond to their children’s emotions and how they negotiate/share the responsibility of responding to their child’s emotions; coparent roleplays to practice emotion coaching with one another; weekly group reflections for parents to discuss their experience using emotion coach with their children or coparent; and group roleplays to work through difficulties using the learnt skills. See Ambrosi et al. (2022) for additional information about TIK-Together content. The new TIK-Together activities and content was manualised and used alongside the original TIK manual during program delivery.
TIK is based on the theory of emotional socialisation (Gottman & DeClaire, 1997); this theoretical approach was retained in TIK-Together. The program aims to provide parents with an understanding of their child’s emotions and the strategies they can implement to promote their child’s emotional development. Parents are taught the five steps of emotion coaching: 1) noticing children’s emotions, particularly at lower intensities; 2) recognising emotions as an opportunity for teaching and closeness; 3) communicating empathy and acceptance of emotions; 4) helping the child to verbally communicate their emotions; and 5) helping with problem solving and/or setting boundaries, as required (Gottman & DeClaire, 1997). In addition, parents receive information about the importance of their own self-care and emotion regulation. Parents are also encouraged to explore their meta-emotion philosophies through reflection on their family of origin experiences. The program consists of a combination of psychoeducation, handout materials, roleplays, group discussion, and home activities.
In the current study, TIK-Together was delivered in community settings on weekday evenings. Two facilitators delivered each program. Prior to commencing program delivery, facilitators met with Professor Sophie Havighurst (co-developer of Tuning in to Kids) and CA to discuss the theoretical background for TIK-Together and the TIK-Together manual. During delivery, facilitators used the TIK manual and TIK-Together manual and completed a fidelity checklist after each session. Sessions often involved a combination of activities from the TIK manual and the TIK-Together manual. The program manual consisted of eight weekly two-hour sessions. In the pilot study, the length of the program varied as some services ended their programs early due to small group size. Facilitators also attended fortnightly supervision with Professor Sophie Havighurst and CA to ensure session content was understood and delivered appropriately, and to discuss any immediate barriers to program delivery.
Fifty-seven parents (28 females, 29 males) attended the parenting programs (27 coparenting dyads, 1 coparenting triad – a separated couple and a stepfather). Parents reported a mean age of 40.33 years (SD = 4.85). Most parents were in a married/de facto relationship with the other coparent (90.7%) and the remaining coparents dyads were divorced/separated (9.3%). Most parents (83.4%) were raising more than one child (range: 1–3 children). At pre-intervention, over a third (n = 20, 37%) of parents reported having mental health concerns within the last year, which is somewhat higher than the Australian population (20.1%; Australian Bureau of Statistics, 2018). Data on the gross annual household income were collected from 29 different households. Two separated parents (6.90%) reported gross household income below the poverty line for individual adults with two children ($42,521; Melbourne Institute, 2019). Five households with two parents (17.24%) reported income at/slightly above the poverty line ($51,397; Melbourne Institute, 2019). Based on the Australian mean gross household income ($125,944; Australian Bureau of Statistics, 2018) parents’ incomes were as follows: five households (17.24%) reported below average income, three households (11.11%) reported approximately average income, and ten households reported income above (n = 3, 11.11%) or considerably above (n = 7, 21.43%) average.
Measures
Quantitative measures
Facilitators completed an online survey to provide program feedback. Facilitators rated the helpfulness of seven program components (e.g., group roleplays, information presented about emotion coaching) using a 5-point rating scale (1= extremely unhelpful, 5 = extremely helpful). Facilitators also used a 5-point rating scale (1 = strongly disagree, 5 = strongly agree) to rate their agreement to the following three items: “it was beneficial to have both parents present in session”; “the program facilitation was straightforward”; “Tuning in to Kids Together was more challenging to facilitate than the original Tuning into Kids”. The measure was based on items used in previous TIK research/evaluation resources (e.g., Havighurst & Harley, 2007).
Qualitative measures
One-on-one interviews were conducted after facilitators completed program delivery. The interviewer asked approximately twelve questions from the interview schedule, which prompted facilitators to describe their experience delivering TIK-Together (e.g., please tell me about your overall experience delivering Tuning in to Kids Together; how did delivering Tuning in to Kids Together compare with delivering the original Tuning in to Kids?) and discuss their perceptions of program acceptability and appropriateness. Appendix A presents examples of the interview questions, which were informed by implementation frameworks (e.g., Moore et al., 2015; Proctor et al., 2011; Sekhon & Francis, 2018) and based on previous TIK research/evaluation resources (e.g., Havighurst & Harley, 2007).
Data Analysis
Quantitative analysis
Data were imported and analysed in IBM SPSS Version 27. Categorical variables were analysed using frequency of responses and percentages.
Qualitative analysis
Qualitative data from the facilitator interviews were analysed using reflexive thematic analysis, following Braun and Clarke’s (2020) six-phase reflexive thematic analysis method. CA initially imported all transcripts into NVivo 11 and read each transcript several times to familiarise herself with the data. A mixture of semantic and latent codes were then created using both deductive and inductive approaches (Braun & Clarke, 2020). A deductive approach was used when an existing implementation framework guided the analysis of program acceptability and appropriateness (Braun & Clarke, 2020). In contrast, inductive analytical processes were utilised when themes were data-driven (Braun & Clarke, 2020), such as when exploring facilitators’ experiences delivering TIK-Together. All codes were then reviewed and consolidated into preliminary themes. CA discussed and confirmed preliminary themes with co-authors. After these discussions, the definitions and names of the themes were finalised.
Reflexivity Processes
In accordance with Braun and Clarke (2019), CA used a reflexivity journal to record how personal characteristics may have influenced data interpretation and consequently the produced themes. CA’s emotional response to feedback may have led to an increased focus on positive aspects of the program. To minimise this, CA encouraged participants to provide feedback that was true of their whole range of experiences (e.g., negative and positive view of the program) and discussed themes with co-authors.
Results
Program Acceptability
We examined three dimensions of acceptability, as outlined by Sekhon and Francis (2018): affective attitudes, burden, and perceived benefits. Facilitators reported on the overall acceptability of TIK-Together and the acceptability of program components. Table 1 presents additional quotes illustrating facilitators’ perceptions of program acceptability.
Table 1
Additional Quotes Illustrating the Acceptability of Tuning in to Kids Together
Domain | Theme | Example quotes |
|---|---|---|
Acceptability: affective attitude | It was a really rewarding to see that positive growth and the impact the program had on the coparents, both in terms of their relationship with each other and the relationships with their children. (P03) | |
Acceptability: burden | Challenges with manualised delivery | ...the fact that we had to work from the original manual and then the supplementary materials, that was challenging. Just from that logistics point of view, because you’re sort of opening that page and then you’re quickly going and finding, that-that page on that-in that manual um, and then referring to the fidelity checklist so, to me that was challenging because it meant that, normally when I’m facilitating something, I try to give my full attention to the group and what I’m facilitating but I had to sort of really stop and check in and check out to go to the various elements of the-of the materials so not being in one folder and I know there’s a reason why it’s not that, I’m just answering the question [laughing]. (P07) |
Acceptability: perceived benefits | Working as a cohesive team towards a common goal | …if you’ve just got one parent involved…that parent then has to go home, it’s a hit and miss whether they you know, teach or share what they’ve learnt with the other parent. Then it’s about whether the other parent takes it on board or not. So, I think that because of the fact that everyone was hearing the same message, they were able to then talk about that, they were about to monitor or help monitor themselves and each other. (P03) (the) key thing that is different is that both of, well the coparents, are there at the same time, they’re both on the same page, they’re learning the same things and I think that’s the essence of...why you get better results ...they’re there to support each other to get good at it and remind each other to do it. (P04) |
Acceptability of program content | Experiential and interactive activities promote skill development | They really-really love the opportunity to unpack what had happened during the week [their attempts to emotion coach their children] and then… do roleplays and various scenarios on how you could’ve handled that -and what the different options might look like if we had done something differently. (P03) |
Acceptability of program content | Reflective activities generate awareness and understanding of parenting | I think a lot of participants had lightbulb moments between sessions after the discussion of family of origin. So, I think that was quite significant, in terms of having shift, psychological shift. (P02) It was more important…to see how that metacognition stuff was getting in the way, to actually have the experience of you know what’s stopping you in that moment, ‘Oh it’s that message I got from when I was a child that’s making me, you know, feel like I need to say this now’, when actually that’s not a useful thing to say. (P06) |
Acceptability of program content | Psychoeducation promotes parents’ knowledge and understanding | The model of the hand they really liked that, they kind of kept referring to that throughout the course. (P02) |
Affective attitude
All facilitators had a positive experience delivering TIK-Together. Facilitators reported TIK-Together was rewarding, enjoyable, and interesting to deliver. Facilitators frequently stated that they enjoyed TIK-Together because it led to noticeable improvements in parents. The following quotes demonstrate facilitators’ positive attitudes towards the program:
Overall, it was really interesting to watch the group’s growth and development over the eight-week period as well. You could see definite changes within them, and I think that made it a positive experience too, to notice those changes. (P05)
I love it, I loved it and the people loved it and that’s what’s important…they got a lot out of it, and you couldn’t ask for more really could you, once that happens, which is fantastic. (P01)
Burden
Quantitative analysis
In the post-intervention survey, 88.9% of facilitators agreed that delivering TIK-Together was straightforward (33.3% strongly agreed; 55.6% agree; 11.1% neither disagree nor agree); however, most facilitators agreed that TIK-Together was more challenging to facilitate than TIK (11.1% strongly agree; 66.7% agree; 22.2% neither disagree nor agree). Similar sentiment was displayed in facilitators’ interviews.
Theme: Challenges with manualised delivery
One facilitator explained “the whole program ran seamlessly” (P01) and another commented “I found it quite easy to deliver it. I thought the content like was straight forward…once I read over it, I felt pretty confident” (P02). Furthermore, most facilitators reported that the manualised information was clear and succinct. One facilitator explained: “I think the actual program is really clear and concise, like even the additional content, it was easier to follow from a facilitator perspective.” (P05). However, some facilitators reported that TIK-Together required additional preparation time because the TIK-Together manual was separate to the TIK manual. One facilitator stated:
The practicalities of working off different manuals when it came to planning for the sessions and trying to flick between the old original [TIK] manual, the [TIK-Together] manual that you had sent us, then checking in with the fidelity checklist…We both found that challenging, flicking through to double check that we were on the right track. (P14)
One facilitator insisted that although integrating the materials resulted it additional preparation time, she found it a helpful process. She explained:
…not that it was a bad thing, because what it does, is it, you do the reading, you’re thinking about it, so for me that works, but I’m just saying that I always had to make allowances to make sure I had time to do it, that’s all…I got value out of revisiting stuff and then just thinking about how to integrate things and making those transitions you know. (P01)
Facilitators suggested that program developers could create one manual containing TIK-Together and TIK content to reduce preparation time and improve program delivery.
Perceived benefits
Working as a cohesive team towards a common goal
All facilitators reported that they observed improvements in parents’ emotion coaching skills and the way parents worked together. Facilitators observed how coparents began using emotion coaching skills with each other and how this strengthened their relationship. Furthermore, facilitators reported that coparents appeared “more aligned” (P02) in their parenting because they learnt the TIK-Together content at the same time. One facilitator explained: “It’s getting parents on the same page, or you know, at least the same book you know [laughing]- or the same chapter you know is-is really important” (P12).
TIK-Together also helped coparents foster “that sense of being a team” (P10) as coparents aimed to work together to support their children’s emotional development, rather than parent as individuals. One facilitator reported, “I think the group made them think in a more detailed way [about] why they may be the way they are and-and not necessarily about who’s right, who’s wrong, but let’s strive for this [together]” (P12).
By learning the program content at the same time, coparents avoided misinterpretations, confusion, and undermining that can happen when one parents attends a program and shares the information with the non-attending parent. As parents developed a mutual understanding of program concepts and a common goal of supporting their children’s emotional development, facilitators speculated that coparents were less undermining and more supportive when transitioning the newly learnt strategies into the home. The following quotes explain how parents learning the program together led to greater understanding of program information:
And I feel like maybe the bit that’s clearer coming to the group is that, you don’t have to do it all the time and maybe it feels much more normalised and accepting than perhaps when your partner comes home and says ‘this is what we have to do’ and they think they have to do it all the time or I think it’s a much, much more reasonable when you’re in the group and you hear the things that are being suggested (P10).
…where there’s been only one parent and they come back and report, you know, what it’s been like, I have like memories of people saying to me, ‘Oh, you know, I tried to do what the program says, but my partner thinks it’s all just you know, silly or whatever’. So, they’ve been undermined by the person who isn’t at the Tuning in to [Kids] program. But...because these three couples were together… both [parents] in the couple understood what was trying to be achieved because they both heard the same information. (P01)
Some facilitators explained TIK-Together led to greater improvements than TIK. These benefits are explained in the following quotes:
The results that we were able to achieve [with TIK-Together] were really, really positive and anecdotally at least better than I’ve been able to do or experience with just one parent there at a time. (P04)
…because we’ve got all stakeholders involved, then you’re going to see greater impact and you’re going to see that impact faster. (P03)
Facilitators reported that a unique and valuable characteristic of TIK-Together was parents attending sessions together, and many facilitators attributed better program outcomes to parents both being present in sessions. The following quote highlights facilitators’ endorsement of involving coparents in programs:
I felt that compared to TIK with the single parent, I felt that you could see a connection in that sense of being in it together and solving problems together that I thought was really nice and potentially beneficial…I just think that if parents are coparenting together at home, that [it] probably is useful to both be learning the same skills and be on the same page. (P10)
Some facilitators preferred TIK-Together over TIK because it focused on the coparenting relationship in addition to the parent-child relationship:
I prefer TIK-Together because it highlights the importance of all of the system in the family when you’re parenting. So, it’s not just about the relationship with the child, they’re all part of the bigger system, and you need to look at all the elements of the system to help parents understand how everything works together to impact parenting. (P01)
Acceptability of program content
Quantitative analysis
In the post-intervention survey, all facilitators agreed (22.2% agree, 77.8% strongly agreed) that it was beneficial to have both parents present in sessions. Out of all roleplay variations (i.e., scripted roleplays, unscripted roleplays in pairs, group roleplays), group roleplays were rated helpful/extremely helpful by the highest proportion of facilitators (77.7%). One facilitator, who delivered TIK-Together to a small group (2–4 parents), reported that all variations of roleplays were extremely unhelpful. Most facilitators (88.9%) reported activities and discussions that involved coparents working together in pairs were helpful or extremely helpful. All facilitators (100%) reported that information presented about child development, emotion coaching, and the coparenting relationship was helpful or extremely helpful. Quantitative data from the post-intervention survey were consistent with findings from facilitator post-intervention interviews.
Qualitative analysis
We generated three themes to reflect the program components that facilitators believed helped parents’ development: experiential and interactive activities promote skill development, reflective activities generate awareness and understanding of parenting, and psychoeducation promotes parents’ knowledge and understanding.
Theme: Experiential and interactive activities promote skill development
Parents demonstrated high levels of engagement during experiential and interactive activities, such as roleplays and practicing emotion coaching skills. Facilitators explained that parents enjoyed working through personal examples by brainstorming alternative ways of responding to their children’s emotions and practicing these strategies in roleplays. One facilitator stated: “That’s where the learning is - it’s not so much us lecturing, it’s about using their real-life examples and then using the principles of TIK to help them understand that”. (P02)
Facilitators discussed the value of providing parents with opportunities to practice emotion coaching skills in various contexts, including coparents practicing how to emotion coach each other. By practicing emotion coaching in coparenting dyads, facilitators observed parents becoming more emotionally attuned to one another. One facilitator explained:
What I really liked about that was not only did it mean that they were noticing their kids’ emotions, they were also noticing each other’s, so there was, there was a closeness. What this activity does is helps strengthen closeness for the couple because they notice each other, they’re not invisible to each other… I enjoyed observing how much more attuned they were to each other’s feelings, that was lovely. (P01)
Meditation at the beginning of sessions was another experiential activity that assisted facilitators and parents become calm, settled, and focused on the program. Facilitators commented that having different meditations each week was helpful, and shorter meditations were preferable (7–8 minutes). Meditation was particularly helpful for parents who came to the program directly from work and often appeared flustered and rushed upon arrival. As parents sometimes arrived late to session, some facilitators chose to remove the meditation section but reflected this was not helpful for the group:
When we launched into the homework without doing the meditation and it was just so substantially different. Everyone was on different pages. People were carrying into the room what just happened outside or from their work…and then after we did the meditation, we kind of began together. So, I think it’s really important-my biggest takeaway is…make sure that we all start there [with meditation] even if people come late. (P02)
Theme: Reflective activities generate awareness and understanding of parenting
Facilitators observed that parents benefitted from activities about meta-emotion philosophy, in which they reflected on their family of origin experiences and explored how these informed their current parenting. Meta-emotion activities assisted parents as individuals and coparents. Facilitators explained that parents exploring their own meta-emotion philosophies helped them to develop greater awareness and understanding of their comfort with emotion and automatic responses to their children’s emotions. The quote below illustrates the benefits to parents on an individual level:
It’s incredibly valuable for parents to have an opportunity to reflect and realise where their current default setting emanates from and also just have an opportunity to sort of articulate it and verbalise it and acknowledge it and then decide, ‘Oh my god I’m actually doing the same thing [as my parents did]’…and then have an opportunity to say I do or I don’t want to be like this. (P03)
Facilitators also observed parents identifying intergenerational patterns, whereby they noticed connections between their family of origin, their current parenting, and their children’s emotion expression and regulation. Insight gained from reflecting on their family of origin and meta-emotion philosophies assisted parents’ engagement in other program activities. One facilitator explained:
I think the meta-emotion discussion was kind of penny-drops and we were able to keep coming back each week and I think even in the moment, when parents were reacting to examples that we were giving or roleplays that we were able to, you know draw on their kind of meta-emotion beliefs…so that really kind of helped [them] shift. (P02)
Facilitators also highlighted the benefits of coparents discussing their meta-emotion philosophies together. Facilitators explained that for many parents, discussing their meta-emotion philosophies and how it shaped their emotion socialisation practices helped coparents recognise that differences in parenting were a result of childhood experiences not due to deliberate undermining.
We had that meta-emotion conversation, that always really brought to their attention how much of their own parenting is influenced by their family of origin and why sometimes there’s conflict between the two of them…[it’s] not because they were deliberately undermining, but rather it was their trajectories from childhood… It really was some of the best learning for them because it constantly reminded them, they’re not undermining the other person on purpose… Several times I noticed it, if [one parent] said something about her childhood experiences then the [other parent] would say, ‘and that explains why you do that, but in my family of origin we did this and that’s why I do that’, or vice versa. (P01)
Theme: Psychoeducation promotes parents’ knowledge and understanding
Facilitators reported that psychoeducation about children’s emotional development, emotion socialisation, and coparenting was helpful for parents. Content on children’s emotional development included exploring the importance of emotion intelligence (i.e., emotional competence), brain development (e.g., hand model of the brain), and examples of emotion regulation difficulties typically experienced by children. Facilitators stated that parents particularly benefited from information on children’s development as it helped them understand that children need support to regulate their emotions. One facilitator explained:
There were a few times where I thought I saw like, a lightbulb moment for particularly [one father], when we talked about…overwhelming emotions and that it wasn’t just about… [their child] being manipulative…it was around… [their child] being overwhelmed by emotions, not knowing how to express it. (P12)
TIK-Together also contained information about interparental conflict, and facilitators from one group elected to expand on this section as some parents were demonstrating conflict and contempt in sessions. Facilitators incorporated information from Gottman’s Four Horsemen and outlined the impact of family violence on children’s development. Facilitators explained that this additional information theoretically aligned with TIK-Together and may be helpful to include in future groups:
We did elaborate on family violence and the four horsemen… just psycho-ed on the impacts of abuse in front of children, the trauma that children can experience from really high conflict, especially chronic conflict…Parents afterwards were like absolutely shocked and…couldn’t believe that they’ve been learning about this for the first…I think that really had an impact so my only suggestion would be incorporating or elaborating more on…what is family violence, what does that look like? (P02).
Facilitators used visual aids, such as the hand model of the brain, to deliver psychoeducation and explain complex information. One facilitator (P06) commented: “More theoretical content…certainly the hand model…I always find that’s one of the most useful visual aids to give parents in terms of what’s happening with their children when they’re becoming emotionally aroused”. Parents were able to use the hand model as a point of reference throughout sessions.
Program Appropriateness
Meeting a community demand
Facilitators expressed that TIK-Together was a good fit for their communities as it addressed an existing gap in their services’ program offerings. Facilitators reported that parents who attend parenting programs by themselves regularly state that they would like their partner/coparent to also attend. Facilitators explained:
Often when I would run a TIK program, parents would often say ‘I wish my husband was here to hear this’ or ‘I wish my husband would come and do this’ or ‘my partner should come and do this group as well’. So, actually having those parents hear the material and the content and listen to it is really, really useful. (P06)
Any sort of parenting group I run…you can bank money that mums in particularly will say, ‘I wish, wish my partner would come to these’ or ‘I wish my partner could even do this online’ so I think the together bit is really important and yes I do think it’s a benefit. (P12)
A facilitator explained that TIK-Together was particularly helpful for parents who “wouldn’t have come to the group unless they could come together” (P12).
TIK-together is not for everyone
Facilitators suggested that TIK-Together may not be suitable for all parents in their communities, particularly coparents who are not comfortable working with one-on-one with each another. One facilitator explained:
…there’s definitely couples that need this kind of thing, where they’re doing it together and they’re working on their goals together…I know that some of it was aimed at couples that aren’t together anymore, I think that would be really hard to sit for eight sessions with a person that you do not like, it’s that kind of situation that wouldn’t work well. (P12)
Discussion
We used a convergent mixed methods design to explore the acceptability and appropriateness of TIK-Together. Engaging stakeholders, such as facilitators, is a core component of program evaluation as they provide important information about the real-life feasibility and implementation of interventions (Skivington et al., 2021). In the current study, facilitators provided feedback about their experience delivering TIK-Together. Overall, facilitators assessed TIK-Together as being acceptable and appropriate for their respective communities.
Acceptability of TIK
TIK-Together was acceptable to facilitators. Facilitators described delivering TIK-Together as straightforward, enjoyable, and rewarding; however, preparation time was longer than expected due to materials being separated across two manuals. A unique characteristic of TIK-Together was involving coparents in the program, and all facilitators agreed that it was beneficial to have both parents present in sessions. Facilitators reported several perceived program benefits, including coparents being more aligned in their parenting and working together as a cohesive team towards the common goal of supporting their children’s emotional development. Many facilitators highlighted the value of the coparenting program and reported that TIK-Together led to greater improvements than when parents attend TIK individually. This finding is consistent with previous research by Cowan et al. (2009), which showed greater treatment effects were achieved and maintained when coparents attended parenting interventions together compared to fathers predominantly attending alone. Eira Nunes et al. (2021) has argued that it is crucial to involve coparents in parenting programs that aim to change family dynamics because it allows both parents to enact new parenting behaviour and enables direct work on their coparenting relationship. It is likely TIK-Together was able to directly target the coparenting relationship because coparents were both attending sessions, learning information, and practicing new skills. During the program coparents learnt about each other’s family of origin experiences, reflected on their current parenting practices, and practiced emotion coaching one another, which may have helped coparents become less critical and more supportive, understanding, and cooperative in their coparenting relationship. Additionally, it is possible that coparents who attended TIK-Together gained a common understanding of program concepts and developed a mutual framework that guided their parenting. As such, there may be more consistency and predictability in parents’ emotion socialisation practices.
Facilitators identified that coparents receiving information at the same time was an important element of TIK-Together, as it reduced undermining that can occur when only one parent attends a program. The facilitators’ perspectives are consistent with research, which shows that in some circumstances the attending parent may withhold information, or the non-attending parent may disagree with implementing new strategies (e.g., Hauser, 2012). Mothers have higher rates of participation in parenting programs (Panter‐Brick et al., 2014); therefore, they are often responsible for sharing the information they learn with the other parent. Research by Hauser (2012) highlighted that some mothers may act as gatekeepers by withholding information from the other parent, controlling parenting decisions, and dictating the parenting approach that must be adapted without consulting the other parent. In some circumstances (i.e., heterosexual coparent dyads), fathers may become heavily reliant on mothers to guide their parenting, and mothers may be critical of fathers’ attempts to use the new parenting strategies, which consequently impairs fathers’ confidence in their parenting abilities (Stevenson et al., 2014; Talbot & McHale, 2004). Alternatively, the non-attending parent may undermine the attending parent’s attempts to integrate new parenting practices into the family system, which can lead to interparental conflict. The current findings suggest that encouraging both parents to attend TIK-Together may have mitigated gatekeeping for most coparents, as parents learnt the information at the same time and practiced the skills together.
Facilitators also provided information about the acceptability of program components. Facilitators reported that experiential and interactive activities, such as roleplays, were particularly helpful for parents. This finding is consistent with research that shows practice and rehearsal are important for skill development (e.g., NICE, 2007; Michie et al., 2013). Furthermore, a meta-analysis by Kaminski et al. (2008) found programs that included content on emotion communication were successful at improving parent behaviour and skill. Facilitators also highlighted the perceived benefits of reflective activities, particularly those that focused on parents’ meta-emotion philosophies and family of origin experiences. Coparents may have developed greater insight into their own reactions and started approaching parenting differences with more empathy after discussing how their current parenting practices were guided by their childhood experiences. As such, parents may work more collaboratively after recognising differences in their parenting styles (Tavassolie et al., 2016). Facilitators perceived psychoeducation regarding children’s emotional development and family functioning as beneficial for parents. A systematic review and meta-analysis by Eira Nunes et al. (2021) found that coparenting programs are heterogenous; however, psychoeducation about coparenting, family functioning, and child wellbeing was a common element across several interventions. Eira Nunes et al. (2021) suggest that if parents are aware and understand the importance of the coparenting relationship, they may be more engaged in coparenting programs and have greater motivation to improve their coparenting relationship. The combination of group discussions, psychoeducation, skills training (e.g., roleplays), and reflective tasks may collectively assist coparents make improvements to their parenting and coparenting relationship.
Appropriateness of TIK
Facilitators indicated that TIK-Together was appropriate for their communities. Facilitators explained that parents in their community often asked to attend parenting programs with their partners. In some circumstances, parents who had completed the original TIK had returned to the service to ask if their partner could attend the next program. This finding is consistent with research by Patterson et al. (2005) that found many parents believed the parenting program (Webster-Stratton Parenting Programme) would have been more effective if their partners had attended. Patterson et al. reported parents would have preferred to attend the program with a friend, family member, or partner to enable consistent parenting at home. Importantly, facilitators explained that TIK-Together is not suitable for all coparents, such as parents who are uncomfortable working together. Collectively, it appears TIK-Together is an important and valuable option for some parents; however, it is not appropriate for everyone. Given these findings, service providers and facilitators seeking to run coparenting programs should be mindful of coparent dynamics during the enrolment stage and during program delivery. For example, facilitators should meet with parents individually and in their coparenting dyads before program enrolment to gain an understanding of the coparenting relationship (e.g., supportive, undermining), interaction styles (e.g., constructive, conflictual), comfortability working one-on-one, potential safety concerns, and how they will navigate potential disagreements during sessions. During this initial meeting, facilitators can also set realistic expectations about the program (e.g., sessions involve pair work) and the importance of respectful communication. Assessment information will assist facilitators to determine whether a coparenting program (e.g., TIK-Together) is suitable for parents or whether it is best for parents to attend a parenting program individually (e.g., the original TIK). Alternatively, some parents may benefit from engaging with complementary services (e.g., couples counselling) alongside their involvement in a coparenting program. During sessions, if parents become uncomfortable spending time one-on-one during pair work, a facilitator may join them during these activities. Although TIK-Together is considered appropriate, it is important to consider the practicalities and complexity of both parents attending. Future research will examine the barriers and enablers to program delivery and parent engagement in TIK-Together.
Implications
The study provides valuable insights for researchers and practitioners who aim to support family functioning and child wellbeing through parenting interventions. The research highlights the importance of piloting an intervention to assess acceptability and appropriateness as it provides findings that inform important intervention refinement. For example, in the current study, facilitator responses have helped identify a clearer target audience for TIK-Together and additional recommendations for assessing the suitability of coparents before enrolment will be included in the TIK-Together manual. Services aiming to deliver coparenting programs are encouraged to include assessments prior to enrolment to ensure parents feel safe working together and reduce potential parent drop-out, as a decrease in participating parents may impeded group dynamics and led to program attrition. The current research also highlights the value of engaging stakeholders in the feasibility phase of intervention evaluation, as recommended in the United Kingdom Medical Research Council guidelines (Skivington et al., 2021). Throughout this study, facilitators demonstrated an understanding of the program delivery processes, awareness of coparent and group dynamics, as well as knowledge about their communities’ needs. During interviews, facilitators often drew on previous examples of program delivery and conversations with families in their communities. The current study demonstrates that involving facilitators in the feasibility phase of program development and evaluation (Skivington et al., 2021) enables researchers to gather rich, real-world data that could not be achieved if researchers delivered the program themselves.
Facilitators’ acceptance of TIK-Together may reflect a broader acceptance of a family systems approach to parenting interventions within service providers. That is, recognising interconnectedness within a family and the influential role the coparenting relationship has on parenting practices and child wellbeing (Cowan & Cowan, 2019; Feinberg, 2002; Maršanić & Kušmić, 2013; McHale & Sullivan, 2008). Cowan and Cowan (2019) strongly advocate for an integrated approach in which services target family systems, rather than a siloed approach that focuses on an individual family member. Additionally, McHale and Negrini (2018) highlight the importance of the social work profession (e.g., family support services) making a paradigm shift away from mother-only services and towards a coparenting approach that embraces fathers’ participation. Unfortunately, Cowan and Cowan (2019) reported that until very recently politicians and decision-makers in public and private services across the United States, Canada, and England have consistently failed to acknowledge the importance of a family systems approach. Similarly, a report published by the Centre for Family Research and Evaluation at Drummond Street Services (Gibson et al., 2019) highlighted that social research, government policies, and services within Australia often overlook the role of the family system in promoting public health. TIK-Together has shown facilitators the benefits of delivering a coparenting program in their community. The facilitators’ positive experiences and perceived program benefits may help move Australian services one step closer to integrating a coparenting framework into their standard practices. The perceived positive program outcomes may provide additional justification for other services to consider incorporating a coparenting program into their program offerings. More broadly, the findings add to the existing literature that advocates for involving both parents in group-based parenting programs (e.g., Feinberg, 2002; Feinberg & Sakuma, 2011; Lundahl et al., 2008; McHale, 2010; McHale & Negrini, 2018).
Strengths, Limitations, and Future Research
A strength of this study is that it involved facilitators from services across metropolitan and regional Australia, with varying levels of experience. The sample provided good transferability, as facilitators who participated in this study are likely to deliver TIK-Together when it is disseminated into the community. The current study also has several limitations. Firstly, it is possible that facilitators felt pressured to provide positive feedback about TIK-Together as the interviews were conducted with the researcher (CA) that co-created the program. Additionally, facilitators may have been biased in their responding to justify the effort and time they had dedicated to delivering the parenting program. Throughout the interviews, the interviewer attempted to minimise potential bias by reminding facilitators that constructive criticism was welcome and encouraging discussion of negative feedback. The nature of inductive thematic analysis meant that the generated themes are influenced by the researcher’s own experiences, biases, and knowledge, therefore reflexivity was required. By engaging in reflexivity, the first author (CA) was able to recognise the impact of her experiences, biases, and knowledge on the data interpretation. To establish further trustworthiness, the first author discussed data interpretation and the generated themes with the co-authors.
Future research should explore the feasbility of TIK-Together from the perspective of participating parents. Mytton and colleagues’ (2014) research highlights that facilitators and parents have different views regarding the barriers and enablers that influence program engagement and retention. As such, Mytton et al. recommend exploring the opinions of parents and facilitators when evaluating the implementation of parenting programs.
Conclusion
In the current study, we examined the feasibility of TIK-Together. Facilitators from Australian family and community services provided their perspective on the acceptability and appropriateness of the program. The current findings showed that facilitators view TIK-Together as an acceptable and appropriate intervention for coparents in their communities. Facilitators observed that parents improved how they worked together by becoming more aligned in their parenting and having a “team” approach. Importantly, facilitators reported it beneficial to include both parents in sessions, and identified experiential, interactive, and reflexive activities were helpful for parents. Notably, TIK-Together filled a gap in the parenting programs delivered by services, with many facilitators reporting that parents in their community voiced their desire to attend programs with their coparent. The findings provide valuable information for researchers and practitioners who aim to take a coparenting approach to parenting interventions.
Compliance with Ethical Standards
Conflict of interest
Tuning into Kids author, Havighurst, wishes to declare a conflict of interest in that she may benefit from positive reports of this program. Proceeds from dissemination of Tuning into Kids provide funding for development and research with the program. Authors of Tuning in to Kids and the University of Melbourne receive royalties from proceeds of Tuning in to Kids manual sales. Ambrosi also wishes to declare a potential conflict of interest as she may receive royalties from Tuning in to Kids Together in the future. Kavanagh and Evans declare no conflict of interest.
Ethical approval
This study was approved by the University of South Australia Human Ethics Research Committee (200983).
Informed consent
Facilitators provided informed consent before participating in this research.
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