Research

The Parenting and Youth Mental Health research group conducts innovative ‘applied’ research to support parents or carers to support their child’s mental health. Our research utilises a wide range of multi-disciplinary and mixed methods, including qualitative and co-design methods to develop and adapt digital parenting interventions, single-arm and randomised controlled trials to evaluate interventions, Delphi expert-consensus methodologies to translate research evidence into actionable strategies for parents, discrete choice experiments to better understand parent preferences and engagement in interventions, and more. Our research aspires to keep the end in mind from the beginning, to ensure that any intervention we develop is implementable and sustainable. As such, all our projects are inherently multi-disciplinary (in particular, we work closely with Professor Patrick Olivier’s Action Lab), and involve diverse stakeholder groups including NGOs, mental health organisations, parent peak bodies, and child and youth mental health services.

Areas of research/projects:

Partners in Parenting (PiP)

Partners in Parenting Plus (PiP+)

PiP+ (formerly known as Therapist-assisted Online Parenting Strategies, TOPS) is the therapist-assisted version of PiP, designed for parents whose adolescent is experiencing clinical-level difficulties with depression and/or anxiety. We have evaluated PiP+ in a double-baseline open-label trial and found it to be associated with improvements in parenting competencies, parenting confidence, parent-adolescent attachment, family functioning, and parent psychological distress.

We are also partnering with eheadspace to pilot the implementation of PiP+ as part of the services eheadspace provides to parents of young people.

Adaptations of PiP+ for parents of adolescents with other clinical difficulties commonly associated with depression and anxiety, including school refusal, suicide risk, and trauma, have also been developed or are currently in development:

1. PiP for school refusal (PiP-Ed [Education])

Adolescents with depression and/or anxiety disorders are at higher risk of having difficulties engaging in their education, and experience distress about attending school (often called ‘school refusal’). We have co-designed adaptations to the PiP+ program to help parents support their adolescents’ engagement in their learning amidst their depression and/or anxiety difficulties. In 2022, we conducted a pilot acceptability trial of the new program (PiP-Ed+), with results supporting the acceptability, feasibility, and preliminary benefits of the program for parents and young people. Due to the demand for such accessible resources for parents, we have made a self-guided version of the program (PiP-Ed) available to parents across Australia: https://pip-ed.web.app/

2. PiP for suicide prevention (PiP-SP+)

PiP-SP+ was co-designed with parents, youth and clinical/research experts to support parents who are concerned about their teenager’s risk of suicide, in the context of depression and/or anxiety disorders. It equips parents with evidence-based strategies to improve their parenting confidence, support their teen’s mental health, and reduce their teen’s risk of suicide. PiP+ underwent a pilot acceptability trial in 2023. Results support the acceptability, feasibility, and preliminary efficacy of PiP-SP+ for parents and adolescents.

3. PiP for trauma experiences (PiP-TEx)

PiP-TEx is an upcoming adaptation of the PiP+ program, developed in collaboration with experts and parents who have experience supporting teens affected by traumatic events. PiP-TEx aims to address the impact of trauma on adolescent mental health, providing parents with evidence-based strategies to meet their teenagers' unique support needs and boost their parenting confidence. A pilot acceptability trial for PiP-TEx is scheduled for 2025.

PiP Peer-to-Parent (PiP-P2P)

PiP-P2P takes PiP+ and asks: “What if PiP+ is delivered by peers with lived experience of supporting a young person with mental health difficulties?”. Together with parents, family peer workers, clinicians, and supervisors from youth mental health services, we are co-designing an adaptation to the coaching element of PiP+, to be delivered by a new workforce of ‘peer coaches’ embedded in primary-healthcare services like headspace centres. In 2025, we will conduct a randomised controlled trial comparing the new peer-coached version of the program (PiP-P2P) to the self-guided version of PiP.

PiP-Kids

PiP-Kids (formerly Parenting Resilient Kids; PaRK) is an individually-tailored online parenting intervention to reduce children’s (aged 5-11) risk for depression and anxiety problems. PiP-Kids has been evaluated in a randomised controlled trial and found to improve parenting behaviours associated with reduced risk for childhood depression and anxiety.

We are also conducting another randomised controlled trial of a single-session version of PiP-Kids to evaluate its benefits as a universal prevention approach in partnership with schools in Geelong, Victoria.

We have also developed various adaptations of PiP-Kids to increase their reach and effects for more parents. These include:

1. PiP-Kids for parents of Autistic children (PKA)

Mood and anxiety problems exacerbate a child’s current developmental difficulties and lead to additional challenges for the child and their family. Autistic children are also at a higher risk for internalising difficulties associated with depression and anxiety. We have co-designed adaptations to PiP-Kids to better cater to the unique needs of parents of autistic children, known as PKA. With support from Australian Rotary Health, we will conduct a single-arm pilot trial of PKA in 2024/5 to evaluate its feasibility, acceptability and preliminary indications of efficacy.

2. PiP-Kids for parents living with family adversity

We have partnered with IPC Health (a not-for-profit health service provider in Melbourne’s West) to co-design new versions of PiP-Kids for families living with adversities, including lower socioeconomic positions and parental mental health issues, that are being embedded within IPC Health services. We have been working to evaluate these new programs in 2022-2024.

Localisation for other cultural contexts

Localisation processes are a cost-effective and sustainable way to increase access to culturally-relevant parenting resources in diverse cultural settings, including by underserved or low-resource communities.

The localisation of PiP is underway in partnership with collaborators in various countries, including the UK, Singapore, and Canada.

In addition, we are using participatory approaches such as co-design techniques to expand the reach of evidence-based digital parenting interventions to the Indian immigrant population in Australia and to the multiethnic parenting community in Malaysia. These initiatives have the potential to build up parental skills and confidence in supporting young people’s mental health, across different cultural groups.

Increasing Parental Engagement in Preventive Parenting Programs

Despite robust evidence indicating the long-term benefits of preventive parenting programs for child mental health, the population-level impact of many evidence-based programs is limited by the poor uptake and engagement by parents. Moreover, parenting research in general, and evaluation studies of parenting programs specifically, typically see an under-representation by certain subgroups of parents. These include fathers, parents of lower socio-economic positions, and parents residing in rural and remote regions. In this program of research, we are examining the factors that hinder and facilitate parents' engagement in digital preventive parenting programs, with the goal of increasing parental uptake of programs that will improve their child's mental health.

Enhancing treatments for parents and children with anxiety disorders

Cognitive Behavioural Therapy (CBT) is the most widely recognised and efficacious psychological therapy for the treatment of anxiety disorders in children and adults. However, suboptimal remission rates indicate room for improvement in treatments, particularly when both children and their parents have anxiety disorders. We have developed a systemically-focused CBT intervention to treat parents’ and childrens’ anxiety disorders concurrently. Preliminary studies show that the enhanced intervention is valued by and acceptable to both anxious adults parenting an anxious child and children experiencing clinical anxiety. Future work aims to evaluate the intervention more broadly.