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Download the Solihull Approach research list here.

Government articles referring to the Solihull Approach

NHS North West Commissioning document: http://www.northwest.nhs.uk/document_uploads/Maternity_Matters/pimh_April2011.pdf

Government documents: getmedia/acd9dc85-f452-45e0-8957-3c5bd742df66/Details-of-Solihull-Approach-Validation-in-Government-documents.aspx

Commissioning Toolkit - a searchable online database of parenting programmes and approaches: http://www.commissioningtoolkit.org/

The Solihull Approach in Kent: http://camhs.org/solihull-approach/workshop-23-march-2010.html

The Solihull Approach was cited as good practice in the Department of Health's and the Department for Education's 'Information Sharing in the Foundation Years' report.

"At Bowthorpe Children's Centre in Norfolk the health visiting team is fully integrated with the Children's Centre and managed by the Centre Leader, who is a social worker. Children, parents and families who are most likely to benefit from additional or intensive support are often first identified in the context of the universal health visiting service, and then offered the most appropriate package of support through the multidisciplinary team. The whole team is trained in the Solihull Approach, so there is a coherent approach, and a strong, shared language which has enabled a freeing up of roles, a shared professional identity and created the ability to challenge others, and change and create thinking and practice. The centre was judged outstanding by Ofsted."


'Containment and Reciprocity: integrating psychoanalytic theory and child development research for work with children' Douglas, H. (2007) London: Routledge

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'The Solihull Approach: changes in health visiting practice' Douglas, H. Ginty, M. (2001) Community Practitioner 2001; 74, 6: 222-224

This was the first evaluation carried out to assess the effects of the Solihull Approach on the practice of health visitors. Health Visitors in Solihull were sent a questionnaire that contained specific closed questions and multiple choice questions relating to a hypothetical case study. There were also opportunities for health visitors to provide qualitative information about their practice. The study also carried out an audit of referrals made by health visitors to the child psychology department over the previous four years.

The main findings were that it had an impact on 88% of health visitors who had received some training in using it. It improved the consistency of approach between health visitors. It did not increase the overall time required for assessment and intervention. It also showed that the use of the Solihull Approach increased the practitioners' confidence in their skills and increased their job satisfaction.

Health visitors revealed they felt they had a broader understanding of how difficulties develop.

Ninety six percent of health visitors using the Solihull Approach indicated that they found the Solihull Approach 'useful' or 'extremely useful'.

An audit of referrals to child psychology showed that although the number of referrals had not changed significantly the complexity of the referral had changed. Children with simple difficulties were no longer being referred and the referrals received suggested more complex difficulties.

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'Containment, Reciprocity and Behaviour management: Preliminary evaluation of a brief early intervention (the Solihull Approach) for families with infants and young children' Douglas, H. Brennan, A. (2004) The International Journal of Infant Observation. 2004; 7, 1: 89-107

This small scale research study was conducted to identify whether the Solihull Approach is effective. Health Visitors recruited 13 families over a six week period.

Parents and health visitors rated severity of difficulties and parental anxiety about the problem at 3 points, initiation, end of interaction and at follow up. Parents rated their own anxiety using the Beck Anxiety Inventory at all 3 points.

Results showed over all decrease of parental anxiety of 66%.

Significant reduction in anxiety relating to the problem and problem severity decreased.

These results were replicated in a further small study with 18 families.

Health Visitors experiences of using the Solihull Approach. Douglas, H. Whitehead, R. E. (2005) Community Practitioner 2005: 78, 1:20-23.

The aim of this study was to gain an insight into health visitors' experience using the Solihull Approach.

A semi-structured interview was used to examine the effect of the Solihull Approach on three areas:

1. Clinical practice
2. Feelings about work
3. Wider service

Four health visitors were interviewed and the transcripts analysed.

Evaluation outlined how using the Solihull Approach has led to changes in practice. They described focusing more on emotions and trying to understand the story rather than rushing in and trying to solve the problem. One health visitor described this concept, "I don't go in with any strategies, I go in to listen, it is incredibly powerful".

Health visitors revealed they felt more positive about their jobs and how the Solihull Approach impacted upon referral processes and improved health visitors' working in partnership with other professionals.

The findings had implication for the development of the Solihull Approach and recommendations for future research. The findings around the need for further support are likely to be relevant in the implementation of any programme, for example, the Edinburgh Postnatal Depression Scale.

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'Mothers' perception of community health professional support' Maunders, H. Giles, D. and Douglas, H. (2007) Community Practitioner: Vol 80:4, 24-29

This study used qualitative methods to explore mothers' experiences of the support they received from community health professionals:

Nine mothers were interviewed and transcripts analysed. All mothers received the Solihull Approach from their health visitors. Mothers discussed support provided by their health visitors and also by other community health professionals.

The findings were pertinent to professionals who work in early childhood intervention, including those who use the Solihull Approach.

The mothers discussed how they had reached the decision to seek help for their children's difficulties and also discussed the importance of trust and understanding within their relationship with the community health professionals.

Mothers often connected a good quality relationship to a good outcome following professional input.

'A pilot evaluation study of the Solihull Approach' Milford, R., Kleve, L., Lea, J. and Greenwood, R. (2006) Community Practitioner; 79:11, 358-362

This study looked at assessing the effectiveness of the Solihull Approach compared to standard health visiting practice

Quantitative methods were uses to assess effectiveness of Solihull Approach:

Experimental (Solihull Approach) and control group (Standard Health Visiting Practice).

Results showed statistically a significant decrease in distress, parental perception of child difficulty in favour of experimental group.

Greater reduction in overall stress levels in experimental group.

Views of Solihull Approach trained health visitors more closely matched parents' view of problems than control group.

Similar results to Douglas and Brennan 2004.

Outcome of study suggested that Solihull Approach may be more effective than standard health visiting in addressing behaviour problems in young children.

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'Meeting Expectations: the Pilot Evaluation of the Solihull Approach Parenting Group' Bateston, K., Delaney, J., Pybus, R. (2006) Community Practitioner, May 2006, vol. 81, no. 5

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'Parents' evaluation of 'Understanding your child's behaviour', a Solihull Approach group for parents' Johnson, R., Wilson, H. Community Practitioner, May 2012, vol. 85, no. 5

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'Health Visitor views on consultation using the Solihull Approach: a grounded theory study' Stefanopoulou, E., Coker, S., Greenshields, M., Pratt, R. Community Practitioner, July 2011, vol. 84, no. 7

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The use of the Solihull Approach with children with complex neurodevelopmental difficulties and sleep problems: a case study' Williams, L. and Newell, R Community Practitioner86 (6) 30-33

'A service evaluation on the Solihull Approach training and practice'
Moore, T., Adams, M., Pratt, R. (2013) Community Practitioner 86 (5) 26-27

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'The value of evaluating parenting groups: a new researcher's perspective on methods and results' Cabral, J. (2013)  Community Practitioner 86 (6) 30-33

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Brigham, Lindsay and Smith, Ann (2014). Implementing the Solihull Approach: A study of how the  Solihull Approach is embedded in the day to day practice of health practitioners. The Open University in the  North, Gateshead.

Drea C., Lumsden V. and Bourne J. (2014) Using practitioners' feedback to contribute to organisational development in health visiting. Community Practitioner: 87(12): 30–33

Lee P. and Mee C. (2015) The Tameside and Glossop Early attachment Service: Meeting the emotional needs of parents and their babies. Community Practitioner. 88 (8): 31-35.

Oth er publications (please see the research list for full details):

Cullen, M.A. and Lindsay, G. (2006) Sure Start Chelmsley Wood: Report of the local evaluation 2005-06. Centre for Educational Development, Appraisal and Research, University of Warwick.

Lawrence, V (2007, submitted for publication) The Solihull Approach in Northamptonshire.

Lintern, J. (2005, unpublished study) A follow-up evaluation of the Solihull Approach training, Middlesbrough.

Lowenhoff, C. (2004) Practice development: training professionals in primary care to manage emotional and behavioural problems in children. Work Based Learning in Primary Care, 2, 97-101.

Stephanopoulou, E., Coker, S., Greenshields, M. and Pratt, R. (2011) Health visitor views on consultation using the Solihull Approach: a grounded theory study. Community Practitioner, 84 (7) 26-30.

Related publications:

Adams, C (2005) Health visitors and adult mental health: the future begins here. Community Practitioner, 78 (11), 389-391.

Department of Health (2008) Child Health Promotion Programme.

Douglas, H. (2011) The Solihull Approach: a whole school approach. Journal of Educational Psychotherapy, 18, 53-58.

Douglas, H. and Rheeston, M. (2009) The Solihull Approach: an integrative model across agencies. In J. Barlow and P.O. Svanberg Keeping the Baby in Mind. London: Routledge.

Douglas, H., Delaney, J., Cabral, J. and Rheeston, R. (2009) Supporting parenting: the Solihull Approach. Healthcare, Counselling and Psychotherapy Journal, 9 (3), 17-21.

Walker, A., Johnson, R., Banner, C., Delaney, J., Farley, R., Ford, M., Lake, H. and Douglas, H. (2008) Targeted home visiting intervention: the impact on mother-infant relationships. Community Practitioner, 81 (3), 31-34.

Brigham, Lindsay and Smith, Ann (2014). Implementing the Solihull Approach: A study of how the  Solihull Approach is embedded in the day to day practice of health practitioners. The Open University in the  North, Gateshead.

The recommendations above are based on detailed analysis of the finding from this collaborative  piece of work and are focused on minimising barriers and maximising benefits of embedding the  Solihull Approach more consistently across the whole health and social care workforce. It is
recognised that many may be already in place or in the early stages of being implemented.
A key concern is that a superficial understanding of Solihull Approach and formulaic application  could lead to fragmentation across occupational groups with behaviour management strategies  being implemented in a more professionally driven top down way outside the framework of a  developing therapeutic relationship with families. This would impact on the key benefit at the heart  of the Solihull Approach i.e. developing family resilience. Ongoing refresher training and mandatory  Solihull supervision sessions are necessary to enable practitioners to have a deeper understanding of  the Solihull Approach and the central importance of a 'partnership approach' and promotion of  'reflective parenting'. The main resistance to this is perceptions of time input and the corollary is the  'quick fix' approach - which can in fact be more time consuming in the long term. The benefits of
holistic practice and potential efficiencies in use of time need to be stressed in both both training  and supervision.  To address this concern on-going effective leadership and management is essential with key  individuals tasked with taking a strategic plan forward in order to achieve a critical mass of
practitioners, across professional boundaries, with an in depth understanding and level of skills to  fully embed the Solihull Approach. One of the risks identified is that with reorganisation and  changing personnel the momentum becomes lost and embedding the Solihull Approach becomes  fragmented both in terms of its holistic philosophy and inter-professional potential.

Drea C., Lumsden V. and Bourne J. (2014) Using practitioners' feedback to contribute to organisational development in health visiting. Community Practitioner: 87(12): 30–33

This paper presents the findings of a survey of practitioners within a health visiting service. This service was an Early Implementer site for the Health Visitor
Implementation Plan. The survey was administered in the context of training all practitioners in the Solihull Approach. It aimed to gather information from
practitioners about factors they thought could help them do their work with families more effectively. Practitioners' responses were analysed using thematic analysis. The principal needs identified were: more knowledge, skills and training; increased time to support families; increased supervision and support; and improved communication and partnership working. Practitioners' needs identified through the analysis were subsequently taken into account during development of the service.

Lee P. and Mee C. (2015) The Tameside and Glossop Early attachment Service: Meeting the emotional needs of parents and their babies. Community Practitioner. 88 (8): 31-35.

Parent-infant emotional health is probably one of the most complex arenas in which mental health, maternity and health visiting services operate. This critical period can be emotionally charged, not only for the infant but also for the parent. While most parents essentially get it right, severe ruptures in the parent-infant relationship can occur and can have serious consequences. This paper describes a comprehensive and cost-effective parent infant mental health service based on a psychodynamic model. The service aims to meet the needs of all parents from those with a high level of need through to universal provision. Strategic and theoretical underpinnings of the service model are described.