Interventions need to be active and persistent

Merely providing information is unlikely to be sufficient, though it is logically necessary. Participation by the recipient seems to be important. For instance, Beardslee et a/.'(l2' found that a series of discussions about the impact of having a depressed parent with both child and family was superior to lectures in the promotion of psychosocial development of children in families where a parent had been depressed.

Reviewing preventive interventions in early childhood, and early education in particular, McGuire and Earls (13) argue strongly that continuing provision must extend any early intervention or else the effects will wash out. Persistence counts. This is also true for parent management training. (14> A long-term follow-up of early interventions, mainly behavioural, carried out by health visitors in the United Kingdom (15) found the same—gains fade rapidly in the face of social disadvantage. This study may have been unlucky in choosing to focus predominantly on externalizing behaviour problems. Long-term gains in lessening the chance of internalizing (but not externalizing) problems were found in a controlled study in Finland after a 5-year programme in early childhood. (16) Parents of new-born children were visited at home and counselled according to psychodynamic principles 10 times a year over the first 5 years of their child's life. The aim was to optimize their attitudes to, and handling of, their child; 10 years later the adolescents from the experimental group had significantly fewer internalizing symptoms.

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