Commonality: parenting support as prevention work

There are (or have been) efforts to establish a joint Nordic approach to the implementation of parenting support. In 2012, the Nordic Centre for Welfare and Social Issues (Marklund and Simic, Reference Marklund and Simic2012) published the first part of the report on the ‘Early Intervention for Families’ project (part of the Nordic Council of Ministers’ initiative in 2011 and 2012), in which researchers and practitioners had worked to develop a model for implementing parental support programmes in the Nordic region. This report (Marklund and Simic, Reference Marklund and Simic2012) stated what the future strategy for implementing parenting support programmes should be, and describes the commonalities between Nordic countries. The report describes the principle of universalism of public services, including parenting support, as a particular characteristic of the Nordic welfare states, which must be conserved (see also Bråten and Sønsterudbråten, Reference Bråten and Sønsterudbråten2016; Eng et al., Reference Eng, Ertesvåg, Frønes and Kjøbli2017):

The report further states that the provision of parenting support on a universal basis is important, since it offers a unique opportunity for preventive work and improves the outcomes of the intervention. Thus, the Nordic countries’ approach to implementing structured parental guidance programmes is characterised by consideration and investment in this as an early intervention measure for all groups. Particular groupsFootnote ¹ should, however, be offered more intensive services (ibid.). Previous research on the implementation of structured parental support programmes from the Nordic countries indicates that this mix of universal approach and more targeted measures, which was suggested as a model for a common framework, also seems to correspond with current practice in those countries (see contributions from Sihvonen, Reference Sihvonen2018; Sundsbø, Reference Sundsbø2018; see also Lundqvist, Reference Lundqvist2015). In aiming to understand what this approach means in practice, the following description is taken from the report by the Nordic Centre for Welfare and Social Issues (Marklund and Simic, Reference Marklund and Simic2012): Most parents should be offered ‘light’ parenting support in the form of consultations as a short-term intervention. ‘Parents who experience problems with their children or parenting skills’ (ibid.: 14ff.) should be offered participation in parent groups, guided by other parents and led by 1–2 leaders who are trained in one of the recommended parental support programmes. ‘Parents who have children with significant behavioural problems’ should receive more intensive individual support, where parents are trained in parenting skills and developing positive interaction with their child (again, based on certain recommended parental guidance programmes).

Differences: the implementation of parenting support initiatives

Despite the common universalist Nordic approach to providing social services (Esping-Andersen, Reference Esping-Andersen1990; Vidje, Reference Vidje2013), there are also considerable differences in how widespread structured parental support is. According to a report commissioned by the Norwegian Directorate for Children, Youth, and Family Affairs (Rambøll, Reference Rambøll2013: 15), the greatest differences are found when comparing Sweden and Norway with Iceland and Finland. The report (based on data from 2012 and 2013) finds that Sweden and Norway not only implement a broader repertoire of measures, but also distinguish themselves from the other Nordic countries in their number of studies analysing and documenting the effects of parenting support measures (Rambøll, Reference Rambøll2013: 3). Furthermore (2013: 15), Sweden takes a leading role with twenty-three implemented interventions (fifteen studies on effects); Norway implements twenty types of measure (accompanied by twenty studies); and Denmark implements twelve measures (seven studies). In comparison, Iceland (four types of intervention, one study) and Finland (three types of intervention, no studies) make little use of this approach in their preventive and early intervention work. However, in Finland at least, this seems to have changed in recent years (Sihvonen, Reference Sihvonen2016).

The report by Rambøll (Reference Rambøll2013: 14–5) shows that many of the same parental support measures exist in several of the Nordic countries. For instance, the programme called Parent Management Training – Oregon Footnote ² (PMTO) exists in Denmark, Iceland, and Norway, and is among the programmes recommended for further investment by the Nordic Centre for Welfare and Social Issues (Marklund and Simic, Reference Marklund and Simic2012). Sweden implements Komet, which is based on the PMTO programme. The Incredible Years (IY)Footnote ³ programme (a behaviour-oriented programme developed in the US) is implemented in four of the five Nordic countries (except Iceland). Furthermore, the International Child Development Programme (ICDP), developed in Norway, has been formalised as part of the Norwegian Government's Parental Support Programme, and is also provided in Sweden, Denmark, and Finland (Rambøll, Reference Rambøll2013: 14–5). According to the report, the Circle of Security (COS) programme is implemented in the three Scandinavian countries, Norway, Sweden, and Denmark, but not in Finland and Iceland (ibid.).

Rambøll (ibid.) finds that Sweden and Norway are distinguished from their Nordic neighbours by developing many more programmes through initiatives either at the national level, local level, or privately. In Norway, the Directorate for Children, Youth, and Family Affairs has played a central role in initiating parental support programmes (e.g., ICDP) and providing them with public support, but there are also many initiatives from NGOs (e.g., IOGT, which has developed Sterk og Klar) and private actors (e.g., Dialog). Sweden has developed its own measures, such as Alla Barn I Centrum and Örebro Preventionsprogram (now named Effekt) (ibid.).

As will be shown and discussed in more detail below, the uneven distribution of parenting support initiatives throughout the Nordic region is also reflected in the engagement with these policy interventions within the social sciences. However, before examining that issue, we will explore how this phenomena is seen and evaluated from the perspective of ‘psy-expertise’ (Klein and Mills, Reference Klein and Mills2017).

Parenting support: a recipe to improve children's development provided by psy-experts

Structured parenting support expanded in the Nordic countries from the 1990s onwards, although it had long been implemented elsewhere, first and foremost in the UK and US (Daly and Bray, Reference Daly and Bray2015). Many of the parent support programmes currently implemented in the Nordic countries have been developed in and imported from the US and adapted to the specific national context (e.g., PMTO, IY, COS). At the time when structured parenting support was launched and expanded in the Nordic countries in the 1990s, there was increased focus on children's rights and wellbeing across the Nordic countries due to the UN Convention on the Rights of the Child (1990) and its implementation into national laws. The ratification of the Convention facilitated the implementation of these types of interventions, which were claimed to serve children's interests through improving the circumstances in which they grew up.

The development of structured parenting support has been promoted and assigned to professionals and researchers from the ‘psy disciplines’ (psychiatrists, psychotherapists, pedagogues, psychologists, etc.) (Andenæs, Reference Andenæs2005; Hennum, Reference Hennum2010; Kroken and Madsen, Reference Kroken and Madsen2016; Madsen, Reference Madsen, Kroken and Madsen2016; Klein and Mills, Reference Klein and Mills2017). The vantage point for psy-experts who engage in the promotion and development of parenting support is the assumption that parents have immense influence over how their children develop (this is a perspective that social scientists have criticised as the ‘myth of parental determinism’ (Furedi, Reference Furedi2008). Psy-experts are motivated to develop and promote parenting support by their conviction (somewhat undermined by the reliance on evidence from their own discipline) that the ways in which parents communicate and interact with their children significantly influence their development (Ogden et al., Reference Ogden, Amlund Hagen, Askeland and Christensen2009; Hundeide and Rye, Reference Hundeide and Rye2010; Kjøbli et al., Reference Kjøbli, Hukkelberg and Ogden2013; Sherr et al., Reference Sherr, Skar, Clucas, Tetzchner and Hundeide2014; Bråten and Sønsterudbråten, Reference Bråten and Sønsterudbråten2016; Fyhn, Reference Fyhn2017).

The psy-experts’ assignment has been to develop parenting support as a means to prevent and treat childhood mental health disorders and behavioural problems (Rye and Hundeide, Reference Rye and Hundeide2010; Fyhn, Reference Fyhn2017). What they have developed is ‘a set of (service and other) activities oriented to improving how parents (as representing one of the most influential factors of child development) approach and execute their role as parents and to increasing parents’ child-rearing resources (including information, knowledge, skills and social support) and competencies’ (Daly, Reference Daly2015: 599). This kind of parenting support relies upon certain dominant theories from psychological sciences, such as attachment theory and social learning (Rye and Hundeide, Reference Rye and Hundeide2010; Fyhn, Reference Fyhn2017). Thus, their aim is to reduce the occurrence of parental behaviours and attitudes that are perceived as posing a risk to children's development (ibid.). Their engagement is based on the rationale that children will benefit if their parents are given advice and support on how to approach and execute their parental role. More precisely, the benefit for children occurs when parents’ practices and attitudes are tuned to comply with the principles of positive parenting and close attachment (Council of Europe, 2007; Kjøbli et al., Reference Kjøbli, Hukkelberg and Ogden2013; Sherr et al., Reference Sherr, Skar, Clucas, Tetzchner and Hundeide2014).

Many of the academic contributions to parenting support in the Nordic countries originate within this field of psy-expertise. They are mainly concerned with justifying parenting support interventions, and with stating their importance and necessity in preventing and treating childhood mental health disorders or problematic behaviours (e.g., Ogden et al., Reference Ogden, Amlund Hagen, Askeland and Christensen2009; Sherr et al., Reference Sherr, Skar, Clucas, Tetzchner and Hundeide2014). Such arguments are based on research evidence stating that the interventions have been shown to have positive outcomes, which in this context means that parents subsequently change their attitude and behaviour in communication with the child, toward positive and involved parenting (Sherr et al., Reference Sherr, Skar, Clucas, Tetzchner and Hundeide2011). If parents report that they have become more aware of their children's needs, and thereby adjust their parenting approaches following the intervention, the intervention is considered effective and hence successful (Hägglöf, Reference Hägglöf2013; Sherr et al., Reference Sherr, Skar, Clucas, Tetzchner and Hundeide2014).

Since parenting support is promoted and framed as a measure of preventative work, and in relation to mental health and behavioural problems among children, the contributions of psy-experts focus on how the interventions work in terms of whether or not parents adapt to the parameters. Other possible effects or outcomes are not central here. However, the social sciences offer different ways of looking at and producing knowledge about the provision of parenting support. The next section gives an overview of perspectives and findings from Nordic social science research regarding the provision and implementation of parenting support.

Social science perspectives on parenting support from the Nordic countries

Within the social sciences, there is a growing body of international analysis on the expansion of parenting support policies across national borders (e.g., Furedi, Reference Furedi2008; Thelen and Haukanes, Reference Thelen and Haukanes2010; Ramaekers and Suissa, Reference Ramaekers and Suissa2012; Richter and Andresen, Reference Richter and Andresen2012; Faircloth et al., Reference Faircloth, Hoffman and Layne2013; Lee, Reference Lee2014; Betz et al., Reference Betz, Honig and Ostner2016). In the Nordic social sciences, there is also increasing interest in how parenting support policies are defined, and the implications of their implementation.

As shown earlier in this article, the repertoire of parenting support initiatives is much larger in Sweden and Norway than in Denmark and, in turn, Iceland and Finland. This pattern reoccurs in the review of research contributions from the social sciences as regards the provision and implementation of parenting support in the Nordic countries. The majority of contributions engaging with social science perspectives on parenting support are based on empirical investigations conducted in Sweden and Norway.

In general, the common factor – among social science research contributions on parenting support – is the view that parenting support consists of a lot more than simply a method that seeks to prevent or treat children's health or behavioural problems. In practice, the understanding and positive evaluation of parenting support as a health-promoting measure does not tend to be the central focus in this field of research. Contributions on parenting support policies from the social sciences also have in common that they – either implicitly or explicitly – challenge the portrayal of parenting support as serving children's best interests. From their point of view, parenting support is rather a concept that, first and foremost, serves the society's interests (further details below).

In contrast, social scientists are occupied by how the introduction and implementation of parenting support programmes affect:

• • Parenting norms and practices;

• • The relationship between children and their parents; and

• • The distribution of power between parents and the state.

Many social science researchers investigating parenting support in the Nordic countries have focused on critically appraising the content of structured parenting support. Widding (Reference Widding2011), for instance, studied the Swedish version of the Community Parent Education (COPE), a manual-based programme in which parents meet once a week (for ten weeks) to learn strategies for managing different kinds of undesirable child behaviour. The basis for the analysis was the COPE course leader manual and DVD containing a number of film sequences illustrating ‘bad’ parenting skills. From this, Widding finds, firstly, that ‘both parents and children seem to be gendered in a rather traditional way by COPE’ (ibid.: 33), and concludes that this ‘most certainly risks maintaining gender inequality as well as possibly discouraging both women and men from constructing more gender-neutral forms of parenting’ (ibid.). Secondly, she finds that the ideals on parenting presented in the programme portray working-class parents and immigrant parents as being problematic (ibid). The latter matches the findings of a study from Norway (Erstad, Reference Erstad2015), based on participatory observations in ICDP courses provided for mothers of Pakistani background (International Child Development Programme). Erstad describes and discusses how this intervention reinforces the stereotype of these mothers as ‘Others’ (Gullestad, Reference Gullestad2002) and constructs ‘Their’ parenting practices as representing a model distinct from the ‘Norwegian model’. Erstad (Reference Erstad2015) argues that, by displaying ‘Their’ model as problematic, this intervention works to subtly socialise immigrant mothers toward adapting to a ‘Norwegian model’ of mother-/parenthood (see also Hollekim et al., Reference Hollekim, Anderssen and Daniel2016).

Another focus in the Nordic social science contributions on parenting support is the increased influence that certain ‘experts’ have gained in defining parenthood and norms and ideals of good parenting (Kjær, Reference Kjær2003; Andenæs, Reference Andenæs2005; Dahlstedt and Fejes, Reference Dahlstedt and Fejes2013; Hennum, Reference Hennum2014; Madsen, Reference Madsen, Kroken and Madsen2016). Danielsen and colleagues (Danielsen and Mühleisen, Reference Danielsen and Mühleisen2009; Danielsen et al., Reference Danielsen, Ludvigsen and Mühleisen2012) discuss this in an analysis of the norms of sexuality, families, and relationships transmitted to parents through a relationship course (Living Well Together), which is an adapted and shortened version of the Prevention and Enhancement Program (a licenced product from the US, developed in Denver). The course targets first-time parent couples and is offered free of charge by municipal health centres. Hennum (Reference Hennum2010) also focuses on the increased influence of experts in defining parenthood, and the issue is also discussed in the present themed section (see Dannesboe et al., Reference Dannesboe, Bach, Kjær and Palludan2018).

Most Nordic studies that apply a social science perspective to parenting support comprise various forms of policy analysis. They typically investigate how parenting support policies are described, justified, and legitimised in policy documents, political debates, and handbooks of parenting support programmes (Widding, Reference Widding2011; Danielsen et al., Reference Danielsen, Ludvigsen and Mühleisen2012) (see also the contributions from Widding, Reference Widding2018; Sihvonen, Reference Sihvonen2018; Sundsbø, Reference Sundsbø2018; Littmarck et al., Reference Littmarck, Lind and Sandin2018).

Furthermore, a considerable number of studies have discussed strong linkages between parenting support and political interests and goals. Many of the research contributions analyse parenting support as an instrument to control parents and children in order to achieve politically desired goalsFootnote ⁴ (Danielsen and Mühleisen, Reference Danielsen and Mühleisen2009; Hennum, Reference Hennum2010; Dahlstedt and Fejes, Reference Dahlstedt and Fejes2013; Erstad, Reference Erstad2015; Lundqvist, Reference Lundqvist2015) (also see contributions from Widding, Reference Widding2018; Sihvonen, Reference Sihvonen2018; Sundsbø, Reference Sundsbø2018; Littmarck et al., Reference Littmarck, Lind and Sandin2018). Within this line of thought, investments in parental guidance are seen as being introduced in order to shape parents and children into subjects who will conduct themselves and their relations with others in ways that produce politically desirable ends and hence reduce costs for society (ibid). Many of these contributions are inspired either by Foucault's governmentality perspective or by research from other countries (such as the UK, Netherlands, and Germany), stating that parenting support represents a tendency towards increased responsibilisation of parents for raising ‘good’ future citizens (Gillies, Reference Gillies2005; Ellingsæter and Leira, Reference Ellingsæter and Leira2006; Furedi, Reference Furedi2008; Oelkers, Reference Oelkers and Böllert2011; Richter and Andresen, Reference Richter and Andresen2012; Lee, Reference Lee2014; Knijn and Hopman, Reference Knijn and Hopman2015). The basic line of argumentation here is that parents are expected to make greater effort to ensure the positive development of their children, and to adapt their attitudes and practices to the contemporary ideas of ‘good’ (positive, attentive) parenting that such experts promote (see Dannesboe et al., Reference Dannesboe, Bach, Kjær and Palludan2018). Some also argue that this promotes the view that parents can be held responsible for problematic child development. Sihvonen (Reference Sihvonen2016) for instance states that early interventionist parenting support, which focuses on parents as the problem and seeks to activate parents’ quiescent resources and inherent expertise, encourages individualised interpretations of family problems.

While there is much research on policy and its underlying aims and assumptions, there is less research within the social sciences on how policies are organised and implemented in practice (Bråten and Sønsterudbråten, Reference Bråten and Sønsterudbråten2016; Wesseltoft-Rao et al., Reference Wesseltoft-Rao, Holt and Helland2017). Consequently, the assessment of how parenting support works, and which outcome it produces, is a research field still dominated by psy-experts, who have a very different approach to this question (see above). Nevertheless, a few contributions from the social sciences have investigated the implementation of parenting support and thus provide deeper insights into the impacts of parenting support policies (Erstad, Reference Erstad2015; Lundqvist, Reference Lundqvist2015; Widding, Reference Widding2015; Lundqvist and Ostner, Reference Lundqvist, Ostner, Betz, Honig and Ostner2016) (see also the contribution from Sundsbø, Reference Sundsbø2018). A main finding is that the provision of parenting support is more complicated and less top-down than the policy suggests, and that the pressures on municipalities to reduce costs (due to severe cutbacks in welfare services in general, and in support to parents in particular) makes it difficult to implement parenting support policies as a universal offer to all parents (Lundqvist, Reference Lundqvist2015; Wesseltoft-Rao et al., Reference Wesseltoft-Rao, Holt and Helland2017). Thus, parenting support in the Nordic countries is presented as a universal service that aims to reach all (kinds of) parents. However, (a few) observations on how the policies are shaped and implemented in practice, show that this is not realised as a service that addresses all parents on equal terms (Lundqvist, Reference Lundqvist2015; see also contributions from Widding, Reference Widding2018; Sundsbø, Reference Sundsbø2018).

Concluding remarks

This article has shown large differences between how expertise from the field of health and (some parts of) pedagogy understands and evaluates parenting support, compared with how social scientists consider this. Although researchers from these different fields engage with many of the same questions (such as: What is parenting support, and what are its effects?), they do not seem to come together to discuss their different positions and answers. One can get the impression that psy-experts give little attention to the critical debates on parenting support in the social sciences. At the same time, the contributions from social sciences seem to give little acknowledgement to the work and efforts undertaken by psy-experts, which are undoubtedly motivated by ‘goodwill’ toward children (e.g., Hundeide and Rye, Reference Hundeide and Rye2010). Instead, social scientists tend to narrow their focus to the political side of parenting support, and to criticise the accompanying power-related issues. However, evidence shows that parenting support can also provide individuals with insights that can reinforce their individual agency (Sundsbø, forthcoming; Sherr et al., Reference Sherr, Skar, Clucas, Tetzchner and Hundeide2014), and this should not be neglected.

There is a need for more research that manages to consider both the agency perspective of individuals, as well as the structure of the society (i.e., social organisation, power relations, including definition power), and to study how they depend on or constitute each other (Giddens, Reference Giddens1984; Daly, Reference Daly2015). For instance, so-called psy-experts and social scientists could employ new ways to address and investigate the questions in which they are already engaged. There is great potential for collaboration between these different fields of research and expertise. Social scientists could, for instance, contribute with profound analyses of whether or how parenting support actually promotes child development; and develop indicators for measuring this (such as through longitudinal studies). Such a research approach would make a valuable contribution to the body of knowledge around parenting support.

All in all, the published and ongoing research on parenting support in the Nordic countries enables a more nuanced view of what parenting support means in this particular context, and the implications it might have. Nevertheless, there is still a need for further knowledge in order to evaluate the current assumptions and findings in this body of research. For instance, as many contributions have stated, parenting support might turn out to problematise certain parents (e.g., immigrants and socially marginalised groups); and, through subtle ways of convincing them of their own incapability of doing the ‘right’ or ‘best’ thing for their children, force them to adapt to specific ‘middle-class’ norms and idea(l)s of ‘good’ parenting. However, as Erstad (Reference Erstad2015) points out, parenting support can also provide socially marginalised parents and those of immigrant backgrounds with new opportunities, since it also provides them with (new) information about what the society expects from them and what are considered as important values (see also Sundsbø, forthcoming). The potential for parenting support interventions as an instrument to promote upward social mobility and social ‘integration’ of marginalised groups (see the contribution from Sundsbø, Reference Sundsbø2018) has yet to be investigated further or tested empirically.

Another important question concerns how the ‘turn to parenting’ (i.e., Gillies, Reference Gillies2005; Ramaekers and Suissa, Reference Ramaekers and Suissa2011; Faircloth, Reference Faircloth and Lee2014) affects efforts to establish gender equality – one of the trademarks of the Nordic countries (see Gíslason and Símonardóttir, Reference Gíslason and Símonardóttir2018). Several authors (e.g., Widding, Reference Widding2011; Lee, Reference Lee2014; Bråten and Sønsterudbråten, Reference Bråten and Sønsterudbråten2016) have observed, and problematised how – even in these countries where the idea of parents being equally obligated and important to children is so heavily promoted – women or mothers are (still) regarded as the primary, self-evident parent (see Gíslason and Símonardóttir, Reference Gíslason and Símonardóttir2018).

There is also a need for more empirical research on the observation that ‘professionalism has positioned children and parents as objects rather than subjects in their own lives and, in so doing, required them to live up to standards of life defined for them by experts’ (Hennum, Reference Hennum2014: 441; see also Andenæs, Reference Andenæs2005). Is this observable from the perspective of how parents go about organising their daily lives and interacting with their children? To date, very few studies have encompassed parents’ perspectives on the parenting support they received, beyond quantitative questionnaires in which they are confronted with closed questions and rating scales. Lastly, the widespread assumption that parenting support expresses a shift of responsibilities, from the state to parents, for the production of ‘good’ future citizens, must be investigated further.

The Nordic context is a specific one, characterised by a strong welfare model in which there is a tradition of comparatively far-reaching state intervention in citizens’ private lives (Kildal and Kuhnle, Reference Kildal and Kuhnle2005; Danielsen and Mühleisen, Reference Danielsen and Mühleisen2009; Hatland et al., Reference Hatland, Kuhnle and Romøren2011; Bråten and Sønsterudbråten, Reference Bråten and Sønsterudbråten2016). Thus, what appears to be a responsibilisation of parents could be an expression of the welfare state expanding its mandate of taking responsibility for children's development, as also discussed as the dialectic relationship of defamilialisation/refamilialisation (Ellingsæter and Leira, Reference Ellingsæter and Leira2004). There is a need to explore these mechanisms further; in doing so, Ervik and Kildal's (Reference Ervik, Kildal, Nilssen, Kildal and Ervik2015) distinction between ‘individual responsibility as task responsibility’ and ‘individual responsibility as accountability’ can be helpful. They state: ‘[There is an ongoing] transference of responsibility from the public to the private, though not primarily towards individual responsibility as accountability, but to individual responsibility as “task responsibility”’. Current research on parenting support policies in Nordic countries has started to discuss these issues, but there remains a long and stony path toward understanding what this responsibilisation means in the specific Nordic context. Thus, does the increased responsibilisation of individuals indicate that the state seeks to retreat from its responsibility for providing for children? Or is it, rather, an expression of the welfare state applying new strategies to maintain or even strengthen its governing of citizens (Leira, Reference Leira, Ellingsæter and Leira2004)? This would require a great deal more empirical analysis of how the welfare states engages in different fields, and where the eventual retreat or expansion of control or influence takes place in the real world.