Children’s Rights (Absent) in Universal Parenting Training

Abstract

In public health policies the child-parent relationship is regarded as a determinant for children’s development and future health. During the first two decades of the twenty-first century Sweden implemented parenting training on a universal level as a proactive measure. Sweden ratified the UN Convention on the rights of the Child in 1990 by which follows that all policies involving children are entwined with children’s rights. Still, research on society’s universal manual-based parenting training interventions depicts that the concept of rights is not an intrinsic value. Adult norms and a preventive approach tend to rule over health promotion goals involving children. Moreover, research results show that children possess an awareness of democratic values and insight in how to handle a dynamic interchange in daily family life. Children’s involvement in parenting training should be investigated and discussed as an ethical public health challenge for the future.

1. Introduction: Institutionalized rights and their realities

Internationally political initiatives to implement the UN Convention on the Rights of the Child [1] have institutionalized children’s right to participation and self-determination [2, 3]. In Sweden children’s rights are established as a core rhetoric in social policies since the country’s ratification of the UNCRC in 1990. In 2009 a national strategy to strengthen the rights of the child [4] outlined principles for the parliament, government, state authorities, county councils and municipalities, to ensure that the rights of the child were acknowledged in all activities. As a historic step the Swedish parliament initiated a bill to incorporate the UNCRC into Swedish law in 2020. Legislative measures were taken to ensure that the articles of the UNCRC were considered in all decisions made by public authorities. Literally this meant that other legislation must be interpreted in the light of the convention. Among the Nordic countries Norway had been a predecessor to this move towards consolidating children’s rights, as the convention was incorporated into Norwegian law in 2003.

2. Manual-based universal parenting training

In consequence with the Swedish political intention to respect children’s rights in all things that concern children, a rights perspective was present when a broad governmental scheme to support the use of universal parenting training was implemented on a national level during the second decade of the twenty-first century. This parenting training scheme was realized through a national strategy for a developed parental support [5]. The strategy was initiated by a government proposal that suggested that parenting training should be available as a universal public health intervention for all parents with children aged 0–17. Local efforts for parental support interventions should be coordinated at central level in the municipalities. Collaboration between public, non-profit and private actors was also recommended, as was national and regional collaboration. Manual-based parenting courses were generally forwarded as an important intervention, but without favouring specific programs at this point [5].

The government’s political step bore similarities to other European policy documents that informed that parents need to have access to expert advice in order to fulfil their parental tasks for the benefit of their children’s best development [6, 7].

3. Statistics as a fundament for parenting interventions

With referral to the UNCRC, the National strategy for developed parental support stressed that care of children primary is a parental task but also a societal responsibility. Care and welfare issues were moreover described as closely related to parent–child relationships. That in turn motivated society’s parental interventions. On one hand from a rights perspective on the other for societal sustainability. For better understanding of the communication between children and their parents, Sweden has since 1985 cooperated with the World Health Organization (WHO). Surveys have been launched to investigate children’s welfare in family settings [8]. These surveys have contributed with important information for political decisions in family policies. With consistency the results have shown that a high percentage of girls and boys above 10 years approve of the relationship with their parents. Their parents share time with the children and listen to them [9, 10].

Other national Swedish surveys have pointed in the same direction. As an example, 90% of 10–15 years old children have said that they mostly can rely on their mother’s attention, and a bit less so on their fathers [11].

It can be problematic to identify children as a group in statistics and even to make comparisons over time [12]. Evaluating statistical material for policy purposes about children’s well-being has been described as based either on a developmental perspective, focusing on the future or a children’s rights perspective [13, 14, 15]. A predominantly developmental perspective has steered public health interventions towards parenting training in the twenty-first century [5, 16].

The political initiative for public health-based universal parenting training interventions [5] relied on reports about increased mental health problems among young people. Statistics about mental illness among children and young people received a lot of attention in the early 2000s as a growing public health problem. Psychosomatic symptoms such as headache and stomach-ache and psychological symptoms such as depression and nervousness were reported to have become more frequent among school-aged youth since the 1990s.

Following the national strategy on parental support [5], Sweden chose to support parents on a universal level with group-based parenting training. Group-based parenting training can be implemented on different levels, as indicative, selective or universal interventions [11]. Indicative interventions are not relevant for this chapter as they are aimed at families with diagnosed problems and primarily implemented as individual consultations [17]. Selective group interventions are used for problem-solving with families who have perceived difficulties with child behavior. Selective programmes have been in use in Sweden since the late 1900s [16]. Universal group interventions are intended for all parents with children between 0 and 17 years [11] and were recommended for use by the National Strategy for Developed Parental Support [5].

A public health argument for universal interventions referred to the prevention paradox that the few in need could be reached by targeting all parents, without stigmatizing those at risk. Possible benefits of preventive measures to promote health without targeting specific groups were explained in the National strategy in 2008:

“By investing in universal prevention efforts, we are able to reduce the proportion of the population who would later have developed problems if no action was taken (…) with great opportunities to prevent ill health among a big group of children who have not yet shown any early symptoms” [5].

From 2009 manual-based parenting training courses were disseminated to parents for free. Municipalities all over the country were, from then onwards, encouraged to offer all parents with children between 0 and 17 training with manual-based group-based courses with educated leaders and without costs. A problem following this political decision was that few Swedish efforts had been made to produce course material that met the purpose for universal use [18]. In absence of universal courses Sweden resorted to selective manual-based courses designed to adjust children’s perceived problem behavior. The selective courses, mainly called programmes, were structured, effect-oriented and demanded high manual fidelity [19]. Some Anglo-Saxon selective programmes were tried for universal use, for example, The Incredible Years [20], Parent Management Training (PMT) [21]; Triple P [22] and Connect [23]. Selective programmes could broadly be labeled either as interaction or communication programmes [16], or as relational or behavior modification programmes [24]. Some of them have theoretical underpinnings from two of these categories.

Behavior modification programmes that are associated with social learning theory [25] like COPE [26] and Triple P [22] are prevalent. These programmes focus on observable and measurable behaviors which are learned from the environment through the process of observational learning [27]. Relational programmes, like Connect, are associated with attachment theory focusing on relational development, security and parental response [28, 29, 30]. In a selective context the methodologies have been proven to give some positive results in effect studies measuring parental feedback.

Societal parenting training interventions aiming at all parents have met with criticism from scholars and professionals in the twenty-first century. Some scholars have disputed the applicability of normative manual-based programmes in multi-faceted postmodern settings [31]. The programmes have also been criticized for disempowering parents, children and facilitators, because of prioritizing professional expertise over lay knowledge [32, 33]. Some of these critical aspects were forwarded by the Swedish Council on Health Technology Assessment and Assessment of Social Services (SBU). The council expressed concerns about the efficiency of parenting training interventions as such, stating that traditional welfare issues like staffing levels, health care in schools, social services and education are examples of structural changes that are “important to consider along with (or instead of) investing in programmes” [19].

The Swedish political effort to educate parents was summarized by the government as an “activity that gives parents knowledge of the child’s health, emotional, cognitive and social development and/or strengthens their social networks, based on evidence-based models, methods and applications with a set of values based on the UN Convention on the Rights of the Child” [5].

With that statement in mind, it is the aim of this chapter to shed light on how Sweden’s commitment to UNCRC was reflected and transmitted in manual-based universal parenting training implemented in a preventive/promotive setting from 2009 and onwards. Taking the discussion one step further, preventive top-down approaches as opposed to promotive bottom-up approaches could play out in parenting training as distinct practices of governing of parents and children [34].

4. Prevention and promotion

For more than a decade universal parenting training interventions have now been incorporated in Swedish public health policies. Manual-based courses are launched all over the country as a rhetorically rights-based preventive intervention in a health promotion context, formulated to

“promote mental health and prevent mental illness among children and young people, by reducing psychosomatic symptoms like anxiety, depression, sleeping disorders, tiredness and headache among school children, and thus promote health and prevent ill health among children and youth” [35].

Sweden has a long tradition of supporting parents, but parenting training was previously rooted in welfare policies with a heritage of liberal education in the early welfare state [36]. During the first decade of the twenty-first century a least two major changes made way for the shift, from traditional welfare policies that previously had promoted child rearing: A political demand for scientific rationality of caring and evidence-based practices paved the way for new structured manual-based parenting methods, mainly embedded in a Anglo Saxon context [5, 19, 37]. Secondly political target groups for parenting interventions expanded, from parents with babies and infants to parents with children between 0 and 17 years. Underlying theories about parental uncertainty in a risk-oriented society supported the new policies.

From an equity perspective the promotive side of public health polices was paired with prevention in a new structure for Swedish public health in 2018. The idea of connecting prevention and promotion with one another was motivated to enforce the possibilities for successful intervention results [38, 39]. Public health science had at that time long drawn on the same tradition as the positivistic biomedical paradigm where only classical experimental designs were acceptable. Still, since the 1980s, when the WHO proclaimed the importance of health promotion [40], the promotive side of public health policies has played an important part also in preventive interventions. This was apparent in the national strategy for parental support [5] when described by the government as a strategy for universal preventive parental support. The government thus wrote that the goal of universal preventive parental support was to promote children’s health and positive development via parents and maximize the child’s protection. Such a societal turn to govern the direction of parenting relates to behavioral modification models with roots in the 1960s. These methods were therapeutically used for indicated problem solving, working with the parent (mediator) to improve the behavior of the child (target) [41]. Such methods were later developed and reconceptualized for group intervention in programmes like The Incredible Years [20], Triple P [22] and similar selective programmes.

As one of the fundamental principles in the UNCRC, the limits and possibilities of children’s participatory rights have been discussed and analyzed since the UNCRC was adopted. The balance of power connected to adult’s rights and children’s participatory rights have thus emerged as an issue of scientific concern [42].

Politically a child’s perspective was acknowledged as important when the Swedish parenting support strategy was processed in 2008. The inquiry searched for and found only four research studies and two student thesis involving children’s views on parent child relationships in Sweden [5]. Such a white spot in research posed a challenge for the future. Even more so as children’s status as informants in research had progressively changed since the 1990s. From being mere objects of socialization and adult interventions, children were now also regarded as subjects and knowledge providers in their own right. The concept of “childism”, which emerged in the twenty-first century, can be regarded as a theoretical development from this change.

Some researchers propose that children’s participatory rights could hollow out the rights that adults have to make decisions, [43]. What it boils down to is to acknowledge the existence of a power balance between adults and children.

In the following children’s perspective as distinctive from a child perspective is considered. There is currently room for discussions about how parenting interventions involve a children’s rights perspective.

5. Child perspective-children’s perspective

The term “child perspective” has, influenced by children’s rights, been frequently used in the twenty-first century, given different meanings depending on the context and who the senders are—politicians, lawyers, psychologists, researchers, social workers or children’s rights advocates, etc. [44]. In science the term has been used by researchers both as a theoretical statement of adherence to a child rights paradigm and as an analytical tool. Due to often poorly performed definitions though, its usability in science has been disputed as lacking in clarity and distinction [45]. Some researchers have advocated for the use of the term “children’s perspective” to clarify when children themselves are heard or have their say. But even this term has been disputed depending on how the word perspective is interpreted [46]. Today it seems hard, though, to bypass the ontological considerations affecting research about child–parent relations [47].

A natural consequence of ethical stances in child research is to incorporate children’s views in research. Keeping in mind that capturing children’s perspectives require adults, parents and health professionals to be attentive, sensitive and supportive of each child’s expressions, experiences and perception [48, 49].

6. Adult views on children

The emergence of the “new sociology of childhood” [50] during the 1980s challenged socialization as an instrumental and one dimensional concept of child development. Theoretically “new” children emerged, declared as subjective actors in their own right—competent, interacting and socially constructed. Parenting was accordingly conceptualized as a bi-directional communication.

With insights about how interaction works in multifaceted relationships, the use of a child perspective, as an adult assessment of children rights and needs, has been disputed and debated. In the place of child perspective, children’s own perspective is claimed as an important analytical stance. Children’s perspective is motivated as a rights-based conception of children’s status in parenting [46]. Today it seems hard, to bypass ontological considerations in research about child–parent relations [47]. A natural consequence of ethical stances in child research is thus to incorporate children’s views in research.

This is not an easy adult task. It requires an open mind and dynamic apprehension of children’s ways of expressing themselves. Basically, awareness of diverse constructions of childhood leads away from structures where children are diminished as receivers of instructions [49, 50, 51].

7. Childism as a new understanding of childhood

The concept of childism serves as a more recent theoretical base for childhood studies and has developed further from new social studies of childhood. Childism postulates that social theory needs to embrace the more fundamental potential for children’s lived experiences, rather than just break down social norms. This requires reconstructing of interdependent social relations and generational orders.

Today childism theories are discussed in a global network with The Childism Institute as its base. Professor John Wall, founder of the institute, argues that by placing children at the centre of research, childhood studies can not only understand children’s agency and experiences in their own right, but also develop critical understandings of child-adult relations and social practices [52].

8. Three research studies

As part of a larger research project on parenting training, the adherence to children’s rights was studied sing material from two courses which were implemented universally in Sweden: The Canadian Connect programme and the Swedish All Children in Focus (ABC). Both courses were introduced to parents in 2011–2012 [53, 54].

As mentioned above, the Canadian Connect programme [23] is associated with attachment theory focusing on relational development, security and parental response [28, 29, 30]. Connect is originally designed as a selective programme, aimed at children between 8 and 12 with declared problem behavior. Connect has also been used universally in Sweden.

The Swedish course All Children in Focus (ABC) was developed by the Karolinska Institute and Stockholm Social Services in 2011 [55] for universal use only. ABC adheres to social learning theory but also uses some attachment theory. The developers were influenced by selective programme effectiveness as reviewed by Wyatt Kaminski et al. [56].

Both courses were chosen for the studies as they posed an alternative to the selective courses based on social learning theory that had been previously recommended in Sweden.

9. Course manuals

The Connect manual is extensive and consists of nine sessions coherently built up to fulfill the programs intentions. One optional follow-up session is also available. The manual contains four components with the aim to develop secure connections between parents and their children: sensitivity of parenthood, cooperation and reciprocity, ability to reflect as a parent and dyadic affect regulation. The group leader’s lectures are mixed with role play and discussions with the part taking parents.

An overall purpose of the course manual is to inspire parents and guardians “to think about new ways to understand their children and their behaviour, new ways of understanding themselves and their behaviour as parents, as well as new opportunities in parenting” [23].

The ABC manual is presented in a binder with exchangeable information. The manual is less comprehensive with four basic sessions and one optional extra session. Each of the four parts has a theme: showing love (parental factors, five to one, focus on what works), being there (the interaction chain), showing the way (annoyance and anger) and picking your battles (natural consequences).

ABC seeks to strengthen parent-child relations. The part takers in the course get to learn more about relevant research on parenting and children’s development. Role play is also used and short films about day-to-day family problems [55].

Both manuals were analyzed with qualitative content analysis which depicted that children’s rights were not included as an aspect in either manual. The ABC manual’s introduction mentioned rhetorically that the course values were founded on the UNCRC (1989). In the absence of referrals to children’s rights in the manuals, the analysis concentrated on how the manuals displayed adult and child perspectives and if an ethos of children’s welfare or liberty rights was present. The findings showed that the course manuals of Connect and ABC harmonized with a risk-prevention paradigm, prominent in Swedish public health policies [53].

The manuals forward advice and guidelines for parents in different ways. The Connect program uses adult preventive perspectives as well as child-oriented promotive methods. Children are to some extent seen as agents in a mutual developmental process with adults. The ABC affiliates to positive discipline based on authoritative prevention and control. The adherence to child autonomy and children’s rights is weak.

In relation to the UNCRC, an ethos of children’s well fare rights could be traced in the manuals, while a liberty rights perspective was restricted by adult preventive norms.

10. The course sessions

The sessions of Connect and ABC were observed, audio taped and transcribed. Between 12 and 16 parents took part in the Connect course and between 6 and 8 in the ABC course. Two leaders were present at each course. The recorded material from both courses was analyzed separately with discourse analysis [54].

The study confirmed that both courses relied on high manual fidelity. Normative goal-oriented methods were used which displayed adult centred child constructs and unidirectional parenting strategies. In general, parents were positioned as protagonists in the discussions between leaders and parents. Children, on the other hand, were mainly positioned as secondary actors and subordinate others. Neither children’s own perspectives on parent–child relations, nor the children’s participatory expectations were explicitly met during sessions. The Connect course leaders used expressions describing human relationships—connection, lifelong attachment, natural conflicts, empathy and slow change. The ABC course leaders used expressions associated with regulation of human behavior show feelings, choose battles and of conflict handling like leadership in critical situations and use of natural consequences.

Findings from discussions during the two course sessions showed that neither Connect nor ABC dealt with children’s rights as such. These findings confirm previous research with course leaders of the COPE programme and the Swedish universal course Family workshop. Leaders declared that they were aware of the intentions of the UNCRC but did not discuss children’s rights during sessions [57].

Children’s rights are highly regarded in Swedish social politics which makes the absence of children’s rights as a guiding principle in universal parenting training courses notable. Today universal parenting training is embedded in public health politics which suggests that children’s welfare rights and liberty rights have a different standing. Welfare rights, e.g., health and well-being, are an underlying value in adherence to a public health aim to secure children’s health and welfare for the future. On the other hand, children’s liberty rights, e.g., rights to participation can in a public health context be restrained by an adult position of parental strength, significant for a preventive public health paradigm [18]. The findings of these studies show that children’s liberty rights can be limited by a preventive framework where children play a part as receivers of adult norms.

11. A research study with children

Advocacy for children’s rights as expressed in the UNCRC [1] should be informed by a moral, ethical and political responsibility for giving strength to children’s voices [58]. Consequently, a third study in the research project consisted of semi-open interviews with 11 children aged five to nine whose parents had taken part in universal parenting training courses (72). Qualitive content analysis was used in this case [51]. The research questions did not deal with children’s rights as such but aimed to reflect the children’s views on their own standing in family relationships. Hence the study intended to shed light on children’s capability to reflect on interaction between parents and children—a core issue in universal parenting training.

Today adult power towards children is a matter of concern for many researchers dealing with children: Several ethical issues have been critically discussed in the literature [59, 60].

Where children are concerned, an adult perspective is to some extent inevitable.

The findings of this study were divided in themes and categories. As an example, self-protection included to cherish one’s own thoughts, withdraw from the adult company and to set limits for one’s own space.

Togetherness’ involved taking part in decision making, a will to compromise and a wish to behave in a good way. In general, the children expressed that they ideally took on a position that put them on equal terms with their parents in family discussion. Still, they listened to their parents and respected their knowledge. The children showed clearly that they were willing to compromise in decision making,

“I usually badger a bit but then it blows over and after a while we agree” (Lotta, age 8).

Moreover, the interviewed children sensed that they were qualified as active family members themselves. At the same time, they saw their parents as providers and protectors with good intentions.

The children’s recollections and thoughts depicted strong desire to be listened to and to be taken seriously. They also displayed trust and belief in their parents’ will and ability to meet their expectations [51].

12. Summary

Children’s rights as expressed in the UNCRC have influenced Swedish social policies since the 1990s and are, in a European context, regarded as a primary consideration in parenting [61]. Consequently, the Swedish expansion of universal parenting training interventions to cover the whole period of child rearing could have great impact on rights of both children and their parents.

From a child rights perspective, this chapter has focused on how children’s rights are realized in two parenting courses that are universally implemented. Two research studies of parenting course manuals and proceedings have shown a lack of adherence to children’s liberty rights as expressed in the UNCRC. Moreover, children are placed as subordinate others in the course material and during sessions. These results do not suggest an absence of rhetoric acknowledgment of the fact that children have rights. Still it should be acknowledged that rights were not used as a fundamental principle in either of the studied courses.

Another suggestion has arisen from the findings from manuals and sessions. The possibility exists that a public health rule of preventive methods, based on adult norms, hinders the courses to forward children’s liberty right and children as active agents in family relationships. Such a public health scenario would contradict the Swedish commitment to children’s rights as a fundament for political interventions concerning children.

A possible future research area would be to investigate how children and parents regulate their joint family spaces in comparison with the parameters for family life that are outlined in today’s parenting training programs. More knowledge about children’s and parent’s relational interactions can be gained by involving children themselves. Children’s involvement could contribute to further development of policies for parent and child support. Health promotion as a theoretical base for parenting training interventions could also be further researched in relation to children’s agency and participatory rights. Conclusively there still is a need for society to ethically and morally consider children’s position and dependence on adult norms and wishes. Children’s involvement in parenting training needs to be investigated and discussed as an ethical public health challenge for the future. As Wall claims, “rights have to be forged in social contexts that are always too narrow. The social whole has constantly to recreate itself” [62]. UNICEF has more cautiously described a way forward as “adults’ evolving capacity and willingness to listen to and learn from their children (…) re-examine their own opinions and attitudes and to envisage solutions that address children’s views [63].