Peer-reviewed article

Parent Learning Groups in Alternative Provision: A Mixed-Methods Study of Psychoeducation, Mentalization, and Peer Support for Parents of Children with Neurodevelopmental and Conduct Difficulties.

Chelouche-Dwek G, Fonagy P · 21 Mar 2026

Abstract

Background Parents of school-age children with neurodevelopmental and conduct difficulties face elevated stress, reduced self-efficacy and relational strain, yet evidence for scalable, school-embedded support remains limited. Drawing on mentalization theory-which emphasises parents' capacity to understand behaviour in terms of underlying mental states-this mixed-methods study evaluated a weekly parent learning group integrating psychoeducation, mentalization-based practice and peer support, delivered within an alternative provision school. Methods A group of twelve parents who attended at least six sessions completed retrospective pretest-posttest questionnaires assessing parental reflective functioning (PRFQ) and parenting self-efficacy (PSOC). Semi-structured interviews explored parents' subjective experiences and perceived changes in parent-child interactions and parent-school relationships. Quantitative outcomes were analysed using paired t-tests and effect sizes; qualitative data underwent reflexive thematic analysis. Results Quantitative analyses revealed statistically significant improvements in parental reflective functioning and self-efficacy. Pre-mentalizing scores decreased substantially (d = 1.34), indicating reductions in non-mentalizing, while interest and curiosity about children's mental states increased markedly (d = 1.83). Parenting self-efficacy improved significantly (d = 1.61). Although a reduction in excessive certainty about mental states approached significance (d = 0.63, p = 0.053), trends suggested greater epistemic balance. Qualitative analysis identified six themes elucidating mechanisms of change, including enhanced mentalizing capacity, reduced parental stress, transformed parent-child interactions and facilitation style as a critical active ingredient. Integration of findings suggests that psychoeducational content provided conceptual grounding for understanding behaviour, facilitator modelling scaffolded reflective practice, and relational safety within the group enabled authentic engagement with challenging experiences. Conclusions These preliminary findings indicate that a school-based parent learning group combining psychoeducation, mentalization-based practice and peer support is feasible and associated with meaningful improvements in parental reflective functioning and self-efficacy. Parent narratives of transformed relational practices and shifts from reactive to reflective engagement echo broader literature demonstrating that group-delivered mentalization-oriented programmes can enhance reflective capacities and caregiving quality in diverse family contexts. The school setting may extend the reach of such interventions to families not engaged with clinical services and support collaborative parent-school partnerships. Future research should employ larger, controlled designs, incorporate observational and child outcome measures, and explore scalability across educational contexts.