# 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

**Authors:** Gali Chelouche-Dwek, Peter Fonagy

PMC · DOI: 10.3390/children13030431 · 2026-03-21

## TL;DR

A school-based parent group combining psychoeducation, mentalization, and peer support improved parents' ability to understand their children's mental states and boosted their confidence in parenting.

## Contribution

This study demonstrates the feasibility and effectiveness of integrating mentalization-based practices into school settings for parents of children with neurodevelopmental and conduct difficulties.

## Key findings

- Parents showed large improvements in reflective functioning and parenting self-efficacy.
- Qualitative analysis revealed six themes, including relational safety and transformed parent–child interactions.
- School-based mentalization-informed groups may enhance emotional regulation in children through improved parental mentalizing.

## Abstract

What are the main findings?
•A school-embedded parent learning group integrating psychoeducation, mentalization-based practice, and peer support was associated with large improvements in parental reflective functioning and parenting self-efficacy.•Parents showed reduced pre-mentalizing and increased curiosity about their children’s mental states, alongside greater confidence in managing challenging behaviour.•Qualitative analysis identified six interconnected themes, including relational safety, enhanced mentalizing capacity, improved affect regulation, and transformed parent–child interactions, elucidating the mechanisms of change.

A school-embedded parent learning group integrating psychoeducation, mentalization-based practice, and peer support was associated with large improvements in parental reflective functioning and parenting self-efficacy.

Parents showed reduced pre-mentalizing and increased curiosity about their children’s mental states, alongside greater confidence in managing challenging behaviour.

Qualitative analysis identified six interconnected themes, including relational safety, enhanced mentalizing capacity, improved affect regulation, and transformed parent–child interactions, elucidating the mechanisms of change.

What are the implications of the main findings?
•School-based mentalization-informed parent groups are a feasible and accessible intervention model for families of children with neurodevelopmental and conduct difficulties who are not engaged with clinical services.•Embedding parent support within schools may strengthen parenting capacity while transforming adversarial parent–school relationships into collaborative partnerships.•Improvements in parental mentalizing may contribute to children’s emotional regulation and engagement by enhancing relational safety and containment.

School-based mentalization-informed parent groups are a feasible and accessible intervention model for families of children with neurodevelopmental and conduct difficulties who are not engaged with clinical services.

Embedding parent support within schools may strengthen parenting capacity while transforming adversarial parent–school relationships into collaborative partnerships.

Improvements in parental mentalizing may contribute to children’s emotional regulation and engagement by enhancing relational safety and containment.

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.

## Full-text entities

- **Diseases:** Neurodevelopmental and Conduct Difficulties (MESH:D051346)

## Figures

1 figure with captions in the complete paper: https://tomesphere.com/paper/PMC13025162/full.md

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Source: https://tomesphere.com/paper/PMC13025162