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Hitkashrut

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Evidence rating: 3+
Cost rating: 2

Hitkashrut is an Israeli programme targeting children between the ages of three and five with identified behavioural difficulties.

It is delivered in 14 sessions (2.5 hours' duration each) by Hitkashrut facilitators (trained psychologists) to small groups of parent couples.

It is a co-parent training programme designed to reshape parent-child interactions to reduce conduct problems. Sessions focus on parent-child and couple communication skills, behaviour management, discipline skills and parental self-regulation.

EIF Programme Assessment

Evidence rating: 3+
Level 3 indicates evidence of efficacy. This means the programme can be described as evidence-based: it has evidence from at least one rigorously conducted RCT or QED demonstrating a statistically significant positive impact on at least one child outcome. This programme does not receive a rating of 4 as it has not yet replicated its results in another rigorously conducted study, where at least one study indicates long-term impacts, and at least one uses measures independent of study participants.
Cost rating: 2
A rating of 2 indicates that a programme has a medium-low cost to set up and deliver, compared with other interventions reviewed by EIF. This is equivalent to an estimated unit cost of €125 - €599. This figure is based on an analysis of UK costs and a conversion rate of 1.19.

What does the plus mean?

The plus rating indicates that this programme has evidence from at least one level 3 study, along with evidence from other studies rated 2 or better.

Child outcomes

This programme can affect outcomes for children in Active and healthy, physical and mental wellbeing.

According to the best available evidence for this programme's impact, it can achieve the following positive outcomes for children:

Preventing crime, violence and antisocial behaviour

Improved conduct problems

based on study 1

  • Statement: 8.98-point improvement on the Eyberg Conduct Scale
  • Score: 28
  • Timeframe: Immediately after the intervention

Improved callous/unemotional traits

based on study 1

  • Statement: 4.05-point improvement on the Antisocial Process Screening Device
  • Score: 30
  • Timeframe: Immediately after the intervention

Improved effortful control

based on study 1

  • Statement: 0.39-point improvement on the Child Behavioural Questionnaire
  • Score: 18
  • Timeframe: Immediately after the intervention

This programme also has evidence of supporting positive outcomes for couples, parents or families that may be relevant to a commissioning decision. Please see About the evidence for more detail.

Who is it for?

The best available evidence for this programme relates to the following age-groups:

Preschool

How is it delivered?

The best available evidence for this programme relates to implementation through these delivery models:

  • Group

Where is it delivered?

The best available evidence for this programme relates to its implementation in these settings:

  • Children's centre or early-years setting

How is it targeted?

The best available evidence for this programme relates to its implementation as:

  • Targeted indicated

Where has it been implemented?

  • Israel

Ireland provision

This programme has not been implemented in Ireland.

Ireland evaluation

This programme’s best evidence does not include evaluation conducted in Ireland.

About the programme

What happens during the delivery?

How is it delivered?

  • Hitkashrut is delivered by two educational psychologists (QCF-7/8) to groups of seven parent couples.
  • Hitkashrut is delivered over 14 sessions, of 2.5 hours' duration each.

What happens during the intervention?

  • Sessions focus on parent-child and couple communication skills, behaviour management, discipline skills and parental self-regulation. Each session involves psycho-educational instruction, where facilitators model problematic and optimal behaviour with prepared role plays. This is followed by group discussion and parental role play. The session closes with a summary of take-home points, and the setting of a homework assignment.

What are the implementation requirements?

Who can deliver it?

  • Two practitioners deliver this programme. Both are educational psychologists with NFQ-9.


What are the training requirements?

  • The practitioners have 30 hours of programme training. Booster training of practitioners is recommended.

How are the practitioners supervised?

  • It is recommended that practitioners supervised by one programme developer supervisor (qualified to NFQ-9/10 level), and one host-agency supervisor (qualified to NFQ-7/8 level).


What are the systems for maintaining fidelity?


Is there a licensing requirement?

There is no licence required to run this programme.


How does it work? (Theory of Change)

How does it work?

  • Child behavioural problems are rooted in negative and coercive parent/child interactions.
  • During the course of Hitkashrut, parents learn effective positive parenting strategies relating to parent-child and couple communication skills, behaviour management, discipline skills and parental self-regulation.
  • In the short-term, Hitkashrut aims to improve effortful control (executive functions that enable the inhibition of dominant socially inappropriate responses and the activation of subdominant desirable responses) and callous unemotional traits (ie limited empathy and guilt, absence of concern, constricted emotionality).
  • In the longer-term, this will lead to reductions in conduct problems.

Intended outcomes


Contact details

Professor Yoel Elizur
School of Education
Hebrew University of Jerusalem
yoel.elizur@mail.huji.ac.il


About the evidence

Hitkashrut’s most rigorous evidence comes from an RCT which was conducted in Israel.  

This study identified statistically significant positive impact on a number of child and parent outcomes.

This programme is underpinned by one study with a Level 3, hence the programme receives a Level 3 rating overall.

Study 1

Citation:Somech, L. Y. & Elizur, Y. (2012)
Design:RCT
Country:Israel
Sample:209 parents with a preschool child identified with behavioural problems
Timing:Post-intervention; one-year follow-up
Child outcomes:
  • Improved conduct problems
  • Improved callous/unemotional traits
  • Improved effortful control
Other outcomes:
  • Decreased distress
  • Improved marital quality
  • Improved negative/inconsistent parenting
Study rating:3

Somech, L.Y., & Elizur, Y. (2012). Promoting self-regulation and cooperation in pre-kindergarten children with conduct problems: A randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 51, 412-22. 

Elizur, Y., Somech, L. Y., & Vinokur, A. D. (2016). Effects of Parent Training on Callous-Unemotional Traits, Effortful Control, and Conduct Problems: Mediation by Parenting. Journal of abnormal child psychology, 1-12.

Available at
http://www.sciencedirect.com/science/article/pii/S0890856712000883
http://link.springer.com/article/10.1007/s10802-016-0163-7

Study design and sample

The first study is a rigorously conducted RCT.  

This study involved random assignment of parents with a preschool child to a Hitkashrut treatment group and a low-dose control group.   

This study was conducted in Israel, with a sample of 209 families. The average age of children were 48.5 months. The majority (76%) of parents were born in Israel.

Measures

Child conduct problems were measured using the Eyberg Child Behaviour Inventory (parent report). Child callous/unemotional traits were measured using the preschool modification of the Antisocial Process Screening Device (parent report) and the preschool version of the Inventory of Callous-Unemotional Traits (parent report). Child effortful control was measured using the Child Behaviour Questionnaire (parent report). 

Parental distress was measured using the Parental Distress Index (parent report). Negative/inconsistent parenting was measured using the Alabama Parenting Questionnaire (parent report). Marital quality was measured using the Marital Quality Scale (parent report).

Findings

This study identified statistically significant positive impact on a number of child and parent outcomes.

Child outcomes include:

  • Improved conduct problems
  • Improved callous/unemotional traits
  • Improved effortful control
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