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Panel Presentation from the Evidence Based Parenting Programmes and Social Inclusion conference held at Middlesex University, 20th September 2012

Panel Presentation from the Evidence Based Parenting Programmes and Social Inclusion conference held at Middlesex University, 20th September 2012

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Triple P Panel Triple P Panel Presentation Transcript

  • Triple P-Positive Parenting Program® Dr Majella Murphy & Meave Darroux 1
  • Outline • Overview of the Triple P system – What is Triple P? – Case study • Overview of Triple P Provider Training – Training, Accreditation, Courses on offer • Questions
  • Why do we need parenting programs? A disturbingly large number of children develop significant social, behavioural and emotional problems that are preventable
  • No group has a monopoly on eithercoercive or positive parenting practices 100 90Percentage of parents 80 70 60 50 40 30 20 10 0 Threaten Shout Single spank Spank with object Inappopriate Strategy Low Lower Middle Upper Middle High
  • The case for a population basedapproach to supporting parents • Parenting has a pervasive impact on children’s development • Parenting programs benefit both children and parents • Potential impact is diminished because many programs reach relatively few parents
  • What is Triple P? • Flexible system of parenting and family support • Evidence-based • Prevention / early intervention approach • Five intervention levels of increasing intensity • Principle of sufficiency • Multidisciplinary focus
  • What makes Triple P different? • A public health model of parenting intervention • Suite of evidence based programs not a single program from infancy through to adolescence-5 levels, 4 delivery modalities • Blends universal and targeted programs • Uses self regulatory framework
  • Theoretical Basis of Triple P • Social learning models of parent-child interaction • Child and family behaviour therapy research • Developmental research on parenting in everyday contexts and social competence • Social information processing models • Developmental psychopathology research • Public/population health framework
  • Research evidence• Studies conducted on each intervention level and delivery format with consistent results – Fewer behavioural and emotional problems in children – Greater parental confidence and use of positive parenting – Less negative parenting, stress, depression, and anger – Less marital conflict over parenting• Independent replications of main findings across different sites, cultures and countries
  • Evidence with high need groups• Parents at risk of abuse (Sanders et al, 2004)• Depressed parents of children with conduct problems (Sanders & McFarland, 2000)• Parents who have separated or divorced (Stallman & Sanders, 2007)• Maritally discordant parents (Dadds, Schwartz & Sanders, 1987)• Parents of children with ADHD (Hoath & Sanders, 2004)• Parents of children with developmental disabilities (Plant & Sanders, 2007)• Parents of children with chronic illnesses (Morawska & Sanders, 2008)• Parents of children with feeding disorders (Sanders & Turner, 2000)• Parents of children with recurrent pain syndromes (Sanders et al, 1994)• Parents of gifted and talented children (Morawska & Sanders, 2007)
  • Current international trials • Belgium (University of Antwerp) • The Netherlands (Trimbos Institute) • Sweden (University of Uppsala) • Germany (University of Braunschweig) • Switzerland (University of Friborg) • Canada (University of Manitoba; UBC) • USA (Oregon Research Institute, USC) • England (University of Manchester, Oxford University, Cambridge University, University of Birmingham) • NZ (University of Auckland, University of Waikato, University of Canterbury) • Iran (Medical University of Tehran) • Japan (University of Tokyo, University of Wakayama) • Hong Kong (DOH)
  • Countries Disseminating Triple P Watch this space...... Australia Germany New Zealand Chile The Netherlands & BES Islands Canada France Belgium United States Portugal Switzerland Ireland Sweden Turkey Scotland Singapore Estonia England Japan Wales Panama Hong Kong Iran Austria Curacao Romania Luxembourg
  • Principles and Strategies underlying Triple P 13
  • Principles of positive parenting • Ensuring a safe, engaging environment • Creating a positive learning environment • Using assertive discipline • Having realistic expectations • Taking care of yourself as a parent
  • 17 Core Parenting Skills Promoting good Encouraging good relationships behaviour -Spending time with children - Praise - Talking to children -Attention - Affection -Interesting activities Managing misbehaviour Teaching new skills and behaviours - Ground rules - Directed discussion - Setting a good example - Planned ignoring - Incidental teaching - Clear, calm instructions - Ask-say-do - Logical consequences - Behaviour charts - Quiet time - Time-out
  • Triple P intervention levels 1. Universal Triple P Media-based parenting information campaign 2. Selected Triple P Information/advice for a specific parenting concern 3. Primary Care Triple P Narrow focus parenting skills training 4. Standard/Group/Self-Directed Triple P Broad focus parenting skills training 5. Enhanced Triple P Behavioural family intervention
  • The Triple P System
  • Level 4 Broad Focus Parent Training18
  • Level 4: Group Triple P • Groups of 10-12 parents • Active skills training in small groups • 8 session group program – 4 x 2 hour group sessions – 3 x 15-30 minute telephone sessions – Final group / telephone session options • Supportive environment • Normalise parenting experiences
  • Level 4: Standard Triple P • Broad focus parent skills training • Active skills training • Generalisation enhancement strategies • 10 sessions – Assessment and feedback – Causes of children’s behaviour problems – Positive parenting strategies – Practice – Planned activities for high-risk settings – Maintenance
  • Level 4: Self-Directed Triple P • Parent workbook • 10 week self-directed program – Set readings – Practice tasks • Optional telephone consultations – Minimal support – Prompt self-directed learning and problem solving
  • Benefits of broad focus interventions• Addresses complex child behaviour problems• Addresses child behaviour problems occurring in multiple settings e.g. home, school and public settings• Normalises parenting experiences• Referral of severe child behaviour problems to specialised services
  • Triple P Parallel Programs23
  • Program Variants
  • Teen Triple P • For parents of teenagers or children making the transition to high school • Program variants – Selected – Primary care – Group – Standard – Self-directed
  • Stepping Stones • For parents of children who have mild to moderate disabilities • All modalities are available including: – Primary Care – Group – Standard
  • Level 5 Intensive Family Intervention27
  • Level 5: Enhanced Triple P • Adjunct to other intervention levels • Review and feedback • Negotiation of additional modules tailored to family’s needs – Practice Module – Coping Skills Module – Partner Support Module • Maintenance and closure
  • Level 5: Enhanced Triple P Group Triple P plus Coping Skills Partner Support Module Module Practice Module
  • Level 5: Pathways Triple P • Extra Level 5 modules • For parents at risk of maltreating their children, parents with prior abuse notification, or parents with anger management problems • Attribution Retraining Module (re child’s and own behaviour) • Anger Management Module
  • Level 5: Pathways Triple P Group Triple P plus Attributional retraining Anger Management Explanations Explanations For child’s For own behaviour behaviour
  • Family Transitions Triple P • For parents and families experiencing separation and divorce • Variation of Group Triple P (5 additional sessions) • Personal adjustment following divorce • Strategies for – improving coping skills, reducing parenting stress anxiety, anger and depression, reducing conflict between parents & improving communication, promoting work, family, play balance and gaining appropriate social support • Helping parents develop independent problem solving skills
  • Lifestyle Triple P • For parents of overweight and obese children • Variation of Group Triple P (14 session program) • Strategies for – increasing self-esteem and reducing problem behaviour – promoting healthy eating – increase physical activity and reducing sedentary activities
  • Research update34
  • United States – Population trial • 18 counties – Triple P System – Comparison (services as usual) • Government records for maltreatment were monitored
  • Effect sizes in human terms • Assume a population with 100,000 children under 8 years of age • What we found ……. – 688 fewer substantiated cases of child maltreatment per year – 240 fewer child out-of-home placements per year – 60 fewer hospitalized or ER treated children with child-maltreatment injuries per year
  • Driving Mum and Dad MadResearch • 723 parents • Significant improvements in child behaviour, dysfunctional parenting, parental anger, depression and self-efficacy after watching the series • Improvements maintained at 6 months follow up • Parents who watched the entire series had more severe problems at pre and high socio- demographic risk • Media interventions may be engagement strategy for hard to reach families
  • Triple P in practice – Case Study An example of how 1-1 Triple P strategies were used within a child protection plan.
  • Triple P Provider Training & Accreditation
  • Triple P Provider Training Courses Completion of each of the following 5 steps is essential for the successful implementation of Triple P. • Attendance at a training course (Part 1) • Completion of set readings • Implementation of Triple P in the workplace including development of peer support networks. • Completion of accreditation requirements (Part 2) • Access to Triple P Provider Network (web based)
  • Accreditation Overview • 2 to 3 months after the initial training • Take Home Quiz • Expert feedback on core competencies • Details of accreditation are provided during each Triple P Provider Training Course.
  • Triple P Practitioner Resources • Each practitioner receives (eg Group Triple P): • Facilitator’s Kit for Group Triple P – Facilitator’s Manual for Group Triple P – PowerPoint Presentation CD – Copy of Every Parent’s Group Workbook. • Every Parent’s Survival Guide [DVD]
  • Triple P Resources for parents • Parent tip sheets • Parent workbooks • Practitioner manuals • Practitioner teaching aids (e.g., PowerPoint presentations, desktop flip chart) • DVD’s Parent Resources are essential for the successful implementation of Triple P. These resources are protected by copyright.
  • Triple P Pactitioners’ Networkwww.triplep.net The Practitioner Network provides: • Clinical tools e.g. Assessment measures, checklists and parent worksheets • Promotional materials e.g. Posters and brochures • Question and answer forum • Radio podcasts • Suggested reading lists and additional information
  • The differences between practitionersthat use Triple P and those that don’t Practitioners more likely to use if: • Have completed accreditation (Seng, Prinz & Sanders, 2006) • Have greater line management support (Turner, Nicholson & Sanders, 2005) • Identify fewer barriers to program implementation (Seng et al, 2006) • Have higher self efficacy post training (Turner et al, 2006)
  • Barriers to Usage Practitioners less likely to use if: • Insufficient knowledge and skills • Received a lack of recognition from colleagues for their Triple P work • Had difficulty coordinating with other practitioners • After hours appointments clash with other commitments
  • Questions?47
  • Further information • General Information www.triplep.net • Training queries (Triple P UK) Email: Jo Andreini (jo@triplep.uk.net) or Majella Murphy (majella@triplep.net) • Research (University of Queensland) www.pfsc.uq.edu.au/evidence Thank you for your time and attention!