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Overview

Delivered To: 

  • Parents/Carers

Components: 

  • Component 3 : Working with parents and carers
  • Component 4 : Helping children with mental health difficulties

Issues: 

  • Emotional and Behavioural difficulties
  • Parenting education
  • Internalising and externalising

Special Student Group: 

  • Culturally/Linguistically diverse
  • Special needs (disability in learning, intellect, physical etc)

Overview: 

Target groups:
Primary Care Triple P (Level 3)
Parents with a specific concern/s about their child’s behaviour or development who require consultations or active skills training.

Group Triple P, Standard Triple P, Self-Directed Triple P (Level 4)
Parents wanting intensive training in positive parenting skills. Typically parents of children with more severe behaviour problems such as aggressive or oppositional behaviour.

Enhanced Triple P (Level 5)
Parents of children with concurrent child behaviour problems and family dysfunction such as parental depression or stress or conflict between partners.

Pathways Triple P
Parents at risk of maltreating their children. Targets anger management problems and other factors associated with abuse.

Stepping Stones Triple P
Families of children with disabilities who have or are at risk of developing behavioural or emotional disorders.

Designed for, or demonstrated applicability to, special groups:
Various Triple P intervention levels and delivery modalities have been evaluated with culturally and ethnically diverse populations. Stepping Stones Triple P was designed for families of children with special needs. Pathways Triple P was developed for families at risk for abuse and neglect. There also exists an Indigenous Triple P, which was specifically designed for Indigenous communities.

Aims: 

Triple P is a multilevel, evidence-based parenting and family support strategy designed to prevent behavioural, emotional and developmental problems in children (or halt their progression and reduce their severity) and provide support for parents and families. The Triple P system aims to help parents develop a safe, nurturing environment and promote positive, caring relationships with their children, and to develop effective, non-violent strategies for promoting children’s development and dealing with common childhood behaviour problems and developmental issues.

In addition to the primary aim of improving parenting skills, Triple P aims to promote parents’ confidence in their parenting and reduce parents’ stress. For two-parent families, Triple P also aims to improve couples’ communication and consistency (or teamwork) in relation to parenting. As such, it aims to both reduce known risk factors for conduct problems and increase protective factors.

Specific aims of the program are:

  • To promote the development of non-violent, protective and nurturing environments for children
  • To promote the resourcefulness and self-sufficiency of families by enhancing parents’ knowledge, skills and confidence in raising their children
  • To promote the development, health and social competencies of children and young people
  • To reduce the community incidence of child abuse, mental illness, behaviour problems, delinquency and homelessness
Implementation/Delivery

Details: 

Triple P interventions range from universal mass media information campaigns and brief primary care consultations targeting mild behaviour problems to intensive parent training and family intervention programs for families with multiple risk factors or children with severe conduct problems.

Primary Care Triple P
Brief consultation framework combining advice, rehearsal and self-evaluation to teach parents to manage a discrete child problem behaviour or develop a specific parenting plan.

Group, Standard, Self-Directed Triple P
Broad focus program focusing on parent-child interaction and the application of parenting skills to a broad range of target behaviours, and the use of generalisation-enhancement strategies to promote parental autonomy. Incorporates session activities and homework tasks covering causes of children’s behaviour problems; strategies for promoting positive family relationships and encouraging children’s development; strategies for managing misbehaviour; and generalisation enhancement. May involve group sessions with individual telephone consultations (Group Triple P), individual sessions (Standard Triple P), or be self-directed with or without telephone support (Self-Directed Triple P).

Enhanced Triple P
Designed to follow on from Standard, Group or Self-Directed Triple P, this is an intensive, individually tailored program for families with child behaviour problems and family dysfunction. Program modules include practice sessions to enhance parenting skills, mood management strategies and stress coping skills, and partner support skills.

Pathways Triple P
An adjunctive intervention strategy for parents at risk of child maltreatment used in combination with other Triple P interventions. Intervention modules focus on parental anger and attribution retraining.

Stepping Stones Triple P
An early intervention strategy for families of children with disabilities who currently have or are at risk of developing behavioural and emotional disorders. It is particularly useful for families who also have difficulty adjusting to their child’s disability. The program is parallel to Standard Triple P and includes parent training with additional strategies drawn from disability research.

Program Structure / Methods of Delivery: 

Primary Care Triple P
A brief 3-4 session selective intervention designed for use in primary care settings when problems are first identified (sessions last 15-30 minutes). Consultations combine advice and active skills training to help parents acquire new knowledge and skills, and take-home resources such as parent tip sheets.

Group
Parent groups of 10-12 people, that involve four 2-hour group sessions, followed by three 15-30 minute telephone calls, addressing each person’s individual progress, and a final group session. Sessions are usually conducted once per week. Group sessions include video and live demonstrations and active group participation. Telephone sessions involve personal goal setting and self-evaluation.

Standard
A 10-session parenting skills program delivered in individual sessions. Sessions typically last 60 minutes each (with the exception of three practice sessions which should last 40 minutes each). In-session behavioural rehearsal and dedicated practice sessions provide opportunities for parents to practice and review their use of positive parenting skills.

Self-Directed Triple P
A self-help workbook guides parents through a 10-week series of reading and practice tasks covering the same content as Standard Triple P. Additional recommended resource materials are also listed for each week of the program. Designed for families in rural or remote areas and families wanting a self-help program that they can work through at home. Telephone consultations may be included to support personal goal setting and self-evaluation.

Enhanced Triple P
This 5-11 session adjunctive program includes a review interview, three optional therapy modules (Practice, Coping Skills and Partner Support), and a closure session that aims to promote maintenance of treatment gains. The modules are used to tailor the intervention to the family’s needs. Each module is generally conducted in a maximum of three sessions lasting up to 90 minutes each (with the exception of practice sessions which should last 40 minutes each).

Pathways Triple P
A 4-5 session intervention strategy for parents at risk of child maltreatment, used in combination with either Triple P interventions. There are two additional intervention modules (2 sessions each) focusing on coping with anger and avoiding parent traps (attribution retraining), and a closure session that aims to promote maintenance of treatment gains.

Stepping Stones Triple P
The program has been designed to be completed in 10 sessions, but may take considerably less or more time depending on the needs of individual families. Sessions typically last 60-90 minutes each (with the exception of the three practice sessions which should last about 40 minutes each).

Staff professional learning (PL):
Generally, Triple P Provider Training Courses are offered only to professional practitioners, post-secondary school qualifications are required in the Health, Education, and Social Services.

Primary Care Triple P
(2 days training + 1 day accreditation)
This level of training is relevant to practitioners who regularly offer advice and support to parents during brief consultations carried out in the course of providing routine well-child health surveillance and care. This course is recommended for maternal and child health nurses, community health nurses, general practitioners, preschool field officers, childcare workers, teachers, children’s services advisers and allied health professionals. Training provides an overview of common developmental and behavioural problems in children, strategies for promoting children’s competence and positive approaches to behaviour management. In addition, participants will receive active skills training for the consultation skills required to deliver brief, effective, time-limited interventions. No prerequisites apply.

Group Triple P
(3 days training + 1 day accreditation)

Practitioner training for delivery of Group Triple P is recommended for psychologists, family counsellors, social workers, parent educators, nurses and other allied health professionals who have the capacity to organise and deliver an active skills training program in group format to parents. This course provides training in the delivery of behavioural family intervention in a group format and includes suggestions for managing group processes. No prerequisites apply.

Standard Triple P
(3 days training + 1 day accreditation)

This training course is recommended for professionals offering intensive parenting interventions such as psychologists, psychiatrists, social workers, family counsellors, school guidance officers and behaviour management teachers and other allied health professionals who in the course of their duties regularly consult with parents about child behaviour. This course provides participants with a rationale and background to conduct behavioural intervention in families, together with techniques and materials for assisting parents to successfully respond to a broad range of childhood behaviour problems. No prerequisites apply.

Enhanced Triple P
(2 days training and 1 day accreditation – following completion of Level 4 training)

This training course has been developed for practitioners involved in intensive family intervention work. It is recommended for professionals with appropriate mental health qualifications and experience in family intervention, such as psychologists, psychiatrists, social workers and family counsellors. This training builds on material presented in Standard Triple P training. It involves training in the assessment and treatment of multi-problem families, and in the skills required to provide intensive intervention tailored to address the individual needs of these families. Specifically, training is provided for implementation of partner support, mood management and stress coping skills interventions with parents. Completion of Standard Triple P or Stepping Stones Triple P is a prerequisite.

Pathways Triple P
(2 days training + 1 day accreditation – following completion of Level 4 training)

Training to deliver this intervention is recommended for professionals who in the course of their duties regularly consult with parents at risk of maltreating their children, and have the capacity to deliver an extended group program. This training course extends understanding of parent training with parents at risk for child maltreatment and the factors associated with abuse, and includes components addressing risk factors commonly encountered with maltreating parents, such as anger control problems. Completion of Group or Standard Triple P training is a prerequisite.

Stepping Stones
(3 days training + 1 day accreditation)

This training course is recommended for psychologists, psychiatrists, social workers, family counsellors, school guidance officers and behaviour management teachers, and other allied health professionals who in the course of their duties regularly consult with parents about child behaviour. This professional training course provides participants with a rationale and background information to conduct behavioural intervention in families of children who have a disability. No prerequisites apply.

Cost: 

Triple P resources include standardised training materials, practitioner manuals and audiovisual aids (e.g. video/DVDs, flip charts, wall charts and Microsoft PowerPoint presentations) and parent resources (e.g. workbooks and tip sheets) to ensure that the program is standardised, easy to follow, accessible, and culturally sensitive. For information regarding the cost of the various Triple P resources, see http://www.triplep.net.

Program Specific Audience: 

KMP

No. of Sessions: 

21

Professional Learning: 

  • Restricted Professional Learning Available

Professional Learning Compulsory: 

Yes

Formal Parent/Carer Component Provided: 

Yes
Evidence of Effectiveness

Evidence of Effectiveness Rating: 

4

Evidence of Effectiveness Description: 

(According to criteria developed by CASEL for rating program effectiveness.) Multiple studies document positive behavioural outcomes at post-test, with at least one study indicating positive behavioural impacts at follow-up at least one year after the intervention ended.

Identified Theoretical Framework: 

Yes

Identified Theoretical Framework Description: 

The Triple P system of parenting and family support involves a behavioural family intervention approach that aims to promote social competence and prevent severe behavioural and emotional disturbances in children. The system draws on social learning models that highlight the reciprocal nature of parent-child interactions, and incorporates many successful behaviour change techniques identified through research in child and family behaviour therapy. In its population approach, the Triple P model also draws on public health research on changing health risk behaviours that has been applied within a mental health framework.

The Triple P system is based on the principle of sufficiency. For parents concerned about their parenting skills or child’s behaviour, there are differences in the severity of problems experienced, breadth of knowledge, motivation, access to support and additional family stresses (e.g. substance abuse, financial difficulties). The Triple P model assumes that any one family intervention program is unlikely to cater for the requirements of all parents, therefore differing levels of support are offered. Consequently, Triple P allows the strength of the intervention to be tailored to the assessed needs and preferences of individual families.

The program is based on self-regulation. The goals are for children to develop emotional self-regulation and for parents to become resourceful, independent problem-solvers. As families determine their own particular goals, the program is tailored to suit their aspirations. Practitioners consult and guide through active skills training. Parents decide what they wish to take on.

Survey/Audit Tools Available: 

No

References: 

Primary Care Triple P
Turner, K. M. T., & Sanders, M. R. (2006). Help when it’s needed first: A controlled evaluation of brief, preventive behavioral family intervention in a primary care setting. Behavior Therapy, 37, 131-142.

Group Triple P
McTaggart, P., & Sanders, M. R. (2003). The Transition to School Project: Results from the classroom. Australian e-Journal for the Advancement of Mental Health, 2. Zubrick, S. R., Ward, K. A., Silburn, S.R., Lawrence, D., Williams, A. A., Blair, E., et al. (2005). Prevention of child behavior problems through universal implementation of a group behavioral family intervention. Prevention Science, 6, 287-304.

Self-Directed Triple P
Markie-Dadds, C., & Sanders, M. R. (2006). A controlled evaluation of an enhanced self-directed behavioural family intervention for parents of children with conduct problems in rural and remote areas. Behaviour Change, 23, 1-16.

Markie-Dadds, C., & Sanders, M. R. (2006) Self-directed Triple P (Positive Parenting Program) for mothers with children at-risk of developing conduct problems. Behavioural and Cognitive Psychotherapy, 34, 259-275.

Standard and Enhanced Triple P
Bor, W., Sanders, M. R., & Markie-Dadds, C. (2002). The effects of the Triple P-Positive Parenting Program on preschool children with disruptive behavior and attentional problems. Journal of Abnormal Child Psychology, 30, 571-587.

Sanders, M. R., Markie-Dadds, C., Tully, L., & Bor, W. (2000). The Triple P- Positive Parenting Program: A comparison of enhanced, standard, and self directed behavioral family intervention for parents of children with early onset conduct problems. Journal of Consulting and Clinical Psychology, 68, 624-640.

Pathways Triple P
Sanders, M. R., Pidgeon, A., Gravestock, F., Connors, M. D., Brown, S., & Young, R. (2004). Does parental attributional retraining and anger management enhance the effects of the Triple P- Positive Parenting Program with parents at-risk of child maltreatment? Behaviour Therapy, 35, 513-535.

Stepping Stones Triple P
Roberts, C., Mazzucchelli, T., Studman, L., & Sanders, M. R. (2006). A randomized control trial of behavioral family intervention for young children with developmental and behavioral problems. Journal of Clinical Child and Adolescent Psychology, 35, 180-193

Author(s)/Contacts

Author(s): 

Matthew R. Sanders, Karen M. T. Turner, Carol Markie-Dadds, Aileen Pidgeon, Trevor Mazzucchelli and Lisa J. Studman

About the Author(s): 

Matthew R. Sanders PhD is a Professor of Clinical Psychology and Director of the Parenting and Family Support Centre at The University of Queensland. Over the past 25 years Matt has gained an international reputation for his scientific research into childhood behaviour problems and family interaction. He has written numerous books and scientific articles on parenting, family psychology and prevention of psychopathology in children and adolescents. He is the author of the popular parenting book, Every Parent: A Positive Approach to Children’s Behaviour. He is past National President of the Australian Association of Cognitive Behaviour Therapy, and has received a distinguished career award from this association. He is also a Fellow of the American Academy of Experimental Criminology. He is an experienced media broadcaster and a spokesperson for the Australian Psychological Society on child and family matters.

Karen Turner PhD is Deputy Director of the Parenting and Family Support Centre. She is a clinical psychologist and research academic and has had a major role in the development of Triple P resources and materials for practitioners and parents. Her work has involved consultancy projects for state and federal government departments. She has extensive clinical and research experience relating to the prevention and treatment of a variety of childhood behavioural and emotional problems, including work with Indigenous populations, feeding disorders, pain syndromes and conduct problems. Her research has also focused on the development and evaluation of brief primary care interventions and the subsequent dissemination of these interventions to the professional community.

Carol Markie-Dadds has a Masters degree in Clinical Psychology from The University of Queensland. She is currently Assistant Director, Education Futures within the Queensland Department of Education and the Arts. She has specialist experience in the field of prevention of conduct problems in children. She has also served as a consultant to state governments in the implementation of evidence-based parenting programs in child health services.

Aileen Pidgeon is a clinical psychologist who provides supervision to telephone counsellors at Kids Helpline, a national telephone counselling service for children and youth. She conducted her PhD research on the effects of attribution retraining with parents presenting with anger control problems. She has previously worked as an Early Intervention Specialist with Queensland Health and has interests in the prevention of behavioural and emotional problems in children and youth.

Trevor Mazzucchelli is a Specialist Clinical Psychologist at Disability Services Commission in Western Australia. He has a Masters degree in Clinical Psychology from the University of Western Australia. His work involves developing resource materials for Stepping Stones Triple P, providing consultative advice to other health professionals, and providing services to families who have a child with a disability. He has specialist clinical and research experience in working with families of children with behavioural and emotional problems.

Lisa Studman is a Developmental Psychologist with a Masters degree in Developmental Psychology from the University of Western Australia. Lisa works as a Developmental Psychologist for the Disability Services Commission. She serves on the Australian Psychological Society’s WA College of Educational and Developmental Psychologists. Her work involves developing resource materials and providing interventions to multi-stressed families who have a child with a disability.

Contact Information: 

Triple P International
PO Box 1300
Milton, QLD. 4064
Phone: (07) 3236 1212
Fax: (07) 3236 1211
Email: info@triplep.net
Website: http://www.triplep.net

Website: 

http://www.triplep-parenting.net.au/au-uken/get-started/triple-p-courses-for-parents-of-children-birth-12-years/