Sara van Driel, PhD - Helping Families...
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Design: Triple P Communications 2011 © Copyright University of Queensland 2011 Sara van Driel, PhD US Program Dissemination Specialist Triple P America
Transcript of Sara van Driel, PhD - Helping Families...
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© Copyright University of Queensland 2011
Sara van Driel, PhD
US Program Dissemination Specialist
Triple P America
Agenda
The Problem
Triple P System overview
• What is Triple P?
• How was it developed?
• What are the different levels of Triple P intervention?
• What outcomes can be expected?
• Who benefits from Triple P?
• Is Triple P effective across cultures?
• Why the public health approach?
The Triple P Implementation Framework
The current state of Triple P in the US
Meet Thomas
Slide no.2
Significance of the Problem
Percentage of children with emotional or behavioral problems
10-12%
1. Sawyer, M. G., Arney, F. M., Baghurst, P. A., Clark, J. J., Graetz, B. W., Kosky, R. J., Nurcombe, B., Patton, G. C., Prior, M. R., Raphael, B., Rey, J., Whaites, L. C., & Zubrick, S. R. (2000).
The mental health of young people in Australia. Canberra, ACT, Australia: Mental Health and Special Programs Branch, Commonwealth Department of Health and Aged Care.
2. NSW Department of Health (2001). New South Wales Child Health Survey 2001. Sydney, NSW, Australia: Epidemiology and Surveillance Branch, NSW Department of Health
3. Zubrick, S.R., Silburn, S.R., Garton, A., Burton, P., Dalby, R., Carlton, J., Sheperd, C., & Lawrence, D. (1995). Western Australia Child Health Survey: developing health and well-being in the
nineties. Perth, WA: Australian Bureau of Statistics and the Institute for Child Health Research.
Domains of Parenting Influence
Influences
key risk and
protective
factors Language,
communication
Coping with
adversity and
life transitions
Physical health
and well being
Social skills and
peer
relationships
School
achievement
Emotion
regulation
Sustained
attention and
problem solving
Reduced social, emotional and health problems
What is Triple P?
A coordinated system of programs
Multi-level programs of increasing intensity
Content for developmental periods of infancy through
adolescence
A public health model of parent education and support
Aim is to: • Promote children’s healthy development • Prevent children’s social, emotional and behavioral problems • Prevent child maltreatment • Strengthen parenting at a population level • Destigmatize seeking information and support
30+ years of research
Timeline for the Development of Triple P
Research started in 1979 • Clinical research operation based at UQ • Developed and trialled procedures in dealing with behavior problems of children 0-12 years
Limited impact on professional practice
Accessed only by parents in clinical trials
By 1994 clinical trials of core program completed
Establishment of Parenting & Family Support Centre
From 1996 -1999 established a system of training and dissemination to move from clinical research to a small operation to train health professionals
In 2000 Triple P International was created and licensed by UQ to roll out the Triple P System worldwide
Triple P: International dissemination
1996 onwards… 60,000+ training places
Australia
New Zealand
Canada
United States
United Kingdom −England
−Scotland
−Wales
Ireland
Germany
France
Luxembourg
Belgium
Sweden
Austria
Switzerland
Romania
The Netherlands
Caribbean Netherlands (BES Islands)
Curacao
Chile
Iran
Singapore
Hong Kong
Watch this space......
Greece
Portugal
Turkey
Estonia
Panama
20+ Countries
Japan
Aruba
What outcomes can you expect using Triple P?
The evidence consistently shows impact on:
• Increased positive parenting
• Reduced coercive parenting
• Lower social, emotional and behavior problems
• Improved parent-child relations
• Decreased parent stress
US Triple P System Population Trial
Prevention of child/family problems
Standardized prevention rates per 100,000 children
ages 0-8 yrs.
• 240 fewer out of home placements/year
- Triple P counties 16% lower than comparison counties
• 60 fewer hospitalizations/ER visits for child
maltreatment injuries/year
- Triple P counties 17% lower than comparison counties
• 688 fewer substantiated child abuse cases/year
- Triple P counties 22% lower than comparison counties
Prinz, R. J., Sanders, M. : R., Shapiro, C. J., Whitaker, D. J., & Lutzker, J. R. (2009). Population--based prevention of child maltreatment: The U.S.
Triple P System Population Trial. Prevention Science,10(1), 1-12..
Triple P and culturally diverse populations
Evaluations have been conducted
• in many culturally, racially and linguistically diverse contexts
• with many different family types (e.g. two-parent, single-
parent, and stepparent) and with diverse socio-economic
status groups.
Partial availability of parent resources in at least 16
languages
Studies show parents across cultures share many
of the same challenges and value many of the
same approaches in raising children.
Practitioners report high client satisfaction and
acceptability in all populations
How do individual practitioners or communities know they
are successful?
Built-in assessment framework
• Pre/Post Measures
• Family Demographics
• Parent Satisfaction
• Session Checklists
May also choose to monitor community
outcomes
• Population rates of potential outcomes (e.g.,
child maltreatment rates)
• Community collaboration
Theoretical Basis of Triple P
Social learning models of parent-child
interaction
Child and family behavior therapy research
Developmental research on parenting in
everyday contexts and social competence
Social information processing models
Developmental psychopathology research
Public/population health framework
Public Health Approach
Unit of interest is the population rather than the
individual
Aim is to change population prevalence rates
(i.e., decrease rates of heart disease, increase
vehicle motor safety, or reduce child
maltreatment rates)
Requires a multi-faceted strategy aimed at
impacting an entire population
• Media and awareness
• Educating professionals about prevention
• Early detection and intervention
Principles of positive parenting
• Ensuring a safe, interesting environment
• Creating a positive learning environment
• Using assertive discipline
• Having realistic expectations
• Taking care of yourself as a parent
Guiding themes
present in all
interventions
17 Core
Parenting
Skills
Age Appropriate Interventions (0-16 yrs)
Babies | Toddlers | Pre-K | K | Primary | Teens
17 Specific Parenting Skills for 0-12 Year Olds
Promoting a
Positive
Relationship
• Brief quality time
• Talking to children
• Affection
Teaching New Skills
and Behaviors
• Modeling
• Incidental teaching
• ASK, SAY, DO
• Behavior charts
Encouraging Desirable
Behavior
• Praise
• Positive attention
• Engaging activities
Managing Misbehavior
• Ground rules
• Directed discussion
• Planned ignoring
• Clear, calm instructions
• Logical consequences
• Quiet time
• Time out
Specific
skills
Some key flexibilities of the Triple P approach …
Use of strength-based self-regulatory framework Parents determine the goals Practitioners use examples that are relevant to the
family A menu of parenting strategies Practitioner helps the parent to make informed
choices
Triple P System
Level 5
Level 4
Level 3
Level 2
Level 1
Intensive family Intervention………................
Broad focused parenting skills training………...
Narrow focus parenting skills training………….
Brief parenting advice……………………………
Media and communication strategy…………….
Breadth of reach
Inte
nsity
of in
terv
entio
n
Level 1: Universal Triple P
A media strategy to reach out
to families, normalize the
concept of seeking help, and
make them aware of Triple P
assistance • Television and Radio clips
• Parenting articles and other print
resources
Stay Positive - a tailored
communications campaign
• Website with syndicated and local
content to generate referrals or
publicize events
• Brochures, flyers, posters, etc.
Level 2 – Selected Triple P
A ‘light touch’ intervention approach
Selected Seminars
• 1½-2 hour seminars for large groups of parents
• General guidance provided for promoting a child’s healthy
development and well-being
Brief Primary Care
• 1-2 brief (20 minutes), individual face-to-face and/or phone
contacts
• Specific guidance provided on 1-2 common
concerns
Parenting Seminars
Three 90-minute presentations at each age level
0-12 years
The Power of Positive Parenting
Raising Confident, Competent Children
Raising Resilient Children
12-16 years
Raising Responsible Teenagers
Raising Competent Teenagers
Getting Teenagers Connected
Functions as information session and promotes
engagement at more intensive levels
Provision of parenting tip sheets summarising
content of each seminar
Triple P Seminar Series Tipsheets
Level 3 – Primary Care Triple P and
Discussion Groups
Primary Care
• Brief, flexible parent consultation targeting
families of children with mild to moderate
behavioral difficulties.
• Typically provided to parents in 4 individual
sessions (15-30 minutes in duration)
• Includes active skills training for parents
Discussion Groups
• Presentation of tips for parents around a common concern (e.g.,
disobedience, going shopping with a preschooler)
• Delivered in one 2-hour session to small groups of parents (8-12)
• Parents develop their own tailored plan for future management of
the concern
• Possible follow-up with parents via telephone
Primary Care Group Triple P
Parent Discussion Groups
Hassle Free Shopping
Fighting and aggression
Disobedience Bedtime
Problems
Level 4 – Standard and Group Triple P
A moderately intensive parent program for moderate
to severe behavioral or emotional difficulties
Can also be used as a primary prevention strategy to
promote positive development
Multiple formats of delivery
• Standard - 10 individual sessions
• Group - 8 sessions (5 sessions of 2 hours each and 3
individual phone consultations for each participating family)
• Online – 8 modules accessed via the web
• Self-Directed – self-help workbook
Level 5 – Enhanced Triple P
An intensive individually-tailored program (3-11
sessions) for families with child behavioral
problems and family dysfunction
Used in combination with either Standard or Group
Triple P
Primary program modules:
• Coping Skills (stress management)
• Partner Support
Level 5 – Pathways Triple P
4-session intensive intervention strategy for parents
at risk of child maltreatment
Used in combination with either Standard or Group
Triple P
Addresses parental anger and parent explanations
for their children’s behavior as well as their own
behavior
Primary program modules:
• Avoiding Parent Traps (attributional biases)
• Coping with Anger (anger management)
Level 5 Family Transitions
Cognitive-behavioral family intervention
Delivered to parents who are experiencing personal
distress from separation or divorce, which is
impacting or complicating the task of parenting.
• 5 group or individual sessions
• Provided in conjunction with Level 4 Triple P
- Typically delivered prior to beginning Level 4
Slide no.28
Level 5 Group Lifestyle
Family intervention strategy to help manage
children’s weight-related behavior.
Delivered to parents of overweight or obese children
aged 5 to 10 years, over a minimum of 14 weeks.
• 10 (1½ hour) group sessions - educate and actively
train skills related to nutrition, physical activity and
positive parenting
• 4 (15 to 30 minute) individual telephone
consultations that follow a self-regulatory format to
facilitate individual family goal-setting and progress
monitoring.
Slide no.29
Adaptability through flexible delivery formats
Delivery formats
Individual
Web
Self directed
TV
series
Phone
Small Group
Large group
Adaptability through tailored variants for different parents
Core Triple P
Program
Indigenous Triple P
Lifestyle Triple P
Workplace Triple P
Teen
Triple P Stepping Stones Triple P
Pathways
Triple P
Baby
Triple P
Family Transitions
Triple P
Slide no.32
Triple P Implementation Framework
Triple P in the US: Where?
AK
MT
WY
ID
WA
OR
NV
UT CA
AZ
ND
SD
NE
CO
NM
TX
OK
KS
AR
LA
MO
IA
MN
WI
IL IN
KY
TN
MS AL GA
FL
SC
NC
VA WV
OH
MI
NY
PA
MD DE
NJ
CT RI
MA
ME
VT
NH
HI
Triple P in the US: Who?
Variety of agencies
• E.g., medical practices, health departments,
mental health agencies, childcare centers,
schools, juvenile justice, military, libraries,
churches, drug and alcohol treatment centers
Over 8000 practitioners trained
Slide no.34
Sara van Driel, PhD
US Program Dissemination Specialist
Thank you
Head Office Address: 1201 Lincoln Street, Suite 201, Columbia, South Carolina 29201 Postal Address: PO Box 12755, Columbia, SC 29211 Phone: (803) 451.2278 | Fax: (803) 451.2277 | www.triplep.net
