Accentuating the positives with a Triple P

Concerns about children’s behavioral and emotional problems are common among Australian parents, and some of the strategies many parents say they use are as likely to aggravate any difficulties as to remedy them.

Only a minority pf parents seek professional help or participate in a parenting program, but their predicament amounts a significant public health problem and indicates a need for a coordinated, multilevel, whole population approach.

Triple P [1] – so called for being a Positive Parenting Program – is a multi-level parenting and family support strategy developed in Brisbane by the Parenting and Family Support Centre [2] at the University of Queensland.

It aims to prevent behavioral, emotional and developmental impairments in children by enhancing the knowledge, skills and confidence of parents.

Underpinning Triple P is the idea of promoting family-friendly environments. So it targets the everyday social contexts that influence parents, such as the mass media, primary health care services, preschool, child care and school systems, work-sites and religious networks and organisations.

The program is tailored to children at five developmental stages: infants, toddlers, preschoolers, primary schoolers and teenagers. Within each period the extent of the intervention can be very broad (targeting an entire population) or quite narrow (targeting only high-risk children). The intention is to be flexible and to enable practitioners to determine the scope of the intervention to reflect local conditions, priorities and funding.

By now there is sufficient evidence to be able to say with confidence that Triple P has an impact on child outcomes. For example, 29 randomized controlled trials have demonstrated its efficacy and effectiveness. The studies cover the various levels of intervention, modes of delivery and target populations.

Benefits are counted in terms of reduced developmental problems, such as persistent feeding difficulties and habit disorders, as well as reduced conduct and attention problems. At Triple P we pride ourselves in achieving these outcomes across risk groups, including among children of depressed parents and those from maritally discordant homes. The program appears to work with children in rural and remote areas where access to services is limited.

Perhaps the most exciting development has been the use of Triple P as a whole population strategy. Evaluations indicate the potential to reduce the prevalence of conduct problems in preschool aged children living in high-risk neighborhoods. Benefits are also apparent during the transition to school, and in reducing the risk of child abuse and neglect. Evidence is also beginning to show the cost benefit of using Triple P at a population level.

For the future the challenges include supporting Triple P as it becomes established practice outside Australia. Programs are running in Canada, Germany, Hong Kong, New Zealand, Singapore, Switzerland, UK and the US. Worldwide, over twenty thousand practitioners have been trained in Triple-P methods.

The Helping Families Change Conference in Braunschweig, Germany, next February will be an opportunity for Triple P researchers and practitioners worldwide to share ideas, present latest knowledge, contribute to debate, and engage in hands-on practice. Now in its 10th year, the conference will be hosted by the Institute of Clinical Psychology, Psychotherapy and Assessment at the Technische Universität in Braunschweig.