Core Components

The Triple P – Positive Parenting Program® is a parenting and family support system designed to prevent and treat behaviour and emotional problems in children and teenagers. All programmes in the system take a self-regulatory approach that encourages practitioners, parents and children to promote independent problem solving. The Triple P System also takes a minimal sufficiency approach, offering families just the amount of support they require.

The Triple P System has five levels of intervention each increasing in intensity and directed towards a different level of family need or dysfunction. The levels range from level 1 which takes a universal approach, to level 5 interventions which include programmes which offer intensive family support or families with complex concerns.

Stepping Stones Triple P forms part of the Triple P – Positive Parenting Program® system and includes adaptations for children who have a disability. Group Stepping Stones Triple P is a Level 4 intensive intervention, this level focuses on families whose children have a disability who have or are at risk of developing problem behaviours. Practitioners offer 6 (2½ hrs) group sessions followed by 3 (15-30 minute) telephone consultations with a final wrap up group session for parents only with up to 12 participants. During these sessions’ parents are educated and actively trained and supported in between sessions to assist parents to refine the use of their parenting skills and to develop independent problem-solving skills. Group Stepping Stones Triple P sessions covers positive parenting, developing good relationships, promoting children’s development, teaching new skills and behaviours, managing misbehaviour and parenting routines, planning ahead, implementing parenting routines and a program close to review progress and look at ways to maintain changes.

Group Stepping Stones Triple P is well operationalised, each practitioner receives a facilitator's manual that  provides comprehensive guidance around what should be covered in each session. It also gives clear guidance about which strategies are recommended across the different ages.  Parents receive a workbook, which describes the information and strategies presented during the sessions and includes homework tasks.

Fidelity

Triple P – Positive Parenting Program® has 3 main fidelity checks / quality assurance strategies for all the programmes delivered in-person:

• Accreditation of practitioners undertaken as part of a provider training course. Intended to establish a baseline of competence for all practitioners.
• Session Checklists are provided for every session in the programme manual.
• Peer Support Networks – Triple P has a Peer Assisted Supervision and Support (PASS) model which is a self-regulatory framework for practitioners where they can support each other’s skills development. The PASS model is covered in the training days.

Modifiable Components

Triple P practitioners can tailor the intervention to meet the needs of individual parents, while maintaining adherence to the overall principles and content of the programmes, appropriate adaptions are covered during training.

Group Stepping Stones Triple P should be adjusted for parents who have an intellectual disability for example a support worker attending each session to assist parents in completing exercises and transfer ideas to their home.

Training in Triple P has been delivered in 30 countries and written and audio-visual materials have been translated from English, dubbed or subtitled into 21 languages, with videoclips and workbooks including images of diverse ethnicities. Practitioners can tailor the intervention, so it is culturally acceptable, such as using culturally familiar terminology and examples.

Triple P consultants can offer support to implementing services to consider appropriate adaptions.

 

Triple P – Positive Parenting Program® was developed in Queensland, Australia. Training and implementation has been delivered across 30 countries. Within the United Kingdom training and implementation support can be accessed from Triple P UK.

Support for Organisation / Practice

Implementation Support

Triple P UK has structured implementation supports available to sites. All implementation supports are flexible and tailored to the site’s requirements and are available for all programmes in the Triple P system. Triple P have developed a framework for implementation, it has five phases and are all described in detail in the Triple P Implementation Framework (TPIF). Triple P UK also has Implementation Consultants (IC) available to support new sites work through the phases of implementation. The 5 phases of implementation supported by Triple P are detailed below:

• Engagement – ICs share information about the Triple P system and work with key contacts to establish if there is a potential fit.
• Commitment and Contracting – ICs work with the organisation to help establish more detailed plans and goals, choose suitable Triple P programme variants, set up implementation support and communications strategies, and together agree on mutual commitments.
• Implementation Planning – ICs help support development of detailed plans for service delivery, communications, training and accreditation, and evaluation for the organisation’s outcomes, based on their readiness and capacity.
• Training and Accreditation – ICs work with key contacts to ensure there are enough trained practitioners to offer the planned Triple P services. This includes ensuring practitioners are prepared for training, have a high-quality experience of training, and have time after training to work on their skills and prepare for and complete their accreditation.
• Implementation and Maintenance – The goal of this phase is to ensure that Triple P is effectively delivered, that there is an active evaluation process from which feedback is provided to practitioners and leadership, that practitioners are getting the most out of Triple P peer support networks, and strategies are in place to support sustainable, effective delivery.

After training, practitioners can access the Triple P Provider Network which has resources such as questionnaires and monitoring forms, further information for learning and development of competencies and access to the Automatic Scoring and Reporting Application (ASRA). Using the ASRA tool, sites can score questionnaires, analyse and compare individual cases and outcomes, enabling reporting and evaluation of the programme’s effectiveness.

Additional implementation support options are available from Triple P UK. These include:

- Triple P Briefing
- Support to Managers and Coordinators
- Strategic Project Consultation
- Support for Practitioners

Licence Requirements

No licence is required.

Start-up Costs

Costs can be provided directly from Triple P UK for training groups of staff from 12–20 practitioners or individual open enrolment training.

Costs that need to be considered are the training course, programme resources for working with parents and children, and any additional implementation supports required. Certain locations will require additional costs of trainer travel and accommodation.

Building Staff Competency

Qualifications Required

Triple P UK recommends that for all programmes, practitioners have a post-high school qualification in health, education, early childhood education, or social services. However, para-professionals who actively work with families may also be suitable for training.

Triple P UK note that professionals who usually undertake the course are those who may be involved in support for the client and are able to provide focused therapeutic interventions, including teachers, school counsellors, nurses, health visitors, family physicians and allied health professionals. Triple P UK suggest that the intervention is carried out by a professional in the course of providing routine care for families.

Training Requirements

Practitioners are required to attend three days of training. This is followed by a one day pre-accreditation and a half day accreditation workshop. Prior to the accreditation session practitioners need to complete a quiz and competency preparation. In total it is estimated that training and accreditation should take six days of practitioner time.

Organisations can host agency training at a time and location convenient to them or alternatively individual practitioners can apply for open enrolment training held remotely (video conference) through the UK open enrolment timetable.

Supervision Requirements

No official supervision requirements are detailed by Triple P UK. However, they do have a professional development and peer support model; Peer Assisted Supervision and Support (PASS). This approach brings together Triple P practitioners to support one another to strengthen and refine their Triple P delivery.

Theory of Change

The Triple P system aims to enhance family protective factors and reduce risk factors associated with severe behavioural and emotional problems later in childhood. Triple P interventions are based on social learning, cognitive behavioural and developmental theory.

Values

Triple P interventions including Stepping Stones interventions aim to promote positive caring relationships between parents and their children and to help parents develop effective management strategies for dealing with behaviour and emotions problems.  

Triple P takes a minimal sufficiency approach, offering families just the amount of support parents requires to resolve a problem and enable parents to be confident, competent and independent in their parenting. It also takes a self-regulatory approach that encourages practitioners, parents and children to promote independent problem solving.

• Is working with families with a developmental disability to promote a positive caring relationship with their child match with your service values?
• Does taking a minimal sufficiency approach to offering support align with your service values?

Priorities

The Stepping Stones Triple P system has been developed as an early intensive intervention strategy within a preventative framework for parents of children up to the age of 12 with a developmental disability who have or are at risk of developing problem behaviours.

• Is taking an early intensive intervention and prevention approach to children with a developmental disability and who have or are at risk of developing behaviour and emotional difficulties a priority for your service?

Existing Initiatives

• Does your service already provide early intervention programmes aiming to support parents of children with a developmental disability who has or is at risk of developing problem behaviours?
• Does your service, or a locally accessible service, provide this intervention or plan to implement Level 4 interventions?

Workforce

Practitioners require time to deliver the intervention, usually 18 hours face to face and 45-90 minutes telephone calls (6 sessions of 2½ hours and 3 telephone consultations of 15-30 minutes), as well as preparation, administration and supervision time.   Triple P UK recommends that practitioner have a post-high school qualification in health, education, child care, or social services, but there are no pre-requisites to access training. Training takes place over 3 days, followed by a 1-day pre-accreditation and a half-day accreditation. 

• Do you have the required staff numbers to meet the need of the demand in your service / area?
• Do you have appropriate staff with the capacity to train and deliver this intervention?

Technology Support

To implement Group Stepping Stones Triple P a computer / data projector and screen is required to show the presentation and video clips (available for practitioners to download or access online). 

• Do you have access to adequate technology to support practitioners to effectively deliver the technological components of the programme?
• Do you have the technology to support practitioners to download, print and photocopy the materials they need to deliver the programme?

Administrative Support

Administrative support is required to collect evaluation data and feedback, print off materials along with co-ordinating and booking of venues.

• Do you have enough administrative capacity and systems to meet these administrative needs?
• Do you have access to facilities to host Group Stepping Stones Triple P sessions?

Financial Support

Costs can be provided directly from Triple P UK for training groups of staff from 12–20 practitioners. In addition to training, the costs of programme resources and any additional implementation supports need to be taken into consideration.

• Do you have the finances available to support the training and implementation of this programme?

Comparable Population 

Group Stepping Stones Triple P is for families with children up to 12 years old with a developmental disability who have or are at risk of developing difficult behaviours. 

Evidence of its effectiveness includes children up to 12 years with a developmental disability including Autism Spectrum Disorder, Down Syndrome, Cerebral Palsy or an intellectual disability.  

• Is this an identified population of particular concern to your organisation?
• Is this comparable to the population you serve?

Desired Outcome

Group Stepping Stones Triple P is a group intervention that aims to increase parents confidence and competence in managing common behavioural/emotional problems and developmental issues, reduce parents use of coercive and punitive methods of discipline, improve parents communication skills and reduce parents stress associated with raising a child with a developmental disability.

Research has identified that parents participating in Group Stepping Stones Triple P had fewer parent reported child behaviours, improved parenting skills and confidence, improved satisfaction and reduced stress and over-reacting behaviours. 

• Are the improvements of parenting practices and children’s behaviour a priority outcome for your organisation?
• Is supporting parents to develop skills to resolve conflicts and cope positively with stress a priority for your service?
• Do you have other existing initiatives that would be supportive of addressing this need and achieving these outcomes?