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The Hexagon: An Exploration Tool
The Hexagon can be used as a planning tool to guide selection and evaluate potential programs and practice for use.
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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. The system takes a minimal sufficiency approach, offering families just the amount of support they require. It also takes a self-regulatory approach that encourages practitioners, parents and children to promote independent problem solving. 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.
Standard Teen Triple P is a level 4 intensive targeted intervention aimed at parents of adolescent children, aged between 12-16 years, who have or are at risk of developing moderate to severe problematic teenage behaviours. The programme is suitable for parents who have concerns about their teenager’s development and behaviour and require intensive positive parenting training on a one-to-one basis. One practitioner meets with parents individually for 10 sessions (one-hour sessions) to educate and actively train parents to refine the use of their parenting skills and develop their confidence.
During these sessions, parents learn practical strategies to manage their teen’s problematic behaviour, promote healthy development, to set goals, learn ways to encourage positive behaviour from teens, and teach their teens new skills such as problem solving, conflict resolution, and self-regulation.
Standard Teen Triple P is well operationalised, each facilitator 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 Teen Triple P Family Workbook, which describes the information and strategies presented during the sessions and includes homework tasks.
Fidelity
Triple P – Positive Parenting Program® has three main fidelity checks / quality assurance strategies across all the programmes:
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 programme. Appropriate adaptions are covered during training.
Training in Triple P programmes 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 five phases of implementation 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 at an additional cost.
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
Costs that need to be considered are the training course, programme resources for working with parents, and any additional implementation support 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 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.
Training in Standard Teen Triple P is available as a standalone course or as an extension to Standard Triple P (0-12 years). There are no pre-requisite participation requirements for a standalone course.
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.
Primary school: 6 to 12 years - Rating: 3+
Research Design & Number of Studies
The best evidence for Standard Teen Triple P for children in the age range 6-12 years comes from one Quasi-Randomized Comparison Group Study identified, undertaken by the programme developer. This study included families (n=46) with children aged between 11 and 16 years of age with detectable behavioural and emotional problems. Separate outcomes were not available for 12-year olds.
Outcomes Achieved
Child Outcomes
Significant reduction in parent reported levels of teen disruptive behaviours and parent-adolescent conflict in the intervention group (Salari, R. et al., 2014).
Parent Outcomes
Significant greater reduction in the use of ineffective parenting strategies in the intervention group compared to the control group (Salari, R. et al., 2014).
Significant decreased disagreement/conflict over child-rearing issues in the intervention group (Salari, R. et al., 2014).
Key References
Salari, R., Ralph, A., & Sanders, M.R. (2014). An Efficacy Trial: Positive Parenting Program for Parents of Teenagers. Behaviour Change. 31 (1) pp. 34-52.
Adolescents: 13 to 18 years - Rating: 3+
Research Design & Number of Studies
The best available evidence for children within the age range 13-18 comes from one Quasi-Randomized Comparison Group Study undertaken by the programme developer. This study included children (n=46) with children aged between 11 and 16 years of age. Evidence outcomes for age 13-18 years are the same as for 6-12 years evidence above.
Key References
Salari, R., Ralph, A., & Sanders, M.R. (2014). An Efficacy Trial: Positive Parenting Program for Parents of Teenagers. Behaviour Change. 31 (1) pp. 34-52.
Need
Comparable Population
Standard Teen Triple P is for parents of adolescent children, 12-16 years, who have concerns about their teenager’s development and behaviour and require one-on-one support.
Evidence of its effectiveness includes families with adolescents aged between 11-16 years in Australia.
Is this comparable to the population you serve?
Desired Outcome
Standard Teen Triple P is an individual one-on-one intervention that aims to equip parents with intensive training to set goals, learn ways to encourage positive behaviour from teens, and teach their teens new skills such as problem solving, conflict resolution, and self-regulation.
Research has found the intervention to be effective in decreasing levels of teen disruptive behaviours and parent-adolescent conflict, along with reducing the use of ineffective parenting strategies and conflict over child-rearing issues.
Is reducing adolescent moderate to severe problem behaviour whilst improving the quality of family relationships an aim of your service?
Need Score
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Fit
Values
Triple P interventions aim to promote positive caring relationships between parents and their children. Standard Teen Triple P aims and to help parents learn, on a one-to one basis, intensive practical strategies to manage their adolescent’s problematic behaviour, promote healthy development and improve the quality of the parent-child relationship.
Is working with families with adolescents to reduce moderate to severe behavioural problems a priority for your organisation?
Triple P takes a minimal sufficiency approach, offering families just the amount of support parents require 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.
Does taking a minimal sufficiency approach to offering support align with your service values?
Priorities
Standard Teen Triple P has been developed as an early intensive intervention strategy within a preventative framework for parents of adolescent children aged 12-16 years who are concerned about their teenager’s development and behaviour.
Is taking an early intensive intervention and prevention approach to teenagers who have or are at risk of developing moderate to severe problem behaviours a priority for your service?
Existing Initiatives
Does your service already provide early intervention programmes aiming to improve adolescent child development and mental health outcomes?
Fit Score
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Capacity
Capacity
Standard Teen Triple P practitioners require time to attend the training. 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 to deliver the intervention with families.
Triple P UK recommends that in addition to the session time (10 one-hour sessions per family,) that practitioners have time for session preparation and supervision (5 hours), questionnaire scoring and feedback (1 ½ hours), and case notes and report writing (2½ hours). Practitioners require time to attend training and accreditation which is estimated to take six days.
Do you have appropriate staff available to train? Do you have staff able to commit time to training and delivery of the intervention?
Technology Support
To implement Standard Teen 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 the technology to support practitioners to download, print and photocopy the materials needed to deliver the programme? Programme delivery can involve families viewing a DVD with the practitioner, do you have the technology available for practitioners to do this?
Administrative Support
Administrative support is required to collect evaluation data and feedback, print off materials along with co-ordinating and booking of venues.
Do your current administrative procedures support your practitioners to implement a programme like this?
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, 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?
Capacity Score
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