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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.
Teen Triple P Discussion Groups is a level 3 brief targeted intervention. This level focuses on families whose children have mild to moderate behaviour concerns. Teen Discussion Groups are for parents of adolescents aged 12 to 16 years with the aim of preventing problems from developing or for addressing discreet, mild to moderate behavioural problems. The programme is delivered in a 2-hour discussion group format and is normally delivered to groups of 10 parents.
The Teen Discussion Groups are aimed at parents or caregivers with specific concerns about their child’s behaviour, each session can cover one of four possible topics; Getting teenagers to cooperate; Coping with teenagers’ emotions; Building teenagers’ survival skills and Reducing family conflict. A single discussion group can be delivered, or they can be delivered as a series. The sessions are designed to provide parents with an overview of positive parenting principles and encourage parents to put strategies into place at home. During group sessions practitioners use video clips to demonstrate parents successfully dealing with challenging behaviours. Parents are invited to contribute their thoughts and experiences with the other parents in the group. Parents are encouraged to put the skills learned into practice and this is supported by active skills training during the discussion group.
Teen Triple P Discussion Groups 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 Teen Triple P Discussion Group Workbook which describes the information and strategies presented during the sessions.
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 day
Modifiable Components
Triple P practitioners can tailor interventions 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 has been delivered in 30 countries and written and audio-visual materials have been translated from English, dubbed or subtitled into 21 languages, with video clips 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 are now available 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 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. Para-professionals are expected to have knowledge of child or adolescent development, and/or experience working with families.
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 training and accreditation. The total time required to attend training and accreditation is estimated to take four days. This includes two days of training, one day for a pre-accreditation workshop, half a day for quiz and competency preparation, a half day for accreditation. Training in Teen Triple P Discussion Groups is available as a standalone course or as an extension to Triple P Discussion Groups and several other Triple P courses. There are no pre-requisite participation requirements for a standalone course.
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.
Primary school: 6 to 12 years - Rating: 4+
Research Design & Number of Studies
The best evidence for Teen Triple P Discussion Groups with children 6 – 12-year-olds comes from one pilot Randomised Control Trial (RCT) externally conducted, and one external PhD study. The pilot RCT (Dittman et al, 2020) included parents (n=90) of teenagers aged 11-16 years and the PhD study (O’Connor, 2013) included parents (n=25) of teenagers aged 12-15 years. Separate data for children aged between 6 and 12 years were not reported.
Outcomes Achieved
Compared to the control group, outcomes in favour of the intervention group included:
Child Outcomes
Significant reductions in parent-adolescent conflict (O’Connor, 2013)
Significant reductions in adolescent problem behaviour (Dittman et al, 2020 & O’Connor, 2013)
Significant improvement in adolescent oppositional behaviour at six-month follow-up (Dittman, et al., 2020)
Parent Outcomes
Significant reductions in parental stress (O’Connor, 2013)
Significant reductions in dysfunctional parenting practices (O’Connor, 2013)
Significant increases in parental efficacy (O’Connor, 2013)
Key References
Dittman, C. K., Burke, K., & Hodges, J. (2020). Brief parenting support for parents of teenagers dealing with family conflict: A pilot randomized controlled trial. Child & Youth Care Forum, 49 (5), pp. 799-816.
O’Connor, B. (2013). A preliminary evaluation of the Teen Triple P Discussion Group ‘Reducing Family Conflict.’ [Honours thesis, University of Queensland].
Adolescents: 13 to 18 years - Rating: 4+
Research Design & Number of Studies
The best available evidence for Teen Triple P Discussion Groups for with children ages 13 – 16 is the same as the evidence above for 6–12-year-old.
Need
Comparable Population
Teen Triple P Discussion Groups are for parents or caregivers with specific concerns about their adolescent’s behaviour. This intervention is aimed at those with discreet, mild to moderate behavioural problems. The programme is also appropriate as a brief universal prevention strategy for parents of adolescents aged 12 to 16 years of age to learn about positive parenting principles.
Research has found Teen Triple P Discussion Groups to be effective when conducted with families who were recruited in an urban area in Australia.
Is this comparable to the population you serve?
Desired Outcome
Triple P Teen Discussion Groups are suitable as a brief targeted intervention aiming to intervene early with families to avoid challenging behaviours escalating, and as a universal prevention programme to support parents in developing positive parenting strategies to promote adolescent development. Research has found the groups to be effective in reducing parent-adolescent conflict, adolescent problem behaviour and adolescent oppositional behaviour along with parent outcomes of reduced parental stress and dysfunctional parenting practices.
Is reducing parent-adolescent conflict, behaviour problems, parental stress and dysfunctional parenting practices a desired outcome for your service?
Need Score
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Fit
Values
Triple P interventions aim to promote positive caring relationships between parents and their children/adolescents and to help parents develop effective management strategies for dealing with behaviour and emotions problems. Teen Triple P Discussion Groups aim to help parents learn, in a discussion group setting, about managing commonly encountered problems such as getting teenagers to cooperate, coping with teenagers’ emotions, reducing family conflict, and building teenagers’ survival skills.
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 requires to resolve a problem and enable parents to be confident, competent and independent in their parenting. It also takes a self-regulatory approach.
Does taking a minimal sufficiency approach to offering support align with your service values? (10)
Priorities
Teen Triple P Discussion Groups have been developed as an early intervention strategy within a preventative framework for parents of adolescents aged 12 to 16 years who are concerned about relatively discreet, mild or moderate issues related to their child or teenager’s development or behaviour. Teen Triple P Discussion Groups can also be implemented as a brief universal prevention strategy.
Is taking an early intervention and prevention approach to adolescent behaviour and emotional difficulties a priority for your service?
Existing Initiatives
Does your service already provide a brief targeted intervention for parents of adolescents with a discrete behaviour or developmental issue? Are the existing initiatives effective? Do existing initiative fit your current and anticipated future requirements?
Fit Score
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Capacity
Workforce
Triple P UK recommends that the practitioner has a post-high school qualification in health, education, childcare, or social services. One practitioner is required to deliver a Teen Triple P Discussion Group.
Do you have the required staff numbers to meet the need of the demand in your service / area? Do you have appropriate staff to train and deliver this intervention?
Teen Triple P Discussion Group practitioners require time to attend training and for group delivery. Triple P UK recommends that in addition to the session time (four 2-hour sessions), that practitioners have time for session preparation and post-session debrief/supervision (1 hour) and case notes and report writing (1 hour) for each session. These time estimates are based on a group delivery with ten families participating, times will vary for different group sizes. Practitioners require time to attend training and accreditation which is estimated to take four days. This includes two days of training, one day for a pre-accreditation workshop, half a day for quiz and competency preparation, and a half day for accreditation.
Do you have staff with the capacity to train in, and deliver this intervention?
Technology Support
To implement Teen Triple P Discussion Groups, 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 undertake training online and to access the optional teaching elements of the programme? Do you have the technology to support practitioners to download, print and photocopy the materials needed 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.
Does your organisation have enough administrative capacity and systems to meet these administrative needs? Do you have access to facilities to host Teen Triple P Discussion Groups?
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?
Capacity Score
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