Triple P - Positive Parenting Program® - Level 3 Discussion Group

Scientific Rating:
2
Supported by Research Evidence
See scale of 1-5
Child Welfare System Relevance Level:
Medium
See descriptions of 3 levels

About This Program

The information in this program outline is provided by the program representative and edited by the CEBC staff. Triple P - Positive Parenting Program® - Level 3 Discussion Group has been rated by the CEBC in the area of: Parent Training Programs that Address Behavior Problems in Children and Adolescents.

Target Population: Parents or caregivers of children ages 0-12 years with mild-moderate emotional and behavioral concerns

For parents/caregivers of children ages: 0 – 12

Brief Description

Triple P - Positive Parenting Program - Level 3 Discussion Group (Level 3 Triple P Discussion Group) is one of the interventions within the Triple P - Positive Parenting Program System which helps parents learn strategies to promote social competence and self-regulation in children as well as decrease problem behavior. Level 3 Triple P Discussion Group offers 4 two-hour groups for parents on specific common behavior concerns. Parents set personal goals, develop their own parenting plans, and learn to use positive parenting strategies to encourage children to learn the skills and competencies they need. Level 3 Triple P Discussion Group is designed as brief, early intervention strategies to be offered by those in a community in regular contact with families of children and may include such settings as health care clinics, schools or early childhood education programs, childcare facilities, community libraries, and/or by other providers in various family-serving community agencies.

Program Goals:

The goals of Level 3 Triple P Discussion Group are:

  • Prevent development, or worsening, of severe behavioral, emotional and developmental problems in children and adolescents by enhancing the knowledge, skills, and confidence of parents
  • Increase parents’ competence in promoting healthy development and managing common behavior problems and developmental issues
  • Reduce parents’ use of coercive and punitive methods of disciplining children
  • Increase parents’ use of positive parenting strategies in managing their children’s behavior
  • Increase parental confidence in raising their children
  • Decrease child behavior problems (for families experiencing difficult child behavior)
  • Improve parenting partners’ communication about parenting issues
  • Reduce parenting stress associated with raising children

Essential Components

The essential components of Level 3 Triple P Discussion Group include the following:

  • A brief pre-post intervention assessment of parenting experiences that covers child behavior, parenting confidence, parent adjustment, and parenting conflicts
  • Development of a good working alliance between practitioner and participants
  • Provides small group(s) (for 8-12 parents) on commonly encountered problems such as disobedience, fighting and aggression, going shopping with children, and bedtime routines and ways of implementing positive parenting strategies:
  • Addresses one common behavior concern per group session
  • Actively involves parents throughout the 2-hour small group format discussions
  • Allows parents to attend one or all of the different discussion groups depending on their interest and needs
  • Offers an optional individual parent follow-up (15-30 minutes in-person or via telephone) 1 to 2 weeks after the discussion group to aid the parent in fine-tuning their parenting plans
  • Uses an explicit self-regulatory framework, including principles of and exercises to promote:
    • Self-sufficiency
    • Self-efficacy
    • Self-management
    • Problem-solving
  • Teaches parents how to monitor their own and their child’s behavior, and asks them to set specific and observable goals for change
  • Assists parents in applying the principles they have learned to solve problems in a self-sufficient manner that leads to more independence
  • Encourages practitioners to use multiple, relevant examples with families and create a flexible teaching environment
  • May be offered in a variety of settings (e.g., home, clinic, school, family resource center)

Parent/Caregiver Services

Triple P - Positive Parenting Program® - Level 3 Discussion Group directly provides services to parents/caregivers and addresses the following:

  • Behavioral, social, emotional, or developmental concerns for a child that are either anticipatory or mild to moderate in nature; also parental behavioral, social, and/or emotional concerns including depression, anxiety and stress, parenting confidence, and sense of self-efficacy
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: Parents and caregivers are encouraged to share their parenting plans with other caregivers, family members and/or additional supports as relevant/helpful. In addition, other caretakers or family members may also participate in the direct service delivery when relevant and agreed upon by the family.

Delivery Settings

This program is typically conducted in a(n):

  • Adoptive Home
  • Birth Family Home
  • Community Agency
  • Community Daily Living Settings
  • Foster/Kinship Care
  • Hospital
  • Outpatient Clinic
  • Residential Care Facility
  • School

Homework

Triple P - Positive Parenting Program® - Level 3 Discussion Group includes a homework component:

In Level 3 Triple P Discussion Group, parents identify, select, and apply the strategies they learn in the group. Parent workbooks for the discussion groups are designed to help parents integrate the strategies learned into their daily interactions with their children. Those seeking additional support are encouraged to engage in a follow-up consultation with a Triple P practitioner to further refine their parenting plans and skills.

Languages

Triple P - Positive Parenting Program® - Level 3 Discussion Group has materials available in a language other than English:

Chinese

For information on which materials are available in this language, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

Audiovisual equipment to deliver a PowerPoint presentation as well as show DVD clips to parents and a white board or large flip pad

Minimum Provider Qualifications

A post-high school degree in health, education, childcare, or social services is preferred. In exceptional circumstances, this requirement is relaxed when the prospective practitioners are actively involved in hands-on roles dealing with the targeted parents, children, and teenagers. These particular practitioners have developed, through their workplace experience, some knowledge of child/adolescent development and/or have experience working with families.

Education and Training Resources

There is a manual that describes how to implement this program, and there is training available for this program.

Training Contact:
Training is obtained:

Most commonly training is provided onsite with an agency or organization hosting the training. However, Triple P also hosts and provides trainings in an Open Enrollment format several times a year for agencies and organizations that do not have a large enough group for an agency-based training. Open Enrollment trainings are conducted in major cities around the U.S., depending on regional demand, and will be posted on the Triple P website at www.triplep.net

Number of days/hours:

2 full training days. Depending on prior training, there may be an option for this course to be provided as a one-day extension course. Following the initial training, practitioners complete 1 full-day of Pre-Accreditation (about 4-6 weeks later), and a 1/2 day accreditation (per trainee) held 6-8 weeks post-training. Training and Pre-Accreditation cohorts are comprised of 20 trainees with one Triple P trainer. These cohorts are divided into smaller groups during the final accreditation procedures. The actual training hours for each training day are 9:00 am - 4:30 pm, including two 20-minute breaks and a 45-minute lunch break, most often catered onsite by the hosting agency.

Implementation Information

Since Triple P - Positive Parenting Program® - Level 3 Discussion Group is rated on the Scientific Rating Scale, information was requested from the program representative on available pre-implementation assessments, implementation tools, and/or fidelity measures.

Show implementation information...

Pre-Implementation Materials

There are pre-implementation materials to measure organizational or provider readiness for Triple P - Positive Parenting Program® - Level 3 Discussion Group as listed below:

Support using the Implementation Framework is inclusive of several tools designed to support agencies in the successful adoption of Triple P. Examples of these documents include:

  • Organizational Readiness Checklist
  • Organizational Selection/Fit Form
  • Practitioner Selection/Fit Form
  • Community Assessment/Implementation Milestones Checklist
  • Quality Assurance Checklist
  • Evaluation Checklist
  • Shared Learning Network Planning

The Triple P Implementation Tools are provided with support from an Implementation Consultant at no cost for agencies planning to adopt Triple P. Please email contact.us@triplep.net for more information related to the Triple P Implementation Framework.

Formal Support for Implementation

There is formal support available for implementation of Triple P - Positive Parenting Program® - Level 3 Discussion Group as listed below:

Triple P America employs Implementation Consultants who are available from the first point of interest through the implementation process. They provide technical support, coaching, and consultation. This includes supporting organizations in the implementation planning process and the sharing of Triple P implementation tools for agencies/jurisdictions adopting Triple P. For complex initiatives, organizations without experience in implementing manualized practices, or organizations without the capacity to support multi-organizational implementation, Triple P America can provide additional implementation support at an additional cost.

Triple P America utilizes the Triple P Implementation Framework. The Framework is flexible and follows the key principles of Triple P – self-regulation and minimal sufficiency (i.e., it is a guiding framework for support of those implementing Triple P and the level of support may be decreased or increased to match the needs and available resources for a given agency or community).

Fidelity Measures

There are fidelity measures for Triple P - Positive Parenting Program® - Level 3 Discussion Group as listed below:

There are fidelity measures for Level 3 Discussion Groups as listed below:

  • Session Checklists – These checklists assist practitioners in implementing the service as intended. Organizations have the flexibility to utilize these instruments as self-assessments or in more formal quality assurance procedures. These can be provided for agencies interested in adopting Triple P Level 3.
  • Accreditation of Practitioners – Completed within the context of a Triple P Provider Training Course, this establishes baseline competence of all practitioners and certifies them as being able to implement the program as intended. The accreditation process has two steps: obtaining a passing score on a written exam and displaying competence in parent consultation skills as scored by an accredited Triple P trainer through direct observation or DVD submission. Procedures are in place to help and “recycle” practitioners to master the intervention when they do not pass accreditation.
  • Peer Support Networks - The Peer Assisted Support and Supervision (PASS) is a model of quality assurance. During PASS sessions, practitioners are expected to present cases, obtain feedback from other qualified practitioners, and continue to supplement their skills with continuing education. The PASS manual and checklist are available to trained practitioners through the Triple P Provider Network.

Other quality assurance and fidelity checks are possible to implement and Triple P America implementation consultants will work with local agencies to craft a plan that is consistent with local oversight agency procedures. Please email contact.us@triplep.net for further information on measures of fidelity.

Implementation Guides or Manuals

There are implementation guides or manuals for Triple P - Positive Parenting Program® - Level 3 Discussion Group as listed below:

The relevant Triple P Practitioner Manual is provided to practitioners when they attend a Triple P Provider Training Course. For the direct service provider, each level of Triple P includes a Practitioner Manual with step-by-step guidelines for successful delivery of Triple P.

Implementation Consultants can provide support to organizations to develop their own handbook of implementing Triple P, using the tools and processes in the Implementation Framework to provide a context specific guide for those responsible for coordinating the implementation of Triple P at that organization or region.

Please email contact.us@triplep.net

Research on How to Implement the Program

Research has been conducted on how to implement Triple P - Positive Parenting Program® - Level 3 Discussion Group as listed below:

While there is not implementation research currently available on the Level 3 Triple P Discussion Group version, implementation research is available for Triple P - Positive Parenting Program® System (System Triple P). This research can be accessed in the System Triple P program entry.

Relevant Published, Peer-Reviewed Research

This program is rated a "2 - Supported by Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The program must have at least one rigorous randomized controlled trial with a sustained effect of at least 6 months. The article(s) below that reports outcomes from an RCT showing a sustained effect of at least 6 months has an asterisk (*) at the beginning of its entry. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Child/Family Well-Being

Show relevant research...

Joachim, S., Sanders, M. R., & Turner, K. M. T. (2010). Reducing preschoolers’ disruptive behavior in public with a brief parent discussion group. Child Psychiatry and Human Development, 41, 47-60. doi:10.1007/s10578-009-0151-z

Type of Study: Randomized controlled trial
Number of Participants: 46

Population:

  • Age — Children: 2-6 years, Parents: 20-47 years
  • Race/Ethnicity — Children: 79% Australian or New Zealand European and 21% Other; Parents: Not specified
  • Gender — Children: 25 Male and 21 Female, Parents: 44 Female and 2 Male
  • Status — Participants were parents and their preschool children who displayed noncompliant behavior.

Location/Institution: Brisbane, Australia

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study examined the efficacy of the Level 3 Triple P Discussion Group format intervention for parents of preschool children that show disruptive behavior on shopping trips. Families were randomized into a Level 3 Triple P Discussion Group or a waitlist control group. Measures utilized include the Family Background Questionnaire (FBQ), Eyberg Child Behavior Inventory (ECBI), the Parenting Task Checklist (PTC), the Depression Anxiety Stress Scales (DASS), a Parent Problem Checklist (PPC), the Client Satisfaction Questionnaire (CSQ) and the Parenting Scale (PS). Results indicated at 6-month follow-up that compared to the waitlist control group, significant effects were found for measures of problem child behavior, dysfunctional parenting styles, and parents’ confidence in the parenting role in the Level 3 Triple P Discussion Group. No group differences were found for parental adjustment or conflict over parenting. The gains were maintained in the Level 3 Triple P Discussion Group at follow-up. Limitations include small sample size, lack of comparison group for follow-up, reliance on self-reported measures, and limited generalizability due to ethnicity of participants.

Length of postintervention follow-up: 6 months (intervention group only).

Morawska, A., Haslam, D., Milne, D., & Sanders, M. R. (2011). Evaluation of a brief parenting discussion group for parents of young children. Journal of Developmental and Behavioral Pediatrics, 32(2), 136-145. doi:10.1097/DBP.0b013e3181f17a28

Type of Study: Randomized controlled trial
Number of Participants: 134

Population:

  • Age — Children: 2-5 years, Parents: Mean=36-39 years
  • Race/Ethnicity — Children: 95% White; Parents: 94.1% White and 5.9% Asian
  • Gender — Children: 37 Male and 30 Female, Parents: 66 Female and 1 Male
  • Status — Participants were parents of children with behavioral issues.

Location/Institution: Brisbane Australia

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study aimed to evaluate the efficacy of a brief parenting discussion group – Level 3 Triple P Discussion Group. Parents were randomly assigned to either Level 3 Triple P Discussion Group or waitlist control condition. Measures utilized include the Family Background Questionnaire (FBQ), the Parenting Scale (PS), the Parenting Tasks Checklist (PTC), the Eyberg Child Behaviour Inventory Intensity Scale, the Parenting Relationship Questionnaire (PRQ:P), the Client Satisfaction Questionnaire (CSQ), and the Parenting Experience Survey. Results indicated at post-intervention that after receiving Level 3 Triple P Discussion Group, there were reductions in child behavior problems and use of dysfunctional parenting and improvements in parental self-efficacy and the parenting experience for parents. These effects were maintained in the Level 3 Triple P group at 6-month follow-up. Limitations include reliance on self-reported measures, lack of comparison group at follow-up, small sample size and generalizability due to ethnicity.

Length of postintervention follow-up: 6 months (intervention group only).

*Mejia, A., Calam, R., & Sanders, M. R. (2015). A pilot randomized controlled trial of a brief parenting intervention in low-resource settings in Panama. Prevention Science, 16(5), 707-717. doi:10.1007/s11121-015-0551-1

Type of Study: Randomized controlled trial
Number of Participants: 108

Population:

  • Age — Children: 3-12 years, Parents: Not specified
  • Race/Ethnicity — Children: Not specified, Parents: Not specified
  • Gender — Children: Not specified, Parents: Not specified
  • Status — Participants were parents of children with difficult behaviors.

Location/Institution: Panama City

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The aim of this study was to determine whether Level 3 Triple P Discussion Group was effective in reducing parental reports of child behavioral difficulties in urban low-income settings in Panama City. Parents were randomized to either receiving Level 3 Triple P Discussion Group or to a no-intervention control group. Measures utilized include Depression-Anxiety-Stress Scale 21 (DASS-21), and the Eyberg Child Behaviour Inventory Intensity Scale. Results showed that parental reports of child behavioral difficulties changed over time and decreased more steeply in the Level 3 Triple P group than in the control group. The effects of the intervention on parental reports of behavioral difficulties were moderate at postintervention and 3-month follow-up, and large at 6-month follow-up when compared to the control group. At 6-month follow-up, parents who participated in the Level 3 Triple P Discussion Group reported fewer behavioral difficulties in their children after the intervention than those in the control condition. They also reported reduced parental stress and less use of dysfunctional parenting practices. Limitations include reliance on self-reported measures and small sample size

Length of postintervention follow-up: 3 and 6 months.

Chung, S., Leung, C., & Sanders, M. R. (2015). The Triple P – Positive Parenting Program: the effectiveness of group Triple P and brief parent discussion group in school settings in Hong Kong. Journal of Children’s Services, 10(4), 339-352. doi:10.1108/JCS-08-2014-0039

Type of Study: Randomized controlled trial
Number of Participants: 91

Population:

  • Age — Children: Not specified, Parents: Not specified
  • Race/Ethnicity — Children: Not specified, Parents: Not specified
  • Gender — Children: Not specified, Parents: Not specified
  • Status — Participants were parents and their preschool children.

Location/Institution: Hong Kong

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study aimed to evaluate the effectiveness with Hong Kong Chinese families of both Level 4 Group Triple P in preschool settings and the brief parent discussion group based on the Level 3 Triple P Discussion Group and then compare the two groups to each other and a waitlist control group. Families were randomized into three groups: Triple P Level 4 group (TP), brief parent discussion group based on Level 3 Triple P Discussion Group (DI), and a waitlist control group (WL). Measures utilized include the Eyberg Child Behaviour Inventory (ECBI), and the Chinese Parental Stress Scale (PSS). Results showed that there was a significant group difference on reported child disruptive behaviors between the TP group compared with the WL group. There was no significant difference on child behavior problems between the TP group and the DI group. There was no significant group difference in parenting stress and no significant difference in parenting stress scores between the DI group and the WL group. Limitations include small sample size, self-reported measures, and lack of follow-up.

Length of postintervention follow-up: None.

*Dittman, C., Farruggia, S. P., Keown, L. J., & Sanders, M. R. (2016). Dealing with Disobedience: An evaluation of a brief parenting intervention for young children showing noncompliant behavior problems. Child Psychiatry & Human Development. 47(1), 102-112. doi:10.1007/s10578-015-0548-9

Type of Study: Randomized controlled trial
Number of Participants: 85

Population:

  • Age — Children: 3-5 years, Parents: 20-47 years
  • Race/Ethnicity — Children: 79% Australian or New Zealand European and 21% Other; Parents: Not specified
  • Gender — Children: 65% Male and 35% Female, Parents: 94% Female
  • Status — Participants were parents and their preschool children who displayed noncompliant behavior.

Location/Institution: Auckland, New Zealand and Brisbane, Australia

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study examined the efficacy of the Dealing with Disobedience discussion group, Triple P Level 3 intervention [now called Level 3 Triple P Discussion Group. Families were randomized into a Level 3 Triple P Discussion Group or a waitlist control group. Measures utilized include the Eyberg Child Behaviour Inventory (ECBI), the Parenting Task Checklist (PTC), the Depression Anxiety Stress Scales (DASS), a Parent Problem Checklist (PPC), Relationship Quality Inventory (RQI), the Client Satisfaction Questionnaire (CSQ) and the Parenting Scale (PS). Results showed at 6-month follow-up that compared to the waitlist control group, significant intervention effects were found for disruptive child behavior, ineffective parenting practices, parenting confidence, as well as clinically significant improvements on child behavior and parenting. Limitations include small sample size, self-reported measures, and limited generalizability due to ethnicity of participants.

Length of postintervention follow-up: 6 months.

References

Sanders, M. R. (2012). Development, evaluation, and multi-national dissemination of the Triple P – Positive Parenting Program. Annual Review of Clinical Psychology, 8, 345-379. doi:10.1146/annurev-clinpsy-032511-143104

Contact Information

Agency/Affiliation: Triple P America
Website: www.triplep.net
Email:
Phone: (803) 451-2278
Fax: (803) 451-2277

Date Research Evidence Last Reviewed by CEBC: May 2017

Date Program Content Last Reviewed by Program Staff: August 2017

Date Program Originally Loaded onto CEBC: September 2017