Address for correspondence: Matthew R. Sanders, Parenting and Family Support Centre, The University of Queensland, St Lucia QLD 4072, AustraliaEmail: firstname.lastname@example.orgCopyright 2003 The Parenting and Family Support Centre, The University of QueenslandISBN 1 875378 46 4
This paper outlines the theoretical, empirical and clinical foundations of a unique parenting and family supportstrategy designed to reduce the prevalence of behavioural and emotional problems in children and adolescents.The program known as the Triple P-Positive Parenting Program is a multi-level system of family intervention,which provides five levels of intervention of increasing strength. These interventions include a universal population-level media strategy targeting all parents, two levels of brief primary care consultations targeting mild behaviour problems and two more intensive parent training and family intervention programs for children at risk for more severe behavioural problems. The program aims to determine the minimally sufficient intervention a parent requires in order to deflect a child away from a trajectory towards more serious problems. The self-regulation of parental skill is a central construct in the program. The program uses flexible delivery modalities(including individual face-to-face, group, telephone-assisted and self-directed programs) to tailor the strength and format of the intervention to the requirements of individual families. Its multi-disciplinary, preventive and community-wide focus gives the program wide reach, permitting the targeting of destigmatised access pointsthrough primary care services for families who are reluctant to participate in parenting skills programs. Theavailable empirical evidence supporting the efficacy of the program and its implications for research ondissemination are discussed.
The quality of family life is fundamental to the wellbeing of children. Family relationships in general and the parent-childrelationship in particular have a pervasive influence on thepsychological, physical, social and economic wellbeing of children. Many significant mental health, social andeconomic problems are linked to disturbances in family functioning and the breakdown of family relationships(Chamberlain & Patterson, 1995; Patterson, 1982; Sanders &Duncan, 1995). Epidemiological studies indicate that family risk factors such as poor parenting, family conflict andmarriage breakdown strongly influence children’sdevelopment (e.g., Cummings & Davies, 1994; Dryfoos,1990; Robins, 1991). Specifically, a lack of a warm positiverelationship with parents; insecure attachment; harsh,inflexible, rigid or inconsistent discipline practices;inadequate supervision of and involvement with children;marital conflict and breakdown; and parentalpsychopathology (particularly maternal depression) increasethe risk that children will develop major behavioural andemotional problems, including substance abuse, antisocialbehaviour and juvenile crime (e.g., Coie, 1996; Loeber &Farrington, 1998). Although family relationships are important, parentsgenerally receive little preparation beyond the experience of having been parented themselves; with most learning on thejob, through trial and error (Risley, Clark, & Cataldo, 1976;Sanders et al., 2000). The demands of parenthood arefurther complicated when parents do not have access toextended family support networks (e.g., grandparents ortrusted family friends) for advice on child rearing, do nothave partners, or experience the stress of separation, divorceor repartnering (Lawton & Sanders, 1994; Sanders,Nicholson, & Floyd, 1997). This paper describes the conceptual and empiricalfoundations of the program’s comprehensive model of parenting and family support, which aims to better equipparents in their child rearing role. The program’s uniquefeatures, derivative programs and issues involved in theeffective dissemination of the system are discussed anddirections for future research are highlighted.
WHAT IS THE TRIPLE P –POSITIVE PARENTING PROGRAM?
The Triple P-Positive Parenting Program is a multi-level,preventively-oriented parenting and family support strategy developed by the authors and colleagues at The University of Queensland in Brisbane, Australia. The program aims toprevent severe behavioural, emotional and developmentalproblems in children by enhancing the knowledge, skills andconfidence of parents. It incorporates five levels of intervention on a tiered continuum of increasing strength(see Table 1) for parents of children and adolescents frombirth to age 16. Figure 1 depicts the differing levels of intensity and reach of the Triple P system. Level 1, auniversal parent information strategy, provides all interestedparents with access to useful information about parenting through a coordinated promotional campaign using printand electronic media as well as user-friendly parenting tipsheets and videotapes that demonstrate specific parenting strategies. This level of intervention aims to increasecommunity awareness of parenting resources and thereceptivity of parents to participating in programs, and tocreate a sense of optimism by depicting solutions tocommon behavioural and developmental concerns. Level 2is a brief, one to two-session primary health care
Parenting Research and Practice Monograph No. 1