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The Efficacy and Acceptability of the Triple P-Positive Parenting Program

With Japanese Parents

Article · November 2007

DOI: 10.1375/bech.24.4.205 · Source: OAI

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 The Efficacy and Acceptability of the
Triple P-Positive Parenting Program
With Japanese Parents
Yuki Matsumoto, Kate Sofronoff and Matthew R. Sanders
The University of Queensland, Australia

This study examined the efficacy of the Group Triple P-Positive Parenting
Program with a Japanese population to evaluate the feasibility and acceptability of
the program and the parenting skills taught in a crosscultural context. The study
involved 50 Japanese parents living in Australia and used a randomised group
comparison design with two conditions, Triple P group and a waitlist control
group. The results revealed significant reductions in parent reported child
behaviour problems, parental overreactivity and laxness, and parental conflict as
well as increasing parental competence. The acceptability of the program was
found to be high. Intervention effects and program acceptability in a Japanese
context as well as limitations and future research are discussed.

P arenting programs should be made available, relevant and acceptable to all pop-
ulations (Gorman & Balter, 1997). However, it has been suggested that tradi-
tional parenting programs may be of questionable utility for minority ethnic families
(Alvy, 1987); for example, Butt and Box (1998) have shown that minority ethnic
families in the United Kingdom feel that standard parenting programs do not suit
them and that this, in part, is because of the ways in which parenting techniques
and strategies are presented. The impact of sociocultural contexts should be consid-
ered, especially when programs are introduced to parents from cultures other than
those for which the program was originally developed. The current study examined
the efficacy of Triple P with Japanese parents living in Australia based on the
notion that culturally appropriate parenting interventions need an empirical knowl-
edge of the parental values and practices (Melendez, 2005).
The assumption that parental values and beliefs are important determinants in
the socialisation process of families has been conceptualised within the literatures
of attribution theory and learning theory (see Harrison, Wilson, Pine, Chan, &
Buriel, 1990). Studies in the United States have shown that common child rearing
goals among parents from diverse ethnic groups included positive orientation to
their own culture (Brooks, 1991; Harrison et al., 1990). The social ecology of any
family impacts on the socialisation of that family since it includes patterns of
values, social customs, perceptions, behaviour roles and language usage (Phinney 205
& Rotheram, 1987).
Cross-cultural research in the United States found that both cultural and parenting
cognitions are slow to change among Japanese immigrant parents (Cote & Bornstein,

Address for correspondence: Dr Kate Sofronoff, School of Psychology, University of Queensland, St Lucia QLD
4072, Australia. E-mail: kate@psy.uq.edu.au

Behaviour Change | Volume 24 | Number 4 | 2007 | pp. 205–218

 Yuki Matsumoto, Kate Sofronoff and Matthew R. Sanders

2003). Cross-cultural studies in Australia have shown that migrant communities typ-
ically retain their cultural identity while establishing an effective relationship with
the wider Australian society (e.g., Papps, Walker, Trimboli, & Trimboli, 1995).
Japanese parents in Australia espouse parenting styles that reflect Japanese values
and beliefs alongside accommodations made to Australian parenting beliefs
(Andreoni & Fujimori, 1998).
Traditional Japanese childrearing values are different from those of western cul-
tures (Yamada, 2004); Japanese parents place more value on children’s cooperation,
getting along with others, and education and academic success, whereas European
and American parents emphasise individual achievement and responsibility (Joshi &
MacLean, 1997). Child behaviours are also regulated differently: collectivism and
interdependence in Japanese culture versus individualism and independence in
Western culture (Joshi & MacLean, 1997; Oyserman, Coon, & Kemmelmeier,
2002). However, recent research found that the Japanese are not necessarily more
collectivist than are western individuals, and acknowledged the coexistence of indi-
vidualistic and collectivistic orientations within Japanese culture (Oyserman et al.,
2002; Takano & Osaka, 1999; Yamada, 2004).
Triple P is a behavioural family intervention program founded on the theoretical
models of behavioural, social learning theory and child developmental psychology.
The Triple P system has a strong evidence-base and includes a multilevel structure to
provide parents with varying degrees of intervention in an ecological approach where
positive parenting strategies can be delivered in a variety of social contexts (Sanders,
Markie-Dadds, & Turner, 2003).
The group format of Triple P is likely to be useful for Japanese parents who are
seeking parenting training. Parents like group-based programs due to the support
that they receive from other parents, as well as to the mirroring of concerns on the
part of other parents for generalisation (Barlow & Stewart-Brown, 2001). Murayama
(2004) highlights the significant effect of group interventions used in Japanese clini-
cal psychology. Growing up in a group-oriented society carries with it the idea of
conformity (Seibert, Stridhlgo, & Zimmerman, 2002) and Japanese conformism
enable individuals to learn more positively by the associated sense of ‘belonging’ to a
group and through collaborative activities with group members (Kelly, 2001).
Group Triple P has eight sessions (four 2-hour group sessions, three telephone
consultations, and the final session as a group or a telephone session) and is ideally
conducted in groups of 10 to 12 parents. Participants are encouraged to learn and
practice positive parenting skills in a self-regulatory framework; this includes setting
goals for change and self-evaluation. Benefits of the group program include peer sup-
port, friendship and feedback from other parents and opportunities for parents to
normalise their parenting experience through group interaction (Sanders et al.,
2003). The Group Triple P with Chinese parents in Sydney (Crisante & Ng, 2003)
and in Hong Kong (Leung, Sanders, Leung, Mark, & Lau, 2003) showed significant
program effects and satisfaction with the program. Crisante and Ng found some
206
aspects of parents’ resistance to completing questionnaires such that only one third
of the total participants completed the Client Satisfaction Questionnaire. They also
found some resistance to using some parenting skills such as ‘descriptive praise’. The
researchers suggested a need to address parental concerns arising from beliefs, parent-
ing styles and goals.
The impact of cultural differences has been associated with the level of accept-
ability of programs to parents (e.g., Fixsen & Dunlap, 2004). Acceptability refers

Behaviour Change
 Triple P Parenting Program with Japanese Families

to parents’ judgments of whether interventions are appropriate, fair and reasonable

for them to use with their child in the circumstances in which they live (Reimers
et al., 1998), and is related to parenting practices (Axia & Weisner, 2002;
Bornstein et al., 1996; Ceballo & McLoyd, 2002; Kalyanpur & Harry, 1999;
Maitra, 2005; Stewart & Bond, 2002), to parenting beliefs and values (Greenfield,
1994; Keller, 2003; Turnbull & Turnbull, 2001), and to parental intention to
implement and maintain an intervention plan (Peterson, Derby, Berg, & Horner,
2002). However, the acceptability of parenting programs has unclear criteria for
the measurement of cultural acceptability of programs (e.g., Chorpita, Barlow,
Albano, & Daleiden, 1998; Reimers et al., 1998; Taban & Lutzker, 2001). The cur-
rent study focused on program effects as well as parental satisfaction of the program
and core parenting skills to identify whether the Triple P program is relevant and
acceptable to Japanese families.
The present study was a randomised controlled trial of the Group Triple P pro-
gram with Japanese parents in Australia. The study predicted that a Triple P inter-
vention group would show:
1. Significant program effects at postintervention compared to a waitlist control
condition.
2. The maintenance of the effects at the 3-month follow-up.
3. Considerable parenting acceptability (that is, program satisfaction and use of par-
enting skills).
4. Variation in usage of 17 parenting skills in terms of cultural diversity.

Method
Participants
The target population was families with Japanese parent/s in Brisbane and the
Gold Coast area of Queensland, Australia, whose children were aged 2 to 10 years.
Participants were 50 families recruited through the Japanese Society and/or the
Japanese Supplementary School where parents receive support to learn and main-
tain Japanese culture and language. Parents in the program were all Japanese: 47
mothers and one aunt carrying a maternal role whose partners included 13
Japanese fathers, 30 Australians and five of other ethnicity, and two Japanese
fathers with Australian partners. The average age of the children targeted in the
study was 4.9 years and there were 27 boys and 23 girls.
Table 1 illustrates the demographic information as measured by the Family
Background Questionnaire for the total sample. The majority of parents were mar-
ried and mothers’ education level ranged from Year 12 to University. Fathers’ edu-
cation levels were similar and fathers were mainly employed, whereas most
mothers did not work. Families (except one) spoke Japanese at home, either as the
primary language or in conjunction with English. 207

Materials
Family Background Questionnaire
This questionnaire gathered demographic information on the parents and children.
The measure excluded total family income since it was suggested that Japanese par-
ticipants would be reluctant to report financial information.

Behaviour Change
 Yuki Matsumoto, Kate Sofronoff and Matthew R. Sanders

TABLE 1
Demographic Characteristics of Sample and Frequencies

Triple P Waitlist Pearson

Variable (n = 25) (n = 25) chi-square P value
N N χ2
Child gender 2.01 .156
Female 9 14
Male 16 11
Marital status 2.36 .502
Married 22 23
De facto 1 1
Divorced 2 1
Separated 0 0
Mother’s education .91 .823
Year 12 3 5
TAFE/college 6 7
University 15 12
Trade/apprentice 1 1
Father’s education 3.56 .313
Year 12 4 3
TAFE/college 3 4
University 18 15
Trade/apprentice 0 3
Mother employed .50 .480
No 21 19
Yes 4 6
Father employed .76 .384
No 4 2
Yes 21 23
Parenting support .08 .777
No 13 12
Yes 12 13
Parent health .00 1.000
No 21 21
Yes 4 4
Language at home 1.06 .589
Japanese 9 8
English 0 1
Both 16 16
Mother’s ethnicity .00 1.000
Japanese 24 24
Australian 1 1
Father’s ethnicity 5.60 .231
Japanese 8 7
208 Australian 17 13
Others 0 5

Behaviour Change
 Triple P Parenting Program with Japanese Families

Eyberg Child Behaviour Inventory (ECBI: Eyberg & Pincus, 1999). The ECBI is a
36-item measure used to assess parental reports of problem behaviour in children
aged 2 to 16 years. It includes a frequency measure (Intensity score ranging 36–252;
with clinical cut-off ≥ to 131) and a quantitative measure of problem behaviours
(Problem score ranging 0–36; clinical cut-off ≥ 15). The ECBI showed high inter-
nal consistency for both the Intensity (α = .90) and Problem (α = .90) scales in
this study.
Parenting Scale (PS; Arnold, O’Leary, Wolff & Acker, 1993). The PS is a 30-
item questionnaire that measures three dysfunctional discipline styles including lax-
ness (permissive discipline), overreactivity (authoritarian discipline) and verbosity
(overly long reprimands or reliance on talking). The total score of the PS ranges
from 1 to 7, and scores in excess of 3.1 are used to discriminate between clinical
and nonclinical levels of dysfunctional parenting. In this study, the PS showed an
adequate internal consistency in the Overreactivity scale (α = .79), but poor in the
Laxness scale (α = .58), and inadequate in the Verbosity scale (α = .04).
Parent Problem Checklist (PPC; Dadds & Powell, 1991). The PPC is a 16-item
measure to assess interparental conflict over child rearing. It is comprised of a
Yes/No scale wherein parents indicate whether or not each issue has been a problem
during the last 4 weeks (problem), and a 7-point scale where parents rate the extent
to which each issue was a problem (intensity). The PPC showed high internal con-
sistency for both the Problem (α = .85) and Intensity (α = .92) scales in this study.
Relationship Quality Index (RQI; Turner, Markie-Dadds & Sanders, 1998). The
RQI is a 6-item questionnaire to assess the degree of partner satisfaction within the
relationship. The first five items are rated on a 7-point scale from 1 = very strongly
disagree to 7 = very strongly agree. The last item is a 10-point scale from 1 = unhappy
to 10 = perfectly happy. The scale showed high internal consistency (α = .94) in this
study.
Problem Setting and Behaviour Checklist (PSBC; Sanders & Woolley, 2005). The
PSBC is a 28-item rating scale that assesses how confident parents are in dealing
with child behaviour problems in various settings. It uses a scale from 0 = certain I
cannot do it to 100 = certain I can do it with intervals of 10. The scale showed high
internal consistency (α = .95) in this study.
Depression Anxiety Stress Scale (DASS; Lovibond & Lovibond, 1995). The
DASS is a 42-item measurement to assess symptoms of depression, anxiety and
stress in adults on a 4-point scale from 0 = did not apply to me at all to 3 = applied to
me very much or most of time. The scale showed high reliability for Depression (α =
.95), Anxiety (α = .86) and Stress (α = .92) in this study.
Client Satisfaction Questionnaire (CSQ; Turner et al., 1998). The CSQ is a 13-
item scale that evaluates the quality of service provided by the program and
allows parents to comment on any aspect of the program. The measure has a 7-
point scale for each item. The CSQ showed high internal consistency (α = .91) 209
in this study.
Questionnaire About Core Parenting Skills (Matsumoto, 2005). To investigate
parental acceptability of 17 skills based on their employment at home, parents
rated the usefulness of parenting strategies from 0 = not useful to 7 = very useful.
This measure was developed for this study, and showed good internal consistency
(α = .94).

Behaviour Change
 Yuki Matsumoto, Kate Sofronoff and Matthew R. Sanders

Materials
As requested by participants, all questionnaires in English were accompanied by a
Japanese translation. Handouts of translations of the Every Parent’s Group
Workbook (Markie-Dadds, Turner, & Sanders, 1997) were distributed weekly.
However, video segments and overhead projector sheets were in English as the con-
tent was covered by the workbook.

Procedure
Families were recruited through newsletters issued by the Japanese Society in
Brisbane and delivered by the Japanese Supplementary School in Brisbane and the
Gold Coast. These organisations have contributed to Japanese families whose par-
ents are seeking Japanese sociocultural opportunities, by providing Japanese cul-
tural events and language support.
After completing questionnaires (preassessment), parents were randomly
assigned either to the intervention (TP) or waitlist (WL) group. Participants in
the intervention completed the same questionnaires at the end of the program
(postintervention) and at 3-month follow-up. Waitlist participants completed the
same questionnaires at postintervention and then commenced the program.
The program involved five group sessions (2 hours each) and three telephone con-
sultation sessions (20 to 30 minutes each). Active skills training methods were used to
facilitate the development of a self-regulatory framework for parents, involving mod-
eling, role-plays, feedback and the use of specific homework.
All sessions were conducted by a Japanese accredited Triple P trainer. The
impact of culture and language differences on the implementation was carefully
considered in each session by clarifying parents’ understanding and concerns as
well as encouraging their questions and opinions.

Results
Data from 25 families in the TP group and 25 in the WL group were used to
assess intervention effects, and 25 in the TP to measure maintenance effects and
program acceptability. There was no attrition from either group. There were no
serious violations of statistical assumptions and no significant differences across
conditions on any measures at Time 1.
The intervention effects were analysed using a 2 (Condition) × 2 (Time)
between-subjects MANOVA, where univariate repeated measures ANOVAs and
pairwise comparisons were used to identify the source of significant differences
between conditions and times. Table 2 presents intervention outcomes at Times
1, 2 and 3 across groups. The maintenance effects were analysed using a series of
within subjects repeated measures (Time: T1 vs. T2 vs. T3), shown in Table 3.

210 Program Effects

Child Behaviour
There was a significant group × time interaction for the ECBI intensity scale, F(1, 48)
= 14.22, p < .0005. Post hoc comparisons of the simple effects showed a significant dif-
ference only for the intervention group between T1 and T2. Similarly for the ECBI
problem scale, there was a significant main effect for time in the intervention group
only; T1 and T2, F(1, 48) = 7.09, p = .011. Intervention parents reported significantly

Behaviour Change
 TABLE 2
Program Effects

Triple P (n = 25) Waitlist (n = 25) Condition

T1 (pre) T2 (post) T3 (3-month follow-up) T1 (pre) T2 (post) × Time × Time

Behaviour Change
M (SD) M (SD) M (SD) M (SD) M (SD) F F

Child behaviour
ECBI (intensity) 110.80 (27.50) 94.12 (23.79) 92.32 (26.80) 101.72 (23.07) 105.80 (25.28) 14.22*** 5.24*
ECBI (problem) 8.84 (6.68) 5.04 (6.18) 4.48 (4.40) 8.00 (7.55) 6.72 (5.82) 1.75 7.09*

Parental practices
PS (laxness) 3.50 (0.58) 3.13 (0.65) 3.12 (0.61) 3.36 (0.83) 3.30 (0.76) 2.19 4.50*
PS (overreactivity) 3.40 (0.82) 2.84 (0.83) 2.92 (0.92) 3.24 (1.11) 3.29 (0.88) 8.83** 6.10*
PS (verbosity) 4.09 (0.65) 3.94 (0.68) 4.05 (0.86) 3.99 (0.58) 3.93 (0.71) 0.18 1.08
Parental competence
PSBC 79.10 (16.14) 85.76 (13.08) 86.51 (12.56) 82.09 (10.11) 79.84 (11.78) 10.40** 2.56
Family functioning
PPC (problem) 4.52 (3.73) 2.52 (3.71) 2.16 (2.30) 4.04 (4.33) 2.48 (3.49) 0.21 13.77**
PPC (intensity) 34.12 (15.83) 30.04 (13.72) 24.12 (8.81) 35.32 (18.70) 33.12 (17.99) 0.29 3.25
RQI (relationship) 32.64 (7.81) 34.80 (7.11) 35.24 (6.94) 32.92 (9.12) 32.28 (9.29) 2.67 0.79
Parental adjustment
DASS (depression) 6.36 (7.66) 4.80 (8.51) 2.68 (3.50) 6.36 (7.71) 5.88 (9.55) 0.33 1.17
DASS (anxiety) 4.12 (5.83) 2.04 (2.89) 1.76 (2.47) 3.00 (3.15) 3.40 (4.99) 4.32* 1.98
DASS (stress) 10.32 (9.53) 7.12 (7.08) 5.92 (4.42). 10.76 (6.53) 9.68 (9.71) 0.70 2.87
Note: ECBI = Eyberg Child Behaviour Inventory; PS = Parenting scale; PSBC = Problem Setting Behaviour Checklist; PPC = Parent Problem Checklist; RQI = Relationship
Quality Index; DASS = Depression Anxiety Stress scale.
*p < .05, **p < .01, ***p < .0005
Triple P Parenting Program with Japanese Families

211
 Yuki Matsumoto, Kate Sofronoff and Matthew R. Sanders

TABLE 3
Maintenance Effects and p Values Between T1–T2 and T1–T3 Within TP Group

Measures TP group (n = 25)

T1–T2 T1–T3
p value p value
Child behaviour
ECBI (intensity) .000 .000
ECBI (problem) .008 .002
Parental practices
PS (laxness) .042 .011
PS (overreactivity) .001 .015
PS (verbosity) .308 .820
Parental competence
PSBC .002 .001
Family functioning
PPC (problem) .014 .004
PPC (intensity) .183 .004
RQI (relationship) .170 .055
Parental adjustment
DASS (depression) .319 .012
DASS (anxiety) .031 .019
DASS (stress) .076 .008
Note: ECBI = Eyberg Child Behaviour Inventory, PS = Parenting Scale, PSBC = Problem Setting
Behaviour Checklist, PPC = Parent Problem Checklist, RQI = Relationship Quality Index,
DASS = Depression Anxiety Stress Scale.

lower levels of child behaviour problems on the ECBI intensity and problem scales at
the postintervention.

Parenting Styles
The Parenting Scale measured three styles of parenting: laxness, overreactivity and ver-
bosity. A significant group × time interaction was found for parental overreactivity, F(1,
48) = 8.83, p = .005. Posthoc comparison of the simple effects revealed a significant dif-
ference for overreactivity in the intervention group between T1 and T2, with no signif-
icant differences in the wait list group. A significant main effect for time was found for
parent ratings of the laxness in the intervention group only, F(1, 48) = 4.50, p = .039.

Parental Competence
For parental competence as measured by the PSBC, a significant group × time inter-
action was found, F(1, 48) = 10.40, p = .002. Post hoc comparisons revealed a sig-
212 nificant difference in the intervention group only between T1 and T2. Intervention
parents showed significantly higher levels of confidence in successfully dealing with
child problem behaviours.

Family Functioning
For the problem subscale of the PPC, both groups revealed a significant main effect for
time, F(1, 48) = 13.77, p = .001. For the intensity subscale of the PPC, no interaction

Behaviour Change
 Triple P Parenting Program with Japanese Families

or main effects were found. Parents in the intervention group reported a significant
reduction in problems of interparental conflicts over child rearing.
At T2, the parent reports on the degree of partner satisfaction within the rela-
tionship as measured by the RQI revealed no change. Parents in both groups
reported higher levels of partner satisfaction than the cut-off score (29) both at pre
and postintervention.

Parental Adjustment
There was a significant interaction for anxiety in the DASS, F (1, 48) = 4.32, p =
.043. The TP group reported significant reduction in the anxiety subscale compared
to the WL group. There were no interactions or main effects for the depression and
stress subscales.

Maintenance Effects
Table 3 shows that significant differences between T1 and T2 were maintained at
T3. At 3-month follow-up, parents in the TP reported scores indicating the main-
tenance of improvement in the ECBI, the PS laxness and overreactivity, the
PSBC, the PPC problem, and the DASS anxiety found at T2. Additionally, the
follow-up scores indicated improvement in the PPC intensity, the DASS depres-
sion and stress between T2 and T3.

Parents’ Acceptability Ratings

Program
The parents’ ratings of satisfaction with the program ranged from 4.92 (1.15) to
6.24 (0.93) on a 7-point scale (Table 4). Parents rated highest in the item of
‘quality of service received’, 6.24 (0.93), ‘type of help expected’, 6.04 (0.84) and
‘overall satisfaction’, 6.00 (0.87), while lowest in the item of ‘improvement in
partnership’, 4.92 (1.15).

Positive Parenting Skills

Table 5 illustrates parents’ ratings of the perceived usefulness of 17 positive par-
enting skills. Participants were asked to rate each of 17 positive parenting skills
on a Likert-style scale from 0 to 7 where 0 is the least useful and 7 is the most
useful. ‘praising child’ and ‘showing affection’ were rated highest, whereas ‘quiet
time’ and ‘time-out’ were lowest. The overall usefulness ranged from 4.68 (2.14)
to 6.44 (1.36); this represents 66.9% to 92.0% approval for the usefulness of skills
that parents learned in the program.

Discussion
The present study aimed to evaluate the efficacy and acceptability of Triple P with
Japanese parents in Australia. At postintervention, parents in the intervention
213
group reported significantly lower levels of child problem behaviours, higher levels
of parental competence and lower levels of parental disagreements than parents in
the wait-list condition. The program and parenting core skills were considerably
accepted. However, significant effects were not found in levels of parental depres-
sion, anxiety or stress.
The first hypothesis, predicting a significant program effects at postintervention,
was supported by the significantly lower scores of the ECBI, the increased parenting

Behaviour Change
 Yuki Matsumoto, Kate Sofronoff and Matthew R. Sanders

TABLE 4
Program Satisfaction Ratings in Triple P Group (n = 25)

Questions M SD
Quality of service received 6.24 0.93
Type of help expected 6.04 0.84
Program met child’s needs 5.08 1.26
Program met parents’ needs 5.28 1.21
Amount of help received 5.80 1.00
Effectiveness in dealing with child behaviour 5.76 0.88
Effectiveness in dealing with family issues 5.32 0.99
Improvement in partnership 4.92 1.15
Overall satisfaction 6.00 0.87
Intention to come back to Triple P 5.92 1.08
Applicability of skills to other family members 5.56 1.00
Child’s behaviour at this point 5.56 0.71
Child’s progress at this point 5.96 0.73
Total mean score 5.65 0.69
Note: Mean scores in the Client Satisfaction Questionnaire range from 7= very satisfied to
1 = very dissatisfied.

competency measured by the PSBC, changes in parenting styles measured by the

PS, and the significantly lower levels of parental disagreements measured by the
PPC compared to those in the control condition . These results are consistent with
the research findings of Group Triple P trials in other studies (e.g., Crisante &
Ng, 2003; Leung et al., 2003; McTaggart & Sanders, 2003; Zubrick et al., in
press; Zubrick, Silburn, Burton, & Blair, 2000). Parents in the intervention
reported higher levels of confidence in their ability to manage their children in
a variety of settings compared with wait-list parents. The self-regulatory frame-
work that is used throughout the program seemed to facilitate parents’ recogni-
tion of their own successful management of parenting practices and child
behaviour, this in turn is thought to enhance parental self-efficacy (Sakano,
2004; Sanders et al., 2003).
Discipline styles targeted in Triple P are laxness, overreactivity and verbosity
which were assessed by the PS. However, the verbosity subscale seems to have
failed to assess what it was intended to measure by the low reliability of the scale
(α = .04). Japanese mothers’ preference for verbal explanations and reasoning as
discipline methods have been widely reported (Conroy, Hess, Azuma, &
Kashiwagi, 1980; Ujiie, 1997). It is important to assess the overtalkative style
214 which may account for dysfunctional parenting in some cases.
There were no pre- and postdifferences in parental depression, stress, and the quality
of parental partnerships. The scores reported on the DASS and the RQI did not fall
into the clinical level and were relatively stable over the pre- and postinterventions.
The second hypothesis predicting that the changes gained at postinterven-
tion would be maintained at 3-month follow-up was supported. The result is
consistent with that of other research (see Sanders, et al., 2003).

Behaviour Change
 Triple P Parenting Program with Japanese Families

TABLE 5
Usefulness Rating on Core Parenting Skills in Triple P Group (n = 25)

Skills M SD
Spending quality time 5.96 1.54
Talking with child 6.04 1.54
Showing affection 6.36 1.38
Praising child 6.44 1.36
Giving attention 5.96 1.54
Providing engaging activities 5.88 1.74
Setting a good example 5.40 1.53
Incidental teaching 5.40 1.41
Ask, say, do 5.00 1.73
Behaviour chart 5.08 2.04
Ground rules 5.32 1.60
Directed discussion 4.76 1.76
Planned ignoring 4.76 2.11
Clear, calm instruction 5.80 1.53
Logical consequences 5.48 1.85
Quiet time 4.68 1.97
Time-out 4.68 2.14
Note: Mean scores of each skill ranging from 7 = very useful to 1 = of little use.

The third hypothesis, predicting acceptability of the program and the core
parenting skills, was supported. The average program satisfaction rate (M =
5.65, SD = 0.69) in this study with Japanese parents was higher than that of
Chinese parents, 5.13, 0.92 (Crisante & Ng, 2003), and similar to Australian
parents, 5.52 for the mothers and 5.42 for the fathers (Dean, Myors, & Evans,
2003). Although no comparison was available with other ethnic groups, the pos-
itive evaluation of parenting strategies by Japanese parents is considerable. The
results may indicate good acceptability of Triple P by Japanese parents.
The final hypothesis predicted that there would be variation in parents’ rat-
ings of the usefulness of strategies related to cultural differences, which was sup-
ported. Parents gave high ratings to ‘descriptive praise’, ‘showing affection’ and
‘talking with child’, but gave lower ratings to ‘quiet-time’ and ‘time-out’. The
results may reflect Japanese parents’ use of a non authoritarian approach
(Dennis, Pamela, Zahn-Waxler, & Mizuta, 2002; Ujiie, 1997), of affective
vocalisations (Minami & McCabe, 1995), and engagement to foster empathy
(Tamis-LeMonda, Bornstein, Cyphers, Toda, & Misako, 1992).
Parents initially showed some concern about the nature and success of ‘descrip- 215
tive praise’ and it was a contentious aspect of group discussion in this trial. The
self-regulatory framework in the program encourages parents to decide for them-
selves which strategies they are comfortable using in their own environment with
their child: strategies are suggested to parents, not prescribed by the therapist
(e.g., Sanders et al., 2003). During this process, the context to which the fami-
lies belong can affect parental decisions since acculturation in parental practices

Behaviour Change
 Yuki Matsumoto, Kate Sofronoff and Matthew R. Sanders

depends on the context where the practice takes place (Cocking, 1994). At the
postintervention, ‘descriptive praise’ was rated the highest of all 17 skills.

Limitations and Future Research

Although all the participants in the program were Japanese, many of the families
were bicultural having a Japanese mother and Australian father with relatively
high education levels. It should be noted, therefore, that the results from this
study may not generalise to families where both parents are Japanese.
It is also unknown to what extent the Japanese participants in the study were
acculturated to Australian society as no assessment was used to measure the accultura-
tion. Acculturation refers to the degree of cultural maintenance and adaptation to the
host culture (Stevens, Vollebergh, Pels & Crijnen, 2007). Future research needs to
identify more specific ethnic characteristics such as levels of acculturation, period of
immigration, social class, and appropriate comparison groups (Harrison et al., 1990).

Conclusion
The efficacy study found significant intervention effects and considerable accep-
tance of the Triple P program and its positive parenting skills with Japanese parents
living in Australia. The findings encourage the study of the effectiveness and
parental acceptance of Triple P in Japan.

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