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Positive Parenting Program (Triple P) - Level 3 Discussion Groups

Category

Family Support

Child's Age

0-1 years, 1-2 years, 2-3 years, 3-4 years, 4-5 years

Participant

Parents/Guardian

Languages

English, Spanish

Brief Description

Parent education groups for parents of children with mild to moderate behavioral difficulties, focusing on a specific problem behavior or issue. Discussion groups can be delivered as a series or taken as stand-alone sessions.

Expected Impact

  • Reduced frequency of child problem behaviors 
  • Lower scores on the Parenting Scale for dysfunctional parenting styles
  • Higher confidence on Behavioral Self-Efficacy and Setting Self-Efficacy scales of the Parenting Tasks Checklist
  • Increased likelihood of children scoring in the non-clinical range on the Eyberg Child Behavior Inventory Intensity scale
  • Reduced likelihood of parents scoring in the clinical range on the Parenting Scale overall and Behavioral Self-Efficacy and Setting Self-Efficacy scales of the Parenting Tasks Checklist
  • Improved scores on Eyberg Child Behavior Inventory, Parenting Scale Over-Reactivity and Verbosity scales, and Parenting Tasks Checklist Setting Self-Efficacy scale
  • Reduced likelihood of using dysfunctional parenting styles 
  • Increased parent confidence in managing specific behaviors
  • Improved relationships with their partner/co-parent

Core Components for Model Fidelity

  • Discussion Group Topics: Discussion groups are offered in 2-hour increments. Each session covers one of the 5 following topics: 
    • Topic 1: Dealing with disobedience 
    • Topic 2: Managing fighting and aggression
    • Topic 3: Developing good bedtime routines 
    • Topic 4: Hassle-free shopping with children
    • Topic 5: Hassle-free mealtimes with children

Languages Materials are Available in

English, Spanish

Delivery Mode

In person or virtual via webinar platform

Dosage

2-hour small group format discussions made up of 8 to 12 parents.

Infrastructure for Implementation

Materials: Facilitator’s Kit for Triple P Discussion Group (includes Presentation Guide and five Workbooks); Access to the Triple P Discussion Groups PowerPoint presentations; Facilitator’s Manual for Triple P Discussion Groups; Each family receives a Triple P Discussion Group Workbook on the corresponding topic they are attending.

Space: Adequate meeting space for in person group sessions, computer, projection, and sound for video components if delivered in-person. If delivered virtually, a virtual meeting platform with video streaming capability.

Staffing Requirements

Staffing requires a Discussion Group Triple P Accredited practitioner. This practitioner only needs to have a knowledge of child development to be eligible for training. It is recommended that the staff member have high levels of comfort with small group delivery. 

Based on the research, it is strongly recommended that group facilitators are licensed psychologists.

NCPC strongly recommends staff receive training in the Standards of Quality for Family Support and Strengthening. Contact Positive Childhood Alliance North Carolina (PCANC) or National Family Support Network (NFSN) for more information, training, and certification. 

Training for Model Fidelity

Practitioners must complete training and accreditation through Triple P America. Training is available in-person or through a hybrid option supported by video conference.

The virtual and in-person options include 2 days of training, 1 pre-accreditation day, and a half-day accreditation day. Preparation for the accreditation day requires 4-6 hours of time to prepare for the quiz and competency assessment. It is also strongly recommended that practitioners participate in peer support post-training, which can vary in time and/or frequency (usually about 1 hour a month, but may be more frequent at the beginning). 

Contact Information

https://www.triplep.net/glo-en/the-triple-p-system-at-work/the-system-explained/

contact.us@triplep.net
803-451-2278  

Sara van Driel, PhD: Community Engagement/Implementation Consultant at Triple P America; sara@triplep.net

Ashley Lindsay: Community Engagement/Implementation Consultant at Triple P America; ashley.lindsay@triplep.net

Cost Estimates

2023 cost for Level 3 Discussion Groups virtual Open Enrollment is $2,140/person which is inclusive of training, pre-accreditation, accreditation, practitioner materials, and access to the Triple P Provider Network. The 2023 cost for a virtual agency-based training is $34,110 (which equates to approximately $1,705.50 per person when there are 20 practitioners.) Smart Start local partnerships interested in Triple P training should connect with their local Lead Implementing Agency for North Carolina. If you are unsure of your local contact, please email contacts.us@triplep.net. Further, the 2023 parent resource cost for Discussion Group is approximately $8/parent/discussion group. The costs noted here are just for training and parent materials. Other start up costs will depend on the agency and specific practitioner.

Purpose Service Code (PSC)

5505 - Parent Education

Program Identifier (PID)

Positive Parenting Program (Triple P) - Level 3 Discussion Groups

Minimal Outputs for NCPC Reporting

  FY 24-25:

  • Number of parent/guardians participating† 

    †Select Family Support Programs data collection will include basic demographic data for parent/guardian participants including Race, Ethnicity. Data on interpretation and transportation will be collected when appropriate.  

Minimal Outcomes for NCPC Reporting

  FY 24-25:

  • Increase in positive parenting practices

Minimal Measures for NCPC Reporting

FY 24-25:

  • TRIPLE P CLIENT SATISFACTION
    SURVEY– LEVEL 3 (Discussion Group)

NCPC Evidence Categorization

Evidence Based - 3 publications, all of which were randomized control trials.

Research Summary

Four of the most relevant publications on Triple P Level 3- Discussion Groups include four randomized control trials.1,2,3,4 Sample populations included families from Australia or New Zealand with children ages 2-7 years old who showed behavior problems during shopping trips or demonstrated noncompliant behaviors, as well as children whose parents reported concerns about their behavior. Most participants were women, white, held university degrees, and worked in paid employment. The samples all featured slightly more boys than girls. Most children lived with married parents in their original families. One study exclusively sampled children of Māori descent. Results of these studies indicated that, compared to the control group, participants in the intervention reported a lower frequency of child problem behaviors and fewer problem behaviors. The intervention group scored significantly lower on the Parenting Scale (PS) for dysfunctional parenting styles. They also reported significantly higher confidence on Behavioral Self-Efficacy and Setting Self-Efficacy scales of the Parenting Tasks Checklist (PTC). Significantly more children in the intervention group scored in the non-clinical range on the Eyberg Child Behavior Inventory (ECBI) Intensity scale, while significantly fewer parents in the intervention group scored in the clinical range on the PS overall and Behavioral Self-Efficacy and Setting Self-Efficacy scales of the PTC. A higher proportion of intervention parents showed reliable improvements on ECBI, PS Over-Reactivity and Verbosity scales, and PTC Setting scale. The intervention group was significantly less likely to use dysfunctional parenting styles at posttest and felt more confident in managing specific behaviors (but not managing behavior in different settings). The intervention group reported improved relationships with their partner/co-parent. They also indicated improvements in their child’s behavior and attributed these improvements to their parenting rather than another factor. The intervention group reported significant reductions in child behavior, use of ineffective discipline practices (p < .001), and interparental conflict (p = .002) from pretest to follow-up. They also reported greater improvements in parenting confidence (p < .001) and parental well-being. At the 6-month follow-up, families from the intervention group indicated maintenance in child behavior, parenting style, confidence, parenting experience, social support, and partner support. 

  1. ^  See Joachim, Sanders, & Turner (2010). This randomized control trial evaluated a brief, topic-specific Triple P intervention delivered in a group format. The sample population included 46 families or 26 responding parents of 2–6-year-old children (M = 3.23 years) who showed behavior problems during shopping trips. Most participants were women (96%), ethnically Australian (91.3%), and held university degrees (70%). About half were employed (52%), working an average of 23.96 hours per week, and had a weekly income of $1,346 or higher (56%). The sample featured slightly more boys than girls. Most children lived with married parents in their original families. Parents were randomly assigned to receive the intervention or join a waitlisted control group. In the intervention group, parents participated in a 2-hour discussion group on hassle-free shopping trips. Each group served an average of 10 participants. All participants received a parent workbook, a Positive Parenting booklet, and a Going Shopping parent tip sheet. They completed questionnaires before the intervention (pretest), 4 weeks after (posttest), and 6 months after the intervention as a follow-up. The waitlist group completed the same questionnaires at pre/post-intervention. After completing the posttest, they participated in the discussion group but no further data was collected or included in analysis for this study. Measures included Family Background Questionnaire (participant demographics), Eyberg Child Behavior Inventory (ECBI), Shopping Observation Checklist, Parenting Scale (PS), Parenting Task Checklist (PTC), Parent Problem Checklist (PPC), Depression Anxiety Stress Scales 21 (DASS-21), Client Satisfaction Questionnaire (CSQ), and Session Feedback Form. The CSQ was completed at the 4-week posttest period while the Session Feedback Form was completed immediately after the intervention concluded. Participants in the intervention reported a lower frequency of child problem behaviors and fewer problem behaviors (p = .014, with medium and large effect sizes respectively). At pretest, 100% of intervention participants reported problematic shopping trips, while only 34.8% of participants reported difficult shopping trips at posttest (p = .014). The waitlisted control group reported an increase in problematic shopping trips, from 95% at pretest to 100% at posttest. The intervention group scored significantly lower on the PS for dysfunctional parenting styles (medium effect size, p = .003). They also reported significantly higher confidence on Behavioral Self-Efficacy and Setting Self-Efficacy scales of the PTC (large effect sizes, p < .001). There were no significant differences in scores on the DASS-21 or PPC. Finally, the researchers found that significantly more children in the intervention group scored in the non-clinical range on the ECBI Intensity scale, while significantly fewer parents in the intervention group scored in the clinical range on the PS overall and Behavioral Self-Efficacy and Setting Self-Efficacy scales of the PTC.
  2. ^ See Morawska et al. (2011). This randomized control trial evaluated Triple P’s brief parenting intervention for parents concerned about their child’s disobedience. The sample population included 67 parents (66 mothers, 1 father) of children ages 2-5 years (M = 3.63 years) in the Brisbane, Australia metropolitan area. Most children were white (95.5%) and lived with married parents (91%). The sample featured slightly more boys (55.2%) than girls. Mothers' mean age was 36.3 years and fathers' mean age was 39.67 years. Approximately half of parents had obtained a university degree and 73% of mothers and 97% of fathers worked in paid employment. Parents indicated they had enough money to purchase some (45.5%) or most (40.9%) of the things they wanted. Parents completed pretest questionnaires and were randomly assigned to the intervention group (33) or a waitlisted control group (34). In the intervention group, parents participated in a 2-hour discussion group on child noncompliance. Each group served an average of 6 families and was facilitated by 1 of 3 psychologists. Parents received workbooks and 2 brief telephone consultations in the 2 weeks after the discussion group. Questionnaires were completed before the intervention (pretest), after the intervention (posttest), and 6 months after the intervention (follow-up). Measures included Family Background Questionnaire, Eyberg Child Behavior Inventory (ECBI), Parenting Scale (PS), Parenting Tasks Checklist (PTC), the attachment subscale of the Parenting Relationship Questionnaire (PRG:P), Parenting Experience Survey, Client Satisfaction Questionnaire, and two study-specific questions regarding improvements in child’s behavior in the 6 weeks between posttest and follow-up and what parents attributed this change to. The intervention group reported lower frequency and number of child behavior problems. They were significantly less likely to use dysfunctional parenting styles at posttest and felt more confident in managing specific behaviors (but not managing behavior in different settings). The intervention group reported improved relationships with their partner/co-parent. They also indicated improvements in their child’s behavior and attributed these improvements to their parenting rather than another factor. The intervention group reported no changes in their perceptions of attachment or their parenting experience. At the 6-month follow-up, families from the intervention group indicated maintenance in child behavior, parenting style, confidence, parenting experience, social support, and partner support.
  3. ^ See Dittman et al. (2016). This randomized control trial evaluates Triple P’s brief parent discussion group for parents of children ages 3-5 years who were seeking specific advice about managing noncompliant behavior. The sample included 85 parents recruited from Auckland, New Zealand and Brisbane, Australia. Most participants were mothers (94%) with an average age of 37.33 years and held university degrees (70%). Most children were male (65%). Participants were randomly assigned to the intervention or waitlisted control group. The intervention group was assessed before the discussion group (pretest), 4-8 weeks after the discussion group (posttest), and at a 6-month follow-up. Participants attended the one-time, 2-hour discussion group on managing noncompliant behaviors and received a workbook and parent tip sheet. Groups were led by a registered psychologist trained and accredited to deliver Triple P discussion groups. Each group served an average of 6 parents for a total of 12 groups. Measures included Family Background Information, Eyberg Child Behavior Inventory (ECBI), Parenting Scale (PS), Parenting Task Checklist (PTC), Depression Anxiety Stress Scales (DASS), Parent Problem Checklist (PPC), Relationship Quality Inventory (RQI), and Client Satisfaction Questionnaire (CSQ). A greater proportion of parents in the intervention group than the comparison group reported shifts from the clinically elevated range to the non-clinical range on ECBI and PS scales. A higher proportion of intervention parents showed reliable improvements on ECBI, PS Over-Reactivity and Verbosity scales, and PTC Setting scale. The intervention group reported significant reductions in child behavior, use of ineffective discipline practices (p < .001), and interparental conflict (p = .002) from pretest to follow-up. They also reported greater improvements in parenting confidence (p < .001) and parental well-being.
  4. ^ See Keown et al. (2018). This randomized control trial evaluated the impacts of two 2-hour Triple P Discussion Groups: "Being a Positive Parent" and "Dealing with Disobedience." The study sampled 70 parents of children ages 3-7 years (M = 4.5 years) of Māori descent. Most children were male (63%) and the majority of parents were mothers (80%). Parents primarily reported being married (14.3%) or living with their partner (40%). Participants were recruited from one rural and one urban area in northern New Zealand. Interested parents completed a screening interview for eligibility, which included reporting concerns about their child's behavior, not receiving services for their child's behavior problems or their own psychological difficulties, and reporting that the child did not have a developmental disability. Families were randomly assigned to the intervention group (N = 41) and waitlisted control group (N = 29). Assessments were completed at pre-intervention, 5-week post-intervention, and 6-month follow-up. Measures included the Eyberg Child Behavior Inventory (ECBI), Strengths and Difficulties Questionnaire (SDQ), SDQ impact supplement, Parenting Scale (PS), Parenting Task Checklist (PTC), Depression Anxiety Stress Scales (DASS-21), Parent Problem Checklist (PPC), Relationship Quality Inventory (RQI), and a Client Satisfaction Questionnaire (CSQ). Parents attended the two discussion groups, led by accredited Māori Triple P practitioners and supported by Māori elders. Participants received resources specifically designed to connect Māori tikanga (values) with Triple P positive parenting principles. Group sizes ranged from 4 to 12 in the intervention group (average of 6 parents) and 3 to 10 in the waitlist group (average of 5 parents).Transportation and child care assistance were provided to enable participation. Preliminary results indicated that parents who did not complete the 6-month follow-up were more likely to be single parents and have higher DASS stress scores at baseline. From pre- to post-intervention, parents in the intervention group reported significantly fewer (p = 0.003) and less severe (p = 0.018) child behavior problems, as well as lower levels of child functional impairment as measured by SDQ impact scores (p = 0.013). Parents in the intervention group also reported significantly fewer (p < 0.001) and less severe (p = 0.001) interparental conflicts regarding child rearing, according to PPC problem and extent scores, respectively. Intervention group parents reported significant improvements in partner relationship quality based on RQI scores (p = 0.017). Long-term intervention effects (pre-intervention to follow-up) indicated that the outcomes observed at post-intervention maintained. Additionally, intervention group parents' scores on the PS overreactivity scale and PTC setting and behavioral scales indicated significant reductions in overreactive parenting practices (p = 0.013) and improvements in parenting confidence and self-efficacy (p = 0.044 for both PTC scales), respectively. One limitation of this study is that the sample was based on one Māori tribe in New Zealand and thus the findings cannot be generalized to other populations.

Researched Population

  • Families from Australia or New Zealand
  • Children ages 2-7 years old who showed behavior problems during shopping trips or demonstrated noncompliant behaviors
  • Most participants were women, white, held university degrees, and worked in paid employment
  • Slightly more boys than girls
  • Most children lived with married parents in their original families
  • Māori families

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. https://www.doi.org/10.1007/s10578-015-0548-9

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. https://www.doi.org/10.1007/s10578-009-0151-z

Keown, L. J., Sanders, M. R., Franke, N., & Shepherd, M. (2018). Te Whānau Pou Toru: a Randomized Controlled Trial (RCT) of a Culturally Adapted Low-Intensity Variant of the Triple P-Positive Parenting Program for Indigenous Māori Families in New Zealand. Prevention Science. 19, 954-965. https://doi.org/10.1007/s11121-018-0886-5

Level 3 – Triple P. (n.d.). https://www.triplep.net/glo-en/the-triple-p-system-at-work/the-system-explained/level-3/

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. https://www.doi.org/10.1097/DBP.0b013e3181f17a28



Local Partnerships Currently Implementing

Local Partnerships in purple have adopted Positive Parenting Program (Triple P) - Level 3 Discussion Groups. Local Partnership contact information can be found here.