Thepositive parenting program or Triple P for short is was developed at theuniversity of Queensland located in Brisbane Australia (Sanders, 1999).Triple-P is a form of behavioral family intervention based on social learningprinciples.
This approach to the treatment and prevention of childhooddisorders has the strongest empirical support of any intervention withchildren, particularly those with conduct problems (Sanders, 1999). Theprograms aims to (a) enhance the knowledge, self-sufficiency, andresourcefulness of parents ofpreadolescent children; (b) healthy and low conflict environments for children;(c) promote children’s social, emotional, language, intellectual, andbehavioral development through positive parenting practices(Sanders, 1999). The program also draws on the Social learning models of parent-childinteraction that highlight the reciprocal and bidirectional nature ofparent-child interactions identifies learning mechanisms, which maintaindysfunctional patterns of family interaction and predicts antisocial behaviorin children (Sanders, 1999). As a consequence the program specifically teachesparents positive child management skills as an alternative to coerciveparenting practices (Sanders, 1999).
Theprogram has five levels of intervention that are on a continuum of increasingstrength that is designed for parents of children zero to age twelve (Sanders,1999). The levels are structured asfollows: “Level 1, a universal parent information strategy, provides allinterested parents with access to useful information about parenting through acoordinated media and promotional campaign using print and electronic media, aswell as user friendly parenting tip sheets and videotapes which demonstratespecific parenting strategies(Sanders, 1999).” This level of intervention aimsto increase community awareness of parenting resources, receptivity of parentsto participating in programs, and to create a sense of optimism by depictingsolutions to common behavioral and developmental concerns (Sanders, 1999). “Level 2 is a brief, one- to two-session,primary health care intervention providing early anticipatory developmentalguidance to parents of children with mild behavior difficulties (Sanders,1999).
” ” Level 3, a four-session intervention, targets children with mild tomoderate behavior difficulties and includes active skills training for parents(Sanders, 1999).” “Level 4 is an intensive eight- to ten sessions individual orgroup parent training program for children with more severe behavioraldifficulties and Level 5 is an enhanced behavioral family intervention programfor families where parenting difficulties are complicated by other sources offamily distress (Sanders, 1999).” The reason for this multilevel strategy isthat there are differing levels of dysfunction and behavioral issues in eachfamily. The tiered system also serves to maximize efficiency and to ensure theprogram has a wide reach in the community, contain cost, avoid waste, and over servicing(Sanders, 1999). Also the multidisciplinary nature of the program involves thebetter utilization of the existing professional work force in the task ofpromoting competent parenting (Sanders, 1999). Triple P aims to enhance familyprotective factors and to reduce risk factors associated with severe behavioraland emotional problems in preadolescent children (Sanders, 1999). A 2008 studyfound that the multilevel intervention of triple P promoted short- andlong-term positive outcomes for children and parents after divorce suggesting thatcurrently Triple P remains effective despite no changes to the interventionhave been implemented since 1999 (Stallman & Sanders, 2007). HNCand Triple P are both Evidence based treatments that though there is slightoverlap primarily contrast each other in their approach.
Triple P as mentionedis tiered intervention with five levels and parents move through the levelsonly when it is deemed fit to do so (Sanders 2008). In contrast, HNC only hastwo phase and parents are expected to complete both phases. The lack ofstructure is a benefit that Triple P has over HNC because it allows forclinicians to only implement as much time, energy and resources that a familyneeds. Furthermore, HNC focuses on children from age three to eight. Any childoutside of that range are ruled out as possible participants. Meanwhile Tripe Pis designed for parents of children zero to twelve years old Giving Triple P awider range of possible participants. The wider age range is a benefit tofamilies but it does require that clinicians are knowledgeable on a wider rangeof ages in order for interventions and given resources to be effective. Additionally,HNC is a program designed for parents and their child to participant throughoutthe process.
In contrast, parents can participate in Triple P without a childduring level one and most likely will include their child in some or all of thefollowing levels. The ability for parents to engage without children simply toobtain parenting resources makes Triple P a preventative option for parentswhich is a strength over HNC where parents can only engage once there isalready intense behavior issues. Moreover,HNC specifically addresses struggles parents have with noncompliant children.Triple P is similar to HNC in the way that the program works to in increaseparental knowledge and address behavior issues within families however itdiffers by not specifying that children need to be considered non-compliant.This allows for Triple P to support a larger variety of families. The two interventions diverge when it comes towho can implement them as well.
HNC isdescribed as being implemented by a therapist Triple P, can be implemented byvarious professionals such as nurses,family doctors, pediatricians, teachers, social workers, psychologists,psychiatrists, and police officers, to name a few (Sanders, 1999). This in theory allows for Triple P to be moreaccessible to more families since more professionals can be trained toimplement it. It also opens up for the opportunity for families to receiveintervention from professionals they already know and trust versus a newtherapist where they must build rapport with.
HNC also is conducted in astructured environment families are expected to come to in order to engage withthe therapist to learn and improve skills. Triple P however, can be conducted face-to-facegroup, over the phone, or self-directed, or a combination of all these options(Sanders, 1999). This flexibility enables parents to participate in ways thatsuit their individual circumstance (Sanders, 1999). HNC also within its verystructured approach has an objective to teach parents how to attend, rewards,ignore and timeout and how to implement them effectively.
In contrast, withinTriple P it is stated that when applicable family interventions will be givenbut it does not specify that specially timeout, attends, rewards, or ignorewill be used. This is because unlike HNC Triple P addresses the unique needs ofeach family which does not rule out families being taught these methods, butopen the door to other methods they can be taught to implement at home.Overall Triple P is a strong evidence based intervention that fills the gaps thatpresented by HNC. I feel as though with the success of Triple P, it would bebeneficial to broaden the criteria for participants in terms of age range.Currently, parents can seek this intervention for children zero to age twelve. Itwould be interesting to see how Triple P could be adapted for teenagersthirteen to eighteen years old. Parents still need support and resources fortheir teens and their populations is often forgotten with evidence basedtreatments. Furthermore Triple P has a similar struggle that most EBTS havewhere it is hard to spread its implementation.
I think the best way to addressthis is to get more professionals trained in Triple P (Sanders, 2002). It boastthe potential for any practitioner to be trained by partnering withinstitutions such as hospitals.