Level 5 Pathways Triple P is a parenting intervention for parents who have difficulty regulating their emotions and may be at risk of physically or emotionally harming their child. The intervention is delivered by a Triple P practitioner to families individually over five sessions (lasting 60 to 90 minutes), or to groups of parents over four sessions (lasting 120 minutes) supplemented by four individual telephone sessions.
The information above is as offered/supported by the intervention provider.
2 to 12 years old
Individual, Group
Level 5 Pathways Triple P is part of the Triple P multilevel system of family support, developed specifically for parents who have difficulty regulating their emotions and may be at risk of physically or emotionally harming their child. The intervention is delivered by a Triple P practitioner to families individually over five sessions (lasting 60 to 90 minutes), or to groups of parents over four sessions (lasting 120 minutes) supplemented by four individual telephone sessions.
The content includes many of the core principles taught in Level 3 or Level 4 Triple P interventions, supplemented with content aimed at helping parents develop appropriate expectations and attributions their child’s behaviour, alongside anger management skills. Examples of the content covered include:
0 to 16 years old
Parents who are at risk of physically or emotionally harming a child between 0 and 16 years old.
Disclaimer: The information in this section is as offered/supported by the intervention provider.
Science-based assumption
Experiences of maltreatment, trauma, and ongoing family stress in childhood increases the risk of poor outcomes in childhood and adolescence.
Science-based assumption
Unrealistic parental expectations of children’s behaviour and negative attributions are associated with an increased risk of child maltreatment.
Science-based assumption
Parents where there are concerns about child maltreatment risk
Parents who have difficulty managing their emotions or negatively attribute normal child behaviour.
Intervention
Parents learn:
To develop appropriate expectations of their child’s behaviour.
Strategies for recognising and reducing unhelpful attributions
Strategies for managing negative parental moods
Strategies for discouraging negative child behaviour.
Short-term
Improved expectations of child behaviour
Reduced negative attributes of child behaviour
Medium-term
Improved child behaviour
Reduced child maltreatment risk.
Long-term
Reduced child maltreatment risk
Improved child wellbeing.
Parents who have difficulty regulating their emotions and as a result are considered at risk of physically or emotionally harming their children (aged 16 or younger).
Pathways Triple P is an adjunctive intervention for parents undertaking a Level 4 Triple P intervention (e.g. Group Triple P or Standard Triple P).
The intervention is delivered by a single practitioner to families individually over five sessions (lasting 60 to 90 minutes each), or groups of approximately eight parents over four sessions (lasting 120 minutes each) supplemented by four individual telephone sessions.
The last session focuses on how parents can maintain changes, problem-solve for the future, and create future goals.
Pathways Triple P is delivered by a single practitioner who has experience in providing regular interventions, such as a school counsellor, nurse, psychologist, social worker, or allied health professional. In addition, it is expected that practitioners will have experience of working with parents at high risk of physically maltreating their children.
Practitioners delivering Pathways Triple P must attend two days of training and a half-day accreditation session.
Practitioners must have completed one of the following Triple P courses as a prerequisite to attending Pathways: Group, Standard, Group Teen or Standard Teen.
It is recommended that practitioners undergo peer supervision four times a year. The supervision is delivered in two-hour sessions by one practitioner that is typically a master’s qualified psychologist or social worker with previous Triple P experience.
Triple P has also developed their own Peer-Assisted Supervision and Support Model (PASS), whereby practitioners can both provide and receive structured feedback from each other while they deliver the intervention. PASS sessions are conducted in small groups of six to eight practitioners and run for one to two hours every month.
Triple P UK can also provide additional clinical support for practitioners, as either a one-day workshop or a small-group phone consultation with a Triple P trainer.
Intervention fidelity is maintained through the following processes:
Supervision and practitioner support standards using the Peer Support Network.
Organisation: Triple P UK
Email address: contact@triplep.uk.net
Websites: www.triplep-parenting.net
www.triplep.net
https://pfsc-evidence.psy.uq.edu.au/
*Please note that this information may not be up to date. In this case, please visit the listed intervention website for up to date contact details.
Level 5 Pathways Triple P qualifies for a Level 3+ rating, as it has evidence from at least one Level 3 study, along with evidence from other studies rated 2 or better.
Level 5 Pathways Triple P’s most rigorous evidence comes from a single RCT conducted in the United States that is consistent with Foundations’ Level 3 evidence strength criteria.
This study identified statistically significant improvements in Triple P parents and children’s reports of the child’s quality of life compared to families not receiving the intervention.
Additional evidence from two RCTs conducted in Australia consistent with Foundations’ Level 2+ evidence strength threshold.
The first study observed statistically significant improvements in Pathways Triple P’s parent reports of their child abuse potential and expectations for their child relative to parents who did not receive the intervention.
The second study observed that Pathways Triple P parents were significantly more likely to report improvements in their children’s behaviour and emotional symptoms compared to parents not receiving the intervention. Additionally, Pathways Triple P parents reported improvements in their own parenting behaviours relative to parents who did not receive Pathways Triple P.
Level 5 Pathways Triple P can be described as evidence-based: it has evidence from at least one rigorously conducted RCT or QED demonstrating a statistically significant positive impact on at least one child outcome.
| Identified in search | 7 |
| Studies reviewed | 5 |
| Meeting the L2 threshold | 2 |
| Meeting the L3 threshold | 1 |
| Contributing to the L4 threshold | 0 |
| Ineligible | 2 |
| Study design | RCT |
| Country | United States |
| Sample characteristics | 144 families with children aged 3 to 12 who received standard or intensive in-home services following child welfare system investigation or assessment. Eligibility for study inclusion was based on the following criteria: (1) a child between 3 years and 11 years living in the home; (2) allegations of child physical abuse or neglect with no current allegation of sexual abuse; (3) parents were at least 18 years old; (4) parents spoke English; (5) child was not medically fragile and did not have a pervasive developmental disorder. |
| Race, ethnicities, and nationalities | Parents’ ethnicities were as follows: Black/Mixed racial background
White American
|
| Population risk factors |
|
| Timing |
|
| Child outcomes | Improved quality of life |
| Other outcomes | No |
| Study rating | 3 |
| Citations | Lanier, P., Dunnigan, A. & Kohl, P. L. (2018) Impact of Pathways Triple P on pediatric health-related quality of life in maltreated children. Journal of Developmental and Behavioral Pediatrics. 39 (9), 701–708. |
| Study design | RCT |
| Country | Australia |
| Sample characteristics | 98 families with children between 2 and 7 years old who were previously reported for potential child abuse or neglect; and/or expressed concerns regarding difficulties in controlling their anger in relation to their child’s behaviour |
| Race, ethnicities, and nationalities | Not reported |
| Population risk factors | Most participants reported psychiatric illness in family (66% in the treatment group). Over half of the participants reported argument between parents. Roughly half of the participants received ‘belting’ as discipline. Less than 30% of the participants reported physical harm between parents. |
| Timing |
|
| Child outcomes | Reduced parental potential for child abuse (Parent report) |
| Other outcomes |
|
| Study rating | 2+ |
| Citations | Sanders, M. R., Pidgeon, A. M., Gravestock, F., Connors, M. D., Brown, S. & Young, R. W. (2004) Does parental attributional retraining and anger management enhance the effects of the Triple P – Positive Parenting Program with parents at risk of child maltreatment?,’ Behavior Therapy. 35, 513–535. |
| Study design | RCT |
| Country | Australia |
| Sample characteristics | 60 parents with concerns about a problematic relationship with a child between 4 and 10 years old |
| Race, ethnicities, and nationalities | Not reported |
| Population risk factors | Participants experienced borderline to clinically significant parent–child relationship disturbance. Parents in the sample also had a child with emotional and/or behavioural problems. |
| Timing |
|
| Child outcomes |
|
| Other outcomes |
|
| Study rating | 2+ |
| Citations | Wiggins, T. L., Sofronoff, K. & Sanders, M.R. (2009) Pathways Triple P-Positive Parenting Program: Effects on parent–child relationships and child behavior problems. Family Process. 48, 517–530. |
The following studies were identified for this intervention but did not count towards the intervention’s overall evidence rating. An intervention receives the same rating as its most robust study or studies.
Lewis, E. M., Feely, M., Seay, K. D., Fedoravicis, N. & Kohl, P. L. (2016) Child welfare involved parents and Pathways Triple P: Perceptions of program acceptability and appropriateness. Journal of Child and Family Studies. 1–11. This reference refers to a qualitative study, conducted in the USA.
Whalley, P. (2015) Child neglect and Pathways Triple P: An evaluation of an NSPCC service offered to parents where initial concerns of neglect have been noted. NSPCC
–
Note on provider involvement: This provider has agreed to Foundations’ terms of reference (or the Early Intervention Foundation’s terms of reference), and the assessment has been conducted and published with the full cooperation of the intervention provider.
Note on provider involvement: This provider has agreed to Foundations’ terms of reference (or the Early Intervention Foundation's terms of reference), and the assessment has been conducted and published with the full cooperation of the intervention provider.
Rated 1: Set up and delivery is low cost, equivalent to an estimated unit cost of less than £100.
Rated 2: Set up and delivery is medium-low cost, equivalent to an estimated unit cost of £100–£499.
Rated 3: Set up and delivery is medium cost, equivalent to an estimated unit cost of £500–£999.
Rated 4: Set up and delivery is medium-high cost, equivalent to an estimated unit cost of £1,000–£2,000.
Rating 5: Set up and delivery is high cost. Equivalent to an estimated unit cost of more than £2,000.
Set up and delivery cost is not applicable, not available, or has not been calculated.
Click here for more information.
Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient montes, nascetur ridiculus mus.
Supporting children’s mental health and wellbeing: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing child maltreatment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Enhancing school achievement & employment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing crime, violence and antisocial behaviour: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing substance abuse: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing risky sexual behaviour & teen pregnancy: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing obesity and promoting healthy physical development: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Rated 2: Has preliminary evidence of improving a child outcome from a quantitative impact study, but there is not yet evidence of causal impact.
Rated 2+: Meets the level 2 rating and the best available evidence is based on a study which is more rigorous than a level 2 standard but does not meet the level 3 standard.
Rated 3: Has evidence of a short-term positive impact from at least one rigorous study.
Rated 3+: Meets the level 3 rating and has evidence from other studies with a comparison group at level 2 or higher.
Rated 4: Has evidence of a long-term positive impact through at least two rigorous studies.
Rated 4+: Meets the level 4 rating and has at least a third study contributing to the Level 4 rating, with at least one of the studies conducted independently of the intervention provider.
Rating has a *: The evidence base includes mixed findings i.e., studies suggesting positive impact alongside studies, which on balance, indicate no effect or negative impact.
Click here for more information.
