Level 5 Enhanced Triple P is a parenting intervention for parents with concerns about the behaviour of their child. It combines Standard Triple P with adjunctive components aimed at improving parental mood and reducing partner conflict. It is delivered by a Triple P practitioner to families individually or in groups via 12 to 14 sessions lasting 40 to 90 minutes each.
The information above is as offered/supported by the intervention provider.
3 to 4 years old
Individual
Level 5 Enhanced Triple P is part of the Triple P multilevel system of family support, developed specifically for parents with concerns about their child’s behaviour. It is delivered by a Triple P practitioner to families individually or in groups via 12 to 14 sessions lasting 40 to 90 minutes each.
Enhanced Triple P combines Standard Triple P with adjunctive components aimed at improving parental mood and reducing partner conflict. It can be attended by one or both parents, although both parents are preferable if issues regarding the co-parenting relationship need to be addressed.
During the first session, parents provide detailed information about their child’s behaviour, developmental history, and family circumstances. Parents then complete a detailed questionnaire about their child and receive a form to help them observe and monitor their child’s behaviour during the following weeks.
During the second session, the practitioner observes the parents interacting with their child and provides detailed feedback. The practitioner and parent then work together to develop a shared understanding of the nature, severity, and probable causes of the parents’ concerns about their child’s behaviour. The practitioner and parent then identify specific goals for child and parent behavioural changes.
During sessions 3 to 10, parents are introduced to 17 strategies for encouraging positive child behaviour and enforcing age-appropriate discipline. Ten of the strategies are designed to promote children’s competence and development (i.e. quality time; talking with children; physical affection; praise; attention; engaging activities; setting a good example; Ask, Say, Do; incidental teaching; and behaviour charts), and seven strategies are designed to help parents manage misbehaviour (i.e. setting rules; directed discussion; planned ignoring; clear, direct instructions; logical consequences; quiet time; and time-out). Parents are also introduced to a six-step planned activities routine to enhance the generalisation and maintenance of skills promoted during the sessions.
The adjunctive Enhanced Triple P components are included as within-session exercises and homework assignments, tailored to the needs of each family.
On average, adjunctive components require two sessions in addition to the Standard Group Triple P.
0 to 12 years
Parents who have concerns about their child’s behaviour and are experiencing family stresses, such as couple conflict and/or low parental mood
Disclaimer: The information in this section is as offered/supported by the intervention provider.
Science-based assumption
Challenging and non-compliant behaviours are common in early childhood.
Challenging child behaviours during childhood increase the risk of antisocial behaviour in adolescence.
Science-based assumption
Ineffective parenting responses to challenging child behaviours increase the likelihood of problematic behaviour persisting and becoming more entrenched.
Science-based assumption
High levels of family stress, including stress associated with couple conflict and parental mood, increase the likelihood of ineffective parenting responses.
Intervention
Parents learn strategies for:
Managing sources of family stress
Reinforcing positive child behaviour
Improving the parent–child relationship.
Short-term
Parents are better able to manage their own mood and family conflict.
The parent–child relationship improves.
Medium-term
Children are better able to manage their own behaviour
Child behaviour improves.
Long-term
Children are at less risk of antisocial behaviour in adolescence
Children are more likely to engage positively with teachers and peers.
Parents who have concerns about their child’s behaviour and are experiencing family stresses such as couple conflict and/or low parental mood.
Enhanced Triple P consists of four modules, delivered in three to 11 sessions of between 40 and 90 minutes duration each, by one practitioner to individuals, couples, or families. The sessions include:
1) A review session to negotiate a treatment plan (1 hour)
2) Three optional modules of up to three sessions each (40–90 minutes)
3) A closure session to plan for maintenance and future problem solving (one hour).
The optional modules are Practice, Coping Skills, and Partner Support.
The three to 11 sessions are delivered in conjunction with a Level 4 Triple P intervention.
A certified Triple P practitioner, who may come from a range of helping professions, including psychologists, social workers, and family support workers.
Typically, an NFQ-9 qualified practitioner would supervise practitioners with 2 hours’ supervision time per quarter.
Practitioners learn the Triple P Peer Assisted Supervision and Support Model (PASS), a structured feedback process to promote learning of a complex set of consultation skills. Using the self-regulatory framework, practitioners are both providers and recipients of peer support. PASS sessions are conducted in small groups of 6 to 8 practitioners and run for one to two hours every month. TPUK can provide additional clinical support for practitioners as either a one-day workshop or small group phone consultations with a Triple P Trainer. This support is beneficial for practitioners who do not have access to formalised or peer support.
Organisation: Triple P UK
Email address: contact@triplep.uk.net
Website/s: 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 Enhanced Triple P’s most rigorous evidence comes from a single RCT conducted in Australia that is consistent with Foundations’ Level 3 evidence strength criteria.
This study identified statistically significant improvements in children’s behaviour that are consistent across a variety of measures.
This means Enhanced 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.
Enhanced Triple P does not receive a rating of 4 as it has not yet replicated its results in another rigorously conducted study, where at least one study indicates long-term impacts, and at least one uses measures independent of study participants.
Improved child behaviour
Immediately after the intervention
Improvement index
Interpretation
Study
Improved child behaviour
Immediately after the intervention
Improvement index
Interpretation
Study
Improved child behaviour
Immediately after the intervention
Improvement index
Interpretation
Study
Improved child behaviour
Immediately after the intervention
Improvement index
Interpretation
Study
Improved child behaviour
Immediately after the intervention
Improvement index
Interpretation
Study
| Identified in search | 2 |
| Studies reviewed | 1 |
| Meeting the L2 threshold | 0 |
| Meeting the L3 threshold | 1 |
| Contributing to the L4 threshold | 0 |
| Ineligible | 1 |
| Study design | RCT |
| Country | Australia |
| Sample characteristics | 305 Australian families experiencing behavioural problems with a child between 3 and 4 years old. |
| Race, ethnicities, and nationalities | Australian |
| Population risk factors | All families had at least one of the following family adversity factors: maternal depression, relationship conflict, single-parent household, or low gross family income. |
| Timing |
|
| Child outcomes |
|
| Other outcomes |
|
| Study rating | 3 |
| Citations | Study 1a: Sanders, M. R., Markie-Dadds, C. Tully, L. A. & Bor, W. (2000) The Triple P-Positive Parenting Program: A comparison of enhanced, standard, and self-directed behavioural family intervention for parents of children with early inset conduct problems. Journal of Consulting and Clinical Psychology. 68 (4), 624–640. Study 1b: Sanders, M. R., Bor, W. & Morawska, A. (2007) Maintenance of treatment gains: A comparison of enhanced, standard, and self-directed Triple P-Positive Parenting Program. Journal of Abnormal Child Psychology. 35 (6), 983–998. Study 1c: Bor, W., Sanders, M. R. & Markie-Dadds, C. (2002) The effects of the Triple P-positive Parenting Programme with co-occurring disruptive behaviour and attentional/hyperactive difficulties. Journal of Abnormal Child Psychology. 30, 571–587. |
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.
Bodenmann, G., Cina, A., Ledermann, T. & Sanders, M. R. (2008) The efficacy of the Triple P-Positive Parenting Program in improving parenting and child behavior: A comparison with two other treatment conditions. Behaviour Research and Therapy. 46 (4), 411–427
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.
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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.
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