Level 4 Standard Triple P is a parenting intervention for parents with concerns about their child’s behaviour. It is delivered by a Triple P practitioner to parents individually though 10 weekly sessions lasting approximately one hour each. During these sessions, parents learn strategies for encouraging positive child behaviour and implementing age-appropriate discipline.
The information above is as offered/supported by the intervention provider.
3 to 4 years old
Group
Level 4 Standard Triple P is part of the Triple P multilevel system of family support and is specifically for parents with concerns about the behaviour of a child under 12 years old.
Parents attend 10 one-to-one weekly sessions with an individual therapist lasting approximately one hour. The sessions are provided by a practitioner (most frequently a psychologist) trained and accredited in Triple P.
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 the child’s behaviour 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 three 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.
During all 10 sessions, a particular emphasis is placed on specific concerns identified in the first two sessions. Parent learning is supported through role-play exercises, homework exercises, and discussions involving videotaped examples of effective parenting strategies.
0 to 12 years old
Parents who have concerns about their child’s behaviour.
Disclaimer: The information in this section is as offered/supported by the intervention provider.
Science-based assumption
Young children naturally exhibit challenging and non-compliant behaviours
Challenging child behaviours during preschool and primary school increase the risk of behavioural problems in adolescence
Science-based assumption
Effective parenting behaviours and a predictable family environment help the child to regulate their own behaviour and reduce the risk of child behavioural problems becoming entrenched
Ineffective parenting strategies occasionally increase the risk of child behavioural problems becoming entrenched.
Science-based assumption
Higher levels of family stress and disadvantage can increase the risk of child behavioural problems.
Intervention
Parents learn:
Age-appropriate expectations for their child
Strategies for establishing predictable family routines
Strategies for promoting positive parent–child interaction through non-directive play
Strategies for reinforcing positive child behaviour through labelled praise
Strategies discouraging challenging child behaviour through age-appropriate discipline.
Short-term
Parents implement effective parenting strategies in the home
Parents’ confidence increases
Parent–child interaction improves.
Medium-term
Children’s self-regulatory capabilities and behaviour improves.
Long-term
Children are at less risk of antisocial behaviour in adolescence
Children are more likely to engage positively with others.
Parents with a child aged 0 to 12 years who have concerns about their child’s behaviour.
Standard Triple P is delivered in 10 sessions of one-hour duration to individual families by a single Triple P practitioner.
Parents learn 17 different strategies for improving their children’s competencies and discouraging unwanted child behaviour.
Learning is supported through role-play exercises, homework exercises, and discussions involving videotaped examples of effective parenting strategies.
A Triple P Practitioner, with a qualification in a helping profession, most typically a master’s qualified psychologist or social worker.
The practitioner has three days of intervention training, one day of pre-accreditation and a half-day accreditation workshop (accreditation workshops are held over two days; practitioners attend in groups of five). Booster training of practitioners is not required.
It is recommended that practitioners are supervised by one host-agency supervisor. There is no required training for the supervisor.
Intervention fidelity is maintained through the following processes:
Fidelity monitoring.
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 4 Standard 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 Triple P parent reports of their children’s behaviour compared to parents not receiving the intervention. Researchers also observed significant improvements in the quality of parent–child interaction compared to families not receiving the intervention.
Level 4 Standard 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.
Reduced disruptive behaviour
Immediately after the intervention
Improvement index
Interpretation
Study
Reduced disruptive behaviour
Immediately after the intervention
Improvement index
Interpretation
Study
Reduced problem child behaviour
Immediately after the intervention
Improvement index
Interpretation
Study
Reduced problem child behaviour
Immediately after the intervention
Improvement index
Interpretation
Study
Reduced negative child behaviour in parent-child interactions
Improvement index
Interpretation
Study
| Identified in search | 16 |
| Studies reviewed | 16 |
| Meeting the L2 threshold | 0 |
| Meeting the L3 threshold | 1 |
| Contributing to the L4 threshold | 0 |
| Ineligible | 15 |
| Study design | RCT |
| Country | Australia |
| Sample characteristics | This study involved 305 Australian families who were experiencing behavioural problems with a child between 3 and 4 years. All families had at least one of the following family adversity factors: maternal depression, relationship conflict, single parent household, or low gross family income. |
| Race, ethnicities, and nationalities | Australian |
| Population risk factors |
|
| Timing |
|
| Child outcomes | Reduced child behavioural problems |
| 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.
Cann, W., Rogers, H. & Matthews, J. (2003) Family Intervention Services program evaluation: A brief report on initial outcomes for families. Australian e-Journal for the Advancement of Mental Health. 2 (3).
de Graaf, I., Haverman, M., Onrust, S. & Tavecchio, L. (2009) Improving parenting and its impact on parental psychopathology: Trial of the Triple P Positive Parenting Program.
Frantz, I., Stemmler, M., Hahlweg, K., Pluck, J. & Heinrichs, N. (2015) Experiences in disseminating evidence-based prevention programs in a real-world setting. Prevention Science. 16 (6), 789–800.
Glazemakers, I. (2012) A population health approach to parenting support: Disseminating the Triple P-Positive Parenting Program in the province of Antwerp (Unpublished doctoral thesis, Universiteit Antwerpen, Antwerp, Belgium).
Heinrichs, N. & Jensen-Doss, A. (2010) The effects of incentives on families’ long-term outcome in a parenting program. Journal of Clinical Child & Adolescent Psychology. 39 (5), 705–712.
Heinrichs, N., Kruger, S. & Guse, U. (2006) Der Einfluss von Anreizen auf die Rekrutierung von Eltern und auf die Effektivitaet eines praeventiven Elterntrainings [The effects of incentives on recruitment rates of parents and the effectiveness of a preventative parent training]. Zeitschrift fuer Klinische Psychologie und Psychotherapie. 35, 97–108
Nicholson, J. M. & Sanders, M. R. (1999) Randomized controlled trial of behavioral family intervention for the treatment of child behavior problems in stepfamilies. Journal of Divorce & Remarriage. 30 (3–4), 1–23.
Onrust, S., de Graaf, I. & van der Linden, D. (2012) De meerwaarde van Triple P: Resultaten van een gerandomiseerde effectstudie van de Triple P gezinsinterventie bij gezinnen met meervoudige problematiek [The added value of Triple P: Results of a randomized clinical trial of the Triple P family intervention with families with multiple problems]. Kind en Adolescent. 33 (2), 60–74.
Prinz, R. J., Sanders, M. R., Shapiro, C. J., Whitaker, D. J. & Lutzker, J. R. (2009) Population-based prevention of child maltreatment: The U.S. Triple P system population trial. Prevention Science. 10 (1), 1–12.
Rogers, H., Cann, W., Cameron, D., Littlefield, L. & Lagioia, V. (2003) Evaluation of the Family Intervention Service for children presenting with characteristics associated with Attention Deficit Hyperactivity Disorder. Australian e-Journal for the Advancement of Mental Health. 2 (3).
Sanders, M. R. & McFarland, M. L. (2000) Treatment of depressed mothers with disruptive children: A controlled evaluation of cognitive behavioral family intervention. Behavior Therapy. 31 (1), 89–112.
Sanders, M. R., Pidgeon, A. M., Gravestock, F. M., 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(3), 513-535. doi:10.1016/s0005-7894(04)80030-3
Sanders, M. R., Ralph, A., Thompson, R., Sofronoff, K., Gardiner, P., Bidwell, K. & Dwyer, S. B. (2005) Every Family: A public health approach to promoting children’s wellbeing.
Shapiro, C. J., Kilburn, J. & Hardin, J. W. (2014) Prevention of behavior problems in a selected population: Stepping Stones Triple P for parents of young children with disabilities. Research in Developmental Disabilities. 35 (11), 2958–2975.
Venning, H. B., Blampied, N. M. & France, K. G. (2003) Effectiveness of a standard parenting-skills program in reducing stealing and lying in two boys. Child & Family Behavior Therapy. 25 (2), 31–44.
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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