Triple P - Positive Parenting Program: A population approach to promoting competent parenting
Matthew R Sanders
Parenting and Family Support Centre, University of Queensland, Brisbane QLD
PP: 127 - 143
Abstract
Family conflict and poor parenting are generic risk factors associated with a wide variety of adverse developmental outcomes in children including increased risk for conduct problems, drug abuse, delinquency and academic underachievement.
This paper makes the case for a multi-level population based approach to the development of parental competence. Evidence is reviewed showing that while parenting interventions based on social learning approaches are effective, they have significant limitations in achieving a level of population reach that will do enough to decrease the prevalence of dysfunctional parenting. A case is made for a contextual approach targeting the media, primary care services, schools, and worksites as basic institutions within the community which can potentially support the task of disseminating more widely evidence-based approaches to parenting intervention.
Evidence is reviewed for the efficacy and effectiveness of the Triple P-Positive Parenting Program as a comprehensive, multilevel system of parenting and family intervention. The evidence reviewed shows significant effects across several trials on both child and parent mental health outcomes. Challenges in disseminating empirically supported interventions and possible future directions for family intervention research are discussed.
Keywords
prevention, population, health, parent training, family intervention
Article Text
There is widespread concern amongst parents about the behavioural and emotional problems of their children and youth. Australian prevalence surveys show between 14-18% of children and adolescents show significant behavioural and emotional problems (Sawyer, Arney, Baghurst et al. 2000; Zubrick, Silburn, Garton et al. 1995). The recent report The mental health of young people in Australia: The child and adolescent component of the National survey of mental health and well-being (Sawyer et al. 2000) found that 14% of children and adolescents in Australia have mental health problems, with similar results to earlier surveys. The Queensland Health survey conducted in 1996 of 1218 parents revealed that 25% of parents reported that their child's behaviour was moderately to extremely difficult and 28% perceived that their eldest child, less than 12 years, had an emotional or behavioural problem in the last 6 months (Sanders, Tully, Baade et al. 1999).
Epidemiological studies indicate that family risk factors such as poor parenting, family conflict, and marital breakdown are powerful early predictors for the development and maintenance of behavioural and emotional problems in children and adolescents (eg. Cummings & Davies 1994; Dryfoos 1990; Robins & Price 1991). Specifically, lack of a warm, positive relationship with parents; insecure attachment; harsh, inflexible, rigid, or inconsistent discipline practices; inadequate supervision of and involvement with children; marital conflict and breakdown; and parental psychopathology (particularly maternal depression and high levels of parenting stress), increase the risk that children develop major behavioural and emotional problems, including conduct problems, substance abuse, antisocial behaviour, and participation in delinquent activities (eg, Coie 1996; Loeber & Farrington 1998; Patterson 1982).
In contrast, supportive family relationships have been shown to be a significant predictor of positive adjustment in childhood and adolescence, and indirect evidence suggests that supportive family relationships are a protective factor for conduct problems and adolescent adjustment problems (Cauce, Reid, Landesman & Gonzales 1990; Cohen & Wills 1985; Collins 2000; Wills, Vaccaro & McNamara 1992).
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