Training in parent consultation skills for primary care practitioners in early intervention in the pre-school context
Lea Crisante
Western Sydney Area Health Service Parenting Program, Cumberland Hospital, Parramatta NSW
PP: 191 - 200
Abstract
This paper describes the implementation of a brief behavioural intervention, based on the Triple P-Positive Parenting Program (Sanders 1999), by 13 pre-school practitioners with 39 parents.
The intervention was a response to a need identified by practitioners to deal more effectively with requests for assistance with behaviour management by parents whose children attend pre-schools and long-day care centres. Following completion of training, practitioners were asked to implement the intervention with at least three parents and to keep a personal diary of the strategies used during the consultations. The practitioners reported improvements in their skills in managing difficult behaviour in the pre-school context. Parents reported improved experience of partner support and attitudes towards parenting, as well as high levels of satisfaction with the service provided.
The results point to the role of primary care practitioners in providing services in settings that are easily accessed by parents, thus increasing the availability of support to parents with young children.
Keywords
early intervention, early childhood, Triple P, primary care practitioners
Article Text
Parenting presents considerable challenges for many families (Kotchick & Forehand, 2002), yet few parents actually receive assistance (Staudt, 2003). For example, a recent national survey identified numerous obstacles to accessing services, including lack of knowledge about services and cost (Sawyer, Arney, Baghurst et al., 2000). Sanders, Tully, Lynch et al. (1999) found that only ten per cent of parents had accessed parent education in the year prior to their survey of parenting practices. A key issue in supporting families with parenting is making services easily accessible.
Contact with pre-schools and long-day care centres is a daily occurrence for many parents with young children and regarded as an appropriate place to ask for ideas about how to manage challenging behaviour. However, requests for such assistance are often seen as requiring complex skills and are therefore typically dealt with by the directors of the services. This may be due to graduates of early childhood education programs considering themselves to be poorly equipped to deal with children's problematic behaviours.
The Triple P-Positive Parenting Program is a multilevel, multidisciplinary intervention, well positioned to address the needs of practitioners employed in this field (Sanders, Turner & Markie-Dadds, 2002). This paper describes how one aspect of Triple P, an intervention for primary care practitioners, was introduced into the skill repertoire of a group of 20 early childhood practitioners working in western Sydney.
Triple P as an intervention in the primary care context
Within the Triple P-Positive Parenting Program, a Level 3 intervention has been developed specifically for primary care practitioners, such as early childhood nurses and doctors working in community settings. It aims to equip practitioners to respond to requests for assistance with everyday parenting issues, such as sleep problems, temper tantrums and sibling rivalry, relevant to children and teenagers (Turner, Sanders & Markie-Dadds, 1999; Sanders, 1999). It is based on brief meetings of fifteen to thirty minutes with individual parents, over several weeks, which focus on areas of identified concern. Practitioner introduces parents to relevant resources and strategies, through tip-sheets (Turner, Sanders & Markie-Dadds, 1996), videotapes and monitoring activities. Up to four individual sessions are offered to parents. During this process, parents are introduced to a range of positive parenting strategies, including descriptive praise, quality time and setting a good example, which are combined with behaviour management strategies like setting ground rules, logical consequences and quiet time.
There have been few studies of the use of this type of intervention. Research currently in progress includes randomised controlled trials of Level 3 interventions with nurses, and the effectiveness of training general medical practitioners in this intervention (Sanders, 1999). In the absence of any study of the application of this work to the pre-school context, this paper presents a new area of research.
Aims of the research
The specific aims of this study were to (1) examine the impact of training in parent consultation skills on pre-school practitioners and (2) examine the outcome for parents who participated in the consultations in relation to changes in their experience of managing their children and their parenting role.
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