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Level 4 Group Teen Triple P

Evidence rating
3
Cost rating
1
Review: September 2017

Level 4 Group Teen Triple P is a universal intervention for parents of an adolescent child, aged between 12-16 years.

The programme is delivered by a single practitioner, over the course of eight weeks. Parents participate in five (2-hour) group sessions (of up to 12 parents each), as well as three (15-30-minute) individual telephone consultations. In these sessions, parents learn practical strategies for how to manage their child’s problematic behaviour and improve the quality of the parent-child relationship. 

EIF Programme Assessment

Evidence rating
3

Level 4 Group Teen Triple P has evidence of a short-term positive impact on child outcomes from at least one rigorous evaluation.

What does the evidence rating mean?

Level 3 indicates evidence of efficacy. This means the programme 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.

This programme 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. 

Cost rating
1

A rating of 1 indicates that a programme has a low cost to set up and deliver, compared with other interventions reviewed by EIF. This is equivalent to an estimated unit cost of less than £100.

Child outcomes

According to the best available evidence for this programme's impact, it can achieve the following positive outcomes for children:

Supporting children's mental health and wellbeing

Reduced behavioural difficulties - based on study 1

Increased levels of caring - based on study 1

Preventing crime, violence and antisocial behaviour

Reduced behavioural difficulties - based on study 1

This programme also has evidence of supporting positive outcomes for couples, parents or families that may be relevant to a commissioning decision. Please see About the evidence for more detail.

Level 4 Group Teen Triple P

Key programme characteristics

Who is it for?

The best available evidence for this programme relates to the following age-groups:

  • Preadolescents
  • Adolescents

How is it delivered?

The best available evidence for this programme relates to implementation through these delivery models:

  • Group

Where is it delivered?

The best available evidence for this programme relates to its implementation in these settings:

  • Secondary school
  • Community centre
  • Out-patient health setting

How is it targeted?

The best available evidence for this programme relates to its implementation as:

  • Universal

Where has it been implemented?

Australia, Belgium, Canada, Chile, Germany, Mexico, Netherlands, New Zealand, Singapore, South Africa, Switzerland, Turkey, United Kingdom, United States

UK provision

This programme has been implemented in the UK.

UK evaluation

This programme’s best evidence does not include evaluation conducted in the UK.

Level 4 Group Teen Triple P

About the programme

What happens during delivery?

How is it delivered?
  • Group Teen Triple P is delivered by a single Triple P practitioner. Over the course of eight weeks, parents participate in four (2-hour) group sessions, three (15-30-minute) individual telephone consultations, and a final (2-hour) group session.
What happens during the intervention?
  • In the first four (2-hour) group sessions, parents actively participate in a range of exercises to learn about the causes of common adolescent behaviours, how to set specific goals, promote positive adolescent behaviour, manage difficult behaviour, and plan-ahead for high-risk situations.
  • After these group sessions, three (15-30 minute) individual telephone consultations are conducted. The aim of these consultations is to assist parents in fine-tuning the implementation of the newly learnt parenting strategies, and to problem-solve any implementation difficulties they may be having.
  • As part of the final (2-hour) group session, parents re-convene to review progress, and discuss the use of additional skills to facilitate generalisation and maintenance of positive changes.
  • Group Teen Triple P practitioners use a range of learning methods, including behavioural rehearsal to teach parents new skills, guided participation to discuss assessment findings, active skills training methods to facilitate the acquisition of new parenting routines, and generalisation-enhancement strategies to promote parental autonomy. Positive parenting skills are demonstrated by videos and by practitioner modelling, with the skills then being practised in small groups.
  • Throughout the programme, parents are continuously provided with constructive feedback. They are also encouraged to set goals, practice strategies, and complete their activity workbook and homework tasks.

What are the implementation requirements?

Who can deliver it?
  • The practitioner who delivers this programme can come from a range of professions (e.g. school counsellor, nurse, psychologist, social worker, or parent educator), but must have a minimum recommended QCF level 4/5.
What are the training requirements?
  • Practitioners attend three days of training. They also attend a one-day pre-accreditation workshop, and a half-day accreditation session.
  • Booster training of practitioners is not required.
How are the practitioners supervised?

Practitioner supervision is provided through the following processes:

  • It is recommended that practitioners are supervised on a quarterly basis in two-hour sessions, by one practitioner with a minimum QCF level 7/8.
  • Triple P has also developed its own Peer-Assisted Supervision and Support Model (PASS), whereby practitioners can provide and receive structured feedback from each other while they deliver the programme. PASS sessions are conducted in small groups of 6-8 practitioners and run for 1-2 hours every month.
  • Triple P UK can also provide clinical support for practitioners, either as a one-day workshop or a small group phone consultation with a Triple P Trainer.
What are the systems for maintaining fidelity?

Programme fidelity is maintained through the following processes:

  • Training manual
  • Other printed and online material
  • Video or DVD training
  • Face-to-face training
  • Fidelity monitoring
  • Quality assurance checklist
  • Practitioner accreditation
  • Intervention fidelity checklists, completed by practitioners after each session
  • Supervision and practitioner support, by use of the Triple P Peer Support Network
Is there a licensing requirement?

There is no licence required to run this programme.

How does it work? (Theory of Change)

How does it work?
  • Group Teen Triple P assumes that some parenting practices unintentionally reinforce teenage risk taking and emotional problems. The intervention, therefore, helps parents identify parenting practices that may unintentionally reinforce risky and problematic teenage behaviour. In doing so, it aims to reduce family risk factors known to be associated with the development of problematic behaviours.
  • Parents also learn strategies for effectively communicating with their teenager, monitoring their teenage child’s activities and supporting their teenager’s independence.
  • In the short term, it is expected that the teenage child will become more respective of his or her parents, engage in less risky behaviour and make more positive decisions for him or herself.
  • In the longer term, the teenager will be less likely to engage in antisocial behaviour and substance misuse, and will be more likely to achieve better in school.
Intended outcomes

Supporting children's mental health and wellbeing
Preventing child maltreatment
Enhancing school achievement & employment
Preventing crime, violence and antisocial behaviour
Preventing substance abuse
Preventing risky sexual behaviour & teen pregnancy

Level 4 Group Teen Triple P

About the evidence

Group Teen Triple P's most rigorous evidence comes from one RCT which was conducted in New Zealand. This is a rigorously conducted level 3 study, which has identified statistically significant positive impact on a number of child and parent outcomes. A programme receives the same rating as its most robust study, and so this programme receives a level 3 rating overall.  

Study 1

Citation: Chu et al., 2014
Design: RCT
Country: New Zealand
Sample: 72 families with children aged between 12-15 years (mean = 12.85), recruited through the local community and with low-to-moderate needs
Timing: Post-test
Child outcomes: Reduced behavioural difficulties
Reduced behavioural difficulties
Increased levels of caring
Other outcomes: Reduced family conflict
Improved family cohesion
Reduced parent-adolescent conflict
Improved parental laxness
Improved parental over-reactivity
Increased parental monitoring
Improved parental confidence
Study rating: 3

Chu, J. T. W., Bullen, P., Farruggia, S. P., Dittman, C. K., & Sanders, M. R. (2014). Parent and adolescent effects of a universal group program for the parenting of adolescents. Prevention Science, 16(4), 609-620.

Available at:
https://link.springer.com/article/10.1007%2Fs11121-014-0516-9  
 

Study design and sample

This study is a rigorously conducted RCT, which involved random assignment of parents to a Group Teen Triple P intervention group and a treatment as usual control group.

The study was conducted in New Zealand, with a sample of 72 families with children aged between 12 and 15 years (mean = 12.85). Participating mothers were predominantly married (66.7%), with higher-level education (52.2%) and in paid employment (81.2%). Most families were two-parent families (65.2%), reporting no major difficulties in paying for household expenses in the past year (70.0%), but with less than half the families earning above the average New Zealand household income of $81,067 (34.7%). The children’s ethnic breakdown was comparable to that of the New Zealand population, with the majority of children described as Pakeha/European (72.5 %), and the remaining defined as Māori (Indigenous New Zealanders, 10.1 %), Pacific Islander (8.7 %), or Asian (8.7 %).

Measures

  • Child behaviour was measured using the total difficulties scale of the Strengths and Difficulties Questionnaire (parent and child report).
  • Child problematic behaviour was measured using the Adolescent Problem Behaviour Checklist (child report).
  • Child autonomy was measured using the Autonomy Scale (child report).
  • Child self-esteem was measured using the Rosenberg Self-Esteem Scale (child report).
  • Child level of caring, including sympathy and empathy for others, was measured using the Positive Youth Development (child report).
  • Family conflict and cohesion was measured using the Family Environment Scale (parent and child report).
  • Parent-adolescent conflict was measured using the Parent Conflict Questionnaire (parent and child report).
  • Interparental conflict over child rearing was measured using the Parent Problem Checklist (parent report).
  • Parental relationship quality and satisfaction was measured using the Relationship Quality Index (parent report).
  • Parental discipline practices, including laxness and overreactivity, were measured using the Adolescent Parenting Scale (parent report).
  • Parental monitoring was measured using the Parental Monitoring Scale (parent and child report).
  • Parental confidence was measured using the Parental Self-Efficacy Scale (parent report).
  • Parental mental health and wellbeing, including parental levels of depression, anxiety and stress, were measured using the 21-Item Depression, Anxiety, and Stress Scale (parent report).

Findings

This study identified statistically significant positive impact on a number of child and parent outcomes. Outcomes which have the same strength of evidence as the overall study were found at post-test, when attrition was relatively low. They included: 

  • Child behavioural difficulties (Strengths and Difficulties Questionnaire)
  • Child level of caring (Positive Youth Development)
  • Family conflict and cohesion (Family Environment Scale)
  • Parent-adolescent conflict (Parent Conflict Questionnaire)
  • Parental laxness and overreactivity (Adolescent Parenting Scale)
  • Parental monitoring (Parental Monitoring Scale)
  • Parental confidence (Parental Self-Efficacy).

Further outcomes were found at 6-months follow-up, but were judged to be less rigorous due to high attrition rates. At 6-months follow-up, all the same results found at post-test (and described above) remained significant, except for the parent report of family conflict and parental confidence, which were no longer significant. In addition, the following outcomes became significant:

  • Child problematic behaviours (Adolescent Problem Behaviour Checklist).
More Less about study 1

Other studies

The following studies were identified for this programme but did not count towards the programme's overall evidence rating. A programme receives the same rating as its most robust study or studies.

Chand, N., Farruggia, S., Dittman, C., Sanders, M., & Ting Wai Chu, J. (2013). Promoting positive youth development: Through a brief parenting intervention program. Youth Studies Australia, 32(1), 29.

Ralph, A., & Sanders, M. R. (2003). Preliminary evaluation of the Group Teen Triple P program for parents of teenagers making the transition to high school. Australian e-Journal for the Advancement of Mental Health, 2(3), 169-178.

Ralph, A., & Sanders, M. R. (2004). The 'Teen Triple P' positive parenting program: a preliminary evaluation. Australian Institute of Criminology.

Ralph, A., & Sanders, M. (2006). The 'Teen Triple P' Positive Parenting Program: A Preliminary Evaluation. Youth Studies Australia, 25(2), 41.

Kliem, S., Aurin, S. S., & Kröger, C. (2014). Zur Wirksamkeit des adoleszenzspezifischen Elterntrainings Group Teen Triple P. Kindheit und Entwicklung.

Published December 2017