Level 4 Standard Triple P
Note on provider involvement: This provider has agreed to EIF’s terms of reference, and the assessment has been conducted and published with the full cooperation of the programme provider.
Level 4 Standard Triple P is for parents, with a child aged 0 to 12 years, who have concerns about their child’s behaviour.
Parents attend 10 one-to-one weekly sessions with an individual therapist lasting approximately one hour. The sessions are provided by a practitioner trained and accredited in Triple P. Practitioners also receive ongoing supervision.
Parents learn 17 different strategies for supporting their children’s competencies and discouraging unwanted child behaviour through role play, homework exercises and discussions involving video-taped examples of effective parenting.
EIF Programme Assessment
Level 4 Standard 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.
A rating of 2 indicates that a programme has a medium-low cost to set up and deliver, compared with other interventions reviewed by EIF. This is equivalent to an estimated unit cost of £100–£499.
Child outcomes
According to the best available evidence for this programme's impact, it can achieve the following positive outcomes for children:
Preventing crime, violence and antisocial behaviour
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 Standard Triple P
Key programme characteristics
Who is it for?
The best available evidence for this programme relates to the following age-groups:
- Infants
- Toddlers
- Preschool
- Primary school
How is it delivered?
The best available evidence for this programme relates to implementation through these delivery models:
- Individual
Where is it delivered?
The best available evidence for this programme relates to its implementation in these settings:
- Community centre
- Out-patient health setting
The programme may also be delivered in these settings:
- Home
- Children's centre or early-years setting
- Primary school
How is it targeted?
The best available evidence for this programme relates to its implementation as:
- Targeted indicated
Where has it been implemented?
Australia, Belgium, Canada, Denmark, England, Germany, Ireland, Netherlands, New Zealand, Scotland, Singapore, Switzerland, 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.
Spotlight sets
EIF includes this programme in the following Spotlight sets:
- Parenting programmes with violence reduction outcomes
Level 4 Standard Triple P
About the programme
What happens during delivery?
How is it delivered?
- Standard Triple P is delivered in 10 sessions of one-hour duration to individual families by one Triple P practitioner.
What happens during the intervention?
- 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 video-taped examples of effective parenting strategies.
What are the implementation requirements?
Who can deliver it?
- The practitioner who delivers this programme is a Triple P Practitioner, who can come from a range of professions (eg family support worker) with recommended minimum QCF-4/5 level qualifications.
What are the training requirements?
- The practitioner has three days of programme 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.
How are the practitioners supervised?
- It is recommended that practitioners are supervised by one host-agency supervisor with QCF-7/8 level qualifications. There is no required training for the supervisor.
What are the systems for maintaining fidelity?
- Accreditation process
- Training manual
- Supervision
- Fidelity monitoring
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?
- Triple P is based on the idea that parents often unintentionally perpetuate unwanted child behaviour through ineffective parenting strategies.
- Triple P helps parents replace ineffective parenting strategies with effective methods for encouraging positive child behaviour.
- In the short term, parents learn more effective strategies for managing their child’s behaviour and the child’s behaviour improves.
- In the longer term, children should have greater self-regulatory skills and self-confidence and do better in school.
- It is also expected that children will be less likely to have behavioural problems and/or engage in antisocial behaviour.
Intended outcomes
Supporting children's mental health and wellbeing
Preventing child maltreatment
Enhancing school achievement & employment
Preventing crime, violence and antisocial behaviour
Contact details
Level 4 Standard Triple P
About the evidence
Level 4 Standard Triple P's most rigorous evidence comes from an RCT which was conducted in Australia.
This study identified statistically significant positive impact on a number of child and parent outcomes.
This programme is underpinned by one study with a Level 3, hence the programme receives a Level 3 rating overall.
Study 1
| Citation: | Sanders et al. (2000); Bor et al. (2002); Sanders et al. (2007) |
|---|---|
| Design: | RCT |
| Country: | Australia |
| Sample: | 305 families |
| Timing: | Post-test |
| Child outcomes: |
Reduced disruptive behaviour
Reduced problem child behaviour Reduced negative child behaviour in parent-child interactions |
| Other outcomes: | Improved parenting Increased self-efficacy |
| Study rating: | 3 |
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.
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.
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.
Available at
https://www.ncbi.nlm.nih.gov/pubmed/10965638
https://www.ncbi.nlm.nih.gov/pubmed/12481972
https://www.ncbi.nlm.nih.gov/pubmed/17610061
Study design and sample
The first study is a rigorously conducted RCT.
This study involved random assignment of children to one of three treatment conditions and a control group: Triple P (Level 4) Standard; Enhanced Triple P (including partner support and coping skills); Self-directed Triple P (involving 10 workbooks); and a wait-list control group.
This study was conducted in Australia, with a sample of 305 families with a preschool child (average age of 40.88 months). The parents were predominantly of lower socioeconomic class and Caucasian.
Measures
Child behaviour was measured using the Eyberg Child Behavior Inventory (Intensity score) (parent report). Child problem behaviours were measured using the Parent Daily Report (mean Problem score) (parent report). Observed negative child behaviour was measured using the Revised Family Observation Schedule (FOS-R-III) (expert observation of behaviour).
Parental sense of competency was measured using the Parenting Sense of Competency Scale (parent report). Conflict between partners over childrearing was measured using the Parent Problem Checklist (parent report). Quality of dyadic relationship adjustment was measured using the Abbreviated Dyadic Adjustment Scale (parent report). Parental symptoms of depression, anxiety, and stress were measured using the Depression Anxiety Stress Scales (parent report). Observed negative maternal behaviour was measured using the FOS-R-III (expert observation of behaviour).
Findings
This study identified statistically significant positive impact on a number of child and parent outcomes.
Child outcomes include:
- Reduced disruptive behaviour
- Reduced problem child behaviour
- Reduced negative child behaviour in parent-child interactions
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.
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). doi:10.5172/jamh.2.3.208 - This reference refers to a pre-post study, conducted in Australia.
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. doi:10.1007/s11121-015-0554-y
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 - This reference refers to a quasi-experimental design, conducted in 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. doi:10.1080/15374416.2010.501290 - This reference refers to a randomised control trial, conducted in Germany.
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 - This reference refers to a randomised control trial, conducted in Germany.
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. doi:10.1300/J087v30n03_01 - This reference refers to a randomised control trial, conducted in Australia.
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 [Child and Adolescent], 33(2), 60-74. doi:10.1007/s12453-012-0008-2 - This reference refers to a randomised control trial, conducted in Australia.
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. doi:10.1007/s11121-009-0123-3 - This reference refers to a randomised control trial, conducted in the USA..
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). doi:10.5172/jamh.2.3.216 - This reference refers to a pre-post study, conducted in Australia.
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. doi:10.1016/s0005-7894(00)80006-4 - This reference refers to a randomised control trial, conducted in Australia.
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 - This reference refers to a randomised control trial, conducted in Australia.
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. Retrieved from Brisbane, Australia - This reference refers to a randomised control trial, conducted in Australia.
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. doi:10.1016/j.ridd.2014.07.036 - This reference refers to a randomised control trial, conducted in the USA.
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 - This reference refers to a case study design, conducted in New Zealand.
Published April 2024