York Region Orientation
What is Triple P? • Flexible system of parenting and family support • Evidence-based • Prevention/early intervention approach • Five intervention levels of increasing intensity • Principle of sufficiency • Multidisciplinary focus
Why Triple P? • Effective parenting single largest factor for healthy child development • All sectors have the opportunity to enhance parenting capacity within their day to day work • Provides consistent language and approach across sectors to enhance parenting capacity • Provides a framework and resources that enhance service integration across service providers
Theoretical Foundation of Triple P • Social learning models of parent-child interaction • Child and family behaviour therapy research • Developmental research on parenting in everyday contexts and social competence • Social information processing models • Development psychopathology research • Public/population health framework
Community Sector Partners • Early Years • Developmental Services • Child Care • Recreation • Education • Children's Services • Child Protection • Cultural Services • Family Services • Children's Mental Health • Health
York Region System Capacity for Integrated Triple P Service Provision Triple P is a parenting and family support strategy that aims to prevent severe behavioural, emotional and developmental problems in children by enhancing the knowledge, skills and confidence of parents. Service Providers in York Region provide the following levels of Triple P to clients :
Triple P York Implementation Committee • Addiction Services of York Region • Blue Hills Child and Family Services • Catholic Community Services of York Region • Early Intervention Services • Family Services of York Region • Kinark Child and Family Services • Ontario Early Years Centres • Panorama Program for Children and Youth • Region of York • Social Enterprise • York Centre for Children Youth and Families • York Region District School Board • York Region Catholic District School Board
Referral Gateways Direct Service access at each agency intake Upcoming Events posted at www.triplepontario.ca Contact Health Connection for Service Providers in area
Principles of Positive Parenting • Ensuring a safe, engaging environment • Creating a positive learning environment • Using assertive discipline • Having realistic expectations • Taking care of yourself as a parent
Five Intervention Levels 1. Universal Triple P Media-based parenting information campaign 2. Selected Triple P Tip sheet discussions, seminar presentations 3. Primary Care Triple P Narrow focus parenting skills training 4. Standard/Group/Self-Directed Triple P Broad-focused parenting skills training 5. Enhanced Triple P Behavioural family intervention - Programs for parents of children 0-12 and teen
17 Core Parenting Skills Promoting positive relationships Brief quality time, talking to children, affection Encouraging desirable behaviour Praise, positive attention, engaging activities Teaching new skills and behaviours Modelling, incidental teaching, ask-say-do, behaviour charts Managing misbehaviour Ground rules, directed discussion, planned ignoring, clear, calm instructions, logical consequences, quiet time, time-out
Level One – Universal Triple P • Print – Newspaper editorials/features, positive parenting column, posters & brochures • Television – Current affairs stories, 15-30 second positive parenting community service announcements (CSAs), Families TV series • Radio – Interviews, 1-2 CSAs, weekly talkback • Internet – Parent direct websites, e-journals
Level One: Benefits of Universal Intervention • Normalize • Destigmatise • Increase receptivity • Promote self-sufficiency • Provide coping models • Depict solutions to common problems • Alert parents to availability of services
Level Two: Selected Triple P Three 90-minute presentations at each age level 0-12 • The power of positive parenting • Raising confident, competent children • Raising resilient children 12 – 16 • Raising responsible teenagers • Raising competent teenagers • Getting teenagers connected Functions as information session and promotes engagement at more intensive levels Provision of parenting tip sheets summarizing content of each seminar
Level Three – Primary Care Triple P • Practical advice for discrete behavioural or developmental issues • May involve active skills training procedures • 2 hour topic specific workshop OR • One – Four consultations - Nature and history of problem/monitoring - Formulation/parenting plan/obstacles - Review/rehearsal/new parenting plan - Follow-up/trouble shooting
Level Three – Benefits of Primary Care • Early detection of significant deviations from normal development • Provision of advice to parents seeking information about developmental issues • Provision of brief behavioural counseling for child behavioural problems • Referral of moderate to severe child behaviour problems to specialized services
Level Four: Standard Triple P • Broad focus parent skills training • Active skills training • Generalization enhancement strategies • 10 sessions - Assessment and feedback - Causes of children’s behaviour problems - Positive parenting strategies - Practice - Planned activities for high-risk settings - Maintenance
Level Four: Group Triple P • Groups of 10-12 parents • Active skills training in small groups • 8 session group program - 4x2 hour group sessions - 3x15-30 minute telephone sessions - Final group/telephone session • Supportive environment • Normalize parenting experiences
Level Four: Benefits variety of modalities available – individual, group, self directed -parents learn to apply parenting skills to a broad range of behaviours in both home and community settings with the identified child as well as siblings – self-regulatory framework - benefits of group include support, friendship and constructive feedback from other parents as well as opportunities for parents to normalise their parenting experience through peer interactions.
Stepping Stones Triple P • For parents with a child who has a disability who has or is at risk of developing behavioural or emotional problems • Variation of • Primary Care Triple P (1 – 4 individual sessions) • Group Triple P (8 group sessions) • Standard Triple P (10 individual sessions)
Level Five – Family Transitions Triple P • Adjunct to other intervention levels For parents who are experiencing personal distress from separation or divorce, which is impacting on, or complicating, the task of parenting. • 9 individual or group sessions and 3 individual telephone consultations • Assist with • managing conflict with former partners • Coping with distressing emotions • Managing the transition from being a two parent family to a single parent family
Level Five – Enhanced Triple P • Adjunct to other intervention levels • Review and feedback • Negotiation of additional modules tailored to family’s needs - Practice Module - Coping Skills Module - Partner Support • Maintenance and closure
Level Five – Practice Module • Conducted in the family home or community setting if possible • Practice task negotiated • Practitioner observes • Parent self-evaluates (practitioner provides feedback as appropriate) • Parents sets goals for change • Parents sets homework tasks
Level Five – Coping Skills Module • Education about mood • Relaxation/stress management • Managing dysfunctional thoughts • Coping statements • Challenging unhelpful thoughts • Coping plans for high-risk times
Level Five – Partner Support Module • Use of casual conversation • Effective partner support • Problem solving discussions
Level Five – Pathways Triple P • Extra level 5 modules • For parents at risk of maltreating their children, parents with prior abuse notification, or parents with anger management problems • Attribution Retraining Module (re: child’s and own behaviour) • Anger Management Module
Level Five – Benefits • Individually tailored – can do 1 or more module related to parents goals • Parents learn about managing their own emotions and behaviours along with those of their children • Overall programs work toward enhancing parents self-management skills – reducing reliance on clinician
Fidelity (Quality Assurance) • Session checklists (review in supervision, element of Performance Appraisal system) • Peer support networks and coaches • Service delivery targets and measures • Practice Leader
Other programs • Lifestyles Triple P Parents or caregivers of overweight or obese children who are concerned about their child’s weight and are willing to make changes in their family’s lifestyle. Indigenous Triple P Variations specifically designed for Indigenous populations Online Triple P • Self Help Triple P Designed for families in rural or remote areas and families wanting a self-help program that they can work through at home. Telephone consultations may be included to support personal goal setting and self-evaluation.
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