• By Laura Whybra
  • Posted on Thursday 16th October, 2014

Long-term Triple P results raise questions as well as answers

strong>New evidence from Germany on the widely used Triple-P parenting program finds parents maintaining improvements in their skills an impressive four years after they took part. But a lack of matching long-term reductions in children’s behavior problems may leave service planners scratching their heads.Researchers in Braunschweig, Lower Saxony evaluated a group-based version of Triple P (the “Positive Parenting Program”) that was made universally available to parents of children aged 2 to 6 attending a number of pre-schools. Eleven were randomly chosen to provide the program and parents at another six provided a control group.There have been many evaluations of Triple P internationally since it originated in Australia 35 years ago, but the German trial was unusual for continuing to monitor parents’ progress over several years. After four years the researchers successfully interviewed nine out of ten families out of the 186 originally recruited to the intervention group and 94 in the control group.The version of Triple P used consisted of four group sessions of two-hours each when parents learned about child development and effective parenting techniques, including the use of praise to reinforce positive behavior and consistent, non-violent responses to behavior problems. After completing the groups, parents were offered four personal consultations by telephone on a weekly basis. Three measures based on interviews with parents were chosen to test the long-term effects of the program – a German version of the Parenting Scale (measuring dysfunctional parenting), the Positive Parenting Questionnaire (measuring positive parenting behaviors), and the Child Behavioral Checklist (measuring children’s emotional and behavioral problems).Changing parents’ behaviorThe results show that both mothers and a smaller group of fathers recruited to the program reported less dysfunctional parenting behavior after taking part, compared with the control group. This improvement was being maintained four years later. Additionally, while Triple P parents were making less use of positive parenting methods than four years earlier, the rate of decline had been significantly slower than among the control group.Nevertheless, a modest but significant difference in mothers’ ratings of their children’s behavior that had favored the intervention group just after they completed the Triple P program appeared to have washed out four years later. In discussing possible reasons for this, the researchers highlight the “universal” sample of families among whom serious child behavior problems were relatively rare from the start.They also present their findings in the context of continuing debate in Germany (and elsewhere) about the value and appropriate use of parenting programs like Triple P that focus on child behavior management. Notwithstanding the lack of any long-term impact on child behavior, they argue that the Braunschweig results contradict assumptions that such programs chiefly benefit for children with clinically diagnosable conduct disorders.But is it enough?Measured over an unusually long follow-up period, the results add to a growing archive of studies providing evidence that Triple P’s approach can bring about durable change in parenting behavior. But, as the researchers themselves ask: “Is this enough?”Policy makers when wondering how best to invest in evidence-based parenting programs may need to consider whether improvements in parenting style and behavior constitute “good outcomes” in themselves. Should they necessarily expect to see improvements in children’s behavior as well?Those tasked with planning and commissioning services for children and families may decide this latest study leaves them with at least as many questions as it equips them with answers.*********ReferenceHeinrichs, N., Kliem, S., & Hahlweg, K. (2014). Four-Year Follow-Up of a Randomized Controlled Trial of Triple P Group for Parent and Child Outcomes. Prevention Science, 15, 233–245. doi: 10.1007/s11121-012-0358-2

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