Triple P: a toolkit for happier families

Parenting programme shown to decrease behaviour problems and parental stress across Midlands community

 

‘It was completely life-changing. I went from being a traumatic single mother with five kids to a positive mother with happy kids.”

It’s a powerful testimony, indeed, from Laura Gervasoni of Longford about a positive parenting programme, known as Triple P, that has been trialled as a universal public health initiative in the midlands.

“I used to think I was a bad mother and that my kids were out of control,” says Gervasoni, a childcare worker who has lived alone for the past three years with her five daughters, aged from 16 to six.

As soon as she took up the course, which is available free across four counties to all parents with a child under eight, she began to understand that “It was just the way I was behaving – I wasn’t a bad person. The kids weren’t bad, it was just the way I was seeing things.”

Cutting trouble off at the pass

Among the tips she took to heart straight away was not letting an issue escalate. By reacting earlier, she explains, she was able to head off trouble “rather than leaving it to a situation where my daughter was having a tantrum because I wasn’t listening and I was breaking down because she was having a tantrum.

“I was much happier because I was able to get her out of a potential tantrum and she was much happier because she was able to speak to me because I was listening to her.”

While Gervasoni can only vouch for the difference Triple P has made to her family, an independent population study, the first of its kind in Ireland for a parenting programme, has revealed the impact it has made right across the community.

Conducted by the Unesco Child and Family Research Centre of NUI, Galway, the research over three years in Longford-Wesmeath shows that the number of children with emotional and behavioural problems is significantly reduced in the population as a whole, when compared with a similar area where the Triple P programme was not delivered.

“By the end of the trial, the numbers of children showing signs of hyperactivity, anxiety and emotional or conduct problems, or who were prone to troublesome disobedience, were significantly down,” according to a briefing report on the research. For children with higher levels of need, these problems were down by 37.5 per cent.

Parents, too, were less worried and depressed, and their relationship problems had eased. There was a 30 per cent decrease in reports of parental distress and stress.

“The results are significantly better than we expected,” says the director of Triple P in Longford-Westmeath, Conor Owens. Although he readily admits he is biased, the figures have been independently scrutinised.

“When you get things that good, you really want to be sure that they stand up,” he says.

It’s certainly a vindication of the local services in the area that not only identified but also responded to the need and desire parents have for support in raising their children. Nine organisations, including the Health Service Executive, collaborated to form the Longford-Westmeath Parenting Partnership in 2006 and went looking for an evidence-based programme it could implement across the community.

Triple P, which was devised in Australia and is used in 25 countries, had sufficient weight of proof to convince the partnership that it was the one to use.

It operates on five levels, from the promotion of positive parenting through newsletters, newspaper columns and websites, to short seminars, once-off two-hour courses, an eight-week course and then, at level five, intensive support for families with serious problems.

Parents themselves choose whatever level they think is right for them, which is really important, says Owens, who reports that 10,000 places on Triple P courses have been taken up since 2010.

“Nobody is telling anybody: it is about responsibility and self-regulation. It means some parents would have gone to more than one level.”

Provides tools

As the founder of Triple P, Brisbane clinical psychologist Prof Matt Sanders told The Irish Times at the start of the research in 2010, it is not about being preached at. It is for parents to determine their goals and values for their children – the programme simply provides tools to help achieve these.

Offering Triple P is like immunising the community, he said. “You prepare parents, make families healthier and prevent problems before they happen.”

Coming to a course, parents can be unsure if they are in the right place, says Triple P co-ordinator Karen Heavey. They may just want reassurance that they are handling issues the right way, or maybe they are having a bit of a battle over bedtimes, meal times or whatever.

So often they say “is it only me . . .?” and, through the sharing of experiences with other parents on a course, they soon find they are far from alone.

“It normalises these everyday challenges and the fact that children will test boundaries,” says Heavey.

A key piece of advice is to watch how much attention they are giving to negative behaviour and to try to give attention for positive behaviour – praising when children are doing things well. This can be a lightbulb moment.

“The behaviour they are giving the most attention to is the one that they are going to see repeated,” Heavey points out.

“No child goes to bed thinking how they can ruin Mammy or Daddy’s day. They want to help out, they want attention: but they will take any attention, whether it’s positive or negative.”

The NUI Galway research team surveyed a representative group of 1,500 parents with children aged three to seven, drawn from all the electoral districts of Longford-Westmeath. The same was done in a controlled area that was matched as closely as possible with Longford-Westmeath, but where Triple P was not on offer.

All these households were first visited in 2010 and then again in 2013. Although the survey showed that only about 20 per cent of the respondents in the Longford-Westmeath group had actually attended a Triple P seminar, workshop or group, the results highlight the positive, wider effect such an initiative has.

People who hadn’t done programmes said they knew others who had and they had received tips from them. That, along with the website and newspaper articles, all combined to “start a positive conversation”, says Owens, who describes course participants passing on tips to other parents as being “like gold”.

‘Ripple effect’

“That is the ripple effect, and parents taking over themselves. It shows how interested they are in learning these [strategies] and how useful they found them. It takes a certain amount of confidence to go to a friend or a family member and give them a tip about parenting,” he points out.

From the evidence of the research and the feedback from the parents, “we now know clearly that parents like it, it works and we know it lasts”, says Owens. As well as having expanded into Laois-Offaly in 2013, they have just started a 14-week, childhood obesity programme called Lifestyle, for parents of children aged five to 10 who have weight difficulties.

Funding was provided by Atlantic Philanthropies, the HSE and the Department of Children and Youth Affairs, among others, to implement Triple P. The Longford-Westmeath Parenting Partnership also got a second grant, to extend the programme into Laois-Offaly and sustain it in Longford-Westmeath, and to write implementation guides for any other area in the country interested in using it.

Parenting partnership

To sceptics who thought it was a very nice idea but just too expensive to deliver as a universal service, he says the parenting partnership has been able to do it without additional salary costs.

Various professionals across services, from public health nurses to administrators, social workers to health promotion staff, trained in Triple P and changed the way they were working.

“The same community needs were being met,” he says, “but in a different way.”

There was also a strong economic analysis done that shows the universal is actually more efficient than the targeted, “simply because you are targeting only the people you know about”, he points out. “And targeting also doesn’t allow for prevention.”

Owens also believes the programme has disproved the notion that prevention, early intervention or treatment need to be separate.

“They weren’t for us. We had parents on our courses who wanted to see if they were doing a good job, wanted to get confirmation and ideas and tips. Then we had other parents with mild problems and others where there were significant difficulties. They were all on the same courses; there’s no need to separate them. That was a huge learning for us.”

Gervasoni says that since doing the eight-week Triple P course in 2013 she has no problems with the day-to-day management of her daughters, even in a “house full of women – hormones flying everywhere I tell you!”

She calls family meetings if something is getting out of hand and asks what punishments would be appropriate if the behaviour continues.

“I would rather discuss things with the girls. They’re at the age where they can understand it now, that I am not being a little meanie and that rules are in place for a reason.”

Her daughters love using family meetings too, she adds. “The cat was running up and down the tree lately and they decided to call a family meeting with the cat.”

A copy of the evaluation of Triple P in Longford-Westmeath 2010-2013 is available on mapp.ie, along with a calendar of upcoming courses.

See also triplep-parenting.net swayman@irishtimes.com

‘Because I am more calm, everybody in the house is too’ Mother-of-four and primary school teacher Emer Doyle believes that not only has her parenting improved, but so has she as a person – both at home and in the classroom – as a result of doing a Triple P course.

“At home, it made me look at myself and at how I was with the children. How they reacted to the way I was,” she explains.

“I was speaking so negatively to them most of the time and very seldom said ‘thank you’ – outside them handing you something.” Now, if she has asked them to do something and it’s done, she goes back to thank them.

You can get into a rut of negative thinking, she says, but, once it’s pointed out, you look at yourself and move on. It’s hard to change habits, “but when you see any little benefit at all, it drives you on to try even more”.

Doyle first heard about Triple P, which extended into Laois-Offaly in 2013, at a seminar in Derrylamogue National School in Rosenallis, Co Laois, where she teaches and her two youngest children attend.

Of 70 families involved in the school, only about 20 were represented at the initial meeting and just two others joined her on the follow-up course. She was very impressed by the first seminar at the school and can’t understand why there was such little take-up.

“You would be hopeful that, through word of mouth from those who went, people will catch on and find out where it is going on in different areas.”

She thinks people may have been conscious about the initial meeting being in the school and that, if they turned up, it meant they were having problems.

Yet “as a teacher, you would see it is the parents whose children need help are the ones who would never turn up”, she remarks.

After a day teaching a class of 30, Doyle’s head was always “buzzing” in the car driving home with her own two, Mia (nine) and Peter (eight), so she decided, during the Triple P course, to introduce a rule of five minutes’ silence when the three of them first got into the car.

“They really took that on. Even today, when I went to say something, Mia tapped her watch. The five minutes weren’t up,” she says.

Doyle recalls another mother asking her what the reward was for the children staying quiet.

“The reward was me not taking the head off them if they asked me something!” That was all they needed. It gives them a breather after school too, and then Emer is more receptive to what they have to say afterwards.

In fact, life at the Doyle family home in Kilcavan, Geashill, on the Laois/Offaly border, is generally a lot calmer. “Because I am more calm myself, everybody in the house is more calm.”

By being more prepared, she is not rushing them and so Sean (16) and Ellie (13), along with Mia and Peter, have become better at organising themselves too.

She prioritises quiet time together on a Saturday morning and the television is no longer switched on.

“The other thing that I really took on board was looking after myself, and David and looking after ourselves as a couple. We have taken up running and the children see we are in better form.”

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