TRIPLE P - Positive Parenting Program (Level 4)
At a glance
Country of origin
- USA
Level(s) of intervention
- Indicated prevention
TripleP is a multi-level parenting and family support prevention strategy programme that aims to prevent severe children’s behavioural, emotional and developmental issues by enhancing parental knowledge, skills, and confidence. Triple P encompasses five levels with different types and intensity of interventions: from providing parents with access to information using print and electronic media (level 1) to highly targeted interventions for the most severe cases of family behaviour intervention (level 5).
The five core principles of the intervention are creating a safe, engaging and positive learning environment, employing assertive discipline, having realistic expectations and prioritizing self-care as a parent. Most of the studies available in Europe assess level 4 of the intervention targeted to children with behavioural problems. However, in some studies, level 4 has been implemented at the universal level. Research conducted in Germany and Switzerland indicates positive outcomes for parental competence, primarily reported by mothers; however, no evidence is available to assess the programme's effectiveness on child-related outcomes as it’s only reported by parents.
Links to this programme in other registries
Implementation Experiences
Read the experiences of people who have implemented this programme.
Contact details
Jenna McWilliams
11 Market Street N, Indooroopilly, QLD, 4068, Australia
Contact: +6173236 1212
Email: PIES[at]triplep.net
Overview of results from the European studies
Studies overview
Two RCTs in Germany have examined the effectiveness of Triple P at Level 4 (Heinrichs et al., 2014; Kim et al., 2021). The study by Heinrichs et al. (2014) targeted parents of 2.6 to 6-year-olds. The intervention group (n=186) participated in Triple P level 4 workshops and seminars, while the control group (n=93) underwent repeated assessments to monitor child development. According to mothers’ reports on children's behaviour, there was a significant effect after the intervention; however, this effect was not found in fathers. A significant reduction in dysfunctional parenting behaviour in mothers was maintained at the 4-year follow-up (d = 0.38), but effects on child behaviour problems were not sustained (d=0.19). Notably, all outcomes were parent-reported, with long-term benefits observed only in mothers.
Kim et al. (2021) assessed the impact of Triple P on parenting behaviour and adolescent bullying. Families were randomized to either the intervention group (n=86) or the control group (n=94). After a 10-year follow-up, a notable reduction in bullying behaviours (0.259 standard deviations) was observed in adolescents whose parents had participated in the intervention. However, it is unclear how they achieved such a high retention rate over ten years.
An RCT by Bodenmann et al. (2008) in Switzerland evaluated Triple P’s efficacy in improving parenting and child behaviour among 2-12-year-olds. Fifty couples were randomly assigned to one of three conditions: Triple P programme, a distress prevention programme (CCET) or were left untreated. Mothers who attended the Triple P intervention at 1-year follow-up showed less parental dysfunctionality and a greater sense of parental competence compared to mothers from the other two groups. However, there were no significant effects of the intervention on fathers in any of the three groups. The child behaviour outcomes were only reported by parents, it is unclear what the control group received, and many outcomes were measured but statistical adjustments for these multiple comparisons were not applied.
Little et al. (2012) conducted an RCT in Birmingham to evaluate the effectiveness of Triple P for children exhibiting problematic behaviour. The control group received services as normal (n=73) and the intervention group (n=73), the 8-week Triple Parent Program. There were no significant differences between the groups in any of the child-related outcomes. The authors noted that these results could be explained by low fidelity of implementation or low adherence to the programme.
The report by Fives et al. (2013) was excluded from the assessment due to methodological issues, only a subsample of the original intervention group was analysed (n=59; 34% response rate). The analysis is within a group and not between groups, measures are not blind to intervention, there is no randomisation of participants, no assessment of participants for inclusion (targeted intervention), attrition has not been accounted for and the data included is only available for the post-test.
Countries where evaluated
- Germany,
- Switzerland,
- United Kingdom
Characteristics
Protective factor(s) addressed
- Family: attachment to and support from parents
- Family: Parental monitoring (supervision)
- Family: positive family management
Risk factor(s) addressed
- Family: aggressive or violent parenting
- Family: family management problems
- Family: low parental education
- Family: neglectful parenting
- Family: other
Outcomes targeted
- Emotion regulation, coping, resilience
- Positive relationships
- Social behaviour (including conduct problems)
Description of programme
Level 4 is an intensive, eight-session parenting program delivered in various formats (individual, group, or self-help) for parents of children with significant behavioural challenges. Parents receive five group sessions of parent training (each session lasting two and a half hours). Upon completion of the group sessions, parents participate in three individual telephone consultations (15–30 min duration each). The intervention aims to teach positive parenting strategies to encourage children’s self-regulation, manage misbehaviour and enhance social competence. During the training, are encouraged to practice these strategies and reflect on their effectiveness.
Implementation Experiences
