Triple P-Positive Parenting Program as a public health approach to strengthening parenting.

Parenting programs have considerable potential to improve the mental health and well-being of children, improve family relationships, and benefit the community at large. However, traditional clinical models of service delivery reach relatively few parents. A public health approach is needed to ensure that more parents benefit and that a societal-level impact is achieved. The Triple P-Positive Parenting Program is a comprehensive, multilevel system of parenting intervention that combines within a single intervention universal and more targeted interventions for high-risk children and their parents. With Triple P, the overarching goal is to enhance the knowledge, skills, and confidence of parents at a whole-of-population level and, in turn, to reduce the prevalence rates of behavioral and emotional problems in children and adolescents. The distinguishing features of the intervention and variables that influence its effective implementation are discussed. Self-regulation is a unifying concept that is applied throughout the entire system (e.g., to interactions between children, parents, service providers, and agencies involved in delivering the intervention). Challenges and future directions for the development of public health approaches to parenting are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pour une approche de santé publique dans les programmes de soutien parental factuels.

A public health perspective to the delivery of parenting programs has the potential to greatly increase the impact of evidence-based psychological interventions targeting parents and families. However, a population-level benefit is unlikely to be achieved unless sustained programmatic efforts are undertaken to further increase the reach of efficacious interventions. In addition, such programs need to be adapted to local circumstances, be delivered in a culturally relevant manner, and be used in a sustained way by adoptee organisations if the potential benefits of these interventions are to be realised. The multilevel Triple P system of parenting interventions is used as an example to illustrate the benefits and challenges involved in delivering a comprehensive system of parenting interventions, services, and programs. Practical implications for large-scale implementation and possible future directions for research are identified. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adopting a public health approach to the delivery of evidence-based parenting interventions.

A public health perspective to the delivery of parenting programs has the potential to greatly increase the impact of evidence-based psychological interventions targeting parents and families. However, a population-level benefit is unlikely to be achieved unless sustained programmatic efforts are undertaken to further increase the reach of efficacious interventions. In addition, such programs need to be adapted to local circumstances, be delivered in a culturally relevant manner, and be used in a sustained way by adoptee organisations if the potential benefits of these interventions are to be realised. The multilevel Triple P system of parenting interventions is used as an example to illustrate the benefits and challenges involved in delivering a comprehensive system of parenting interventions, services, and programs. Practical implications for large-scale implementation and possible future directions for research are identified. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parenting the traumatized child: Attending to the needs of nonoffending caregivers of traumatized children.

While there is a growing literature on the impact of trauma on children, there has been relatively little attention to the needs of their caregivers, who are themselves at risk for elevated levels of stress. The current article draws from the broader literature on parenting under stress and the literature on interventions with parents of sexually abused children to outline the need for interventions for caregivers of multiply traumatized children. It reviews components of an intervention model derived from the literature on general parenting interventions as well as the growing literature on trauma treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Investigation of the effectiveness and social validity of the Triple P Positive Parenting Program in Japanese society.

A pilot trial provided some evidence that the Triple P Positive Parenting Program is effective with and acceptable to a Japanese population in Australia (Matsumoto, Sofronoff, & Sanders, 2007). This effectiveness study aimed to address theoretical and practical concerns related to the parent training program in community settings in Japan. The research used community resources within an ecological framework. Fifty-four Japanese families living in a Tokyo metropolitan area were randomly assigned to either a treatment or a wait-list control group. Program effects and acceptability were examined and then compared with the outcomes from the trial with Japanese parents living in Australia. The results showed significant program effects and high levels of acceptability of the program and core parenting skills, which was consistent with the pilot trial. The findings provided support for the effectiveness and sociocultural validation of Triple P in Japanese society. Intervention effects and program acceptability as well as limitations and future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A promising parenting intervention in foster care.

The purpose of this study was to evaluate the effectiveness of a 2-component intervention for biological and foster parent (pairs) to improve parenting practices, co-parenting, and child externalizing problems. Participants were biological and foster parents (N = 128) of primarily neglected children (ages 3 to 10 years) placed in regular foster homes. Biological and foster parents were randomly assigned in pairs to the intervention (n = 80) or a usual care (n = 48) condition. Intervention families received a 12-week parenting course (Incredible Years) and a newly developed co-parenting component. Key findings included significant gains in positive parenting and collaborative co-parenting for both biological and foster parents at the end of the intervention. At follow-up, intervention parents sustained greater improvement in positive parenting, showed gains in clear expectations, and reported a trend for fewer child externalizing problems. Findings supported the feasibility of offering joint parenting training to meet the needs of participating families and demonstrated that the co-parenting construct applied to families in the foster care system was amenable to intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-administered behavioral family intervention for parents of toddlers: Part I. Efficacy.

This study examined the efficacy of a self-administered behavioral family intervention for 126 parents of toddlers. The effects of 2 different levels of intensity of the self-administered intervention were contrasted (self-administered alone or self-administered plus brief therapist telephone assistance). The results provide support for the efficacy of the self-administered form of behavioral family intervention. There were significant short-term reductions in reported child behavior problems and improvements in maternal parenting style, parenting confidence, and anger. Families who received minimal therapist assistance made more clinically significant gains compared with families who completed the program with no therapist assistance. The intervention effects were maintained at 6-month follow-up. The implications of the findings for the population-level delivery of behavioral family interventions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping and parenting: Mediators of 12-month outcomes of a family group cognitive–behavioral preventive intervention with families of depressed parents.

Objective: In a randomized clinical trial with 111 families of parents with a history of major depressive disorder (86% mothers, 14% fathers; 86% Caucasian, 5% African-American, 3% Hispanic, 1% American Indian or Alaska Native, 4% mixed ethnicity), changes in adolescents' (mean age = 11 years; 42% female, 58% male) coping and parents' parenting skills were examined as mediators of the effects of a family group cognitive–behavioral preventive intervention on adolescents' internalizing and externalizing symptoms. Method: Changes in hypothesized mediators were assessed at 6 months, and changes in adolescents' symptoms were measured at a 12-month follow-up. Results: Significant differences favoring the family intervention compared with a written information comparison condition were found for changes in composite measures of parent–adolescent reports of adolescents' use of secondary control coping skills and direct observations of parents' positive parenting skills. Changes in adolescents' secondary control coping and positive parenting mediated the effects of the intervention on depressive, internalizing, and externalizing symptoms, accounting for approximately half of the effect of the intervention on the outcomes. Further, reciprocal relations between children's internalizing symptoms and parenting were found from baseline to 6-month follow-up. Conclusion: The present study provides the first evidence for specific mediators of a family group cognitive–behavioral preventive intervention for families of parents with a history of major depressive disorder. The identification of both coping and parenting as mediators of children's mental health outcomes suggests that these variables are important active ingredients in the prevention of mental health problems in children of depressed parents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Randomized prevention trial for early conduct problems: Effects on proactive parenting and links to toddler disruptive behavior.

Despite knowledge of early pathways to conduct problems, few preventive interventions are specifically designed to modify disruptive behavior in toddlerhood. One potential prevention target is proactive and positive parenting, which is associated with reduced risk of conduct problems in preschoolers. This randomized trial with 120 low-income 2-year-old boys examined whether a brief family-centered intervention that reduces disruptive behavior (D. Shaw, T. Dishion, L. Supplee, F. Gardner, & K. Arnds, 2006) also leads to increases in proactive and positive parenting. It also explored whether change in parenting predicts change in disruptive behavior. In the intervention group, proactive and positive parenting skills increased among parents of 3-year-olds. Change in proactive and positive parenting of 2- to 3-year-old toddlers correlated with change in child disruptive behavior, although the mediation effect of positive parenting was of only borderline significance. Findings suggest that even within a brief and multifaceted preventive intervention, change in proactive parenting skills contributes modestly but significantly to change in child problem behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of parenting education with expectant and new parents: A meta-analysis.

The present meta-analysis integrates the effects of randomized controlled trials that focus on promoting effective parenting in the transition to parenthood. We included 142 papers on interventions which started during pregnancy or in the first 6 months after birth. Computations were based on random-effects models. On average, interventions had small to very small significant effects on parenting (d = .35 SD units), parental stress (d = .20), child abuse (d = .13), health-promoting behavior of parents (d=.15), cognitive development (d = .24), social development (d = .30), motor development of the child (d = .15), child mental health (d = .40), parental mental health (d = .31), and couple adjustment (d = .13). Most of the effects were maintained at follow-up. Effects varied by onset of the intervention, delivery mode, qualification of the intervener, length of intervention, intervention goals, and gender distribution. In addition, we found that older studies reported greater effect sizes. We conclude that parenting-focused interventions are effective and should be made accessible to more expectant and new parents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Triple P-Positive Parenting Program: A comparison of enhanced, standard, and self-directed behavioral family intervention for parents of children with early onset conduct problems.

Three variants of a behavioral family intervention (BFI) program known as Triple P were compared using 305 preschoolers at high risk of developing conduct problems. Families were randomly assigned to enhanced BFI (EBFI), standard BFI (SBFI), self-directed BFI (SDBFI), or wait list (WL). At postintervention, the 2 practitioner-assisted conditions were associated with lower levels of parent-reported disruptive child behavior, lower levels of dysfunctional parenting, greater parental competence, and higher consumer satisfaction than the SDBFI and WL conditions. Overall, children in EBFI showed greater reliable improvement than children in SBFI, SDBFI, and WL. By 1-year follow-up, children in all 3 conditions achieved similar levels of clinically reliable change in observed disruptive behavior. However, the EBFI and SBFI conditions showed greater reliable improvement on parent-observed disruptive child behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parental perceptions of child behavior problems, parenting self-esteem, and mothers' reported stress in younger and older hyperactive and normal children.

40 parents of younger and older hyperactives (Hs; aged 5 yrs 1 mo and 8 yrs 4 mo, respectively) and 51 parents of age-matched normal controls completed measures of hyperactivity and child behavior, parenting self-esteem (PSE), and parenting stress. PSE was lower in parents of Hs than in parents of controls. Self-esteem related to skill/knowledge as a parent was age related, with parents of older Hs reporting the lowest levels; self-esteem related to valuing/comfort in the parenting role was not related to the child's age. Mothers of Hs, especially younger ones, reported markedly higher levels of stress associated with both child characteristics and their own feelings, such as depression, self-blame, and social isolation. Consistent inverse relationships were found between PSE and perceptions of child problems, whereas ratings of child disturbance and maternal stress were positively correlated. Findings are discussed in terms of the social contexts surrounding hyperactivity and the need for multidimensional assessments and interventions in families of Hs. (47 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescents in stepfamilies: Developmental family interventions.

Discusses issues and interventions for working with adolescents who live in stepfamilies. A developmental perspective, using psychoeducation and brief strategic intervention approaches, is proposed for working with stepfamilies. Six major issues for adolescents in stepfamilies are discussed: developmental issues, sexuality issues, parent–child relationships, parenting in stepfamilies, nonresidential parent–child issues, and changes in visitation and custody. Case illustrations and suggested interventions are presented for each of these areas. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

School-based prevention of depression and anxiety symptoms in early adolescence: A pilot of a parent intervention component.

Previous studies suggest that school-based cognitive-behavioral interventions can reduce and prevent depressive symptoms in youth. This pilot study investigated the effectiveness of a cognitive-behavioral depression prevention program, the Penn Resiliency Program for Children and Adolescents (the PRP-CA), when combined with a parent intervention component. Forty-four middle school students and their parents were randomly assigned to the enhanced PRP (the PRP-CA plus parent program) or control conditions. Students completed measures of depression and anxiety symptoms at baseline and 2 weeks, 6 months, and 1 year after the intervention ended. The combined version of the PRP significantly reduced symptoms of depression and anxiety during the follow-up period. Children assigned to the intervention condition were less likely than controls to report clinical levels of anxiety symptoms. Findings suggest that school-based cognitive-behavioral interventions that include parents may prevent depression and anxiety symptoms in early adolescence. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Parenting self-efficacy and parenting practices over time in Mexican American families.

Drawing on social cognitive theory, this study used a longitudinal cross-lagged panel design and a structural equation modeling approach to evaluate parenting self-efficacy's reciprocal and causal associations with parents' positive control practices over time to predict adolescents' conduct problems. Data were obtained from teachers, mothers, and adolescents in 189 Mexican American families living in the southwest United States. After accounting for contemporaneous reciprocal relationships between parenting self-efficacy (PSE) and positive control, results indicated that parenting self-efficacy predicted future positive control practices rather than the reverse. PSE also showed direct effects on decreased adolescent conduct problems. PSE functioned in an antecedent causal role in relation to parents' positive control practices and adolescents' conduct problems in this sample. These results support the cross-cultural applicability of social cognitive theory to parenting in Mexican American families. An implication is that parenting interventions aimed at preventing adolescent conduct problems need to focus on elevating the PSE of Mexican American parents with low levels of PSE. In addition, future research should seek to specify the most effective strategies for enhancing PSE. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do interactions between personality and social-environmental factors explain smoking development in adolescence?

This study examined if the effects of peer smoking, family smoking, and parenting on smoking development during adolescence are moderated by personality characteristics of adolescents. Longitudinal data were obtained from 428 adolescents (aged M = 13.4, SD = .50) and their parents. Latent Growth Curve models assessed the development of smoking as a function of predictors and if effects of smoking-specific parenting and exposure to smoking were moderated by adolescents’ Big Five personality dimensions. Findings revealed that having peers who smoked was associated with an increased likelihood of being a smoker at baseline. Further, significant interactions revealed that adolescents lower in agreeableness were more likely to be a smoker at baseline if they had an older sibling who smoked or if their parents engaged in frequent smoking-related discussions with them and that effective smoking-specific conversation was more strongly related to smoking at baseline among adolescents who were highly emotionally stable. No interactions predicted growth in smoking over time yet significant main effects showed that growth in smoking was associated with higher levels of extraversion, lower levels of emotional stability, and less effective parental smoking-specific communication. This study highlights the relevance of personality-target interventions and policy programs directed at parents and peers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preventing conduct problems in Head Start children: strengthening parenting competencies

The effectiveness of a parenting program with 394 Head Start mothers was examined. Nine Head Start centers were randomly assigned to either an experimental condition in which parents, teachers, and family service workers participated in the intervention or a control condition in which the regular Head Start program was offered. Mothers in the intervention group were observed at home to have significantly fewer critical remarks and commands, to use less harsh discipline, and to be more positive and competent in their parenting when compared with control mothers. Teachers reported that intervention mothers were more involved in their children's education and that their children were more socially competent. Intervention children were observed to exhibit significantly fewer conduct problems, less noncompliance, less negative affect, and more positive affect than control children. One year later most of the improvements were maintained.     

Intergenerational continuity in parenting quality: The mediating role of social competence.

Prospective studies of intergenerational continuity in parenting quality remain scarce, with little attention given to the potential role of social competence as a mediator of continuity. This study examined social competence as a mediator in the pathway from 1st generation (G1) to 2nd generation (G2) parenting quality. A normative sample of children and their parents were assessed in childhood, and again 10 and 20 years later. Parenting quality of G1 parents was assessed at each time point with multiple informants, as was G2 social competence. G2 parenting was assessed at the 20-year follow-up for those who were parents. The mediational role of social competence in G1 to G2 parenting quality was tested via nested path analytic models, accounting for continuity and cross-domain relations. Social competence mediated the intergenerational relation of parenting quality; results were invariant across gender and ethnic minority status and were unchanged after controlling for age, IQ, socioeconomic status, rule-abiding conduct, and personality (i.e., constraint). The authors discuss results regarding developmental theories of close relationships and the potential for cascading benefits within and across generations from interventions to improve G1 parenting or G2 social competence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of culturally adapted parent management training on Latino youth behavioral health outcomes.

A randomized experimental test of the implementation feasibility and the efficacy of a culturally adapted Parent Management Training intervention was conducted with a sample of 73 Spanish-speaking Latino parents with middle-school-aged youth at risk for problem behaviors. Intervention feasibility was evaluated through weekly parent satisfaction ratings, intervention participation and attendance, and overall program satisfaction. Intervention effects were evaluated by examining changes in parenting and youth adjustment for the intervention and control groups between baseline and intervention termination approximately 5 months later. Findings provided strong evidence for the feasibility of delivering the intervention in a larger community context. The intervention produced benefits in both parenting outcomes (i.e., general parenting, skill encouragement, overall effective parenting) and youth outcomes (i.e., aggression, externalizing, likelihood of smoking and use of alcohol, marijuana, and other drugs). Differential effects of the intervention were based on youth nativity status. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contingency Management of Reliable Attendance of Chronically Unemployed Substance Abusers in a Therapeutic Workplace.

The Therapeutic Workplace is an effective drug abuse treatment that integrates abstinence reinforcement into a work setting by using a salary that drug abusers earn for work. Drug abuse patients are trained and hired to become data entry operators in a Therapeutic Workplace business. Despite the opportunity to earn a high wage, participants frequently arrive at work late and fail to work complete shifts. In the present study, a contingency management intervention to promote consistent and reliable attendance was evaluated in 4 participants. Participants were not allowed to work on days that they arrived late, and their pay was temporarily reduced each time they arrived late at work or failed to complete a work shift. A within-subject reversal design showed that the intervention increased the frequency with which participants arrived at work on time and completed work shifts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)