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Alan Ralph, PhD.,

Head of Training, Triple P International

18th Helping Families Change Conference,

Banff, Alberta, Canada

February 2016

Training a workforce to deliver evidence-based interventions: How effective is professional training?

2

Ownership of Triple P

• The Triple P – Positive Parenting Program is owned by

The University of Queensland. The University through its

main technology transfer company, UniQuest Pty Ltd, has

licensed Triple P International Pty Ltd to publish and

disseminate the program worldwide.

• Royalties stemming from published Triple P resources are

distributed in accordance with the University’s intellectual

property policy and flow to the Parenting and Family

Support Centre, School of Psychology, Faculty of Health

and Behavioural Sciences, and contributory authors. No

author has any share or ownership in Triple P International

Pty Ltd.

3

Expression of Interest

• Alan Ralph is co-author of all Teen Triple P programs

• He is also a member of the Triple P Research Network, an

accredited Triple P trainer, and a consultant to Triple P

International as Head of Training globally

4

A bit of history for context - 1996

• Matt Sanders establishes the Parenting and Family

Support Centre (PFSC) in the School of Psychology at UQ

• Training being run from the PFSC

• First training conducted in Australia in Qld, WA, Victoria

and NT

5

1996 - Every Parents Survival Guide video series and

Group Workbook published by Families International

6

First international dissemination of Triple P

- September, 2000 - Scotland

- March, 2001 - Hong Kong

- September, 2001 - Singapore

2001 Triple P International formed and licensed by UniQuest

Slide no.7

Parenting and Family

Support Centre, University of Queensland

Triple P

International Pty Ltd

Uniquest Pty LtdUQ’s technology transfer

company

Program development

Clinical Research

Training and Curriculum

Development

International Research

Network

Training and dissemination

Marketing and

communications

Publications

Financial and legal services

Child and Family Psychology

Clinic

TPI formally takes

over training from

PFSC

What is Triple P?

9

What is Triple P?

• Flexible system of parenting and family

support

- Five intervention levels of increasing intensity

- Principle of minimal sufficiency

• Evidence based

• Prevention/early intervention approach

• Self-regulatory framework

• Multi-disciplinary focus

• A public health model of parent education

and support

10

Flexible system of parenting and family support

11

Level 1 – Communications strategy

Stay Positive

12

Levels 2 – 5

Triple P – Positive Parenting Programs available

0-12

Seminars

Primary Care

Discussion Group

Group

Standard

Enhanced

Pathways

Level 2

Level 3

Level 4*

Level 5

Teen

Seminars

Primary Care

Discussion Group

Group

Standard

Stepping Stones

Seminars

Primary Care

Group

Standard

Lifestyle

Family Transitions

Discussion Group

*On Line

13

Evidence based

0

100

200

300

400

500

600

700

800

900

19

77

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15

N

Program development

begins

Triple P gets a name

Triple P International

begins

823 authors

614 papers

396 conceptual

papers

256 academic

institutions

218 evaluations

25 countries

Prevention/early intervention approach

Triple P system

population trial to

prevent child

maltreatment

Sponsored by the

US Centers for

Disease Control

and Prevention

15

Self-regulatory framework

Parental

self-regulation

Self-sufficiency

Self-efficacySelf-

managementPersonal agency

Problem solving

Minimally

sufficient

intervention

Reduced n

eed f

or

support

16

Multi-disciplinary focus

Health Professionals• Psychologists• Psychiatrists• Doctors and Pediatricians• Occupational therapists• Physiotherapists• Maternal and child health nurses• Speech Pathologists• Audiologists & dental therapists• Dieticians• Indigenous health workers

Others• Policy advisers• Fire fighters• Police officers• Ministers of religion• Probation officers• Students

School Personnel• School counselors• Guidance officers• Behaviour management teachers• Special educators• Principals/deputy principals• Pre-school advisers• Student support workers• Teachers

Welfare Services• Social workers• Parent educators• Family support workers• Child protection workers• Parent helpers• Telephone counselors

17

Scotland

England

WalesCanada

Australia

Japan

Sweden Switzerland

Netherlands Belgium

France Germany

Austria Romania

Iran

BES Islands

Curacao

Chile

Turkey

Hong Kong

Singapore

New

Zealand

Costa Rica

USA

Ireland

Triple P training conducted so far…25

Countries

South Africa

18

A public health model of parent education and support

• Brisbane Every Family research trial

• US Prevention of child abuse trial (CDC)

• Manitoba

• Alberta

• Izmir, Turkey

• Ireland

• NSW Govt

• Queensland Govt

Triple P training

20

Trainer selection and training

• Triple P trainers are all selected and

trained jointly by Triple P International

and the Parenting and Family Support

Centre at UQ – intensive 6-day course

• They are required to have a minimum

Masters degree in Clinical or Educational

Psychology or equivalent

• There is an ongoing professional

development component trainers are

required to complete to retain their

accreditation

21

Not a “train-the-trainer” model

• A Triple P trainer delivers

Triple P training to

practitioners, usually in

groups of 20

• Face to face

• 90-minute blocks over 2 or 3

consecutive days

• Practitioners then deliver

Triple P to parents. They are

not permitted to train other

practitioners

22

Scotland

England

WalesCanada

Australia

Japan

Sweden Switzerland

Netherlands Belgium

France Germany

Austria Romania

Iran

BES Islands

Curacao

Chile

Turkey

Hong Kong

Singapore

New

Zealand

Costa Rica

USA

Ireland

Triple P trainers located in over half…117

Trainers

South Africa

23

Training methods

• Standardised presentations including video examples

• Mix of didactic, group discussion, viewing video

material (parent-focused & practitioner focused), and

role plays

• Active skills training

• Self-regulation also central to training process

24

Triple P Provider training process

• Courses consist of several components, including:

- Training - each course varies in length (1-3 days) and

contains a maximum of 20 participants

- Pre-Accreditation Workshops - required for all first

exposure courses (added recently)

- Accreditation - scheduled approx. 2 months after training in

smaller groups (half-day or full-day)

- Supplementary workshops - as required

25

Parent resources - Workbooks, tip sheets, booklets

26

Practitioner resources –

Manuals, PowerPoint presentations, DVDs

27

Trainer resources - Participant Notes, PowerPoint

presentations, training DVDs

28

Number of courses conducted per year

0

100

200

300

400

500

600

700

800

900

1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014*

Nu

mb

er

of

Co

urs

es

29

Number of practitioners trained per year

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014*

Nu

mb

er

of

Pra

cti

tio

ners

30

0

10000

20000

30000

40000

50000

60000

70000

1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014*

Nu

mb

er

of

Pra

cti

tio

ners

Total number of practitioners trained

Evaluating Triple P training

32

Skills evaluation: Pre-, Post, and Follow-up

• Parent Consultation Skills Checklist

- Do you feel adequately trained to conduct parent

consultations about child behaviour?

- How confident are you in conducting parent

consultations about child behaviour?

- How proficient do you feel in parent consultation skills?

(Several items)

• Scales from 1 - 7

33

“Do you feel adequately trained to conduct parent consultations

about child behaviour?”

4

5

6

7

PRE POST FUP

2012

2013

2014

2015

34

“How confident are you in conducting parent consultations about

child behaviour?”

4

5

6

7

PRE POST FUP

2012

2013

2014

2015

35

“How proficient do you feel in parent consultation skills?”

4

5

6

7

PRE POST FUP

2012

2013

2014

2015

36

Course evaluation: Post and Follow-up

• Workshop Evaluation Survey

- Were you adequately informed about and prepared for

this training?

- Is this level of Triple P appropriate for your work?

37

“Were you adequately informed about and prepared for this training?”

4

5

6

7

TRGWESF ACCWESF

2012

2013

2014

2015

38

“Is this level of Triple P appropriate for your work?”

4

5

6

7

TRGWESG ACCWESG

2012

2013

2014

2015

39

Course evaluation: Post and Follow-up

Workshop Evaluation Survey

1. How would you rate the quality of the workshop presentation?

2. Did the workshop provide enough opportunities for active

participation?

3. How would you rate the content of the workshop?

4. Do you feel you now have the skills to implement Triple P in

your work with families?

5. In an overall sense, how satisfied were you with the workshop?

40

Course evaluation: Post and Follow-up

Workshop Evaluation Survey

1. How would you rate the quality of the workshop presentation?

2. Did the workshop provide enough opportunities for active

participation?

3. How would you rate the content of the workshop?

4. Do you feel you now have the skills to implement Triple P in

your work with families?

5. In an overall sense, how satisfied were you with the workshop?

41

“In an overall sense, how satisfied were you with the workshop?”

7

6

5

4

3

2

1

Training

1 SD

7

6

5

4

3

2

1

Accreditation

6.04

5.09

Global means and standard deviations (Q5)

6.37

5.51

42

“In an overall sense, how satisfied were you with the workshop?”

4

5

6

7

TRGWES5 ACCWES5

2012

2013

2014

2015

43

Pre-accreditation

• Introduced around 2014 between training and

accreditation

• Objectives:

• Prepare for accreditation

• Reduce anxiety about accreditation

• Increase confidence about program delivery

• Encourage access to ongoing support and local peer

support groups

44

Impact on success rates of adding pre-accreditation sessions

50%

60%

70%

80%

90%

100%

Accredited

Stand Alone

Pre-Accred

4137

242485%

97%

t = 12.35, p < .001

45

Impact on satisfaction ratings of accreditation experience

of adding pre-accreditation sessions

4

5

6

7

ACCWES5 Mean

Stand Alone

Pre-Accred

3305

2282

t = 14.78, p < .001

6.49

6.70

46

Summary

• Significant increases from pre- to post- and follow-up

in mean ratings of training in relation to:

- feeling adequately trained, confident and skilled to

conduct parenting consultations

- being adequately informed about and prepared for the

training

- the appropriateness of the training

• Significantly higher mean ratings of overall workshop

satisfaction for accreditation than for initial training

47

Summary

• Significant differences in mean success rates of

accreditation between no pre-accreditation and pre-

accreditation training conditions

• Significant differences in mean satisfaction ratings of

accreditation between no pre-accreditation and pre-

accreditation conditions

48

Future directions

• Increased use of Skype, video-conferencing and DVD for

accreditation in remote settings

• Provision of supplementary training workshops designed to

enhance learning relating to particular aspects of Triple P

- telephone consultations

- assessment and data interpretation

- group skills

• On-line training format under consideration for Triple P variants

- grandparents, bullying,

Thank you for your interest

contact: alan@triplep.net