Meta-analysis finds Triple P effective in preventing antisocial behaviour and delinquency

More evidence has come to hand that parenting programs are an effective evidence-based strategy to prevent antisocial behaviour and delinquency.

A meta-analysis update on the effects of early family/parent training programs on antisocial behaviour and delinquency (Piquero et al., 2016) is an excellent and timely study which shows the huge value that evidence-based parenting programs represent.

If you think about the costs of violent and anti-social behaviour to society, for very little outlay, parenting programs reward investors many times over.

The study, published in the Journal of Experimental Criminology, updates and replicates Alex Piquero’s previous work published in 2009 which found that early family/parent training “is an effective intervention for reducing behaviour problems among young children’’.

The authors conclude:

“In short, early family/parent training programs are an important evidence-based strategy that deserves continued application and expansion as part of a more general strategy for building a safer society.’’

In comparing different interventions, the review authors place Triple P’s effect size of 0.56 midway between Parenting-Child Interaction Therapy (0.98) and The Incredible Years (0.37).

This is an extremely encouraging finding given that PCIT adopts a treatment approach, focusing on more difficult cases with “more room to move’’.

PCIT and, to a lesser extent, The Incredible Years are targeted, treatment interventions for families with children with well-established conduct problems.

In contrast, the Triple P multilevel system of parenting support is based on a population-based public health model which seeks to shift prevalence rates across the community.

Triple P’s approach blends early intervention, light touch programs designed with prevention in mind with more enhanced, targeted treatment options.

The Triple P studies reviewed by Piquero et al. included a mix of different delivery modalities such as over-the-phone, self-directed, and television programs – representing a mixture of brief, low-intensity prevention interventions (Sanders, Montgomery & Brechman-Toussaint) – and more intensive enhanced interventions (Sanders, Markie-Dadds, Tully & Bor).

Prevention interventions usually have lower base rates of problems and therefore less room to “improve” whereas treatment interventions such as PCIT typically have higher base rates and much greater capacity to show change over time as well as larger effect sizes.

An intensive intervention with multiple sessions (12 or more) may produce larger effect sizes than briefer interventions (eight or less sessions) but a brief intervention may have greater impact because it’s less expensive to deliver with more families able to be seen with the same allocation of practitioner time.

Generally meta-analyses of parent training have not looked at these issues of cost and population reach that an intervention can achieve.

Both treatment and prevention approaches are important and both need to be incorporated in any effort to treat and prevent anti-social behaviour and delinquency.

However, issues such as practitioner availability and the amount of time that parents can dedicate to participation are important factors that agencies need to weigh up when considering how to implement a prevention health approach.

Social media a force for families

Social media and electronic gaming strategies can have an extremely positive influence on the lives of impoverished families, a study of The University of Queensland’s Triple P Online program has found.

A version of Triple P Online, the web-based version ofUQ’s Triple P – Positive Parenting Program, was ramped up with social media and gaming smarts and made available to disadvantaged families in Los Angeles.

Triple P founder Professor Matt Sanders said the enhanced version – called Triple P Online Community – was designed to encourage parents to participate in the program and share knowledge about what they had learnt.

He said the study included 155 disadvantaged high-risk parents in Los Angeles.

“Of these, 76 per cent had a family annual income of less than $US15,000, 41 per cent of parents had been incarcerated, 38 per cent were in drug and/or alcohol treatment and 24 per cent had a child removed due to maltreatment,” Professor Sanders said.

The study, led by Dr Susan Love of California State University Northridge, set out to test if gaming and social media could successfully engage this traditionally hard-to-reach population, and show benefits to both parents and children.

“The program’s 50 per cent retention rate of participants was extraordinary, given the stress the participating families would have been under just to manage daily life,” Professor Sanders said.

“More importantly, both parents and their children showed improvements likely to lead to better developmental outcomes for those children and potentially more stability and less stress in the lives of the parents.

“Participation in evidence-based parenting programs has also been shown to reduce risk factors for child maltreatment.

“A program able to engage highly vulnerable families and produce outcomes such as these shows just how important it is that researchers think creatively when it comes to finding solutions for families.”

Triple P Online Community was designed by Dr Love, former UQ-based project manager Marianne Maurange and Triple P authors at UQ’s Parenting and Family Support Centre, as well as researchers at the University of South Carolina and the Oregon Research Institute in the US.

Dr Love said one of the most rewarding aspects of the study was finding that parents in the Triple P Online Community actively encouraged each other.

“Parents in the study shared parenting tips and strategies, not just with each other, but with other family members, their friends, teachers and day care workers,’’ Dr Love said.

“They also were far more engaged than the typical social media audience, far exceeding the 90-9-1 social media rule – the idea that 90 per cent of people watch but don’t contribute to social media, nine per cent contribute occasionally and one per cent of users participate a lot.

“In our study, 50 per cent of our parents ‘lurked’ online, 32 per cent shared occasionally and 17 per cent shared frequently.’’

The study is online in the journal Child Abuse and Neglect.