2017 november 16 zr, se, sr triple p...

NC Department of Health and Human Services Division of Public Health

2017 Fall Child Health MeetingsWebinar 4: Positive Parenting Program

Speakers: Zita Roberts, NC Triple P CoordinatorSheryl Ewing, MA, Executive DirectorSteve Roman, Triple P Program CoordinatorNovember 16, 2017

Webinar Logistics

The sound for this webinar is provided in VoIP‐‐you will use your computer speakers; be sure to turn up the volume; you will use the CHAT function to communicate with the presentersThe webinar will be archived and posted on the Child Health Provider resource page.

Test for Audio

If you cannot hear any sound through your computer speakers at this time try the following:

1) Check to make sure your computer sound is turned up and on

2) For only those who still cannot hear, please call in at 1-877-336-1831 and use this access code: 9728718

We only have limited phone access so please do not call if you have audio through your computer.

2017 Fall Child Health Updates

The Public Health Nursing and Professional Development Unit (PHNPDU), North Carolina

Division of Public Health, is approved as a provider of continuing nursing education, by the North

Carolina Nurses Association, an accredited approver by the American Nurses Credentialing

Centers’ Commission on Accreditation.

Provided by Nurses, for Nurses

Disclosures

Completion criteria: the learner must attend 100% of the webinar, complete the participant evaluation which includes attestation by signature on evaluation of their full attendance, and correctly identify the clue word shared during the presentation in order to receive 1.67 CNE contact hours.

The planners and presenters have no actual, potential or perceived conflicts of interest to disclose.

Welcome and Thank You to Zita Roberts, NC Triple P Coordinator

Children and Youth Branch, Division of Public HealthNorth Carolina Department of Health and Human Services

2017 Fall Child Health Meetings:NC Triple P State Coordinator’s RoleOutcomes:

At the conclusion of the session, participants will be able to state they have:

• Increased knowledge of the purpose of the Triple P (Positive Parenting Program)

• Increased knowledge of the Branch’s role with Triple P

• Increased knowledge of the deliverables for the implementing agencies

• Increased knowledge of the State Coordinator’s role with Triple P

2017 Fall Child Health Meetings:NC Triple P State Coordinator’s Role

Vision Statement:• All children grow up in safe and nurturing environments, with

stable relationships that promote their emotional and behavioral health.

Mission Statement:• To strengthen caregivers to become more positive catalysts of

healthy child development acknowledging that every child deserves to grow-up in safe and nurturing environments, with stable relationships that promote their emotional and behavioral health.


Triple P (Positive Parenting Program)is a universal prevention program that aims to increase parental skills in order to prevent the development of serious behavioral and emotional problems in their children.Our long-term aim at the Branch is to provide funding to implement Triple P with model fidelity through local implementing agencies across the state to:

Reduce out-of-home placements.Prevent hospitalizations and emergency department visits for child maltreatment.Prevent substantiated child abuse cases.Reduce out of child care/school suspensions related to behavioral issues

9

2017 Fall Child Health Meetings:NC Triple P State Coordinator’s RoleThe local implementing agencies implement Triple P for children birth to 17 years of age for their service area through:Training of practitioners in one of more the five levels of Triple P:

5. Enhanced/Pathways/Lifestyle/TransitionsBehavioral family interventions

4. Standard/Group/Self‐Directed/Online Triple PBroad focus parenting skills training

3. Primary Care/Discussion GroupsNarrow focus parenting skills training

2. Seminars/Brief Primary CareInformation/advice for a specific parenting concern

1. Universal Triple P/Stay PositiveMedia‐based parenting information campaign

Intensity

of Intervention

Breadth of Intervention


• Developing Memorandum of Understanding with partner agencies• Developing or revising current implementation plans• Maintaining an infrastructure of a full‐time coordinator, data

specialist, or outreach coordinator• Reporting data regarding the:

• Number of accredited practitioners,• Number of practitioners delivering Triple P,• Number of caregivers served,• Scores of practitioner satisfaction,• Caregiver’s satisfaction,• Pre/post assessment results of caregivers served,• Number of Triple P Online users, and• Monthly activity of coordinators.


Continued:

Monitoring the deliverables of the practitioner agencies

NC Triple P State Learning Collaborative•Collaboration•Efficiencies•Statewide Data Collection•Statewide “Stay Positive” Campaign•Local Coordinator Peer Support•Work Groups


State Leadership TeamGroup of funders and other stakeholders' who meet to discuss:

Maintenance and Expansion of services,

Data Collection and Evaluation,

Triple P Online,

Implementation Team Development, and

Orientation and Operations Manual Development


Role of the State Coordinator:−Manages the Local Triple P agreement addenda,−Facilitates activities for the Triple P State Learning Collaborative planning group, coordinates the logistics for the collaborative meeting quarterly, and manages the work groups of the collaborative,−Facilitates activities for the State Leadership Team,−Manages media campaign for the “Stay Positive”,−Manages the parent and provider websites,−Assures data collection and reporting are completed monthly and quarterly, and −Coordinates activities to assist sites with managing their local programs.


Zita Roberts, Triple P State CoordinatorDivision of Public Health

Women’s and Children’ s Health SectionChildren and Youth BranchHealth and Wellness Unit

Contact Info: [email protected](919) 707-5601

Triple P Parenting Website:http://www.triplep-parenting.net/ncen/home/

Questions

Welcome and Thank You to Sheryl Ewing, MAExecutive Director, Triple P Stepping Stones Provider

Family Support Network of Southeastern NC, Inc.

The Power of Positive Parenting& Temper Tantrums

Sheryl Ewing, MA,

Triple P Provider

Outcomes

At the conclusion of the session, participants will be able to state they have:

• An increased knowledge of the 5 core principles of Positive Parenting and the strategies used for each core principle

• An increased knowledge of examples of preventing temper tantrums

Our hopes and dreams

– To raise healthy, well‐adjusted children who have the skills to:

– Communicate their needs

– Get on with others

– Try to do their best

– Manage their emotions

– Feel good about themselves

In a safe, secure, loving and low conflict environment.

Being a parent

– Parenting can be:

– Rewarding

– Enjoyable

– Demanding

– Frustruating

– Exhausting

We all learn through trial anderror

Every Parent has to develop their own goals and approach to parenting.

Children’s Behavior

The tough part of parenting

The challenge

▪ Some misbehavior is normal

▪ Some discipline problems are inevitable▪ Managing everyday behavior problems can prevent more serious ones

Positive Parenting

– Promoting children’s development and managing their behavior and emotions in a positive way

– Building strong relationships– Good communication– Emphasizing the positive– Planning ahead to prevent problems– Using everyday situations and creating opportunities to help children learn

Benefits for children

Develop skillsDo better at school Build friendshipsFeel good about themselvesHave fewer behavioral and emotional problemsLess likely to become involved in drug abuse or delinquent behavior

Skills children need

▪ Good communication and social skills▪ Ability to manage feelings▪ Independence skills▪ Problem solving skills

Core Principles

1. Having a safe, interesting environment

2. Having a positive learning environment

3. Using assertive discipline

4. Having realistic expectations

5. Taking care of yourself as a parent

Principle 1Having a safe, interesting environment

Strategies

– Develop predictableroutines

– Provide supervision

– Have interesting things to do

Tips for Safety:

– Teach your child road safety rules

– Provide safetyequipment

– Teach your child about personal safety

Principle 2

Having a positive learning environment

Strategies

– Spend time withyour child

– Speak nicely

– Chat and listen often– Share your own experiences

– Be affectionate

– Use descriptive praise

– Give your child attention

– Use incidentalteaching

– Get involved in your child’s school

Principle 3

Using assertive discipline

How discipline helps

Discipline helps children learn to:

– Accept necessary rules and limits

– Develop self control

– Consider others– Express their feelings in ways that respect the needs of others

– Take responsibility for their actions

When discipline works

Discipline works best when:

– Children live in a predictable world

– Children receive plenty of attention for goodbehavior

– Parents have reasonable expectations

– Parents use fair, predictable consequences

– Parents support each other

Strategies

– Use directed discussion for rule breaking

– Give clear, calm instructions

– Start instructions

– Stop instructions

– Take away a problem activity

– Back up instructions with quiet time– Time out only for serious misbehavior – this should be infrequent.

Principle 4

Having realistic expectations

Strategies

–What do I expect?

– Is this rule necessary?

– Can my child understand or do this?– Your expectations of yourself – are your expectations reasonable at this child’s age?

whining & tantrums

Whining is common in young children…

…but frustrating for parents.Whining is a drawn out, complaining way of speaking, often in an irritating tone of voice. Whining can get louder and turn into a tantrum.

Parents contribute to tantrums…

– Accidental Rewards

– Escalation Trap

Prevention

–Make your home a safe environment; put away things they cannot touch.

– Have a few necessary and realistic rules

– Routine; set meals and sufficient sleep

– Praise – catch children doing things right

– Plenty of interesting things to do

– As your child grows older give choices

Teach your child to communicate calmly

…first the parent has to demonstrate how to dothis!

Encourage desirable behavior

Teach your child to communicate how they feel

Teach your child how to calm down

Strategies

– Use your words

– Decide if they can have what they want

– Diversion to another activity

– Logical consequence

– Planned ignoring

– Quiet time or time out

Plan ahead

– Think about when a tantrum is likely

– Use prevention strategies

– Make sure there are plenty of activities to do

– Remind your child of the rules and how tocommunicate

– If a tantrum begins, tell your child what to do– Be consistent and back up your instruction with the logical consequence, quiet time or time out.

Principle 5

Taking careof yourself as a parent

Balancing work and family

– Have realistic expectations of yourself

– Reduce unnecessary commitments

– Develop good transition time routines

– Avoid conflict after work and prepare for the second shift

– Teach your child to be independent

– Organize good reliable child care

Changing how you think

– Notice when you are feeling upset with yourchild

– Identify what negative or unhelpful things your are saying to yourself about the situation, particularly why it is happening

– Try to change negative thoughts to helpful, more rational thoughts

Parenting is stressful and exhausting

–What are some ways that you can take care of yourself better?

– Adults need time with other adults doing adult things – it is a good idea to have a babysitter now and then.

• Make childrena priority

• Create a warm, loving, safeenvironment

• Engaging activities

• Use positive assertive discipline

• Havereasonable expectations

• Stay calm

Healthy families… competent children, strong communities

It is about making it work for YOU!

Resource

http://www.triplep.net/glo‐en/the‐triple‐p‐system‐at‐work/evidence‐based/key‐research‐findings/

Questions

Welcome and Thank You to Steve RomanTriple P Program Coordinator

Lenoir, Greene, Jones, Pitt ,Beaufort, Hyde CountiesPartnership for Children of Lenoir and Greene Counties

TRIPLE P-TEEN

Helping Teens Cope with Anxiety and Depression and Developing Friendships/ Peer RelationshipsTRIPLE P-TEEN

Learner Outcomes:

At the conclusion of the session, participants will be able to state they have: Increase knowledge on how to reduce problem behavior in

children and improve parents’ wellbeing and parenting skills Increase knowledge of how Triple P has positive effects on a range

of outcomes including children’s social, emotional and behavioral measures, parenting satisfaction and effectiveness, and parent relationships

Increase knowledge of how to assist parents to learn coping skills with everyday problems with teenagers emotions and getting them to cooperate, reducing family conflict and building teenagers’ survival skills

COPING WITH ANXIETY

Anxiety is common among teenagers. Sometimes normally happy teenagers will become anxious or fearful about something for a day or two, and then they will be back to normal without any need for parents to take action

Some teens seem to suffer more intense and frequent feelings of anxiety that prevent them from participating in activities

This presentation will give you some suggestions on how to help a teenager cope with and reduce their fears

WHAT IS ANXIETY?

Anxiety is a vague, unpleasant emotional state that can make a person feel dread, distress and uneasiness

Anxiety may range from a fear of being hurt in a fight, to embarrassing themselves in front of the class or worrying about an upcoming event

Teenagers express their emotions is different ways; angry/aggressive, withdrawn, tired and/or irritable

They may have trouble sleeping, show little interest in eating and say very little

Some may avoid peers and social activities or refuse to attend school

WHAT CAUSES TEENAGERS TO BECOME ANXIOUS?

Pressure of school work, such as assignments or exams

Problems with peer relationships

Conflict at home with parents

Problems achieving a desired goal, such as getting onto a sporting team or doing poorly in a competition

Increased heart rate, rapid breathing, sweaty palms, light-headedness, dizzy and stomach tightening are natural reactions to something unpleasant about to happen.

HOW TO PREVENT A TEENAGER FROM BECOMING ANXIOUS

Create a positive family environmentEncourage teenagers to have realistic beliefs in their capabilitiesEncourage teenagers to develop good problem-solving skillsTalk openly about feelings and how to cope with upsetting eventsMake positive comments about things the teenager does wellEncourage teenagers to take part in, rather than avoid, social

settingsMake sure there are plenty of positive interactions with parents

and other family membersTeenagers should have consistent rules and appropriate discipline

so they feel their world is secure and predictable

WHAT TO DO IF YOU THINK A TEENAGER MAY BE ANXIOUS

Monitor the teenager’s emotions and behavior

Talk to the teenager

Encourage regular school attendance

Encourage the parent to talk to someone at school

HOW TO HELP TEENAGERS MANAGE ANXIETY

Encourage the teenager to face their fearsTeenagers may feel ashamed or embarrassed about their

anxietyExplain to them they are reacting in a very normal way

Encourage the teenager to practice their coping skillsWith no-one around, ask the teenager to sit comfortably and count their breathingGet them to monitor their breathing several times a dayThis will help them slow down their breathing when facing a feared situation

HOW TO HELP TEENAGERS MANAGE ANXIETY

Ask the teenager to write down the thoughts he/she has when anxiousness starts

Get them to write down a different, positive thoughts to replace each of the negative thoughts

Get your teen to write down the new positive thoughts on a card he/she can carry with them. Have the teen say these thoughts out loud and then to themselves

POINTS TO REMEMBER

Daily disappointments and fears are all part of life and teenagers need to be able to cope with the regular stress of daily living

Often, it does not require parents to take action, other than to provide understanding and support

When excessive worrying takes over their lives, parents need to take action and consider seeking professional help

Some teenagers who are very anxious may also be depressed……

COPING WITH DEPRESSION

Depression is quite common among teenagers. Sometimes normally happy teenagers will be sad about something for a day or two, then they will be back to normal

Some teenagers become severely depressed, sometimes as a result of some distressing or unusual events

WHAT IS DEPRESSION

Depression is an emotional state where a person feels sad, listless, and discouraged for long periods of time

Teenagers who are depressed usually have a negative outlook on life and often feel that there is no point to anything

Teens who are depressed may start to think about harming themselves or taking their own life

Suicide is one of the leading causes death

WHAT CAUSES TEENAGERS TO BECOME DEPRESSED

Depression sometimes occurs when someone or something a teenager enjoyed is suddenly lost or not available anymoreBreaking up with a boyfriend/girlfriendFighting with a group of friendsBeing cut from a sports teamThe death of a family member or close friendParental divorce Changing schools

HOW TO PREVENT A TEENAGER FROM BECOMING DEPRESSED

Create a positive family environmentEncourage teenagers to have realistic beliefs about their

capabilitiesEncourage teenagers to develop good problem-solving skillsTalk openly about their feelings and how to cope with

upsetting eventsMake positive comments about things they do wellEncourage teens to maintain interest in social and recreational

activitiesMake sure there are positive interactions with parents and

other family members

WHAT TO DO IF YOU THINK A TEENAGER MAY BE DEPRESSED

Monitor their emotions and behaviorsLess social activityLess contact with friendsMore time alone in their roomIncreased irritabilityChanges in their sleep patternsChanges in their eating patterns

WHAT TO DO IF YOU THINK A TEENAGER MAY BE DEPRESSED

Talk to the teen about:Schoolwork or examsFriends and relationshipsDecreased interest in activitiesUpcoming social events

HOW TO HELP TEENS MANAGE DEPRESSION

Encourage the teen to find things he/she enjoysEncourage them to replace negative thoughtsConsider medication and therapy Look out for signs of suicide or self-harm

Self-defeating statementsGiving away their possessions Showing little interest in upcoming eventsSudden improvements in mood after being depressed for

some time

FRIENDS AND PEER RELATIONSHIPS

Peer relationships become increasingly important during the teenage years

Social events provide opportunities for teenagers to mix with peers and they become very important

The relationship between teenagers and their parents may become tense

Strained peer relationships can also be a source of distress for teens

WHY ARE FRIENDS SO IMPORTANT FOR TEENAGERS

Social activities with peers are important to teens

Friends come to play an increasing role in teens’ lives and contact with parents may decrease considerably

If peer relationships are difficult for teenagers it can lower their confidence and self-esteem

Teenagers often turn more to their friends rather than their parents for advice

WHY DO SOME PEER RELATIONSHIPS LEAD TO PROBLEMS?

Associating with a “bad crowd” increases the chances that a teenager will start to behave badly

If the teenager is interacting with older peers, it is possible they will introduce them to drugs and alcohol

Teenagers may be encouraged to deceive parents who attempt to restrict their activities

HOW TO ENCOURAGE TEENAGERS TO HAVE GOOD FRIENDS AND POSITIVE PEER RELATIONSHIPS

Take an interest in who the teenager spends time with

Encourage parents to meet other parents

Show an interest in the teen’s social activities

Have the teen set rules about social activities

Assist the teenager in developing strategies to prevent contact with undesirable peers

Help the teen problem solve when things do not work out

WHAT TO DO IF A TEENAGER APPEARS TO HAVE DIFFICULTY MAKING FRIENDS

Talk to teenagers about their daily activities Some teens are socially isolated and/or ignored, which often

leads to being a target of bullyingCoach the teen on ways to make friends

Ask them to think about places they would go and to identify one or two people they think they could be friends with

When the teen suggests names, ask them what he/she knows about that person

Encourage the teen to join activity based social groupsThis type of situation is usually easier to interact with

others

WHAT TO DO IF THE TEENAGER DOES NOT WANT FRIENDS

Explain that friendships help develop social skills and intimate relationships when they become adults

Affirm solitary activities, such as reading and computers, are acceptable

If the teenager does not want to talk about their friends, encourage them to talk to a reliable adult or trusted friend

DOES IT WORK?

If you’re going to invest your time doing a parenting program, you want to be confident that you will get results. The triple P – Positive Parenting Program has more evidence to back it up and show it works than any other parenting program in the world. Triple P has been tested with thousands of families over more than 35 years and been shown to help families in many different situations and cultures. In fact, Triple P’s evidence base now includes: More than 800 international trials, studies and published papers,

including More than 280 evaluation studies, which also includes More than 145 randomized controlled trialsTriple P has been shown to help reduce kids’ and teens’ problem behavior and also reduce children’s emotional problems. The evidence also shows it helps parents feel more confident, less stressed, less angry and less depressed. And that’s positive!

RESOURCES

London Journal of Primary Care; Parenting and child mental health;Ryan, Rachael, O’Farrelly, Christine Ramchandani, Paul; 2017

Behavior Research and Therapy; Working with parents to treat anxiety-disordered children: A proof of concept RCT evaluating Fear-less Triple P;Cobham, Vanessa E., Filus, Ania Sanders, Matthew R.; 2017

Parenting and the health and well-being of children and adolescents; Sanders, M.R., Morawska, A.; 2016

The Triple P-Positive Parenting Program: An Example of a Public Health Approach to Evidence-based Parenting Support; Pickering, J. A., Sanders, M.R.; 2015

Journal of Child and Family Studies; Parenting practices, children’s peer relationships and being bullied at school; Healy, K. L., Sanders, M. R.Iyer, A.; 2015

POSITIVE PARENTING PROGRAMTRIPLE P

QUESTIONS

2017 november 16 zr, se, sr triple p...

Documents