does#triple#p#work#with#fostercarers?#helpingfamilieschange.org/wp-content/uploads/2013/03/... ·...

1
1 Garland, A. F., Hough, R. L., Landsverk, J. A., & Brown, S. A. (2001). MulBsector of systems of care for youth with mental health needs. Children’s Services: Social Policy, Research, & Prac7ce, 4, 123140. 2 Kerker, B. D., & Dore, M. M. (2006). Mental health needs and treatment of foster youth: Barriers and opportuniBes. American Journal of Orthopsychiatry, 76, 138147. 3 Schofield, G., & Beek, M. (2005). Risk and resilience in longterm foster care. Bri7sh Journal of Social Work, 35, 12831301. 4 Morgan, J., Robinson, D., & Aldridge, J. (2002). ParenBng stress and externalising child behaviour. Child and Family Social Work, 7, 219225. 5 Chamberlain, P., Price, J. M., Reid, J. B., Landsverk, J., Fisher, P. A. & Stoolmiller, M. (2006). Who disrupts from placement in foster and kinship care? Child Abuse and Neglect, 30, 409424. 6 Newton, R. R., Litrownik, A. J., & Landsverk, J. A. (2000). Children and youth in foster care: Disentangling the relaBonship between problem behaviors and number of placements. Child Abuse & Neglect, 24, 13631374. 7 Sanders, M. R., MarkieDadds, C., & Turner, K. M. T. (2003). TheoreBcal, scienBfic, and clinical foundaBons of the Triple P – PosiBve ParenBng Program: A populaBon approach to the promoBon of parenBng competence. Paren7ng Research and Prac7ce Monograph, 1, 124. 8 Goodman, R. (1997). The Strengths and DifficulBes QuesBonnaire: A research note. Journal of Child Psychology and Psychiatry, 38, 581586. 9 TarrenSweeney, M. J., (2007). The Assessment Checklist for Children – ACC: A behavioural raBng scale for children in foster, kinship, and residenBal care. Children and Youth Services Review, 29, 672691. 10 Dadds, M. R., & Powell, M. B. (1991). The relaBonship of interparental conflict and global marital adjustment for parents of opposiBonal children in rural and remote areas. Behaviour Modifica7on, 21, 379408. 11 Norton, R. (1983). Measuring marBal quality: A criBcal look at the dependent variable. Journal of Marriage and the Family, 45, 141 – 151. 12 Sanders, M. R., & Woolley, M. L. (2005). The relaBonship between maternal selfefficacy and parenBng pracBces: ImplicaBons for parent training. Child: Care, Health and Development, 31, 65–73. 13 Arnold, D. S., O’Leary, G. S., Wolff, L. S., & Acker, M. M. (1993). The ParenBng Scale: A measure of dysfuncBonal parenBng in discipline situaBons. Psychological Assessment, 5, 137144. 14 Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scales (DASS) (2 nd Ed). Sydney, NSW: Psychology FoundaBon of Australia. 6. Key Findings Improved child behaviour “Hi\ng others (virtually stopped!)” Increased knowledge I now feel I have a be‘er understanding of why she behaves the way she does….” New skills “Gained some great ideas on handling difficult situa7ons.” Interac=on with other carers “I found the group sessions very helpful, to learn from other carers, and take on sugges7ons with others in similar situa7ons.” Reassurance The program gave me confidence that the approach I currently use to manage issues is OK.” Too basic “None of my children have very easy problems to manage so nothing really helped us.” Repe==ve of other training “I felt that many of the topics discussed were tackled and discussed in other foster carer training.” Not relevant to childrenincare “I didn’t feel it applied to most foster kids.“ More needed on challenging behaviours “Feel I had done all this, was looking for something for the more extreme behaviours” N = 16 (3 male, 13 female). Age range 30 to 67 years (M = 52.13, SD = 11.19). Length of Bme as carers ranged from 1 to 30 years (M = 4.47, SD = 6.90). Number of foster children ranged from 1 to 6 (M = 2.29, SD = 1.35). Another 9 parBcipants akended the program but were excluded from analysis (n = 2 did not complete the program, n = 1 did not complete postassessment, n = 6 did not have any foster children aged between 2 and 12 currently in their care). Four groups were conducted across Queensland, Australia. Program was run for 5 consecuBve weeks (3hour group sessions), with the excepBon of Townsville where the program was facilitated over 2 full days. Childrenincare display a range of emoBonal and behavioural problems, including temper tantrums, aggression, noncompliance, sexualised behaviours, and violence and destrucBve behaviour. 123 ParenBng stress has adverse consequences for carers, including negaBve parental behaviour and higher irraBonal beliefs about parenBng. 4 ProblemaBc child behaviours have been linked with increased placement breakdown and instability. 56 1. OutofHome Care Taking Care Triple P is a promising parenBng program that can assist in the behaviour management and wellbeing of childrenincare. Some carers will undoubtedly require advanced strategies and personalised support for managing complex child behaviours. Feedback should be used to make any necessary changes to the program format and content. An efficacy trial comparing the intervenBon to a control group, and then effecBveness trials exploring outcomes when delivered in community selngs should be conducted. 8. References Contact: Claire Chandler [email protected] 2. Research & Development Cycle 7. Conclusions DOES TRIPLE P WORK WITH FOSTER CARERS? Taking Care Triple P: Program Design and Review of Feasibility Trial Claire Chandler & Jeanie Sheffield The ParenBng and Family Support Centre School of Psychology, The University of Queensland, Brisbane, Australia The Triple PPosiBve ParenBng Program aims to prevent and manage child emoBonal and behavioural problems by enhancing the knowledge, skills, and confidence of parents. It is based on five core principles, has a strong evidencebase, and has been found to be effecBve with many populaBons. 7 Taking Care Triple P is for foster carers of children aged 2 to 12 years. It is an 8session program, with foster carers parBcipaBng in 5 groupbased sessions, followed by 3 weeks of telephone consultaBons. It uses acBve skills training to promote caregiver competence and confidence. Session One: Posi=ve Paren=ng Session Two: Helping Children Develop Session Three: Managing Misbehaviour Session Four: Building SelfEsteem & Resilience Session Five: Planning Ahead Session Six: PuZng It All Together 1 Session Seven: PuZng It All Together 2 Session Eight: Program Close This research involved the development and preliminary trial of Taking Care Triple P, a posiBve parenBng program tailored to suit foster carers. Developing a new intervenBon involves progressing from theory building through to finalisaBon of resources. This project took previous research and input from carers to inform the tailoring of the intervenBon to be suitable for foster carers, compleBng the first four steps in the process. Theory Building Program Development Program Design Pilot TesBng Efficacy Trials EffecBveness Trials Resource Development Claire Louise Chandler Matthew R. Sanders TAKING CARE TRIPLE P FOR OUT-OF-HOME CARE PROVIDERS WORKBOOK FOR USE WITH CHILDREN UP TO 12 YEARS POSITIVE PARENTING SOLUTIONS Qualita=ve Feedback from Carers 4. Par=cipants & Procedure Strength and Difficul7es Ques7onnaire 8 : measuring prosocial and difficult behaviours. Assessment Checklist for Children 9 : measuring behaviours, emoBonal states, and manners of relaBng to others onen manifested by childrenincare. Parent Problem Checklist 10 : measuring interparental conflict over child rearing. Rela7onship Quality Index 11 : index of marital or relaBonship quality and saBsfacBon. Paren7ng Tasks Checklist 12 : used to assess task specific selfefficacy. Paren7ng Scale 13 : measures dysfuncBonal discipline styles. Depression and Anxiety Stress Scale 14 : measures depression, anxiety, and stress. 3. What is Taking Care Triple P? Assessment Measure Pre M(SD) Post M(SD) df tscore Child Behaviour SDQ Total 18.13 (8.11) 13.14 (5.76) 13 2.53* ACC Total 39.56 (28.19) 26.93 (20.17) 13 2.34* Parent’s Rela;onship Conflict in ParenBng 1.00 (1.00) 1.11 (0.60) 8 .56 RelaBonship SaBsfacBon 41.78 (5.65) 43.78 (2.64) 8 1.35 Confidence in Paren;ng Selng SelfEfficacy 90.83 (9.06) 88.59 (16.15) 15 .89 Behavioural SelfEfficacy 84.84 (19.35) 88.28 (18.93) 15 .96 Paren;ng Style Laxness 2.39 (0.70) 2.08 (0.67) 15 1.66 Over reacBvity 2.05 (0.54) 2.05 (0.76) 15 .01 Verbosity 3.51 (0.87) 2.99 (0.59) 15 2.36* Total Score 2.61 (0.50) 2.32 (0.53) 15 2.08* Psychological WellBeing Depression 4.38 (6.33) 2.07 (3.79) 14 1.48 Anxiety 1.75 (5.46) 0.33 (0.72) 14 1.04 Stress 7.25 (6.49) 4.40 (4.55) 14 1.93 Table 1. Means and Standard Devia;ons and Results of ttests for Pre and Post Assessment Measures PreAssessment Preassessment measures indicated a relaBvely low scoring dataset, with only the preassessment scores for child behaviour (both SDQ & ACC) were considered to be in the Clinical Range. PostAssessment A series of ttests revealed significant differences between pre and postassessment on both measures of child behaviour, overall parenBng style, and verbosity. p < .10, *p<.05 5. Assessment Measures

Upload: others

Post on 03-Oct-2020

0 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: DOES#TRIPLE#P#WORK#WITH#FOSTERCARERS?#helpingfamilieschange.org/wp-content/uploads/2013/03/... · 2014. 5. 19. · • Session#Five:#Planning#Ahead# • Session#Six:#PuZng#It#All#Together#1#

1Garland,  A.  F.,  Hough,  R.  L.,  Landsverk,  J.  A.,  &  Brown,  S.  A.  (2001).  MulB-­‐sector  of  systems  of  care  for  youth  with  mental  health  needs.  Children’s  Services:  Social  Policy,  Research,  &  Prac7ce,  4,  123-­‐140.    2Kerker,  B.  D.,  &  Dore,  M.  M.  (2006).  Mental  health  needs  and  treatment  of  foster  youth:  Barriers  and  opportuniBes.  American  Journal  of  Orthopsychiatry,  76,  138-­‐147.    3Schofield,  G.,  &  Beek,  M.  (2005).  Risk  and  resilience  in  long-­‐term  foster  care.  Bri7sh  Journal  of  Social  Work,  35,  1283-­‐1301.    4Morgan,  J.,  Robinson,  D.,  &  Aldridge,  J.  (2002).  ParenBng  stress  and  externalising  child  behaviour.  Child  and  Family  Social  Work,  7,  219-­‐225.    5Chamberlain,  P.,  Price,  J.  M.,  Reid,  J.  B.,  Landsverk,  J.,  Fisher,  P.  A.  &  Stoolmiller,  M.  (2006).  Who  disrupts  from  placement  in  foster  and  kinship  care?  Child  Abuse  and  Neglect,  30,  409-­‐424.    6Newton,  R.  R.,  Litrownik,  A.  J.,  &  Landsverk,  J.  A.  (2000).  Children  and  youth  in  foster  care:  Disentangling  the  relaBonship  between  problem  behaviors  and  number  of  placements.  Child  Abuse  &  Neglect,  24,  1363-­‐1374.  7Sanders,  M.  R.,  Markie-­‐Dadds,  C.,  &  Turner,  K.  M.  T.  (2003).  TheoreBcal,  scienBfic,  and  clinical  foundaBons  of  the  Triple  P  –  PosiBve  ParenBng  Program:  A  populaBon  approach  to  the  promoBon  of  parenBng  competence.  Paren7ng  Research  and  Prac7ce  Monograph,  1,  1-­‐24.        8Goodman,  R.  (1997).  The  Strengths  and  DifficulBes  QuesBonnaire:  A  research  note.  Journal  of  Child  Psychology  and  Psychiatry,  38,  581-­‐586.    9Tarren-­‐Sweeney,  M.  J.,  (2007).  The  Assessment  Checklist  for  Children  –  ACC:  A  behavioural  raBng  scale  for  children  in  foster,  kinship,  and  residenBal  care.  Children  and  Youth  Services  Review,  29,  672-­‐691.        10Dadds,  M.  R.,  &  Powell,  M.  B.  (1991).  The  relaBonship  of  interparental  conflict  and  global  marital  adjustment  for  parents  of  opposiBonal  children  in  rural  and  remote  areas.  Behaviour  Modifica7on,  21,  379-­‐408.    11Norton,  R.  (1983).  Measuring  marBal  quality:  A  criBcal  look  at  the  dependent  variable.  Journal  of  Marriage  and  the  Family,  45,  141  –  151.    12Sanders,  M.  R.,  &  Woolley,  M.  L.  (2005).  The  relaBonship  between  maternal  self-­‐efficacy  and  parenBng  pracBces:  ImplicaBons  for  parent  training.  Child:  Care,  Health  and  Development,  31,  65–73.  13Arnold,  D.  S.,  O’Leary,  G.  S.,  Wolff,  L.  S.,  &  Acker,  M.  M.  (1993).  The  ParenBng  Scale:  A  measure  of  dysfuncBonal  parenBng  in  discipline  situaBons.  Psychological  Assessment,  5,  137-­‐144.    14Lovibond,  S.  H.,  &  Lovibond,  P.  F.  (1995).  Manual  for  the  Depression  Anxiety  Stress  Scales  (DASS)  (2nd  Ed).  Sydney,  NSW:  Psychology  FoundaBon  of  Australia.  

6.  Key  Findings    

                                           Improved  child  behaviour  

“Hi\ng  others  (virtually  stopped!)”    

Increased  knowledge    “I  now  feel  I  have  a  be`er  understanding  of  

why  she  behaves  the  way  she  does….”    

New  skills      “Gained  some  great  ideas  on  handling  

difficult  situa7ons.”      

Interac=on  with  other  carers    “I  found  the  group  sessions  very  helpful,  to  

learn  from  other  carers,  and  take  on  sugges7ons  with  others  in  similar  

situa7ons.”    

Reassurance  “The  program  gave  me  confidence  that  the  approach  I  currently  use  to  manage  issues  is  

OK.”  

Too  basic  “None  of  my  children  have  very  easy  problems  to  

manage  so  nothing  really  helped  us.”    

Repe==ve  of  other  training    “I  felt  that  many  of  the  topics  discussed  were  tackled  and  discussed  in  other  foster  carer  

training.”    

Not  relevant  to  children-­‐in-­‐care  “I  didn’t  feel  it  applied  to  most  foster  kids.“  

 

More  needed  on  challenging  behaviours    “Feel  I  had  done  all  this,  was  looking  for    

something  for  the  more  extreme  behaviours”  

                                     

•  N  =  16  (3  male,  13  female).  •  Age  range  30  to  67  years  (M  =  52.13,  SD  =  11.19).  •  Length  of  Bme  as  carers  ranged  from  1  to  30  years  (M  =  4.47,  SD  =  6.90).    •  Number  of  foster  children  ranged  from  1  to  6  (M  =  2.29,  SD  =  1.35).  •  Another   9   parBcipants   akended   the  program  but  were   excluded   from  analysis   (n   =   2   did   not  

complete  the  program,  n  =  1  did  not  complete  post-­‐assessment,  n  =  6  did  not  have  any  foster  children  aged  between  2  and  12  currently  in  their  care).  

•  Four  groups  were  conducted  across  Queensland,  Australia.  •  Program   was   run   for   5   consecuBve   weeks   (3-­‐hour   group   sessions),   with   the   excepBon   of  

Townsville  where  the  program  was  facilitated  over  2  full  days.    

•  Children-­‐in-­‐care   display   a   range   of   emoBonal   and   behavioural   problems,   including   temper  tantrums,   aggression,   non-­‐compliance,   sexualised   behaviours,   and   violence   and   destrucBve  behaviour.123    

•  ParenBng  stress  has  adverse  consequences  for  carers,  including  negaBve  parental  behaviour  and  higher  irraBonal  beliefs  about  parenBng.4    

•  ProblemaBc   child   behaviours   have   been   linked   with   increased   placement   breakdown   and  instability.56    

1.  Out-­‐of-­‐Home  Care  

•  Taking   Care   Triple   P   is   a   promising   parenBng   program   that   can   assist   in   the   behaviour  management  and  well-­‐being  of  children-­‐in-­‐care.    

•  Some   carers   will   undoubtedly   require   advanced   strategies   and   personalised   support   for  managing  complex  child  behaviours.  

•  Feedback  should  be  used  to  make  any  necessary  changes  to  the  program  format  and  content.    •  An   efficacy   trial   comparing   the   intervenBon   to   a   control   group,   and   then   effecBveness   trials  exploring  outcomes  when  delivered  in  community  selngs  should  be  conducted.    

8.  References  

C o n t a c t :   C l a i r e   C h a n d l e r  [email protected]  

2.  Research  &  Development  Cycle  

7.  Conclusions  

DOES  TRIPLE  P  WORK  WITH  FOSTER  CARERS?  Taking Care Triple P:

Program Design and Review of Feasibility Trial  

Claire  Chandler  &  Jeanie  Sheffield  The  ParenBng  and  Family  Support  Centre  

School  of  Psychology,  The  University  of  Queensland,  Brisbane,  Australia  

The  Triple  P-­‐PosiBve  ParenBng  Program  aims  to  prevent  and  manage   child   emoBonal   and  behavioural   problems  by   enhancing   the   knowledge,   skills,   and   confidence   of  parents.   It   is  based  on  five  core  principles,  has  a  strong  evidence-­‐base,  and  has  been  found  to  be  effecBve  with  many  populaBons.7      Taking  Care  Triple  P  is  for  foster  carers  of  children  aged  2  to  12  years.  It  is  an  8-­‐session  program,  with  foster  carers  parBcipaBng   in   5   group-­‐based   sessions,   followed   by   3  weeks   of   telephone   consultaBons.   It   uses   acBve   skills  training   to   promote   caregiver   competence   and  confidence.    

•  Session  One:  Posi=ve  Paren=ng  •  Session  Two:  Helping  Children  Develop  •  Session  Three:  Managing  Misbehaviour  

•  Session  Four:  Building  Self-­‐Esteem  &  Resilience  •  Session  Five:  Planning  Ahead  

•  Session  Six:  PuZng  It  All  Together  1  •  Session  Seven:  PuZng  It  All  Together  2  

•  Session  Eight:  Program  Close  

This   research   involved   the   development   and   preliminary   trial   of   Taking   Care   Triple   P,   a   posiBve  parenBng   program   tailored   to   suit   foster   carers.   Developing   a   new   intervenBon   involves  progressing   from   theory   building   through   to   finalisaBon   of   resources.   This   project   took   previous  research  and  input  from  carers  to  inform  the  tailoring  of  the  intervenBon  to  be  suitable  for  foster  carers,  compleBng  the  first  four  steps  in  the  process.      

Theory  Building  

Program  Development  

Program  Design   Pilot  TesBng   Efficacy  Trials   EffecBveness  

Trials  Resource  

Development  

Claire Louise Chandler

Matthew R. Sanders

TAKING CARE TRIPLE P

FOR OUT-OF-HOME CARE PROVIDERS

WORKBOOK FOR USE WITH CHILDREN UP TO 12 YEARS

POSITIVE PARENTING SOLUTIONS

Qualita=ve  Feedback  from  Carers  

4.  Par=cipants  &  Procedure  

•  Strength  and  Difficul7es  Ques7onnaire8:  measuring  prosocial  and  difficult  behaviours.  •  Assessment   Checklist   for   Children9:  measuring   behaviours,   emoBonal   states,   and   manners   of  relaBng  to  others  onen  manifested  by  children-­‐in-­‐care.  

•  Parent  Problem  Checklist10:  measuring  inter-­‐parental  conflict  over  child  rearing.    •  Rela7onship  Quality  Index11:  index  of  marital  or  relaBonship  quality  and  saBsfacBon.    •  Paren7ng  Tasks  Checklist12:  used  to  assess  task  specific  self-­‐efficacy.      •  Paren7ng  Scale13:  measures  dysfuncBonal  discipline  styles.  •  Depression  and  Anxiety  Stress  Scale14:  measures  depression,  anxiety,  and  stress.    

3.  What  is  Taking  Care  Triple  P?  

Assessment    Measure   Pre  M(SD)   Post  M(SD)   df   t-­‐score  Child  Behaviour                SDQ  Total   18.13  (8.11)   13.14  (5.76)   13   2.53*            ACC  Total   39.56  (28.19)   26.93  (20.17)   13   2.34*  Parent’s  Rela;onship              Conflict  in  ParenBng   1.00  (1.00)   1.11  (0.60)   8   -­‐.56            RelaBonship  SaBsfacBon   41.78  (5.65)   43.78  (2.64)   8   -­‐1.35  Confidence  in  Paren;ng                            Selng  Self-­‐Efficacy   90.83  (9.06)   88.59  (16.15)   15   .89            Behavioural  Self-­‐Efficacy   84.84  (19.35)   88.28  (18.93)   15   -­‐.96  Paren;ng  Style                Laxness   2.39  (0.70)   2.08  (0.67)   15   1.66            Over  reacBvity   2.05  (0.54)   2.05  (0.76)   15   -­‐.01            Verbosity   3.51  (0.87)   2.99  (0.59)   15   2.36*            Total  Score   2.61  (0.50)   2.32  (0.53)   15   2.08*  Psychological  Well-­‐Being              Depression   4.38  (6.33)   2.07  (3.79)   14   1.48            Anxiety   1.75  (5.46)   0.33  (0.72)   14   1.04            Stress   7.25  (6.49)   4.40  (4.55)   14   1.93†  

Table  1.  Means  and  Standard  Devia;ons  and  Results  of  t-­‐tests  for  Pre-­‐  and  Post-­‐  Assessment  Measures    Pre-­‐Assessment  

•  Pre-­‐assessment  measures  indicated  a  relaBvely  low  scoring  data-­‐set,  with  only  the  pre-­‐assessment  scores  for  child  behaviour  (both  SDQ  &  ACC)  were  considered  to  be  in  the  Clinical  Range.  

 Post-­‐Assessment    •  A  series  of  t-­‐tests  

revealed  significant  differences  between  pre-­‐  and  post-­‐assessment  on  both  measures  of  child  behaviour,  overall  parenBng  style,  and  verbosity.    

†p < .10, *p<.05

5.  Assessment  Measures