Triple P in StokeonTrent

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Triple P in Stoke-on-Trent

• Childrens Centres and Extended Schools
• Claire Halsey, Consultant Clinical Psychologist
• North Staffordshire
• Combined Healthcare NHS Trust
• First Steps Psychological Service
• www.firststepsstoke.co.uk

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Overview

• Childrens Centres and Extended Schools core
  offer.
• Why offer parenting programmes?
• Triple P in Stoke on Trent
• Local Outcomes
• Local Challenges

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Childrens Plan Building Brighter Futures

• Parents want more support in managing the new
  pressures they face.
• It is always better to prevent failure than
  tackle a crisis later.
• Making it happen A service that makes more
  sense to families for whom professional
  boundaries can appear arbitrary and frustrating.
• Extended schools offer
• Parenting support including information sessions
  for parents at key transition points, parenting
  programmes and family learning sessions.
• Research shows that parenting in the home has a
  far more significant impact on childrens
  achievement than parents social class or level
  of education. For children of primary school age,
  parental involvement particularly in the form
  of good parenting in the home has the biggest
  impact on their achievement and
  adjustment. The effect is more significant than
  the school itself. Know How
  Booklet - Parenting Support, 2006

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Childrens Centres core offer

• Child and family health services, including
  ante-natal services
• Parental outreach
• Family support services
• Support for children and parents with special
  needs
• Information and advice to parents/carers on a
  range of subjects, including looking after
  babies and young children

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Why intervene with parents? Times really have
changed

• Mums are working more 70 compared to 56 in
  1971
• More people are caring for elderly parents as
  well as children 10 million by 2010
• More lone parents 3 x as many as in 1971
• Family structure has changed 28 of children
  will experience their parents divorce
• Technology has made children more powerful, more
  vulnerable and altered social interaction
• Higher mobility means less access to local
  support
• Parents of teenagers are asking for support
• Economic independence occurs later
• (DFES Every Parent Matters, March 2007)

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The scale of the problem

• Child Adolescent Difficulties
• 4 - 14 of children young people show a
  clinical level of conduct disorder or
  oppositional defiant disorder, these make up 50
  of referrals for psychological help.
• 60 of children with untreated conduct disorder
  go on to later difficulties.
• Poor educational attainment, difficulties with
  friendships and relationships, anti social
  behaviour

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Screening Project (children age 3 - 4)Strengths
and Difficulties Questionnaire Conduct 18 in
the clinical range (4 above national average
range of 4-14)
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Parenting Scale Over reactivity25 over reactive
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Triple P in Stoke on Trent Joint project NHS
North Staffs MIND, multiple funding sources.

• Stoke on Trent - population 240,000
• High unemployment
• Child Poverty - 50 of children live in families
  receiving benefits
• Index of Multiple Deprivation - 34th most
  deprived area out of 354 in England
• Triple P in Stoke on Trent
• First groups January 2003
• Funded initially by the Childrens Fund
• Trained a core team and staff across
• agencies and disciplines
• Full time co-ordinator to drive the work

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Why did we choose Triple P in Stoke?

• Strong theoretical basis
• International evidence base
• Versions for ages 0 16
• Delivery is not profession/agency specific
• Five intervention levels of increasing intensity
• Tailored 11 or groups
• Common assessment package
• Respectful

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Levels of Intervention
Universal Triple P Level One
Selected Triple P Level Two
Primary Care Triple P Level three
Standard Triple P Level four
Enhanced Triple P Level five
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Universal Triple P

• Information for all parents
• Newspaper regular ask the experts column plus
  good news parenting stories
• Childrens Centre Newsletters
• Radio
• Tip sheets - Available to all parents, everyday
  part of Childrens Centre information and goody
  bags.

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Whats worked in Childrens Centres extended
schools

• Co-ordination of training materials.
• Selecting and briefing practitioners prior to
  training.
• Supporting the transition from trained to
  practicing.
• Provision of supervision.
• Burst of set up training followed by additional
  training annually.
• Establishing an effective skill mix of
  practitioners.
• Higher engagement as school staff have existing
  rapport with parents.
• Seamless working to meet complex needs.

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Do we reach the right families? Demographics of
recently discharged families

• Mums and Dads
• 62 mums (84)
• 12 dads (16)
• Lone parent families
• 43 lone parents (65)
• 23 co-habiting/married (35)

• Waged or unwaged
• 50 unwaged (79)
• 13 waged (21)
• Parental ethnicity
• 36 parents - white British (73)
• 13 parents - black and minority ethnic origin
  (27)

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Triple P and Stoke on Trent 5 years on

• Hundreds of families access Triple P each year.
• Triple P available in all Childrens Centres and
  many schools.
• High brand recognition.
• Multi agency recognition and collaboration.
• Embedded in our strategic documents and outcomes.
• Our local evidence matches the
  international research.

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Stoke-on-Trent LOCAL OUTCOMES
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Triple P group outcomes (SDQ) Conduct emotional
difficulties n 313
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Triple P group outcomes Parenting
Style n 306
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N 175
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Parental mental health outcome data Stoke on
Trent teen data n54
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Follow up survey 6-12 months post discharge(13
of 18 had accessed Triple P)
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Do parents like their service?n 81 of which 62
Triple P
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What could we do to improve? Parents answers
More cups of tea, and more time Nothing.
Fantastic service Try to get the groups together
with parents of children with the same sort of
problems Just keep on doing what you do Do a
review in a few months Have A4 charts instead of
A5. Making it easier to record on (behaviour
monitoring forms)
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Local Challenges

• Initial training selection briefing issues.
• High effort needed to achieve parental
  attendance.
• Expectations that Triple P will be successful
  every time.
• Staff turnover.
• Communicating what Triple P services are running,
  by whom and where at any one time.
• Meeting the needs of a changing population.

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Parent Feedback

• Triple P gave me the strength to carry on, to
  get the help I needed
• Talking with people in a group you realise its
  not just you that has the problem, I found this
  really helpful
• Someone there to listen to us
• The main thing was that member of staff was
  able to come to my house. I felt more
  comfortable, it felt more personable.
• Made me think about what I do and how I respond
  to different situations
• Looking at other parents and knowing that they
  are going through the same thing

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Parent Feedback

• What a relief to know were not alone Parents
  comments after first group session
• Im not shouting at the kids, Im a lot calmer,
  everything has changed. You can see a completely
  different side to the kids. Father after group
  session 2
• Having something to follow, I can refresh my
  memory by using the work book, I forget, so lots
  is there for you in black and white Mother after
  group session 4
• Finding out about praise made the biggest
  difference to our family
• Father after group session 4
• I think every parent should be able to do this
  course. Mother in group
• Claire.Halsey_at_northstaffs.nhs.uk
• For more info about Triple P research contact
  www.pfsc.uq.edu.au
• For more information about Triple P training and
  resources
• contact www.triplep.net
• For more information about Triple P in Stoke on
  Trent contact www.firststepsstoke.co.uk