What now for Triple P?

Triple P - Positive Parenting Programme - was the subject of much comment in the press in November with the publication of an evaluation which recommended that NHS Greater Glasgow and Clyde does not continue to invest in the programme.

The Positive Parenting Programme (Triple P) was created by Matthew R. Sanders and colleagues at the University of Queensland in Australia and evolved from a small 'home-based, individually administered training programme for parents of disruptive preschool children' into a comprehensive preventive whole-population intervention programme. Triple P is one of the central components in the National Parenting Strategy, and there has been considerable interest in the evaluation of the multi-million pound initiative running in Glasgow.

There have been concerns about Triple P from the outset, notably the lack of evidence that the programme has any long-term benefits; or for it working across the whole population.  But these have also been disputed.  And the jury still seems to be out…

A research team led by Glasgow University has evaluated Triple P over the course of four years from 2009 to 2013.  During this time, 730 practitioners have been trained; over 30,000 Triple P 'interventions' have been provided to families to improve parenting skills; and several million pounds have been spent.

The evaluation found that:

  • Families with greater problems than those in the general population were more likely to attend Group Triple P sessions, but those with more severe problems were less likely to complete them.
  • Families living in more deprived areas were more likely to start Triple P interventions than those living in affluent areas but more affluent and more highly educated families were more likely to complete Triple P interventions.
  • Families completing interventions reported high levels of satisfaction with Triple P, and reported improvements in parenting behaviours, emotional wellbeing and child behaviour.
  • It is not possible to be sure whether these improvements were a result of the intervention or whether they represent the passage of time or 'regression to the mean'. This uncertainty, coupled with low completion rates, renders assessment of the effectiveness of interventions impossible.
  • Practitioners were generally satisfied with the Triple P approach to parenting support but some practitioners expressed negative views about a target-driven approach and some considered Triple P was inappropriate for some families.
  • The social and emotional functioning of the population of children aged five years did not change during the implementation of the Parenting Support Framework.

NHS GGC has rejected the findings commenting to the BBC, '…our concerns regarding the quality of data and the lack of impartiality in the report means that we cannot use its conclusions to shape decision making on parenting support within the city.  As such, we are now considering alternative options for an independent evaluation of our parenting support framework.'

So, so far, so inconclusive.

The Glasgow initiative has been branded both as 'a failure' and as 'great value'.  So which is it? It is a contentious field.  But surely if the research evidence holds up, should we not listen to it even if it's not giving the 'right' answers?  But also, given the many millions of pounds of public money spent on the programme so far, would it not make more sense to see what is working well - or is salvageable - rather than simply stopping any further investment in it?  Is it not possible for the evaluators and NHS GGC to work together to come up with a way forward which would benefit families in Glasgow?  Or are there simply too many vested interests associated with the product, the investment and the rationale to make that possible?

Press reports at:

Info about Triple P:

Previous PAS report at: