Family Life Skills Triple P for Carers of Young People with Challenging Mental Health Problems: A Feasibility Trial

The study seeks to determine the effectiveness of the Family Life Skills Triple P Program and Group Teen Triple P, when compared to the delivery of Group Teen Triple P alone. All participants in the study will receive 4 x 90 min sessions of the Group Teen Triple P programme, which has an established evidence base for adolescents (see notes in comparator/control treatment). All participants will also receive 3 x 30 min individual phone calls with a clinician at the end of the group sessions to support application of the skills to their individual family context circumstances. This will be provided for both the active control (GTTP), and the intervention group (FLSTP + GTTP). We anticipate that the groups will be between 8-10 parents in a group, with a max. of 10 people in each group. Every group will have two practitioner facilitators per group. The intervention: Family Life Skills Triple P (FLSTP) is an enhanced version of Group Teen Triple P (GTTP). For this project, FLSTP will be an additional 6 x 90-minute session program that encourages parents to apply the self-regulatory skills they learn during the 4 sessions of Group Teen Triple P parenting program (e.g., goal-setting, planning ahead, self-monitoring, self-reflection) to broader life skills they need to function as healthy, well-adjusted and contributing members of the community. The FLSTP group sessions will focus on a range of life domains: coping with emotions, taking care of relationships, taking care of oneself, dealing with the past, developing healthy habits, and looking to the future. Participants in the intervention arm will receive parenting skills training through four group sessions of GTTP followed by six FLSTP group sessions all facilitated via weekly videoconference by accredited Triple P practitioners employed by Children's Health Queensland Health & Hospital Service (CHQ HHS). The FLSTP group sessions will be conducted with parents/carers only; there will be no direct contact with young people during this study. The study will not involve participants incurring any costs – all materials will be provided to them as part of the research. All participants will also receive 3 x 30 min individual phone calls with a clinician at the end of the group sessions to support application of the skills to their individual family context circumstances. The content of these 6 sessions is summarised below: Family Life Skills Triple P Module 2 5. Coping with emotions • Recognising unpleasant emotions • How emotions affect parenting • Dealing with unpleasant emotions • How emotions work • Coping statements • Personal coping plans Module 3 6. Taking care of relationships • Importance of relationships to wellbeing and family life • Effective communication skills (positive and negative communication habits) • Casual conversations • Problem solving • Improving relationship happiness Module 4 7. Taking care of yourself • Why focus on taking care of yourself? • What is compassion and why is it important? • How the mind works • Mindfulness • Building your compassionate self • Future goals Module 5 8. Dealing with the past • What we bring to parenting • What are negative life events and how do they affect us? • Dealing with difficult memories • Breaking the cycle • Personal coping plans Module 6 9. Developing Healthy Habits • What are habits? • Addictive behaviours • Recognising unhelpful habits • Evaluating unhelpful habits • Motivation to change • Understanding unhelpful habits • Changing a habit, developing a personal habit breaking plan • When to seek help Module 7 10. Looking to the future • Phasing out the program • Progress review (reviewing goals attained) • Keeping up the good changes • 10-point action plan for a healthy lifestyle • Making lifestyle changes • Future goals • Wrap up and final assessment Parents receive a workbook delivered to them via postal service which provides content, exercises for completion and their homework tasks. Group sessions are delivered by a multi-disciplinary team which may include nurses, psychologists, social workers, speech pathologists, psychiatrists and occupational therapists. All practitioners are trained to criterion. These practitioners will also conduct the individual consultations. Participants who miss sessions may receive instructions on workbook exercises to complete, and a follow-up phone call from their practitioners to ensure that the session has been sufficiently completed. To maintain fidelity, and reduce drift over time, practitioners will participate in a cumulative 8-day training, use a manual, attend weekly supervision sessions and complete post-session adherence checklists. A random selection of sessions will be recorded and reviewed for program adherence by an independent practitioner outside of the service delivery team.

The study seeks to determine the effectiveness of the Family Life Skills Triple P Program and Group Teen Triple P, when compared to the delivery of Group Teen Triple P alone. All participants in the study will receive 4 x 120 min sessions of the Group Teen Triple P programme, which has an established evidence base for adolescents (see notes in comparator/control treatment). Following the initial 4 groups sessions, participants will receive additional parenting support specific to the condition they have been allocated to. Participants in the FLSTP condition (intervention) will receive 6 x 120 min sessions of Family Life Skills content after the initial 4 group sessions of Teen Triple P content. Overall, families allocated to this condition will receive 10 weeks of parenting support. We anticipate that the groups will be between 8-10 parents in a group, with a max. of 10 people in each group. Every group will have two practitioner facilitators per group. The intervention: Family Life Skills Triple P (FLSTP) is an enhanced version of Group Teen Triple P (GTTP). For this project, FLSTP will be an additional 6 x 120-minute session program that encourages parents to apply the self-regulatory skills they learn during the 4 sessions of Group Teen Triple P parenting program (e.g., goal-setting, planning ahead, self-monitoring, self-reflection) to broader life skills they need to function as healthy, well-adjusted and contributing members of the community. The FLSTP group sessions will focus on a range of life domains: coping with emotions, taking care of relationships, taking care of oneself, dealing with the past, developing healthy habits, and looking to the future. All sessions will be facilitated via weekly videoconference by accredited Triple P practitioners employed by Children's Health Queensland Health & Hospital Service (CHQ HHS). Sessions will be conducted with parents/carers only; there will be no direct contact with young people during this study. The study will not involve participants incurring any costs – all materials will be provided to them as part of the research. The content of Family Life Skills Triple P sessions is summarised below: Coping with emotions • Recognising unpleasant emotions • How emotions affect parenting • Dealing with unpleasant emotions • How emotions work • Coping statements • Personal coping plans Taking care of relationships • Importance of relationships to wellbeing and family life • Effective communication skills (positive and negative communication habits) • Casual conversations • Problem solving • Improving relationship happiness Taking care of yourself • Why focus on taking care of yourself? • What is compassion and why is it important? • How the mind works • Mindfulness • Building your compassionate self • Future goals Dealing with the past • What we bring to parenting • What are negative life events and how do they affect us? • Dealing with difficult memories • Breaking the cycle • Personal coping plans Developing Healthy Habits • What are habits? • Addictive behaviours • Recognising unhelpful habits • Evaluating unhelpful habits • Motivation to change • Understanding unhelpful habits • Changing a habit, developing a personal habit breaking plan • When to seek help Looking to the future • Phasing out the program • Progress review (reviewing goals attained) • Keeping up the good changes • 10-point action plan for a healthy lifestyle • Making lifestyle changes • Future goals • Wrap up and final assessment Parents in both conditions will receive a workbook delivered to them via postal service which provides content, exercises for completion and their homework tasks. Group sessions are delivered by a multi-disciplinary team which may include nurses, psychologists, social workers, speech pathologists, psychiatrists and occupational therapists. All practitioners are trained to criterion. These practitioners will also conduct the individual consultations. Participants who miss sessions may receive instructions on workbook exercises to complete, and a follow-up phone call from their practitioners to ensure that the session has been sufficiently completed. Alternatively, if several groups are running at the same time, participants may join an alternative group for a makeup session. To maintain fidelity, and reduce drift over time, practitioners will participate in a cumulative 8-day training, use a manual, attend weekly or fortnightly supervision sessions and complete post-session adherence checklists. All sessions will be recorded, and a random selection of sessions will be reviewed for program adherence by an independent practitioner outside of the service delivery team.