Kymberlee Ruff here again. As the mother of two teenage boys that I
have raised here in Santa Barbara, I have found the style described in
this article about "Positive Parenting" very helpful in my practice.
"THE BENEFITS OF POSITIVE PARENTING"
Is there a science to parenting?
For all the current discussion in the United States about gun violence
and mental illness, there has been little attention paid to root
causes. Any effort aiming to reduce gun violence — or child abuse,
intimate partner violence, suicide or sexual abuse — must include a
serious discussion about how society can improve the quality of
In 2010, children’s protective service agencies investigated 1.8
million referrals of child abuse and neglect pertaining to 3 million
children. Although only 20 percent of these were substantiated,
researchers report that physical abuse, including harsh physical
discipline that is equivalent to abuse, is vastly underreported and may
be 20 times more prevalent than is reflected in official statistics.
(In other countries, including Spain, India and Egypt, harsh punishment
is even more prevalent.) In Philadelphia, this behavior has recently
been linked to the recession and the rate of mortgage foreclosures.
When lenders put people out of their homes, one unforeseen consequence
is that more kids end up with traumatic brain injuries.
Severe Discipline Causes Lifelong Damage
It is now well accepted that physical discipline is not only less
effective than other non-coercive methods, it is more harmful than has
often been understood — and not just to children. A review of two
decades worth of studies has shown that corporal punishment is
associated with antisocial behavior and aggression in children, and
later in life is linked to depression, unhappiness, anxiety, drug and
alcohol use and psychological maladjustment. Beyond beating, parents
can also hurt children by humiliating them, labeling them in harmful
ways (“Why are you so stupid?”), or continually criticizing their
Can We Improve Parenting?
Improving the way people parent might seem an impossible challenge,
given the competing views about what constitutes good parenting. Can we
influence a behavior that is rooted in upbringing and culture, affected
by stress, and occurs mainly in private? And even if we could reach
large populations with evidence-based messages the way public health
officials got people to quit smoking, wear seat belts or apply
sunscreen, would it have an impact?
Yes, it can be Done
That’s what was explored in South Carolina in recent years, and the
answer appears to be yes. With funding from the Centers for Disease
Control and Prevention, a parenting system called the Triple P –
Positive Parenting Program, which was developed at the University of
Queensland, Australia, was tested in nine counties across the state.
Eighteen counties were randomly selected to receive either a broad
dissemination of Triple P’s program or services as usual. The results
were both highly promising and troubling.
The good news was that, in contrast to the control counties, over two
years, the nine counties that received the Triple P Program had a 35
percent reduction in hospitalizations and emergency room visits for
child injuries, a 44 percent reduction in out-of-home placements, and a
28 percent reduction in substantiated cases of abuse. The bad news was
that the Triple P counties mainly held their ground, while abuse
increased elsewhere in the state, possibly because of the recession and
the concomitant budget cuts in children’s protective services.
The Triple P Program has evolved over the past 35 years. It focuses on
families with children under age 12 and has shown efficacy in numerous
studies. It started as a home visiting program, but researchers found
it too expensive to deliver more widely, so they looked for ways to
broaden its reach – to get good parenting into the water supply. “You
know how vast Australia is,” explains Matthew Sanders, Triple P’s
founder. “Our question was how do we ensure that all families,
regardless of where they lived, could access good quality
evidence-based parenting interventions.” Sanders experimented with
different dissemination techniques, including telephone consultations,
and found that they could do just as well as face-to-face meetings.
What’s notable about Triple P is that it pursues a community-wide,
preventive approach. Sanders believes that all parents would benefit
from some education — though some need a light touch while others need
significant help. And why would it be otherwise? Unlike driving a truck
or teaching, no one needs a permit to become a parent. We copy others
and make it up as we go. Without a “reflective awareness” and the
benefit of information, says Sanders, parents are apt to struggle with
strategies that don’t work – or that work for some children, but not
others. He has seen a great deal of conflict and unhappiness and
violence-begetting rage and humiliation that could have been averted
with manageable changes.
Multi-level Strategies to Improve Parenting
Triple P works at multiple levels, ranging from media and communication
strategies (TV, Web, radio, newspapers) to brief individual
consultations and group sessions to intensive parenting and family
interventions for serious difficulties. “You need to get lots of
practitioners from different sectors — education, day care, mental
health, health, social services, pastoral counseling – who are trained
to work with parents and families and give them an added skill,”
explained Ron Prinz, the director of the Parenting and Family Research
Center at the University of South Carolina, who led the Triple P study.
“Parents need different ways to get exposed to it.” In the nine
counties in South Carolina, 649 people received training (three to six
days on average) to deliver the program.
For parents, exposures can range from watching a video to participating
in two 20-minute phone calls to attending 14 group sessions. “We follow
the principle of ‘minimal sufficiency,’ ” says Sanders. “Use the
smallest possible intervention to solve or prevent a problem.”
There are dozens of strategies and variations for parents — those who
have children with disabilities, chronic illnesses, obesity or
emotional difficulties, as well as those going through separation or
divorce or at risk of maltreating their children. Parents discover
techniques like “planned ignoring” (good for low-level misbehavior like
whining or minor tantrums where the goal is attention) or learn how to
escape the “escalation trap,” which occurs when parents get exasperated.
The essence of the research is that children do best when they receive
calm and consistent feedback and assertive discipline that’s based on
reasonable expectations – with significantly more encouragement and
positive feedback than criticism. “The main mistake parents make is
forgetting the importance of catching kids doing the right thing,” says
Raising Children the Right Way Leads to More Successful Adults
Stephanie Romney, director of the Parent Training Institute at the San
Francisco Department of Public Health, agrees. Romney and her
colleagues deliver higher level Triple P interventions to 1,000
families, many of whom are involved with children’s services.
“Typically, the children have been on the receiving end of a lot of
negative attention from adults,” she said. “Even if the child has
misbehaved all day, their parents try to catch them for that brief
window when they are behaving well and praise them.” Parents are
sometimes amazed by the changes. “I’ve had parents tearing up talking
about how their relationship with their child has improved,” she added.
“They went for a walk together and held hands for the first time. And
parents report that they try it out on their spouses and coworkers and
it works with them, too.”
Triple P is one of several evidence-based parenting programs that have
demonstrated how society can reduce behaviors that put children at
risk. Some others include SafeCare, Parent Management Training – the
Oregon Model, The Incredible Years and Nurse Family Partnership. What
is different here is the idea that parenting education could be broadly
disseminated. This is important, because parenting training needs to be
de-stigmatized. It’s not just about reducing abuse.
Romney notes that one of Triple P’s strengths is that it presents a
multiplicity of strategies and leaves it to parents to decide which
ones to use. The community approach comes with limitations, however.
It’s difficult to get parents to come in if they aren’t required to and
it involves training numerous people to deliver the program – so
start-up costs can be a barrier. But a lot of Triple P’s teachings are
available online. And unlike many parenting blogs, the advice is
supported by research.
Unfortunately, Politicians Ignore Parenting, so it's up to us
Parenting doesn’t get much attention in policy circles. “We don’t have
mechanisms that help people to understand that parent education and
training can be very effective,” explains Richard Barth, dean of the
University of Maryland School of Social Work, who has studied parenting
programs for 30 years. “The Triple P study showed that if you engage
people before things go awry, they can avoid problems that we might
have predicted for them, or they might have predicted for themselves.
There should be a significant investment in understanding how to
implement some of the elements of Triple P — so every family and
clinician in the United States knows the basics of parenting and the
things we can do if things get more difficult.”
Good Parenting Also Helps Parents
It’s not just for children. “It really influences adult well-being,
too” Sanders said. “Parents become less stressed, less angry, less
depressed, and have less conflict with their partners. We now have
research that shows that parenting interventions improve your capacity
to function at work, too.”
Kymberlee Ruff, MFT
1035a De la Vina St.
Santa Barbara, CA 93101
Phone: (805) 962-5564
Kymberlee Ruff, MFT © 2013