workshop family transitions final.ppt...

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Helping Families Change Conference 2015, February 25th

Paula Speetjens (The Trimbos-Institute)Marion van Bommel (The Netherlands Youth Institute) Geraldien Blokland (Triple P trainer)

Family Transitions Triple P in The Netherlands

Helping Families Through Divorce or Separation

© Copyright University of Queensland 2011

Overview workshop

• Welcome and Introduction

• The impact of divorce on children

• Pilot Family Transition in the Netherlands

• What is Family Transitions Triple P?

• Experiences with Family Transitions in the

Netherlands

Introduction

• Do you know Triple P?

• Job description: practitioner? Policy

maker? Researcher?

• Do you work with Triple P? / is Triple P

available in your country/region?

• Do you work with divorced parents or

their children?

• Do you work with Family Transitions?

Overview workshop






Netherlands

A significant proportion of marriages end in divorce

• In Australia 50% of divorces involve children*

- 24.3% involve children <5 years

- 36.4% involve children 5-9 years

- 39.3% involve children >10 years

• In the Netherlands each year 70.000 children

experience divorce of their parents

* ABS, 2005

A significant proportion of marriages end in divorce

CBS, 2012

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Europe

Eurostat, 2008

Nature and significance of the impact of divorce on children

• Child behaviour problems more common

when families are in the process of

separation and divorce

• Common concerns include:

- Tantrums, aggression,

noncompliance, mealtime problems,

separation anxiety

- Behavioural disorders

Negative Outcomes of Divorce for Children

Short term problems

•Emotional, behavioural & academic

problems and distress

Long term problems

•Lower levels of education attained

•Earn lower incomes

•Increased marital discord

•Poor relationships with parents

•Experience higher levels of

psychological distress

Sanders & Stallman, 2009

Factors influencing child adjustment following divorce or separarion

• Parenting practices

• Quality of the parent–child relationship

• Quality of the co-parenting relationship

• Parent emotional adjustment

• Financial resources

Australian trial Family Transitions Triple P

• Parents who completed Family Transitions Triple P reported:

− lower expressed anger

− lower trait anger

− lower levels of dysfunctional parenting

− lower levels of child behaviour problems

Sanders & Stallman, 2014

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Overview workshop






Netherlands

Triple P in the Netherlands

Triple P for 0-12 year olds Teen Triple P

• Level 2, Brief Primary Care• Level 2, Seminars• Level 3, Primary Care• Level 3, Discussion Groups

• Level 4, Group• Level 4, Standard• Level 5, Enhanced (level 5)

• Level 2, Seminars• Level 3, Primary Care• Level 3, Discussion Groups• Level 4, Group

• Level 4, Standard

Standard

Stepping Stones

Pilot Family

Transitions Triple P Lifestyle

Triple P Online

2015:

Pilot Family Transitions Triple P in The Netherlands (2012 -2014)

Cooperation between:

-The Netherlands Youth institute (implementation)

-The Trimbos-Institute (evaluation)

The pilot involved:

•60 practitioners trained (2½ day training + accreditation)

•24 different organizations from 7 counties

•mix of preventive and curative working practitioners

•regular meetings with local projectleaders

•consultation for practitioners

•no money for RCT

Pilot Family Transitions Triple P in The Netherlands (2012 -2014)

• 27 parent courses were delivered in 2013

• 10 first half year

• 17 second half year

• about 200 parents involved

Overview workshop






Netherlands

What is Family Transitions Triple P?

• Group-based intervention targeted at parents in the process of separation or divorce

• Level 5 intervention in the Triple P model of support

• Focuses on improving parental coping skills and improving child behaviour

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Key objectives of Family Transitions Triple P

• Increase parental competency in managing common behavior problems

• Reduce parental use of coercive and punitive methods of punishment

• Improve parents’ communication about parenting issues

Key objectives of Family Transitions Triple P

• Improve parental coping skills

• Develop a positive co-parenting relationship

• Improve conflict-management skills

• Develop parents’ problem-solving skills

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Family Transitions Triple P delivery options

2 to 3 telephone sessions2 to 3 telephone sessions

Group closure sessionGroup closure session

Group Teen Triple P (4 group sessions)

Group Triple P (4 group sessions)

Family Transitions Triple P(5 group sessions)

Content Family Transitions Triple P

Session Duration

1. Divorce — A Family Transition 120 mins

2. Coping with Emotions 1 120 mins

3. Coping with Emotions 2 120 mins

4. Managing Conflict 120 mins

5. Balancing Work, Family and Play 120 mins

Family Transitions Triple P - materials

Faciltatorskit:

• Manual

• Workbook for parents

• Relaxation CD

• Session presentations

• DVD

Questionnaire Measures of Child and Family Functioning

Pre- and post-group assessment of child andfamily functioning

• Indicates initial child and parental levels of family functioning

• Indicates progress at the completion of Family Transitions Triple P

• Assists with identification of non-responders and referral to further levels of intervention

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Questionnaire Measures of Child and Family Functioning

• Family demographics

• Child behavior and adjustment

• Parental style and confidence

• Parental conflict over parenting

• Parental adjustment

• Acrimony between parents*

• Parental anger* (state, trait, expression)

• Program satisfaction

* Unique to Family Transitions24

Overview of Session 1

Divorce – A family transition

• Working as a group

• Challenges of divorce

• Principles of a positive family transition

• Parent traps during divorce

• Talking to your children about divorce

• Helping children manage emotions

• Setting goals for change

• Homework

Principles for a positive transition

1. Meeting the needs of children

2. An effective co-parenting relationship

3. Communicating appropriately with children

4. Setting up a new life as a single parent

5. Taking care of yourself

Parent traps during separation and divorce

• Discussion in groups

What are the parent traps that makes it more difficult

for children to adjust to their parents’ divorce?

• Short inventory of common traps

• Dvd fragment

• Experiences and comments

Parent traps during separation and divorce Overview of Session 2

Coping with Emotions 1

• Review of Session 1

• Review of homework

• Unpleasant emotions

• Understanding how emotions affect parenting

• Coping with emotions

– Mindfulness and relaxation

– Pleasurable and mastery activities

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Monitoring thoughts

Date Situation Emotions Physical

Sensations

Thoughts

Daily record of stressful events and thoughts


Coping with Emotions 2

• Review of Session 2

• Review homework

• How thoughts influence emotions

• Challenging unhelpful thoughts

• Coping strategies

• Taking care of yourself

• Homework

Linking Thoughts and Feelings

• Different ways of thinking about the same situation create different emotional reactions

• Changing the thoughts changes the emotion

Event Thoughts Emotions

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Challenging unhelpful thoughts


Managing conflict

• Review Session 3


• Understanding conflict

• Assertive communication

• Child-related discussions

• Developing a parenting plan

• Homework

Dealing with anger routine

CO-PARENT DOES NOT BECOME CALMER

APOLOGISE FOR ANY RESPONSIBILITY

PAUSE

ACKNOWLEDGE AND VALIDATE EMOTION

CO-PARENT DOES NOT BECOME CALMER

PROBLEM SOLVE

CO-PARENT BECOMES CALMER

PROBLEM SOLVE

CO-PARENT BECOMES CALMER

PAUSE

BE MINDFUL, ACKNOWLEDGE ANGER AND CLARIFY

POSTPONE DISCUSSION

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Balancing work, family and play

• Review Session 4


• Building a new family identity

• Social support

• Developing new romantic relationships

• Homework

Parents Reflecting on Life

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Overview of Weekly Sessions

Session Duration

1. Divorce – a family transition 120mins

2. Coping with Emotions 1 120mins

3. Coping with Emotions 2 120mins

4. Managing Conflict 120mins

5. Balancing Work, Family And Play 120mins

6. Positive Parenting 120mins

7. Promoting Children’s Development 120mins

8. Managing Misbehaviour 120mins

9. Planning Ahead 120mins

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10. Implementing Parenting Routines 1 15-30mins

11. Implementing Parenting Routines 2 15-30mins

12. Group closure session 120mins

Overview workshop






Netherlands

Improving Mental Health by Sharing Knowledge

Pilot

Results Pilot

Triple P Family Transitions

2012-2014

• Does Triple P Family Transitions fit within the Dutch (youth) care structure?

• Evaluation of satisfaction and experiences of

Professionals

Parents

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Focus of pilot

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TP - Family Transitions

1 Als ouders gaan scheiden 21 Kinderen van 12-15 jaar in echtscheidingssituaties

2 Als je ouders gescheiden zijn 22 Mijn ouders zijn gescheiden, en ik dan?

3 Basisschool kinderen groep 7 & 8 in

echtscheidingssituaties

23 Minitraining opvoeden na echtscheiding

4 BOR Humanitas 24 OKEE

5 Cursus kind en scheiding 25 Omgangsbegeleiding/ Mediation

6 Cursus voor gescheiden ouders van pubers 26 Omgangshuis / Omgangscentrum

7 Dappere Dino’s 27 Opvoeden in je eentje

8 Echt Scheiden 28 Opvoeden na echtscheiding

9 Echtscheiding en nu verder op eigen kracht 29 Oudercursus Kinderen en Echtscheiding

10 Gedeeld verdriet 30 Ouderschap blijft! CJG

11 Gespreksavonden gescheiden opvoeden 31 Ouderschap blijft! GA

12 Groep voor kinderen van gescheiden ouders 32 Ouderschap na scheiding

13 Groepscursus ouderschap na echtscheiding 33 Ouderschap na scheiding en kinderen uit de knel

14 Groepstraining: Ouders en Scheiding 34 Ouderschapsreorganisatie (ORO)

15 JES! 35 Samen de zorg

16 Jonge Helden: Kameleonprogramma 36 Vechtscheiding: behandeling en begeleiding

17 Jongeren en echtscheiding 37 Verwerken van echtscheiding

18 KIES 38 Verwerkingsgroep na scheiding

19 Kind en echtscheiding 39 Zandkastelen

20 Kinderen scheiden ook!

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Divorce programs
























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Divorce programs in NL
























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Divorce programs in NLfocus on kids
























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Divorce programs in NLfocus on parents & kids
























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Divorce programs in NLfocus on parents

• Nationwide: Transitions fills hiatus

• Regional: similar options available

• Available evidence-based programs for these parents:

NON with Dutch RCT-evidence

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Place for TP Transitions in NL?

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• 2012-2014

• 60 professionals trained, 25 institutions, 7 regions

• 163 parents in 27 courses

• 93 parents in pilot study (57%)

– 2/3 mother

– Mean age is 42 year

– 2 (step-) children

– Divorced in last 4 years

• Online evaluation questionnaire after completing program

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Evaluation Parents

• 86 % Transitions + Triple P Course (0-12 or teens)

• Divorced:

– 27% in last 12 months

– 31% between 1-3 years ago

– 38% more than 3 years ago

• This last group is less satisfied with the course

4.9 out of 7: urgency gone?

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Evaluation Parents

Parents:

•43% ‘this is different for each person’

•16% when decision to divorce has been made by one parent

•11% when decision to divorce has been made and both parents have agreed to it

•13% when a divorce is seriously considered

•17% otherwise specified

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What would you advice on when to do Transitions?

Professionals:

•48% ‘this is different for each person’

•21% don’t know

•17 % when decision to divorce has been made and both parents have agreed to it

•14% otherwise specified

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What would you advice on when to do Transitions?

•Both indicated and non-indicated care parents benefit

•Possible in combination with individual help and/or mediation

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Evaluation Parents

Satisfaction of parents Mean on 1-7 scale

Quality of Triple P Transitions? 5.8

Meeting your needs? 5.4

Content program on divorce accurate? 5,4

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Most helpful topics?

•Tips and tricks to deal with ex-partner

•Dealing with conflicts

•Keeping calm, dealing with unhelpful thoughts

•Dealing with own emotions

•Effects of divorce on children

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Least helpful topics?

• 52% ‘Can’t think of any topics that weren’t helpful’

• Dealing with co-parent

• Mindfulness & taking care of oneself

• Parenting

• Life after divorce and new partners

• 23% YES, I’ve missed:

– Divorce when everything is bitterly battled

– New partner and effect on child

– Space for sharing own story’s

– Practical info (legal/juridical, financial and referral to other help)

– Communicating with ex-partner when he/she has psychological/ psychiatric problems

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Missing topics?

• Length of course? good

• Materials? Good

• In group? Most parents said: Love it!

– Man & woman in same group

– Understanding the other view on things

– Learn from each other, share experiences

– Recognition same feelings in others

• AND: ex-partner not in same but in parallel group

• Some parents said: In group? Hate it, because:

Gap in educational background

dealing with emotions of others

too small group, additional parents in Triple P part

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Evaluation

91% YES definitely!

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Recommend a friend?

•fairly satisfied with program

Some improvement ideas

•packed program content VS parental need to talk and share

•time management

•Triple P for step-parents

•too much homework

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Intervision with profesionals

Implementation

•Check regional supply of divorce programs

Program

•Don’t accept additional parents to the regular Triple P group after Transitions

•Co-parents in parallel groups, not together

Recruiting parents is more time consuming!

•via mediators, court, legal system, self-referral

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Recommendation

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Groupdiscussion implementation issuesWhat to do if... ?

1. Both parents insist on joining the same group

2. Parents only want to join the Transition part

3. Parents protest that there is not time to exchange

experiences during the course

4. Practitioners do not feel competent on specific

issues in the program

5. Parents in the group have children of different ages

6. Some parents in the group have a very problematic

divorce

7. Some parents have difficulties following the program

Family Transitions in the Netherlands

Delivery maintained

Information for parents Testimonials

“Within the course I quickly realized that I can not change my ex-husband, but I can change the way I deal with the

situation.”

“Before participating in the course, I would become very angry during a

phone call with my ex-husband. Now I recognize when I get angry and can

stop it in time.”

Testimonials

“The roleplays were a bit scary at the beginning, normally you don’t do

something like that. But I learned a lot from practising: a lot more than just

talking about it.”

Testimonials

“I feel more happy and have more energy left to do enjoyable things with

my daughters”

“Even my ex-husband complimented me about being more happy and doing a

good job with the kids”

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Marion van Bommel: [email protected]

Paula Speetjens: [email protected]

Geraldine Blokland: [email protected]

workshop family transitions final.ppt...

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