Family Life Skills Triple P for Carers of Young People with Challenging Mental Health Problems: A Feasibility Trial
Family Life Skills Triple P for Carers of Young People with Severe and Complex Mental Health Problems: A Feasibility Trial
Children's Health Queensland, Health and Hospital Service
73 participants
Feb 25, 2025
Interventional
Conditions
Summary
The broad aim of this effectiveness study is to conduct a pragmatic randomized controlled two-arm trial (RCT) to determine whether Family Life Skills Triple P plus Group Teen Triple P compared to Group Teen Triple P alone optimizes the parenting and self-regulatory skills, self-efficacy and well-being of parents and carers of young people (12 to 17 years) with severe and complex mental health problems. Recruitment will be statewide, and participants may include the parents/carers of young people (12 to 17 years) on the waitlist for or being discharged from Jacaranda Place Adolescent Unit and Day Program, Day Program South as well as parents/carers of young people referred from referring community CYMHS clinics, E-CYMHS, and CHQ HHS Emergency Departments (ED) (where presenting for serious and complex mental health difficulties). Data will be collected at baseline, post-intervention, and 6 months post intervention. Data will include parental self-report measures of family functioning, parenting, self- and emotional regulation, parental self-efficacy, parental assessment of parent-adolescent relationship and adolescent wellbeing, as well as young person self-report of adolescent functioning, family functioning and parent-adolescent relationship. Routine outcome measure (ROM) data recorded in the young persons’ electronic medical record will be utilised when available. This is a pragmatic study to assess feasibility and effectiveness of the program in ‘real life’ conditions.
Eligibility
Inclusion Criteria10
- Parents/carers of a young person aged 12-17years with severe and complex mental health difficulties, who are either on the waitlist for Jacaranda Place Adolescent Unit or Day Program or Day Program South, being discharged from these services or referred from one of the following state-wide services:
- community CYMHS clinics
- E-CYMHS
- Acute Response Team at the CHQ HHS Emergency Departments where presenting for serious and complex mental health difficulties.
- Families can also be referred by private Child and Adolescent Psychiatrists in Queensland.
- Initially, recruitment focus will be on parents/carers of young people no older than 17years 3 months to ensure young people do not turn 18 during the time of the trial. However, procedures and measures have been approved to include young people who may turn 18 over the course of the trial and carers of these young people will be included if deemed necessary to reach desired participant numbers.
- Practitioner participants are mental health clinicians employed by Jacaranda Place (Adolescent Extended Treatment Centre) (a campus of CHQ HHS), and typically work with adolescents and their families in their roles on the Adolescent Unit or the Day Program.
- They are included in the study if they:
- have completed the Triple P training to run a group
- ran at least one group with parents/carers
Exclusion Criteria5
- Parents of adolescents with severe and complex mental health challenges will be ineligible for participation if:
- (i) their adolescent has an intellectual disability;
- (ii) parents are currently participating in another parenting intervention;
- (iii) parents have difficulties reading and completing forms in English.
- iv) the young person does not live with the parent/carer at least some of the time
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Interventions
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.
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ACTRN12623000684628