Using Triple P with Parents from Diverse Cultural Backgrounds

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Using Triple P with Parents from Diverse Cultural
Backgrounds
Parenting Support Strategies Forum, London
February 2008

• Irene Tymkiw Sarita Strike
• (Chartered Educational Psychologists)

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AIMS

• The challenge we face providing inclusive
  parenting programmes in W. London
• The available research into cultural diversity
  parenting
• How parenting programmes need to accommodate for
  cultural diversity
• How Triple P addresses these issues

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The West London Context
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London Borough of Ealing
(2001 census)

• Population 300,948
• 68,241 children and young people
• 41.3 residents from ethnic minority groups
• Compared with 9.1 Nationally and 28.8 London
  wide

Londons 3rd most ethnically diverse borough (
nationally)
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Complexity of Ethnic Communities in Ealing, W.
London

• Newly arrived immigrants
• Economic migrants
• Asylum Seekers/refugees
• Established communities (up to 4th generation)
• Arranged marriages

Londons 3rd most ethnically diverse borough (
nationally)
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Ethnicity and Ethnic Category of Pupils in Ealing
Schools (2008)
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Ealing School Population (Jan 2008)
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Languages in Ealing Schools

• 100 languages spoken (2001 census)
• 45.8 children speak English as first language
  (Jan 2008)
• Main languages
• Panjabi (9.4)
• Somali (8.2)
• Urdu (6.1)
• Arabic (4.8)
• Polish (3.7)

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How Ealing is Addressing Issues

• Practitioner Training
• Providing trainers from different cultures
• Representing range of ethnicities and cultures in
  Ealing
• Demographic information from training programmes
  representing borough
• Ensuring range of languages can be used

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Progress So Far

• Trained 41 practitioners
• 22 White British
• 5 White other
• 14 Black and Minority Ethnic

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Languages

• 16 different languages spoken
• Many African e.g. Somali
• Also Arabic, Panjabi and various European

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Available Research on Cultural Diversity
Parenting
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Research

• Very limited findings in this area of work,
  especially in the UK
• Why?
• Participation in parenting support by minority
  ethnic groups and also fathers is generally low
  and there is a subsequent lack of evidence about
  what works with them (Moran et al, 2004)

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What research tells us about participation

• A number of groups most particularly fathers and
  MEG, but also parents of disabled children and
  low income groups were under-represented in the
  use of mainstream parenting support services.
  (PricewaterhouseCoopers 2006 2007)
• Grandparents from minority ethnic groups were
  keener to participate in parenting programmes
  than white grandparents. (Barlow, 2004)

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What Research Tells Us

• Black and Ethnic Minority parents tending not to
  complete programmes
• NFPI audit only 2 of services nationally
  specifically targeted ethnic minority groups
• Majority of research from USA
• Triple P evaluations of indigenous Australians
  and some other cultures e.g. Chinese,
  Japanese
• No studies of large UK minority groups, e.g.
  Indian or Pakistani groups

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Evaluation of the 3 Main Types of Parenting
Programme for MEP (Barlow 2004)

• Traditional (translated) programmes had more
  robust evaluations and came out better
• Culturally specific programmes more variable
  results. Lack of strong evidence to support and
  less robust evaluations

• Translated
• Adapted
• Culturally specific

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Commonalities and Differences of Parents Concerns
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Listening to Minority Ethnic Parents Their
worries, their solutions National Family
Parenting Institute Survey 2001
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Listening to Minority Ethnic Parents National
Family Parenting Institute Survey 2001

• Similarities
• Same top important factors for a successful
  family identified
• Anxiety about teenage stage
• Attitude to discipline similar proportion
  advocate smacking
• All parents support more positive methods based
  on praising and communication
• Similarly anxious about bringing up children
  without recourse to punitive methods.

• Differences
• More concerned about managing behaviour (27 vs.
  20)
• More concerned about making ends meet (21 vs.
  13)
• Found birth and first month less difficult (5vs.
  11)
• More emphasis on informal, supportive networks
  (20 vs. 12)
• Less concerned about risk from drugs alcohol
  and about erosion family values

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Universality of Child Development and Best
Parenting Practices

• We know that the basic principles of human
  learning and child development are universal
• Its likely that children have many common needs
  that transcend cultural differences and that
  these needs may be better met by certain
  parenting practices than others. (Barlow, 2004)
  

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Universality of Effective Parenting Approaches

• Understanding disciplining- NFPI Review of
  research on what works in managing childrens
  behaviour.
• Concluded that children fared best with an
  authoritative approach to parenting, which
  combined affection and firm boundaries with an
  encouragement of childrens independence.

Traditional programmes such as Triple P advocate
this approach.
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Parents Primary Goals (Levine,1977)

• Irrespective of race, culture or class all
  parents have three primary goals
• To ensure a childs physical , social and
  emotional wellbeing
• To provide children with the economic competences
  to survive in adulthood
• To transmit the values of their culture

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Additional Tasks

• Additional tasks as a result of their
  location within a culture that is different to
  their own
• How to preserve and transmit aspects of their own
  value system in the face of a dominant culture
  which may be hostile to such values
• A challenge to help their children to succeed
  within a society which may be hostile to such
  success.
• (Ref Barlow et al 2004)

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Further Challenges Faced by MEP
Bringing up children in a society where they may
encounter racist attitudes and negative images in
the media
Disproportionally represented in terms of social
deprivation

• stereotyping

Unemployment rates (25 -31 vs. 12)
Issues of identity in teens
Low income households (60 vs. 21)
Poor housing/overcrowding
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How Parenting Programmes need to Accommodate for
Cultural Diversity?
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Family Interventions must be Culturally
Appropriate.

• An effective population strategy should be
  tailored in such a way that it is
• accessible,
• relevant
• respectful
• of the cultural values, beliefs, aspirations,
  traditions and identified needs of different
  ethnic groups.

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Culturally Specific Factors needing Addressing

• Family structure
• Roles and responsibilities
• Predominant cultural beliefs and values
• Child raising practices
• Sexuality and gender roles

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1. Family structure

• Impact of extended family
• Sudanese society customs traditions linked to
  extended family. Nuclear families rare
• Family structure is dynamic- Changing patterns in
  young Asian community
• Young mens attitude to fatherhood
• Young choosing to live in nuclear households
• Large family size-suggesting communal parenting
• Pakistani 4.7 children vs. 2.47 white British
  families.
• 5-8 children in Sudanese families, often
  including nephews.

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2. Roles and Responsibilities

• Children are shared responsibility within the
  Sudanese community for childrearing
• Broader community has right to challenge and
  punish a childs misbehaviour
• Intergenerational dynamics- role of grandparent
  and differing generational attitudes/values.

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3. Predominant Cultural Beliefs/ Values

• Different cultures have different values and
  belief systems (Gross 1996)
• Europe USA cultures value Independence and aim
  to socialize children to be independent
  competitive achievers
• African Americans Asian cultures value
  interdependence and socialising goals are
  cooperative, obedient, sharing and respectful
  children.
• Affects practices such as bed sharing (Japan)

Cultural beliefs affect childcare practices
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3. Beliefs and Values continued

• Mental illness not discussed openly regarded as
  weakness in Sudanese culture
• Chinese cultural belief that private shame of
  family should not be made known to outsiders.
  (Triple P research)
• Similarly, maintaining good name of family is
  important in Sudanese culture (refugee
  council-country facts)

Cultural beliefs may prevent seeking help for
behaviour problems
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4. Child Raising Practices

• Chinese families are expected to be seen to be
  dealing with inappropriate behaviour. Ignoring
  strategy would be difficult to do in social
  situations because it hurts family reputation.
• Chinese culture believe praise stops the child
  from performing better. Therefore may refuse to
  praise or praise in a mechanistic or unemotional
  way
• In Sudan corporal punishment is regarded as part
  of the child rearing practice

Some parenting strategies are affected by
childrearing traditions
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Other issues impacting on accessibility

• Language issues access to course / written
  materials
• Literacy levels mothers often speak English but
  dont read it.
• In refugees, education may have been interrupted
  by war. Illiteracy is 74 in Sudanese women in
  15-24 age group.

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How does Triple P address these issues?
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3 Components for a Successful Parenting Course

• Successful Recruitment
• Appropriate content accessible delivery
• Retention low drop out

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Recruitment

• A large body of research tells us that
• Ethnic minority groups, new immigrants and
  refugee families/asylum seekers parents are less
  likely to participate in parenting programmes.
• This is particularly true for fathers and younger
  parents

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Listening to ME parents (2001)Differing
Attitudes to Parenting Info

• More open to the need for information advice
  about parenting (33 say do not need it vs. 50)
• Want more info about teenage years -11-14 age
  group (25 vs. 14)

• BME parents find the same sources of information
  about parenting as useful.
• Family or friends Local sources- schools, GP
  surgeries local libraries

• However BMEP
• less likely to find internet useful in 2001 (9
  vs. 14)
• Less awareness of where to find advice, however a
  smaller wouldnt seek info from an organisation
  (25 vs. 35)
• Citizens advice Bureau was most popular source
  (31).

• Why CAB preference?
• Easy accessibility
• No or low cost
• No specific focus on parenting
• No stigmatisation/fear of being accused of
  failure
• Confidence through previous experience and word
  of mouth

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Case Study - Somali Fathers Group

• Engaging Somali fathers was not easy.
• The publicity was supported by
• Project leader making personal contact with
  individual fathers in the places they would most
  likely visit
• mosque, restaurants, coffee shops, halal
  butchers.
• Negotiating suitable time and place for meetings
• Local community centre venue at the fathers
  preferred time (Saturday mornings)
• Ref peace of mind project N. London 2004

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Case Study- Chinese Culture

• Culturally sensitive programme promotion helps
  uptake where
• seeking help for behaviour can be seen as a
  weakness or,
• keeping problems secret from outsiders is the
  norm
• Promoting the course as a way of creating happier
  and less stressed parents was successful.

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Factors to consider in recruitment

• Who we target - mothers, grandparents
• Location of publicity local newspapers, CAB,
  Halal butchers
• Personal contact - in the community and bilingual
  facilitators
• Informal information share
• Address sensitivity to family honour alter
  promotional focus

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Recruitment factors continued

• Promotional materials in ethnic language with
  relevant images
• Identify negotiate practical issues venue,
  parking/public transport, time, childcare
• Support from local leaders mosque
• Word of mouth from previous attendees

In planning at population level we need to
provide groups open to all which need to be as
inclusive as possible.
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Retention - preventing drop out

• Programme completion is related to social
  disadvantage. (Zubrick et al 2005)
• Children of low income parents who complete
  course appear to do just as well as more
  advantaged parents (Sanders et al 2000)
• Important to encourage completion to maximise
  exposure.
• Triple P builds up skills in layers over the 8
  week course. First developing positive
  relationships, then managing misbehaviour.

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How can practitioners maximise attendance?

• Ensure course values are in harmony with parents
  values
• Ensure practical organisation is ideal for
  parents
• Selecting parents appropriately at the outset
• Use information session to check parents
  understand what course is ( isnt) and gain
  commitment.
• Check language literacy needs early so
  appropriate materials / adaptations are
  available.
• Be alert to possible drop out. Tailor course
  flexibly e.g. using other methods of delivery or
  a combination.

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ContentCultural Appropriateness of Triple P

• Triple P evaluations show
• That principles and strategies work in a variety
  of cultures cultural contexts.
• That family income and parent education levels
  are not related to outcome.
• Core principles of positive parenting are all
  fairly universal and each family can interpret
  them in their own cultural context.

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5 principles of Triple P

• Ensuring a safe, engaging environment
• Creating a positive learning environment
• Using assertive discipline
• Having realistic expectations
• Taking care of yourself as a parent

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Achieving cultural sensitivity

• Cultural sensitivity can be demonstrated if
  programme facilitators help parents identify
  their own individual goals for their children,
  and by respecting diverse view points and goals
  
• Generic courses can be individualized to fit
  with the specific experiences and background of
  group members, without the need for different
  curricula for participants from different
  backgrounds.
• (Reid , Webster-Stratton et al 2001).

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How Triple P achieves cultural sensitivity
through self regulation

• Core unifying principle is Self Regulation
• Each parent is responsible for the way they
  choose to raise their children.
• They select aspects of their own and their
  childrens behaviour to work on.
• They set goals choose specific culturally
  acceptable parenting strategies.
• The aim of the programme is for parents to become
  confident, resourceful, independent problem
  solvers.

Self regulatory framework allows culture to form
parents goal.
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Tailoring 5 different levels of intensity.
Universal Triple P Level One
Selected Triple P Level Two
Primary Care Triple P Level three
Standard Triple P Level four
Enhanced Triple P Level five
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Tailoring to individual family needs

• Flexible delivery format
• Individualised component
• Customise to the participating mix of clients
• Sensitive to the beliefs, assumptions,
  expectations traditions and values of families

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Process issues

• Triple P provides and advocates a
• tool box of strategies
• This allows parents to pick and choose what works
  for them what they feel comfortable with.

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Overcoming Language Barrier Triple P
Translations

• Culturally sensitive translation of core
  materials
• Customise materials as needed (types of examples
  used, video models, images used to represent
  culture)
• Key UK languages not yet available

• Albanian
• Portuguese
• Dutch
• German
• Turkish
• Farsi
• Vietnamese
• Mandarin
• Japanese
• Urdu (in progress)
• French (in progress)
• Malay (in progress)
• Spanish (in progress)

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Overcoming Language Barrier

• Triple P reading age 11 yrs.
• Reading materials and writing tasks optional
• Taping workbook in English
• Demonstration DVD for teaching strategies
  further vignettes needed, with cultural examples.
• Translated questionnaires
• SDQ downloadable in 40 languages
• Translate questionnaires check with community
• Bilingual practitioners in key languages. Aim of
  Ealings parenting strategy.
• Interpreters - issues of cost
  ensure awareness course principles.

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Conclusion The challenges of providing cultural
sensitive parenting

• Cultural Diversity in UK is complex dynamic
• Research shows more similarities than differences
  in
• Child development
• Effective parenting approach
• Outcomes for families on parenting programmes
• Parents concerns and fears
• Differences in cultural beliefs values may
  affect recruitment retention
• Triple P successfully addresses Cultural
  sensitivity by Self Regulation and tailoring
• Language barrier is the greatest challenge in
  delivery

At the end of the day, all families are
individual and the flexibility of Triple P allows
true individualisation of the experience of each
parent
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Contact Details

• Sarita Montes Strike
• sarita_at_strikeconsulting.co.uk
• Irene Tymkiw
• itymkiw_at_ealing.gov.uk