Cherokee Nation Positive Parenting Program (“Triple P”)

• CHEROKEE NATION POSITIVE PARENTING PROGRAM (“TRIPLE P”)
• PROGRAM DESCRIPTION
• PLANNING & IMPLEMENTATION
• PROGRAM OUTCOMES

Summary: Starting in 2012, Cherokee Nation’s Children’s Behavioral Health Unit, known as the HERO Project, implemented the Positive Parenting Program (“Triple P”) into their work with children and families in response to a long-standing need for more effective child abuse prevention and parenting intervention services. Triple P is open to all families, not just those who are already involved in the Cherokee Nation Indian Child Welfare system. The program partners with community organizations, such as Head Start, and trains teachers and other service providers to implement Triple P, in order to achieve a wider reach. Triple P has improved outcomes for local families by addressing the social and emotional problems faced by parents and children and by suggesting parenting and behavior management strategies that are tailored to the needs of each family.

Tribe:

Cherokee Nation

Program:

Positive Parenting Program (“Triple P”)

Program Running Length:

2012-present

Contact:

The HERO Project
P: (918) 772-4004

Cherokee Nation Judicial Branch
101 S. Muskogee Ave.
Tahlequah, OK 74465
www.cherokeecourts.org

Location:

Headquartered in Tahlequah, Oklahoma, the Cherokee Nation’s land base spans 14 counties in the northeastern corner of Oklahoma. These counties are: Adair, Cherokee, Craig, Delaware, Mayes, McIntosh, Muskogee, Nowata, Ottawa, Rogers, Sequoyah, Tulsa, Wagoner, and Washington.

Land Characteristics:

The Cherokee Nation’s reservation is located in Northeastern Oklahoma, also known as Green Country, which is characterized by the heavily wooded Ozark Mountains, rolling foothills, and many lakes. The largest city in the region is Tulsa.

Population:

The Cherokee Nation has about 320,000 tribal citizens. As of 2013, 126,000 of those citizens lived within the jurisdictional boundaries of the Cherokee reservation.

Triple P, the Positive Parenting Program, was implemented by the Cherokee Nation because existing parenting programs failed to produce the improved outcomes. Child welfare and children’s behavioral health staff observed little change in parenting skills, knowledge or behavior following parents’ participation in the previous parenting programs. Additionally, these programs did not effectively address the social and emotional problems faced by Cherokee parents and children. Because the programs were ineffective, both court and child welfare involvement often continued after program completion by parents, due to ongoing concerns about the children’s well-being. In addition, there was no parenting support or child abuse prevention programming available to the community at large.As Triple P is preventative in nature, all parents and caregivers in the Cherokee community are encouraged to participate.Originally developed by clinicians in Australia, Triple P is a widely used program which has been implemented in over 20 countries around the world. In 2009, while attending the Graduate School of Social Work at the University of Oklahoma, Juli Skinner, the Program Director for The HERO Project, realized that Triple P could be a good option for use with Cherokee families. Skinner saw that due to the open ended and flexible nature of Triple P, Cherokee culture and traditions could be included as part of an evidence based intervention for children and families.Triple P is a preventative program designed to help all families, not just those who are already involved in the child welfare system. The program’s proactive approach aims to “improve outcomes for families by helping the parents provide healthy, safe, and secure family environments,” thus preventing the need for court and/or child welfare involvement due to child abuse or neglect. The program focuses specifically on the social and emotional development of children and teaches parents how to foster their children’s development.The Cherokee Nation’s Triple P Program is built on an existing evidence-based intervention. The Triple P program has multiple levels, each entailing a different approach to parent education and support. The Cherokee Nation Triple P program uses Level 2, seminars, and Level 3, one-on-one consultations, but does not currently use Level 1, which is not a class or intervention but rather a broad awareness campaign consisting of brochures, posters, and other informational materials. The Level 2 program consists of three seminars: “The Power of Positive Parenting,” “Raising Confident and Competent Children,” and “Raising Resilient Children.” Each seminar lasts 90 minutes and is delivered by a trained practitioner. Anyone from the community can attend, and Cherokee Triple P reports that up to 70 families participate in each seminar. In Level 3, trained practitioners conduct one-on-one consultations with parents in which parents bring in topics to discuss with the practitioners, who in turn suggest specific parenting and behavior management to address the family’s needs. Level 3 Triple P typically consists of 4 sessions, lasting 15-30 minutes each, but can vary from family to family.
Practitioner Training Process
The Cherokee Nation Triple P program requires individuals to apply to participate in the practitioner training. The application includes a written statement about why the individual wants to learn and how he or she will use the program. In order to utilize Triple P, practitioners must then successfully participate in a rigorous training process. After completing a competency-based training course, prospective practitioners must pass a written test and deliver a presentation to demonstrate proficiency in the intervention.
The first practitioner training for Cherokee Nation’s Triple P took place in 2012, lasting 3 days and producing 50 new practitioners. Now the Cherokee Nation Triple P program has 62 trained, active practitioners.The Cherokee Nation Triple P Program staff includes the Program Director and 62 Evidence-Based Specialists.Eligibility Criteria
The Cherokee Nation Triple P program encourages all parents and caregivers to participate.
Referral Process
While no referral is required, the program works with community partners to identify possible participants and raise awareness of the program as a resource for families.
Supervision and Compliance
N/A
Termination Criteria
N/AThe initial purchase of Triple P materials for use in the Cherokee Nation was funded through a Project LAUNCH (Linking Actions for Unmet Needs in Children’s Health) Grant from SAMHSA (the U.S. Substance Abuse and Mental Health Administration). The Cherokee Nation Healthy Nation program also received a Community Transformation grant that provided funding for the first three rounds of practitioner training.
The cost of Triple P program materials depends on the needs of the community, as the three levels can be purchased separately. For instance, the Cherokee Nation Triple P program purchased just two of the levels available based on the needs of their community.The Triple P program did not receive and specialized technical assistanceCherokee Child Welfare partnered with Cherokee Healthy Nation to implement the Triple P Program. The Cherokee Nation Triple P program has also partnered with Head Start and area schools by providing practitioner training to teachers. The program’s philosophy has been to “partner with the people who are looking for the same outcomes you are.”Triple P’s flexibility and adaptability allows families to choose parenting strategies that work best for their family situation and culture. The program’s variety of parenting strategies and methods of presentation allow participants to “pick and choose different strategies that are comfortable to them.” The program director points out that the open-ended nature of the intervention makes it effective and appropriate across cultures by allowing the culture of each family to come across through the strategies that they choose: “It really allows families to help themselves. It really empowers them to choose what works best for them, because in the end, families are the experts on their own families.”The Cherokee Nation Triple P Program has faced considerable societal and cultural stigma against parenting classes. The program worked to overcome this challenge by using events with community partners as a platform to educate parents about the program and encourage them to give it a chance.
Another challenge the program faced was lack of education and knowledge about the program among agency workers. Not only were many unfamiliar with evidence-based programs like Triple P, agency workers also lacked a general familiarity with programs that focused on social and emotional challenges in families. Prior to the implementation of Triple P, children’s social and emotional development had not been addressed by Cherokee child welfare.Following the first round of practitioner training, Cherokee Triple P learned that practitioners must have the right motivation for participating in order to be effective. When the program first began, Cherokee Triple P did not have an application process in place, but soon developed one to ensure that quality candidates were being trained. The program director reports that this has proven effective, saying, “We take this very seriously. This is a very expensive training, highly effective, and you need to make sure that you’re in it for the right reason and that you have a passion to make a difference.”
The Cherokee Nation Triple P program also learned that partnerships are necessary for success– partnerships with local schools have been invaluable by providing teachers with the knowledge and resources to refer families who could benefit from Triple P. Additionally, the program has trained teachers at five area schools to implement Triple P themselves.The Cherokee Nation Triple P Level 2 seminars have served about 1,000 people. The Level 3 one-on-one consultations have served more than 50 families.The Cherokee Nation Triple P has measured the effectiveness of their practitioner training program by conducting Satisfaction Surveys following each training. They have received about 50 responses, which have been overwhelmingly positive.
The program has also conducted Parenting Experience Surveys among community participants. Parents complete an initial survey before attending a Level 2 seminar, then receive a follow up survey 6 weeks later. The program has received 23 responses, with most showing improved child behavior and decreased parenting problems.Creating a change in community perceptions around parenting interventions was a difficult task. Program staff used a strengths based approach when meeting with community partners. Staff used community organizing to discuss Triple P in depth and benefits it could bring to prospective programs. Many programs were already using various parenting curricula. The program goal was not to look to replace anything, but rather enhance existing programs with an evidence-based parenting program. Community partners were very responsive to this approach and after completion of Triple P many used it in lieu of previous parenting programs. The program promoted Triple P using the same strengths based approach for way for parents and caregivers as well. Triple P promotion for families emphasized a way to develop new skills in addition to parenting strengths they already possessed. Families had autonomy to decide what “time in” activities fit into their family culture. Parents and Caregivers were very receptive to this approach, and therefore were more likely to attend community seminars.

• One parent came to the program feeling overwhelmed and distressed because her child had been throwing eight to nine tantrums each day. Triple P asked the parent what outcomes she wanted, and the parent set a goal of decreasing the frequency of tantrums to two to three per day. The practitioner suggested several strategies to the parent, and she picked two that she wanted to try. The parent returned the next week and reported that her child had only two to three tantrums that week: “She was over the moon. She never ever thought that it was going to be possible to get him down to two or three tantrums a day, let alone three a week.” Practitioners report that this is not an uncommon outcome for families involved with the Triple P program–“that’s the typical result we get from Triple P because it’s so effective.”