3/2/2015. Overview workshop. Welcome and Introduction. The impact of divorce on children. Pilot Family Transition in the Netherlands

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1 Overview workshop Welcome and Introduction The impact of divorce on children Pilot Family Transition in the Netherlands Family Transitions Triple P in The Netherlands Helping Families Through Divorce or Separation Helping Families Change Conference 2015, February 25th Paula Speetjens (The Trimbos-Institute) Marion van Bommel (The Netherlands Youth Institute) Geraldien Blokland (Triple P trainer) What is Family Transitions Triple P? Experiences with Family Transitions in the Netherlands Copyright University of Queensland 2011 Introduction Overview workshop 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? 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 A significant proportion of marriages end in divorce A significant proportion of marriages end in divorce In Australia 50% of divorces involve children* % involve children <5 years % involve children 5-9 years % involve children >10 years In the Netherlands each year children experience divorce of their parents * ABS, 2005 CBS,

2 Europe 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 Eurostat, 2008 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 Australian trial Family Transitions Triple P Parenting practices Quality of the parent child relationship Quality of the co-parenting relationship Parent emotional adjustment Financial resources 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,

3 Overview workshop Triple P in the Netherlands 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 Triple P for 0-12 year olds 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) Standard Stepping Stones Pilot Family Transitions Triple P Teen Triple P Level 2, Seminars Level 3, Primary Care Level 3, Discussion Groups Level 4, Group Level 4, Standard 2015: Triple P Online Lifestyle Pilot Family Transitions Triple P in The Netherlands ( ) 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 ( ) 27 parent courses were delivered in first half year 17 second half year about 200 parents involved Overview workshop What is Family Transitions Triple P? 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 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 3

4 Key objectives of Family Transitions Triple P 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 Improve parental coping skills Develop a positive co-parenting relationship Improve conflict-management skills Develop parents problem-solving skills Family Transitions Triple P delivery options Content Family Transitions Triple P Family Transitions Triple P (5 group sessions) Group Triple P (4 group sessions) 2 to 3 telephone sessions Group closure session Group Teen Triple P (4 group sessions) 2 to 3 telephone sessions Group closure session Session Duration 1. Divorce A Family Transition 120 mins 2. Coping with Emotions mins 3. Coping with Emotions mins 4. Managing Conflict 120 mins 5. Balancing Work, Family and Play 120 mins 20 Family Transitions Triple P - materials Questionnaire Measures of Child and Family Functioning Faciltatorskit: Manual Workbook for parents Relaxation CD Session presentations DVD Pre- and post-group assessment of child and family 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 23 4

5 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 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 24 * Unique to Family Transitions Principles for a positive transition Parent traps during separation and divorce 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 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 5

6 Monitoring thoughts Overview of Session 3 Coping with Emotions 2 Daily record of stressful events and thoughts Date Situation Emotions Physical Sensations Thoughts Review of Session 2 Review homework How thoughts influence emotions Challenging unhelpful thoughts Coping strategies Taking care of yourself Homework Linking Thoughts and Feelings Challenging unhelpful thoughts Different ways of thinking about the same situation create different emotional reactions Changing the thoughts changes the emotion Event Thoughts Emotions 32 Overview of Session 4 Managing conflict Review Session 3 Review of homework Understanding conflict Assertive communication Child-related discussions Developing a parenting plan Homework Dealing with anger routine BE MINDFUL, ACKNOWLEDGE ANGER AND CLARIFY APOLOGISE FOR ANY RESPONSIBILITY PAUSE CO-PARENT DOES NOT CO-PARENT BECOMES CALMER BECOME CALMER ACKNOWLEDGE AND PROBLEM SOLVE VALIDATE EMOTION PAUSE CO-PARENT DOES NOT CO-PARENT BECOMES CALMER BECOME CALMER POSTPONE DISCUSSION PROBLEM SOLVE 6

7 Overview of Session 5 Balancing work, family and play Parents Reflecting on Life Review Session 4 Review of homework Building a new family identity Social support Developing new romantic relationships Homework 37 Overview of Weekly Sessions Overview workshop Session Duration 1. Divorce a family transition 120mins 2. Coping with Emotions 1 120mins Welcome and Introduction 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 10. Implementing Parenting Routines mins 11. Implementing Parenting Routines mins 12. Group closure session 120mins 38 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 Improving Mental Health by Sharing Knowledge Focus of pilot Pilot Does Triple P Family Transitions fit within the Dutch (youth) care structure? Results Pilot Triple P Family Transitions Evaluation of satisfaction and experiences of Professionals Parents 41 7

8 Divorce programs Divorce programs in NL TP- FamilyTransitions 1 Alsouders gaanscheiden 21 Kinderen van12-15jaarinechtscheidingssituaties 2 Alsjeouders gescheidenzijn 22 Mijnouders zijngescheiden,enikdan? 3 Basisschool kinderen 23 Minitraining opvoeden na echtscheiding groep 7 & 8 in echtscheidingssituaties 4 BORHumanitas 24 OKEE 5 Cursuskindenscheiding 25 Omgangsbegeleiding/Mediation 6 Cursusvoor gescheidenouders vanpubers 26 Omgangshuis/Omgangscentrum 7 Dappere Dino s 27 Opvoeden inje eentje 8 EchtScheiden 28 Opvoeden naechtscheiding 9 Echtscheidingennuverder opeigenkracht 29 Oudercursus Kinderen enechtscheiding 10 Gedeeldverdriet 30 Ouderschapblijft!CJG 11 Gespreksavondengescheidenopvoeden 31 Ouderschapblijft!GA 12 Groep voor kinderen vangescheidenouders 32 Ouderschapnascheiding 13 Groepscursus ouderschapna echtscheiding 33 Ouderschapnascheidingenkinderen uitde knel 14 Groepstraining: Ouders enscheiding 34 Ouderschapsreorganisatie(ORO) 15 JES! 35 Samen de zorg 16 Jonge Helden: Kameleonprogramma 36 Vechtscheiding: behandelingenbegeleiding 17 Jongeren enechtscheiding 37 Verwerken vanechtscheiding 18 KIES 38 Verwerkingsgroep na scheiding 19 Kindenechtscheiding 39 Zandkastelen 20 Kinderen scheidenook! TP- FamilyTransitions 1 Alsouders gaanscheiden 21 Kinderen van12-15jaarinechtscheidingssituaties 2 Alsjeouders gescheidenzijn 22 Mijnouders zijngescheiden,enikdan? 3 Basisschool kinderen 23 Minitraining opvoeden na echtscheiding groep 7 & 8 in echtscheidingssituaties 4 BORHumanitas 24 OKEE 5 Cursuskindenscheiding 25 Omgangsbegeleiding/Mediation 6 Cursusvoor gescheidenouders vanpubers 26 Omgangshuis/Omgangscentrum 7 DappereDino s 27 Opvoeden inje eentje 8 EchtScheiden 28 Opvoeden naechtscheiding 9 Echtscheidingennuverder opeigenkracht 29 Oudercursus Kinderen enechtscheiding 10 Gedeeldverdriet 30 Ouderschapblijft!CJG 11 Gespreksavondengescheidenopvoeden 31 Ouderschapblijft!GA 12 Groep voor kinderen vangescheidenouders 32 Ouderschapnascheiding 13 Groepscursus ouderschapna echtscheiding 33 Ouderschapnascheidingenkinderen uitde knel 14 Groepstraining: Ouders enscheiding 34 Ouderschapsreorganisatie(ORO) 15 JES! 35 Samen de zorg 16 JongeHelden:Kameleonprogramma 36 Vechtscheiding: behandelingenbegeleiding 17 Jongerenenechtscheiding 37 Verwerken vanechtscheiding 18 KIES 38 Verwerkingsgroep na scheiding 19 Kindenechtscheiding 39 Zandkastelen 20 Kinderen scheidenook! Divorce programs in NL focus on kids Divorce programs in NL focus on parents & kids TP- FamilyTransitions 1 Alsouders gaanscheiden 21 Kinderen van12-15jaarinechtscheidingssituaties 2 Alsjeouders gescheidenzijn 22 Mijnouders zijngescheiden,enikdan? 3 Basisschool kinderen 23 Minitraining opvoeden na echtscheiding groep 7 & 8 in echtscheidingssituaties 4 BORHumanitas 24 OKEE 5 Cursuskindenscheiding 25 Omgangsbegeleiding/Mediation 6 Cursusvoor gescheidenouders vanpubers 26 Omgangshuis/Omgangscentrum 7 DappereDino s 27 Opvoeden inje eentje 8 EchtScheiden 28 Opvoeden naechtscheiding 9 Echtscheidingennuverder opeigenkracht 29 Oudercursus Kinderen enechtscheiding 10 Gedeeldverdriet 30 Ouderschapblijft!CJG 11 Gespreksavondengescheidenopvoeden 31 Ouderschapblijft!GA 12 Groep voor kinderen vangescheidenouders 32 Ouderschapnascheiding 13 Groepscursus ouderschapna echtscheiding 33 Ouderschapnascheidingenkinderen uitde knel 14 Groepstraining: Ouders enscheiding 34 Ouderschapsreorganisatie(ORO) 15 JES! 35 Samen de zorg 16 JongeHelden:Kameleonprogramma 36 Vechtscheiding: behandelingenbegeleiding 17 Jongerenenechtscheiding 37 Verwerken vanechtscheiding 18 KIES 38 Verwerkingsgroep na scheiding 19 Kindenechtscheiding 39 Zandkastelen 20 Kinderen scheidenook! TP- FamilyTransitions 1 Alsouders gaanscheiden 21 Kinderen van12-15jaarinechtscheidingssituaties 2 Alsjeouders gescheidenzijn 22 Mijnouders zijngescheiden,enikdan? 3 Basisschool kinderen 23 Minitraining opvoeden na echtscheiding groep 7 & 8 in echtscheidingssituaties 4 BORHumanitas 24 OKEE 5 Cursuskindenscheiding 25 Omgangsbegeleiding/Mediation 6 Cursusvoor gescheidenouders vanpubers 26 Omgangshuis/Omgangscentrum 7 DappereDino s 27 Opvoeden inje eentje 8 EchtScheiden 28 Opvoeden naechtscheiding 9 Echtscheidingennuverder opeigenkracht 29 Oudercursus Kinderen enechtscheiding 10 Gedeeldverdriet 30 Ouderschapblijft!CJG 11 Gespreksavondengescheidenopvoeden 31 Ouderschapblijft!GA 12 Groep voor kinderen vangescheidenouders 32 Ouderschapnascheiding 13 Groepscursus ouderschapna echtscheiding 33 Ouderschapnascheidingenkinderen uitde knel 14 Groepstraining: Ouders enscheiding 34 Ouderschapsreorganisatie(ORO) 15 JES! 35 Samen de zorg 16 JongeHelden:Kameleonprogramma 36 Vechtscheiding: behandelingenbegeleiding 17 Jongerenenechtscheiding 37 Verwerken vanechtscheiding 18 KIES 38 Verwerkingsgroep na scheiding 19 Kindenechtscheiding 39 Zandkastelen 20 Kinderen scheidenook! Divorce programs in NL focus on parents Place for TP Transitions in NL? TP- FamilyTransitions 1 Alsouders gaanscheiden 21 Kinderen van12-15jaarinechtscheidingssituaties 2 Alsjeouders gescheidenzijn 22 Mijnouders zijngescheiden,enikdan? 3 Basisschool kinderen 23 Minitraining opvoeden na echtscheiding groep 7 & 8 in echtscheidingssituaties 4 BORHumanitas 24 OKEE 5 Cursuskindenscheiding 25 Omgangsbegeleiding/Mediation 6 Cursusvoor gescheidenouders vanpubers 26 Omgangshuis/Omgangscentrum 7 Dappere Dino s 27 Opvoeden inje eentje 8 EchtScheiden 28 Opvoeden naechtscheiding 9 Echtscheidingennuverder opeigenkracht 29 Oudercursus Kinderen enechtscheiding 10 Gedeeldverdriet 30 Ouderschapblijft!CJG 11 Gespreksavondengescheidenopvoeden 31 Ouderschapblijft!GA 12 Groep voor kinderen vangescheidenouders 32 Ouderschapnascheiding 13 Groepscursus ouderschapna echtscheiding 33 Ouderschapnascheidingenkinderen uitde knel 14 Groepstraining: Ouders enscheiding 34 Ouderschapsreorganisatie(ORO) 15 JES! 35 Samendezorg 16 Jonge Helden: Kameleonprogramma 36 Vechtscheiding:behandelingenbegeleiding 17 Jongeren enechtscheiding 37 Verwerkenvanechtscheiding 18 KIES 38 Verwerkingsgroepnascheiding 19 Kindenechtscheiding 39 Zandkastelen 20 Kinderen scheidenook! Nationwide: Transitions fills hiatus Regional: similar options available Available evidence-based programs for these parents: NON with Dutch RCT-evidence

9 Evaluation Parents 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 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? What would you advice on when to do Transitions? What would you advice on when to do Transitions? 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 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 Evaluation Parents Most helpful topics? Satisfaction of parents Quality of Triple P Transitions? 5.8 Meeting your needs? 5.4 Content program on divorce accurate? 5,4 Mean on 1-7 scale Both indicated and non-indicated care parents benefit Possible in combination with individual help and/or mediation 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

10 Least helpful topics? Missing 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 Evaluation 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 Recommend a friend? 91% YES definitely! 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 Intervision with profesionals 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 Recommendation 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

11 Groupdiscussion implementation issues What to do if...? Family Transitions in the Netherlands 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 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 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. 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 11

12 Marion van Bommel: Paula Speetjens: Geraldine Blokland: 12