1 12/1/2017 The experiences of families participating in Group Teen Triple P post-earthquakes: A qualitative study Joanna Burley, Karyn France, and Veronica O’Toole School of Health Sciences and School of Educational Studies and Leadership University of Canterbury, Christchurch, New Zealand Acknowledgements. The authors are grateful to the Ministry of Education especially Clare Shepherd and Toby Stocks We are also grateul to GTTP leaders Kryssy Kavanagh and Suzanne Hall. In addition thanks are due to Joanna’s fellow GTTP thesis students Frances Sutherland and Tabitha Norton. The parents gave us their interest and so much time. We are indebted.
2 12/1/2017 Three years post-earthquake there were still high levels of need for psychosocial support among families 13,000 shakes later: Child and youth mental health cases were up by 67 (e.g. Meates 2015) Demand for child and youth inpatient psychiatric care had increased by 92 percent Interestingly Cobham et al. (2011) found a low uptake of Disaster Recovery Triple P immediately after Cyclone Yasi. Parents reported practical challenges, conflicting priorities, and the risk of being perceived as vulnerable or inadequate In the context of this, the Ministry of Education, in Christchurch, decided to offer Group Teen Triple P (GTTP) to Christchurch parents 3 years post-earthquakes.
3 Why a qualitative study?An inductive approach is typically used when there is little previous knowledge on the topic being studied. Qualitative studies provide rich data on the topic in question. There has been some qualitative work done with Triple P (e.g. Rahmqvist et al., 2013) but little available with Teen Triple P (exception Chu, 2014) and none examining parents’ experiences with Triple P in a post-earthquake environment.
4 Research Questions What were the earthquake experiences of parents who participated in a Teen Triple P programme three years following the Christchurch earthquakes? What role, if any did they believe these experiences may have had in contributing to their difficulties in managing their teen? What were their experiences of the parenting programme itself?
5 Methods 5 Parents (all mothers) of 8 teens (12-17) recruited from 2 GTTP groups 4 semi structured interviews with open questions and open prompts (e.g. tell me more…) Pre GTTP (5) Interview 1 aimed to explore families’ earthquake experiences and reasons for attending GTPP, e.g. What was your familys’ earthquake story? After the telephone interviews (4 & 1) Interviews 2 and 3 aimed to explore the mother’s experiences of the programme as it progressed, e.g. How did the most recent session go for you? Post GTTP (4) Interview 4 aimed to explore the mothers’ experiences of and perceptions of the GTTP programme itself, e.g. Have there been any changes in your teen and/or in the family following this programme?
6 Methods – Data AnalysisConventional content analysis (Hsieh & Shannon, 2005) Codes were derived from narrative elicited by the 3 research questions. Further codes were assigned to text which did not clearly fit those codes. Trustworthiness of the data: member and peer check, immersion in the data, specificity: Mothers were given opportunity to review transcripts Three reviewers, to agreement Clear and precise examples of participant viewpoints and reflections
7 Research Question 1: Immediate effectsImmediate earthquake effects -Significant distress to adults and children -Damage to houses -Streets covered in liquefaction/flooded streets -Stranded without transport -No electricity at home And I remember going down to the school after I picked up [Child 3] from kindy and there was flooding and those kids looked so freaked out and everything. I remember [Child 2] telling me that when it happened she had been on the court and it had cracked.
8 Research Question 1: Ongoing effectsOngoing earthquake effects Persistent thoughts Increased vigilance Sleep problems adults and children Loss of housing, insurance limbo Change of schools and split shifts Delayed reactions Stoicism
9 Research Question 1: Ongoing effects e.gs.Limbo: Living in this house and not knowing where I’m going to end up and whether it’s going to be pulled down, that’s my biggest stress because [they] don’t tell us what’s going on……So I’m living in a limbo sort of thing. Delayed reaction: So I went in there (school-based parents’ meeting about coping after the earthquakes) for my coffee and I just burst into tears. And I thought I wonder why I’ve done that? And it appeared that when it started I just couldn’t stop. Stoicism: It’s nothing compared to what some of the families have gone through. They’ve lost lives, lost loved ones, lost friends, lost houses, they’ve lost everything. We came off quite lightly.
10 Research Question 2 Surprisingly, no mother identified the earthquakes as directly or indirectly contributing to needing to do GTTP. No I don’t think the earthquakes in any way were responsible for me wanting to do Teen Triple P. Behaviour problems were associated instead with recent developmental phases The older two have certainly stepped up with hormones this year and the girl stuff coming in. Or had been present prior to the earthquakes Yup he’s fifteen years old and difficult behaviour from nine.
11 Research Question 2: cont-Mothers had a number of goals for their involvement with GTTP Help to learn specific management strategies for specific problems things to do to get her to co-operate more Help to learn self-management not go on the defensive and start yelling at them which is what I tend to do Help to improve their relationship with their teen I want to be closer to Child 2 Opportunities to share with other parents hear stories of what other parents are dealing with and whether mine are similar or whether they’re at the top of the range which I don’t think so or whether they are at the bottom of the range.
12 Research question 3 From as early as the second interview mothers mention specific GTTP content they had found helpful: praising, rewarding, behaviour contracts, providing encouragement, giving attention, giving time, collaborative discussion around rules and guidelines, routines, active listening, influences on teen behaviour They also gave examples of ways they had managed to control their emotional reactions to teen behaviour keeping calm, avoiding escalation, active encouragement for engaging activities rather than “couch parenting”
13 Research Question 3: Strategies.But because we’d started the two new behaviour contracts, we’ve done the homework one and the bedtime routine and the first time she got up in the morning she got a special milo”. Well we discussed the family rules, I set a couple up and [Child 2] set a couple and we discussed them and then we slotted them in. My teen is responding well to having clear rules and guidelines that we have discussed together. Her compliance has increased and she now knows what she needs to be doing to earn rewards. Yes, I’ve started giving them a time frame and agreeing upon it with them. Once I learnt the technique of repeating what they say, understanding and keeping calm, I put that more into practice.
14 Research Question 3: Parental self-controlAll mothers identified changes they had made to their own reactive parenting. But I have learnt of a couple of easy ones which is the fact that I escalate stuff. And the couch parenting has lessened- and I’m feeling better about that. I am trying to be calmer at home and more fun and enjoy the time I have to spend with my kids I am still keeping up with the not getting into verbal battles with my teen.
15 Research Question 3: cont-The importance of sharing experiences with fellow group members continued to be acknowledged: Being able to receive feedback and have discussions with other parents. Although not all mothers felt this way: I think I learnt more from the content - yes definitely the content and the one to one with the people working on it more than sharing personal stories.
16 Other feedback about the programmeThe mothers also had suggestions for improvements in the programme: Having fewer parents in the group, having more groups, spending more time going over content, and designing groups for a smaller age range of teens. (Re age range and discussions with other parents) We don’t have a lot of the issues of her going out and wanting to do things with her friends. There needs to be more of them, just more programmes. Why they’re not funded more widely and freely in every community, for anyone who wants them.
17 Research Question 3: Pre/post emotion codesStatements referring to emotions were coded pre- and post- intervention. Pre-intervention: Understandably, given the focus on the earthquakes, early codes were more negative, although many of these early statements referred to parenting as well. Post-intervention emotions were more positive.
18 Research Question 3: Pre/post emotion codes
19 Research Question 3: Pre/post emotion codes, parenting examplesMothers’ utterances about their parenting became more positive and hopeful after the programme Sarah: Pre- I never feel good as a parent. It always feels like I should be doing things differently. Post - I feel more confident in my parenting abilities. Some of the skills I have learnt have been very useful so far.
20 Discussion Points Research Question 1The mothers all described a large number of stressful earthquake experiences and post-earthquake stressors. Their responses were congruent with those reported by other authors
21 Discussion Points Research Question 2No mother attributed her need for GTTP to these. But it is possible that they led to Christchurch parents delaying seeking such help for a few years. Did sleep problems, housing crises and emotional dysregulation contribute to need for help in a manner not recognised by the mothers? Instead mothers wanted help with specific parenting problems
22 Discussion Points Research Question 3Despite extensive short- and long-term disruptions after the quakes, mothers still valued the opportunity to participate in Teen Triple P The mothers saw themselves as gaining specific skills, learnings, insight and understandings that related directly to their stated goals These were also reported to have had positive outcomes on their teens and their behaviour These findings were consistent with Chu’s (2014) findings on the social validity of GTTP.
23 References Chu, J. T. W. (2014). A mixed methods evaluation of a universal group parenting programme for parents of adolescents. (Unpublished doctoral thesis), University of Auckland, Auckland, New Zealand. Cobham, V., McDermott, B., Richardson, M., Ronan, K., & Sanders, M. (2011). Post-disaster parenting support: Liaising with parent consumers to increase the reach and impact of Disaster Recovery Triple P. Mater Medical Research Institute: Central Queensland University. Hsieh, H. F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15(9), Rahmqvist, J., Wells, M.B., & Sarkadi, A. (2013). Conscious parenting: A qualitative study on Swedish parents’ motives to participate in a parenting program. Journal of Child and Family Studies, 23,