James N. Kirby

The Triple P-Positive Parenting Program: A systematic review and meta-analysis of a multi-level system of parenting support

This systematic review and meta-analysis examined the effects of the multilevel Triple P-Positive Parenting Program system on a broad range of child, parent and family outcomes. Multiple search strategies identified 116 eligible studies conducted over a 33-year period, with 101 studies comprising 16,099 families analyzed quantitatively. Moderator analyses were conducted using structural equation modeling. Risk of bias within and across studies was assessed. Significant short-term effects were found for: childrens social, emotional and behavioral outcomes (d=0.473); parenting practices (d=0.578); parenting satisfaction and efficacy (d=0.519); parental adjustment (d=0.340); parental relationship (d=0.225) and child observational data (d=0.501). Significant effects were found for all outcomes at long-term including parent observational data (d=0.249). Moderator analyses found that study approach, study power, Triple P level, and severity of initial child problems produced significant effects in multiple moderator models when controlling for other significant moderators. Several putative moderators did not have significant effects after controlling for other significant moderators. The positive results for each level of the Triple P system provide empirical support for a blending of universal and targeted parenting interventions to promote child, parent and family wellbeing.

Surviving or Thriving: Quality Assurance Mechanisms to Promote Innovation in the Development of Evidence-Based Parenting Interventions

Parenting interventions have the potential to make a significant impact to the prevention and treatment of major social and mental health problems of children. However, parenting interventions fail to do so because program developers pay insufficient attention to the broader ecological context that influences the adoption and implementation of evidence-based interventions. This context includes the professional and scientific community, end users, consumers, and broader sociopolitical environment within which parenting services are delivered. This paper presents an iterative stage model of quality assurance steps to guide ongoing research and development particularly those related to program innovations including theory building, intervention development, pilot testing, efficacy and effectiveness trials, program refinement, dissemination, and planning for implementation and political advocacy. The key challenges associated with each phase of the research and development process are identified. Stronger consumer participation throughout the entire process from initial program design to wider community dissemination is an important, but an often ignored part of the process. Specific quality assurance mechanisms are discussed that increase accountability, professional, and consumer confidence in an intervention and the evidence supporting its efficacy.

The current and future role of heart rate variability for assessing and training compassion

The evolution of mammalian caregiving involving hormones, such as oxytocin, vasopressin, and the myelinated vagal nerve as part of the ventral parasympathetic system, enables humans to connect, co-regulate each other’s emotions and create prosociality. Compassion-based interventions draw upon a number of specific exercises and strategies to stimulate these physiological processes and create conditions of “interpersonal safeness,” thereby helping people engage with, alleviate, and prevent suffering. Hence, compassion-based approaches are connected with our evolved caring motivation and attachment and our general affiliative systems that help regulate distress. Physiologically, they are connected to activity of the vagus nerve and corresponding adaptive heart rate variability (HRV). HRV is an important physiological marker for overall health, and the body–mind connection. Therefore, there is significant value of training compassion to increase HRV and training HRV to facilitate compassion. Despite the significance of compassion in alleviating and preventing suffering, there remain difficulties in its precise assessment. HRV offers a useful form of measurement to assess and train compassion. Specific examples of what exercises can facilitate HRV and how to measure HRV will be described. This paper argues that the field of compassion science needs to move toward including HRV as a primary outcome measure in its future assessment and training, due to its connection to vagal regulatory activity, and its link to overall health and well-being.

A commentary on evidenced-based parenting programs: redressing misconceptions of the empirical support for Triple P

A meta-analytic review of the Triple P-Positive Parenting program by Wilson et al., recently published in BMC Medicine, claimed to demonstrate that although Triple P is widely disseminated and adopted, the evidence attesting to the effectiveness of the program is not as convincing as it may appear. Although this review addresses the important issue of evaluation and reporting methods within evidence-based interventions, we contend that the Wilson et al. review contains a number of significant conceptual, methodological and interpretational inadequacies that render the key conclusions of their review problematic.

A tailored compassion-focused therapy program for sexual minority young adults with depressive symotomatology: study protocol for a randomized controlled trial

BackgroundLesbian, gay, and bisexual (LGB) men and women represent one of the highest-risk populations for depressive symptomatology and disorders, with young LGB adults being at greatest risk. To date, there have been no randomized controlled trials (RCT) to specifically target depressive symptoms in young LGB adults. This is despite research highlighting unique predictors of depressive symptomatology in this population. Here we outline a protocol for an RCT that will test the preliminary efficacy of a tailored compassion-focused therapy (CFT) intervention for young LGB adults compared with a self-directed cognitive behavioral therapy (CBT) program with no specific tailoring for LGB individuals.MethodsThe CFT intervention consists of 8 units with self-directed reading and activities tailored to LGB young adults, and 8 x weekly 1-hour consultations with a therapist. The CBT intervention consists of 8 units with self-guided reading and activities, with 1 x 1-hour session with a therapist at the mid-point of therapy. Fifty LGB individuals with scores of 13 or above on the Beck Depression Inventory-II will be randomized to either the CFT or CBT condition. The primary outcome measure is depressive symptomatology. Secondary outcome measures are symptoms of anxiety, suicidal ideation, internalized homophobia, self-compassion, and shame and guilt proneness. Assessments will occur at pre-intervention, post-intervention, and at 3-month post-intervention.DiscussionThis study is an RCT to test the preliminary efficacy of an LGB-tailored compassion-focused intervention for young LGB adults with depressive symptomatology. If this intervention is efficacious, this could begin to address the substantial mental health disparities amongst sexual minorities.Trial registrationACTRN12616001018404. Prospective registration, registered 02/08/2016.

To Whom Do We Confide Our Secrets

Although prior work has examined secret keeping, no prior work has examined who gets told secrets. Five studies find compassion and assertiveness predict having secrets confided in oneself (as determined by both self- and peer reports), whereas enthusiasm and politeness were associated with having fewer secrets confided. These results bolster suggestions that interpersonal aspects of personality (which can fit a circumplex structure) are driven by distinct causal forces. While both related to agreeableness, compassion (empathy and desire to help) predicts being confided in more, whereas politeness (concern with social norms and social rules) predicts being confided in less. Likewise, while both related to extraversion, assertiveness (having the agency and drive to help) predicts being confided in more, whereas enthusiasm (positive sociality) predicts being confided in less.

Motivational interviewing in compassion-based interventions: Theory and practical applications: MI in compassion-based interventions

Background: Definitions of compassion include aspects of motivation, commitment, and action. Compassion-based interventions designed to cultivate compassion and self-compassion incorporate various practice and behavioural change goals. This article proposes that motivational interviewing (MI), which has been extensively used as a prelude to other psychological and health-related treatments to enhance behavioural change outcomes, could be used in a similar way to enhance outcomes of compassion-based interventions. Methods: This article provides an overview of definitions of compassion, common compassion-based interventions as well as their structure and behaviour change components, and describes MI as an approach to enhancing motivation, commitment, and action around these behaviour change components. Results: Three main compassion-based interventions were reviewed, namely Compassion-Focused Therapy, Mindful Self-Compassion, and Compassion Cultivation Training. It was identified that at least four aspects of motivation, commitment, and action could be the focus of MI as a prelude to these interventions, including attendance at sessions, meditation self-practice, active engagement with the suffering of self and others, and embodiment of compassionate action in daily life. Transcripts of example MI conversations in the context of compassion-based interventions have been provided, as well as recommendations regarding assessing motivation and commitment in this context. Conclusions: MI is proposed to be a promising prelude to compassion-based interventions, to enhance compassion motivation and commitment, and increase the likelihood of embodying compassionate action in daily life.

Children imitate antisocial in‐group members

Children demonstrate a pervasive in-group bias, preferring their in-group across a range of contexts that encompass measures of liking, imitation, and, in some cases, resource allocation. A growing number of studies have begun to explore whether antisocial in-group behavior reduces the robustness of this bias. However, these studies have focused on transgression evaluations, with only two studies focusing on social learning and none explicitly on imitation. This, therefore, limits the extent to which childrens responses to interaction between in-group bias and antisocial behavior can be fully understood. The current research expands on the prevailing literature, utilizing imitation as a behavioral measure to explore the reactions of children aged 4-5 and 7-8 years in response to antisocial in-group behavior. Consistent with previous literature, antisocial in-group behavior reduced in-group liking ratings. Surprisingly, however, childrens behavioral imitation preferences were guided solely by group membership, disregarding prosocial or antisocial behavior. These results indicate that childrens explicitly reported social preferences and imitative preferences may be motivated by two independent drives.

Compassion as the Highest Ethic

Ethics are governing principles that help guide people or groups when making moral decisions, judgments, or when engaging in actions. We draw upon our ethical principles when attempting to address some of the most complicated decisions in our lives, for example in health care when dealing with difficult matters such as assisted suicide or with terminally ill patients. Indeed, many modern professions (e.g., doctors, psychologists) have ethical codes to ensure that members engage in behaviors, which are seen as being the human ideal that recognizes the integrity, dignity, and the justice of the individuals and the situation. In this chapter, we posit that compassion might be the foundation principal necessary in making ethically wise decisions. To support this premise, we will first define compassion, and how it can be understood in terms of evolutionary function, physiological processes, and brain functioning. We will then examine the benefits of compassion and how this links with ethics. Finally, we will discuss specific interventions that aim to cultivate compassion and how these might offer hope for individuals and society in making ethically wise decisions.

Erratum to: The Acceptability of Parenting Strategies for Grandparents Providing Care to Their Grandchildren

Authors’ Statement of Conflict of Interest The Triple P – Positive Parenting Program is owned by The University of Queensland. The University, through its technology transfer company Uniquest Pty Ltd, has licensed Triple P International Pty Ltd to disseminate the program worldwide. Royalties stemming from this dissemination work are paid to UniQuest, which distributes payments to the University of Queensland Faculty of Health and Behavioural Sciences, School of Psychology, Parenting and Family Support Centre, and contributory authors in accordance with the University’s intellectual property policy. No author has any share or ownership in Triple P International. James N. Kirby is a co-author of Grandparent Triple P. Matthew R. Sanders is the founder and lead author of the Triple P–Positive Parenting Program, and is a consultant to Triple P International.