Journal of Child and Family Studies

, Volume 20, Issue 6, pp 804–813 | Cite as

Effectiveness of Group Positive Parenting Program (Triple P) in Changing Child Behavior, Parenting Style, and Parental Adjustment: An Intervention Study in Japan

  • Takeo FujiwaraEmail author
  • Noriko Kato
  • Matthew R. Sanders
Original Paper


The purpose of this study is to investigate the effectiveness of a group-based family intervention program known as the Group Positive Parenting Program (Triple P), with families in Japan. Reductions in children’s behavioral problems, changes in dysfunctional parenting practices, and affects on parenting adjustment were examined. Participants of both the intervention and control groups (N = 91 and N = 24, respectively) were recruited from mothers visiting health clinics in Kawasaki City, Kanagawa. Intervention and control groups were assessed in terms of child behavior (Strength and Difficulty Questionnaire, SDQ), parenting style (Parenting Scale, PS), and parenting adjustment (Depression-Anxiety-Stress Scale, DASS; and Parenting Experience Survey, PES), both pre- and postintervention. A repeated measures multivariate analysis of variance was used to determine the intervention’s effects. The SDQ score for the conduct problems subscale indicated a significant intervention effect. In addition, the postintervention scores for all subscales of the PS, the DASS depression subscale and total scores, as well as ratings for perceived difficulty of parenting in the PES, were significantly reduced in the intervention group alone. The PES also revealed that confidence in parenting significantly increased only in the intervention group. Group Triple P is effective in decreasing child conduct problems, dysfunctional parenting practices, depression, anxiety, stress, and the perceived level of parenting difficulty, as well as in improving parenting confidence, among Japanese families.


Child abuse Parenting Intervention Behavior problem Adjustment 



This research is supported by Research on Children and Families, Health and Labor Sciences Research Grants for the program “Support Activity on Early Detection of Developmental Disorders Using the Infant–Toddler Health Checkups and Its Evaluation,” funded by the Ministry of Health, Labor, and Welfare (PI: Noriko Kato). The authors gratefully acknowledge the cooperation of Dr. Hiroko Ishidu and Dr. Mari Mashiko from Kawasaki City’s local government. We especially appreciate the mothers and children who participated in this study, without whom the study would not have been possible.


  1. Arnold, D. S., O’Leary, S. G., Wolff, L. S., & Acker, M. M. (1993). The parenting scale: A measure of dysfunctional parenting in discipline situations. Psychological Assessment, 5, 137–144.CrossRefGoogle Scholar
  2. Brown, J., Cohen, P., Johnson, J. G., & Salzinger, S. (1998). A longitudinal analysis of risk factors for child maltreatment: Findings of a 17-year prospective study of officially recorded and self-reported child abuse and neglect. Child Abuse and Neglect, 22(11), 1065–1078.PubMedCrossRefGoogle Scholar
  3. Cappelleri, J. C., Eckenrode, J., & Powers, J. L. (1993). The epidemiology of child abuse: Findings from the second national incidence and prevalence study of child abuse and neglect. American Journal of Public Health, 83(11), 1622–1624.PubMedCrossRefGoogle Scholar
  4. Chaffin, M., Kelleher, K., & Hollenberg, J. (1996). Onset of physical abuse and neglect: psychiatric, substance abuse, and social risk factors from prospective community data. Child Abuse and Neglect, 20(3), 191–203.PubMedCrossRefGoogle Scholar
  5. Children’s Rainbow Center. (2009). Child abuse in Japan today, and measures for its prevention. Retrieved April 24, 2009, from
  6. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.Google Scholar
  7. Dinwiddie, S. H., & Bucholz, K. K. (1993). Psychiatric diagnoses of self-reported child abusers. Child Abuse and Neglect, 17(4), 465–476.PubMedCrossRefGoogle Scholar
  8. Dubowitz, H., Black, M. M., Cox, C. E., Kerr, M. A., Litrownik, A. J., Radhakrishna, A., et al. (2001). Father involvement and children’s functioning at age 6 years: A multisite study. Child Maltreatreatment, 6(4), 300–309.CrossRefGoogle Scholar
  9. Eckenrode, J., Ganzel, B., Henderson, C. R., Jr., Smith, E., Olds, D. L., Powers, J., et al. (2000). Preventing child abuse and neglect with a program of nurse home visitation: The limiting effects of domestic violence. Journal of American Medical Association, 284(11), 1385–1391.CrossRefGoogle Scholar
  10. Eyberg, S. M., & Pincus, D. (1999). Eyberg child behaviour inventory and Sutter-Eyberg student Behaviour inventory—revised: Professional manual. Odess, FL: Psychological Assessment Resources.Google Scholar
  11. Famularo, R., Fenton, T., & Kinscherff, R. (1992). Medical and developmental histories of maltreated children. Clinical Pediatrics, 31(9), 536–541.PubMedCrossRefGoogle Scholar
  12. Fujiwara, T. (2007). Population strategy to address child maltreatment in Japan. Public Health, 121, 485–486.PubMedCrossRefGoogle Scholar
  13. Fujiwara, T., Okuyama, M., & Takahashi, K. (2010). Paternal involvement in childcare and unintentional injury of young children: a population-based cohort study in Japan. International Journal of Epidemiology, 39(2), 588–597.PubMedCrossRefGoogle Scholar
  14. Fujiwara, T., Okuyama, M., Tsui, H., & Koenen, K. C. (2008). Perinatal factors associated with infant maltreatment. Clinical Medicine Insights: Pediatrics, 1, 29–36.Google Scholar
  15. Goodman, R. (1997). The strengths and difficulties questionnaire: A research note. Journal of Child Psychology and Psychiatry, 38(5), 581–586.PubMedCrossRefGoogle Scholar
  16. Hahn, R. A., Bilukha, O. O., Crosby, A., Fullilove, M. T., Liberman, A., Moscicki, E. K., Snyder, S., Tuma, F., Schofield, A., Corso, P. S., & Briss, P. (2003). First reports evaluating the effectiveness of strategies for preventing violence: Early childhood home visitation. Findings from the task force on community preventive services. Morbidity and mortality weekly report: Recommendations and reports, 52(RR-14), 1–9.Google Scholar
  17. Kotch, J. B., Browne, D. C., Dufort, V., & Winsor, J. (1999). Predicting child maltreatment in the first 4 years of life from characteristics assessed in the neonatal period. Child Abuse and Neglect, 23(4), 305–319.PubMedCrossRefGoogle Scholar
  18. Leung, C., Sanders, M. R., Leung, S., Mak, R., & Lau, J. (2003). An outcome evaluation of the implementation of the Triple P-positive parenting program in Hong Kong. Family Process, 42(4), 531–544.PubMedCrossRefGoogle Scholar
  19. Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the depression anxiety stress scales (2nd ed.). Sydney: Psychology Foundation of Australia.Google Scholar
  20. MacLeod, J., & Nelson, G. (2000). Programs for the promotion of family wellness and the prevention of child maltreatment: a meta-analytic review. Child Abuse and Neglect, 24(9), 1127–1149.PubMedCrossRefGoogle Scholar
  21. Matsuishi, T., Nagano, M., Araki, Y., Tanaka, Y., Iwasaki, M., Yamashita, Y., et al. (2008). Scale properties of the Japanese version of the strengths and difficulties questionnaire (SDQ): A study of infant and school children in community samples. Brain Development, 30(6), 410–415.PubMedCrossRefGoogle Scholar
  22. Matsumoto, Y., Sofronoff, K., & Sanders, M. R. (2007). The efficacy and acceptability of the Triple P-Positive Parenting Program with Japanese Parents. Behaviour Change, 24(4), 205–218.CrossRefGoogle Scholar
  23. Matsumoto, Y., Sofronoff, K., & Sanders, M. R. (2010). Investigation of the effectiveness and social validity of the Triple P positive parenting program in Japanese society. Journal of Family Psychology, 24(1), 87–91.PubMedCrossRefGoogle Scholar
  24. Nihon Shouni Hoken Kyokai (The Japanese Society of Child Health). (2001). Heisei 12 nendo Youji Kenkoudo Chousa Houkokusyo (Report of survey on health status of toddlers, FY2000). Tokyo: Nihon Shouni Hoken Kyokai (The Japanese Society of Child Health).Google Scholar
  25. Olds, D. L., Eckenrode, J., Henderson, C. R., Jr., Kitzman, H., Powers, J., Cole, R., et al. (1997). Long-term effects of home visitation on maternal life course and child abuse and neglect. Fifteen-year follow-up of a randomized trial. Journal of American Medical Association, 278(8), 637–643.CrossRefGoogle Scholar
  26. Prinz, R. J., Sanders, M. R., Shapiro, C. J., Whitaker, D. J., & Lutzker, J. R. (2009). Population-based prevention of child maltreatment: The U.S. Triple p system population trial. Prevention Science, 10(1), 1–12.PubMedCrossRefGoogle Scholar
  27. Roberts, I., Kramer, M. S., & Suissa, S. (1996). Does home visiting prevent childhood injury? A systematic review of randomised controlled trials. British Medical Journal, 312(7022), 29–33.PubMedCrossRefGoogle Scholar
  28. Sanders, M. R. (1999). Triple P-positive parenting program: Towards an empirically validated multilevel parenting and family support strategy for the prevention of behavior and emotional problems in children. Clinical Child and Family Psychology Review, 2(2), 71–90.PubMedCrossRefGoogle Scholar
  29. Sanders, M. R., Markie-Dadds, C., Tully, L. A., & Bor, W. (2000). The triple P-positive parenting program: A comparison of enhanced, standard, and self-directed behavioral family intervention for parents of children with early onset conduct problems. Journal of Consulting and Clinical Psychology, 68(4), 624–640.PubMedCrossRefGoogle Scholar
  30. Sidebotham, P., & Heron, J. (2003). Child maltreatment in the “children of the nineties:” the role of the child. Child Abuse and Neglect, 27(3), 337–352.PubMedCrossRefGoogle Scholar
  31. Smedje, H., Broman, J. E., Hetta, J., & von Knorring, A. L. (1999). Psychometric properties of a Swedish version of the “Strengths and Difficulties Questionnaire”. European Child and Adolescent Psychiatry, 8(2), 63–70.PubMedCrossRefGoogle Scholar
  32. Turner, K. M. T., Markie-Dadds, C., & Sanders, M. R. (1997). Facilitator’s manual for group Triple P. Brisbane, Australia: Families International Publishing.Google Scholar
  33. Turner, K. M., Richards, M., & Sanders, M. R. (2007). Randomised clinical trial of a group parent education programme for Australian indigenous families. Journal of Paediatrics and Child Health, 43(6), 429–437.PubMedCrossRefGoogle Scholar
  34. Turner, K. M. T., Sanders, M. R., & Markie-Dadds, C. (1999). Practitioner’s manual for primary care Triple P. Brisbane: Families International Publishing.Google Scholar
  35. Windham, A. M., Rosenberg, L., Fuddy, L., McFarlane, E., Sia, C., & Duggan, A. K. (2004). Risk of mother-reported child abuse in the first 3 years of life. Child Abuse and Neglect, 28(6), 645–667.PubMedCrossRefGoogle Scholar
  36. Wu, S. S., Ma, C. X., Carter, R. L., Ariet, M., Feaver, E. A., Resnick, M. B., et al. (2004). Risk factors for infant maltreatment: a population-based study. Child Abuse and Neglect, 28(12), 1253–1264.PubMedCrossRefGoogle Scholar
  37. Yogman, M. W., Kindlon, D., & Earls, F. (1995). Father involvement and cognitive/behavioral outcomes of preterm infants. Journal of the American Academy of Child and Adolescent Psychiatry, 34(1), 58–66.PubMedCrossRefGoogle Scholar
  38. Yoshikawa, H. (1995). Long-term effects of early childhood programs on social outcomes and delinquency. The Future of Children, 5(3), 51–75.PubMedCrossRefGoogle Scholar
  39. Zelenko, M., Lock, J., Kraemer, H. C., & Steiner, H. (2000). Perinatal complications and child abuse in a poverty sample. Child Abuse and Neglect, 24(7), 939–950.PubMedCrossRefGoogle Scholar
  40. Zubrick, S. R., Ward, K. A., Silburn, S. R., Lawrence, D., Williams, A. A., Blair, E., et al. (2005). Prevention of child behavior problems through universal implementation of a group behavioral family intervention. Prevention Science, 6(4), 287–304.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Takeo Fujiwara
    • 1
    Email author
  • Noriko Kato
    • 2
  • Matthew R. Sanders
    • 3
  1. 1.Department of Social MedicineNational Research Institute for Child Health and DevelopmentSetagaya-ku, TokyoJapan
  2. 2.Department of Health PromotionNational Institute of Public HealthWako-shi, SaitamaJapan
  3. 3.School of PsychologyUniversity of QueenslandBrisbaneAustralia

Personalised recommendations