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Cited by 264Maternal Mental Health During Pregnancy and PostpartumChild and Adolescent Psychosocial and Emotional DevelopmentFamily Dynamics and Relationships

Group-based parent training programmes for improving parental psychosocial health

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Barlow, Jane, Smailagic, Nadja, Huband, Nick, Roloff, Verena, Bennett, Cathy·2012·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd002020.pub3PMC PMC10898322
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Abstract

BACKGROUND: Parental psychosocial health can have a significant effect on the parent-child relationship, with consequences for the later psychological health of the child. Parenting programmes have been shown to have an impact on the emotional and behavioural adjustment of children, but there have been no reviews to date of their impact on parental psychosocial wellbeing. OBJECTIVES: To address whether group-based parenting programmes are effective in improving parental psychosocial wellbeing (for example, anxiety, depression, guilt, confidence). SEARCH METHODS: We searched the following databases on 5 December 2011: CENTRAL (2011, Issue 4), MEDLINE (1950 to November 2011), EMBASE (1980 to week 48, 2011), BIOSIS (1970 to 2 December 2011), CINAHL (1982 to November 2011), PsycINFO (1970 to November week 5, 2011), ERIC (1966 to November 2011), Sociological Abstracts (1952 to November 2011), Social Science Citation Index (1970 to 2 December 2011), metaRegister of Controlled Trials (5 December 2011), NSPCC Library (5 December 2011). We searched ASSIA (1980 to current) on 10 November 2012 and the National Research Register was last searched in 2005. SELECTION CRITERIA: We included randomised controlled trials that compared a group-based parenting programme with a control condition and used at least one standardised measure of parental psychosocial health. Control conditions could be waiting-list, no treatment, treatment as usual or a placebo. DATA COLLECTION AND ANALYSIS: At least two review authors extracted data independently and assessed the risk of bias in each study. We examined the studies for any information on adverse effects. We contacted authors where information was missing from trial reports. We standardised the treatment effect for each outcome in each study by dividing the mean difference in post-intervention scores between the intervention and control groups by the pooled standard deviation. MAIN RESULTS: We included 48 studies that involved 4937 participants and covered three types of programme: behavioural, cognitive-behavioural and multimodal. Overall, we found that group-based parenting programmes led to statistically significant short-term improvements in depression (standardised mean difference (SMD) -0.17, 95% confidence interval (CI) -0.28 to -0.07), anxiety (SMD -0.22, 95% CI -0.43 to -0.01), stress (SMD -0.29, 95% CI -0.42 to -0.15), anger (SMD -0.60, 95% CI -1.00 to -0.20), guilt (SMD -0.79, 95% CI -1.18 to -0.41), confidence (SMD -0.34, 95% CI -0.51 to -0.17) and satisfaction with the partner relationship (SMD -0.28, 95% CI -0.47 to -0.09). However, only stress and confidence continued to be statistically significant at six month follow-up, and none were significant at one year. There was no evidence of any effect on self-esteem (SMD -0.01, 95% CI -0.45 to 0.42). None of the trials reported on aggression or adverse effects.The limited data that explicitly focused on outcomes for fathers showed a statistically significant short-term improvement in paternal stress (SMD -0.43, 95% CI -0.79 to -0.06). We were unable to combine data for other outcomes and individual study results were inconclusive in terms of any effect on depressive symptoms, confidence or partner satisfaction. AUTHORS' CONCLUSIONS: The findings of this review support the use of parenting programmes to improve the short-term psychosocial wellbeing of parents. Further input may be required to ensure that these results are maintained. More research is needed that explicitly addresses the benefits for fathers, and that examines the comparative effectiveness of different types of programme along with the mechanisms by which such programmes bring about improvements in parental psychosocial functioning.

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  • Concerns about the long-term effectiveness of parenting programmes have led to recommendations for supplementary interventions such as booster sessions.

    “Furthermore, concerns remain about the longterm effectiveness of such programmes, and recommendations for a variety of supplementary interventions to support treatment gains (e.g.booster sessions) are common (Barlow 2012;Eyberg 1998;Hudson 1986;Nock 2003).”

    From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Barlow 2012

    The Authors’ Conclusions (Implications for practice; page unavailable) say the benefits may be short-term and parents may need additional support to maintain improvements. Implications for research calls for investigation of post-intervention support. The review describes a trial with a booster session (Bradley 2003), but does not itself recommend booster sessions or establish that such recommendations are common. (LLM, conf=0.84)

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  • Parenting programmes can significantly improve several aspects of parental mental health, including anxiety, depression, and self-esteem.

    “such programmes can also significantly improve a range of aspects of parental mental health, including anxiety, depression, and self-esteem (Barlow 2012;Barlow 2018)”

    From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Barlow 2012

    The Discussion (page unavailable) reports statistically significant immediate post-intervention improvements in depression and anxiety. The review also measured self-esteem, but its results table (page unavailable) shows no statistically significant improvement in self-esteem at post-intervention or follow-up, so that part of the claim is unsupported. (LLM, conf=0.91)

    Experimental — accuracy not yet measured

  • Standard behavioural or skills-based parent training is widely used, evidence-based, and has shown benefits for many parent and child outcomes in different cultures.

    “Traditional behavioural or skills-based parent training approaches are widely implemented evidencebased interventions that have demonstrated efficacy across a range of parent and child outcomes, and different cultural contexts (Barlow 2010;Barlow 2012;Barlow 2018;Dretze 2005;Furlong 2012;Gardner 2016;Piquero 2008).”

    From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Barlow 2012

  • Four review authors independently extracted data in duplicate using modified, piloted forms.

    “Four review authors (JD, RF, BL & YS) independently extracted data in duplicate using modified, piloted data extraction forms adapted from previous parent training reviews (Appendix 2) (Barlow 2012).”

    From Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents (2024) · cites this paper as Barlow 2012

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Research works printed but not linked: 1

  1. [1]1. Behavioral Disorders 2005; Vol. 13, issue 4:194-9. [MEDLINE: 39300; 1063-4266]

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Authors
Barlow, J., Smailagic, N., Huband, N., Roloff, V., & Bennett, C.
Affiliations
  • University of Warwick (GB)
  • University of Cambridge (GB)
  • University of Nottingham (GB)
  • MRC Biostatistics Unit (GB)
  • University of Plymouth (GB)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
John Wiley & Sons, Ltd
Published
2012-06-13
Issue
5
Pages
CD002020-CD002020
ISSN
1361-6137 (ISSN-L)
DOI
10.1002/14651858.cd002020.pub3
PMC
PMC10898322
OpenAlex
W1951736428
Cited by
262
References
221
Citations by year
2026: 6 · 2025: 6 · 2024: 15 · 2023: 7 · 2022: 11 · 2021: 32 · 2020: 20 · 2019: 23 · 2018: 33 · 2017: 27 · 2016: 31 · 2015: 19 · 2014: 18 · 2013: 12 · 2012: 1
Type
reference entry
Language
en
Update notices
new_version (2014-05-17)
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Apollo (University of Cambridge) (submittedVersion)
  • Apollo
Funders
  • Queen's University Belfast
  • University of Bristol
  • Queen's University
  • Medical Research Council
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Demography › Family Dynamics and Relationships
Keywords
parental depression, parental anxiety, guilt, parental confidence, parent-child relationship, parenting support, child mental health, risk of bias, adverse effects, cost-effectiveness, cost-benefit analysis, cost-utility analysis, cost-effectiveness acceptability
MeSH terms
Anxiety, Depression, Emotions, Female, Humans, Maternal Behavior, Maternal Welfare, Mother-Child Relations, Parents, Paternal Behavior, Self Concept, Program Evaluation, Randomized Controlled Trials as Topic, Parenting

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