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Meta-Analysis
. 2014 May 17;2014(5):CD002020.
doi: 10.1002/14651858.CD002020.pub4.

Group-based parent training programmes for improving parental psychosocial health

Jane Barlow  1 , Nadja Smailagic, Nick Huband, Verena Roloff, Cathy Bennett
Affiliations
Meta-Analysis

Group-based parent training programmes for improving parental psychosocial health

Jane Barlow et al. Cochrane Database Syst Rev. .

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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Conflict of interest statement

  1. Jane Barlow ‐ none known.

  2. Nadja Smailagic ‐ none known.

  3. Nick Huband ‐ none known.

  4. Verena Roloff ‐ none known.

  5. Cathy Bennett ‐ I am employed by Systematic Research Ltd and I received a consultancy fee for my contributions to this review.

Figures

1
1
Risk of bias summary: review authors' judgements about each risk of bias item for each included study
1.1
1.1. Analysis
Comparison 1 Meta analysis: any parent training programme versus control (parental outcomes), Outcome 1 Depressive symptoms.
1.2
1.2. Analysis
Comparison 1 Meta analysis: any parent training programme versus control (parental outcomes), Outcome 2 Anxiety symptoms.
1.3
1.3. Analysis
Comparison 1 Meta analysis: any parent training programme versus control (parental outcomes), Outcome 3 Stress.
1.4
1.4. Analysis
Comparison 1 Meta analysis: any parent training programme versus control (parental outcomes), Outcome 4 Self esteem.
1.5
1.5. Analysis
Comparison 1 Meta analysis: any parent training programme versus control (parental outcomes), Outcome 5 Anger.
1.6
1.6. Analysis
Comparison 1 Meta analysis: any parent training programme versus control (parental outcomes), Outcome 6 Guilt.
1.7
1.7. Analysis
Comparison 1 Meta analysis: any parent training programme versus control (parental outcomes), Outcome 7 Confidence.
1.8
1.8. Analysis
Comparison 1 Meta analysis: any parent training programme versus control (parental outcomes), Outcome 8 Partner satisfaction.
2.1
2.1. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 1 Parental outcomes: depressive symptoms (Beck Depression Inventory).
2.3
2.3. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 3 Parental outcomes: depressive symptoms (subscale of Depression Anxiety Stress Scale).
2.4
2.4. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 4 Parental outcomes: depressive symptoms (Centre for Epidem. Studies Depression Scale).
2.5
2.5. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 5 Parental outcomes: depressive symptoms (subscale of Parenting Stress Index).
2.6
2.6. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 6 Parental outcomes: depressive symptoms (subscale of General Health Questionnaire).
2.7
2.7. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 7 Parental outcomes: anxiety symptoms (subscale of Depression Anxiety Stress Scale).
2.9
2.9. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 9 Parental outcomes: anxiety symptoms (subscale of General Health Questionnaire).
2.10
2.10. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 10 Parental outcomes: anxiety symptoms (STAI State scale).
2.12
2.12. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 12 Parental outcomes: anxiety symptoms (Beck Anxiety Inventory).
2.13
2.13. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 13 Parental outcomes: anxiety symptoms (Brief Symptom Inventory).
2.14
2.14. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 14 Parental outcomes: stress (Perceived Stress Scale).
2.15
2.15. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 15 Parental outcomes: stress (Parenting Stress Index: overall score).
2.16
2.16. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 16 Parental outcomes: stress (Parenting Stress Index: parent domain score).
2.17
2.17. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 17 Parental outcomes: stress (Parenting Stress Index ‐ short form: overall score).
2.18
2.18. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 18 Parental outcomes: stress (Parenting Stress Index ‐ short form: distress subscale).
2.19
2.19. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 19 Parental outcomes: stress (Everyday Stress Index).
2.20
2.20. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 20 Parental outcomes: stress (Ability & Confidence Rating Questionnaire).
2.21
2.21. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 21 Parental outcomes: stress (Parental Stress Scale).
2.22
2.22. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 22 Parental outcomes: stress (modified Uplifts & Hassles Scale: hassles scale).
2.23
2.23. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 23 Parental outcomes: stress (subscale of Depression Anxiety Stress Sscale).
2.24
2.24. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 24 Parental outcomes: self‐esteem (Rosenberg Self‐Esteem scale).
2.25
2.25. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 25 Parental outcomes: anger (subscale of Berger's Feeling Scale).
2.26
2.26. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 26 Parental outcomes: anger (State‐Trait Anger Expression Inventory scale).
2.27
2.27. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 27 Parental outcomes: guilt (subscale of Berger's Feeling Scale).
2.28
2.28. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 28 Parental outcomes: guilt (Situation Guilt Scale).
2.29
2.29. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 29 Parental outcomes: confidence (Parenting Task Checklist).
2.30
2.30. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 30 Parental outcomes: confidence (Parental Efficacy measure).
2.31
2.31. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 31 Parental outcomes: confidence (Parenting Stress Index).
2.32
2.32. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 32 Parental outcomes: confidence (Toddler Care Questionnaire).
2.33
2.33. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 33 Parental outcomes: confidence (Parenting Sense of Competence Scale: total score).
2.34
2.34. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 34 Parental outcomes: confidence (Problem Setting & Behaviour Checklist).
2.35
2.35. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 35 Parental outcomes: confidence (Kansas Parental Satisfaction Scale: satisfaction in parental role).
2.36
2.36. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 36 Parental outcomes: partner satisfaction (Dyadic Adjustment Scale).
2.37
2.37. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 37 Parental outcomes: partner satisfaction (Locke‐Wallace Marital Adjustment Test).
2.38
2.38. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 38 Parental outcomes: partner satisfaction (Parenting Stress Index).
2.39
2.39. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 39 Parental outcomes: partner satisfaction (Relation Quality Index).
2.40
2.40. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 40 Father outcomes: depressive symptoms (Beck Depression Inventory).
2.41
2.41. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 41 Father outcomes: depressive symptoms (Center for Epidemiological Studies Depression Scale.
2.42
2.42. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 42 Father outcomes: stress (Parenting Stress Index: parent domain subscale).
2.43
2.43. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 43 Father outcomes: confidence (Toddler Care Questionnaire: overall scores).
2.44
2.44. Analysis
Comparison 2 Appendix to data and analyses section, results from individual studies (no meta‐analysis): any parent training programme versus control, Outcome 44 Father outcomes: partner satisfaction (Locke‐Wallace Marital Adjustment Test).
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Update of

References

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References to studies excluded from this review

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Barkby 2011 {published data only}
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Barkley 2001 {published data only}
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Chacko 2009 {published data only}
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    1. Davidson VL. A Parent Training Program for Caucasian and Latino Parents of Children with Developmental Delays or Behavioral Difficulties (Psy D dissertation). Chicago, Illinois: Chicago School of Professional Psychology, 2011.
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Dumas 2010 {published data only}
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Hawkins 2006 {published data only}
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    1. Hoff AL, Mullins LL, Gillaspy SR, Page MC, Pelt JC, Chaney JM. An intervention to decrease uncertainty and distress among parents of children newly diagnosed with diabetes: a pilot study. Families, Systems, & Health 2005; Vol. 23, issue 3:329‐42. [MEDLINE: ]
Hughes 2004 {published data only}
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Kaaresen 2008 {published data only}
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References to studies awaiting assessment

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References to ongoing studies

NTR1338 {published data only}
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References to other published versions of this review

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