Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Aug;50(8):987-1009.
doi: 10.1007/s10802-022-00904-6. Epub 2022 Feb 25.

Effectiveness of Child-Focused Interventions for Externalizing Behavior: a Rapid Evidence Review

M Kuhn  1   2 , E Gonzalez  3   4 , L Weil  5 , A Izguttinov  5 , S Walker  5
Affiliations
Review

Effectiveness of Child-Focused Interventions for Externalizing Behavior: a Rapid Evidence Review

M Kuhn et al. Res Child Adolesc Psychopathol. 2022 Aug.

Abstract

Parent behavior management training (BMT) is well established as an effective, evidence-based treatment for children with externalizing behavior. Despite the wealth of data supporting BMT, many community providers use a variety of child-focused and non-directive interventions to target behavior problems. There is lack of clarity as to whether the evidence supporting child-focused externalizing treatments is sufficiently compelling to support offering these treatments rather than or in addition to BMT. This rapid evidence review compares the effectiveness of BMT with several common child-focused interventions for externalizing behavior including cognitive behavioral (CBT), social skill (SS), and play/dynamic (PT) approaches. PubMed, PsychINFO, and Web of Science were searched for English-language articles from year 2000 onwards for each intervention type. Inclusion criteria were child age (12 and under), presence of a child-focused behavioral treatment condition, and externalizing behavior as an outcome variable. A total of 30 studies met inclusion criteria and were coded (13 CBT, 10 SS, 7 PT). Results supported social skills interventions with accompanying BMT as effective in improving externalizing problems, with generally moderate effect sizes. Individual social skills interventions were promising but needing further evaluation compared to treatment as usual. CBT treatments with and without accompanying BMT showed moderate effects over waitlist but produced less consistently significant effects compared to more robust controls. Play therapy approaches showed inconsistent effects and require further evaluation. This review supports social skills plus BMT treatments as a child-focused intervention with probable efficacy for child externalizing problems. Implications for policy and community practice are discussed.

Keywords: Cognitive behavior therapy; Evidence-based treatment; Externalizing behavior; Parent training; Rapid evidence review; Social skills.

PubMed Disclaimer

References

    1. Aarons, G. A., Wells, R. S., Zagursky, K., Fettes, D. L., & Palinkas, L. A. (2009). Implementing Evidence-Based Practice in Community Mental Health Agencies: A Multiple Stakeholder Analysis. American Journal of Public Health, 99(11), 2087–2095. https://doi.org/10.2105/AJPH.2009.161711 - DOI - PubMed - PMC
    1. Abell, M. L., Fraser, M. W., & Galinsky, M. J. (2001). Early Intervention for Aggressive Behavior in Childhood: A Pilot Study of a Multi-Component Intervention with Elementary School Children and Their Families. Journal of Family Social Work, 6(4), 19–37. https://doi.org/10.1300/J039v06n04_03 - DOI
    1. Ahuja, S., & Saha, A. (2016). They Lead, You Follow: Role of Non-Directive Play Therapy in Building Resilience. Journal of Psychosocial Research, 11(1), 167–175.
    1. Augimeri, L. K., Farrington, D. P., Koegl, C. J., & Day, D. M. (2007). The SNAP™ Under 12 Outreach Project: Effects of a Community Based Program for Children with Conduct Problems. Journal of Child and Family Studies, 16(6), 799–807. https://doi.org/10.1007/s10826-006-9126-x - DOI
    1. Barnes, G., Wilkes-Gillan, S., Bundy, A., & Cordier, R. (2017). The social play, social skills and parent–child relationships of children with ADHD 12 months following a RCT of a play-based intervention. Australian Occupational Therapy Journal, 64(6), 457–465. https://doi.org/10.1111/1440-1630.12417 - DOI - PubMed

Publication types

LinkOut - more resources