Evaluating the effectiveness of parent training to improve outcomes for young children: A meta-analytic review of the published research.

摘要

Parent training has been frequently touted as a measure to reduce such problems as aggression, and child abuse and neglect, as well as to enhance developmental outcomes for all children, not just those at risk for future problems or those with identified problems. The preschool years have been targeted as an opportune juncture at which to train parents insofar as parents still wield much influence and problems may be resolved before becoming entrenched. However, despite the availability of a large number of parent training studies, few conclusions have been reached regarding the basic question, "What works for whom, when?".; This meta-analysis evaluated the effectiveness of parent training for children between the ages two and five as a means to enhance child outcomes and examined variables related to the differential impact of parent training. 140 effects (106 controlled, 34 single group) from 94 studies were compiled. The overall mean effect of parent training (effect size = 0.51) was positive and highly significant. Effects were maintained at approximately one year (12.6 months on average) followup (effect size = 0.52). Greater effects were found for stand-alone PT programs and for programs with very low levels of attrition. When outcomes were limited to parent reports of child externalizing behaviour, better effects were found for: (1) referred, as opposed to community samples, (2) individual, as opposed to group formatted programs, and, (3) children identified with externalizing behaviour problems as opposed to children with no identified problem. Mixed findings emerged when type of sample was considered, such that indicated samples obtained better outcomes than selective samples on parent reports of externalizing behaviour but significantly worse outcomes on cognitive/language measures. When the theoretical orientation of programs was considered, there was no evidence of differential effectiveness. Various instructional techniques used in parent training were not differentially effective, with the exception of some evidence of enhanced effect when a "bug-in-the-ear" device was used. This meta-analysis strengthens conclusions in the current literature, and extends our understanding of theoretically and/or clinically relevant variables associated with effective parent training.