When you seek out a doctor for yourself or your child, odds are, you’d like your doctor to be basing their interventions on research and evidence that has been validated in the field. Knowing that your doctor has surveyed the options for treatment and has chosen to proceed in a particular way because the research and knowledge available tells them that it will provide the best outcome is reassuring.
At The Baker Center, we pride ourselves on making treatment plan decisions based on the individual child, family culture, and the research that is available to us. Parent-based interventions for child and adolescent mental health are often surprising recommendations to families, but are highly supported by research, and we know that the approach works. Here’s how:
A study by Champion et al. (2022), examined the effectiveness of parent-based interventions on different kinds of risky behaviors in teens through a large review of available research. The study included many different treatment programs that target risk behaviors including alcohol and tobacco use, sexual risk behavior, unhealthy diet, physical activity, and screen time. Across the seven treatment programs that were included, there were some shared techniques: problem solving and goal setting, parental modeling and reinforcement, information on health consequences for the whole family, and social support and motivational strategies. The analysis overall found that parent-based interventions led to significant improvements in physical activity, reduced screentime, and lower unhealthy food intake. These parent-based interventions were found to be effective because they found that parenting practices, like rule-setting, modeling behaviors, and support, are strongly linked to adolescent behaviors. The interventions that empowered parents to enforce healthy practices, like screentime limits or bedtimes, resulted in enhancements of both child and parent health behaviors, creating family wide benefits. This parental modeling and inclusion in the change model was compounded by the information that youth were more likely to adopt healthy behaviors when parents provided emotional and practical support in the intervention process. We often think of parent-based interventions as useful for little kids, but they are undeniably effective beyond early childhood. This study shows strong evidence that parent-based interventions are profoundly effective and impactful for teenagers and interventions that directly involved parents in treatment were more likely to show significant improvements in outcome than youth-only models.
A study by Dekkers et al. (2022), provides more specific insight to the effectiveness of parent-based interventions for children with ADHD. This paper examines several parenting interventions and their treatment programs, some of which vary in their content focus, delivery methods, or theoretical frameworks, but all of which require parental involvement. While they are different, there are some core common techniques delivered in most interventions including: helping parents set up situations to reduce misbehavior, reinforcement of desirable behaviors, consistent consequences for misbehavior, caregiver stress management, communication and relationship building skills, and homework assignments for the family to practice skills. The results of this meta-analysis supported that behavioral parent training programs are effective first-line treatments for managing ADHD symptoms, achieved by modifying parental behavior. It supports that following parenting interventions, decreases in harsh or inconsistent discipline leads to better ADHD outcomes, and parents increased feelings of effectiveness and reduced feelings of stress are consistently linked with child improvement. In addition, the greatest improvements in ADHD outcomes were observed when interventions targeted pre-school aged children, emphasizing the importance of early intervention. The study also supported that parent training results in greater parent-child relationship quality, and greater parental well-being. With the evidence presented in this study, we can be confident that parent-based interventions are strong recommendations to give when the goal is to manage ADHD symptoms.
In a more recent study by Helander et al. (2024), the researchers examined the effectiveness of parent management training (PMT and PCIT) with or without the child’s involvement, and the outcomes for children with clinical levels of disruptive behavior. The results of the analyses supported that parent management training significantly reduces disruptive behavior, increases use of positive discipline techniques, and reduces the use of harsh or negative disciplines. These changes are related to improved child behavior and social functioning. The analysis also found that Parent-Child Interaction therapy (PCIT, developed for use with children ages 2-7), saw even stronger effects than parent management training with older children. Both PMT and PCIT led to improved relationship quality, reduced parental stress, and increased parental competence and confidence. PMT, if done traditionally, does not always involve the child, and even without child involvement the study found the approach to be highly effective. This highlights the impact of changing parenting behaviors alone to improve child outcomes.
Research from 2019, by Leijten et al., analyzed 150 randomized control trials of parent-based interventions and found that they were consistently effective in reducing disruptive behaviors like aggression, defiance, and conduct problems in children. The most common components across these treatments were focusing on increasing positive parent-child interactions, teaching consistent discipline strategies, and improving parental supervision. The study found that these components were more effective than programs that focused on only child behavior.
There is also research to support the use of parent-based interventions for children who struggle with different challenges, like anxiety. In 2020, Lebowitz et al., published a study evaluating if the Supportive Parenting for Anxious Childhood Emotions (SPACE) treatment, a parenting-based approach, was as effective as traditional cognitive behavioral therapy for children with anxiety. The results found that SPACE was just as effective as child focused therapies in reducing anxiety symptoms in children. SPACE works directly with caregivers to reduce accommodation for anxiety within the family that unintentionally reinforces anxiety behaviors, to encourage brave behaviors, and to teach caregivers how to support their anxious child in overwhelming moments through supportive statements and labeled praise. SPACE was found to be consistently effective without any therapist-child contact, highlighting the power that parent influence can have on child outcomes. This approach is useful when children might be resistant to treatment or unable to participate. The major takeaway from this study is that a parent-based approach for child anxiety treatment is just as strong as a child-based approach and even introduces additional benefits for the family that can maintain the effects of treatment through a supportive environment shaped by caregivers.
The research clearly displays to mental health professionals that parenting-based interventions are consistently effective and help facilitate the outcomes that we want to see for families and children, whether we are targeting risky behaviors, disruptive behaviors, ADHD, or anxiety.
Champion et al. (2022) tells us that parent-based interventions are very effective, even for teenagers. Parental role-modeling and rule-setting plays a large role in the treatment of a child’s mental health.
Dekkers et al. (2022) informs us that parent-based interventions are the first-line recommended treatment for managing ADHD symptoms for children and teens and are more effective than child-only approaches. An added benefit is that the whole family sees positive effects of parent-based interventions, including greater parental well-being and more positive parent-child relationships.
Helander et al. (2024) supports the same conclusions and emphasizes that early parent-based interventions have potential to be the most effective approach. Even so, parent-based interventions done later in a child’s life show strong effectiveness.
Leijten et al. (2019), displays the effectiveness of parent-based interventions for anxiety, showing that they have just as much influence as child-based interventions and have benefits for parents.
Although traditional psychotherapy and many clinicians and providers gravitate to individual therapy, there is a strong and growing body of evidence that parent-based interventions are as effective, and sometimes even more effective than individual approaches. If you've been in treatment that has felt stalled or hasn't worked, perhaps it is time to try a more parent-focused intervention. If you have a provider recommending parenting work, though it might seem odd and you might be confused why they are not as heavily involving your child, it is because they are using best treatment recommendations to help you address the problem as quickly and effectively as possible.
Taking the approach that is most likely to deliver benefits for you and your child is key to effective mental health treatment. If that is a parent-based approach, not only will your child thrive with supportive parents who have received evidence-based information on how to most accurately address their needs, but also, caregivers' relationships and quality of life has the potential to flourish.
Want to learn more?
- Watch our Behavioral Parent Training webinar
- Read Why Do Mental Health Experts Recommend Parent-Based Interventions?
- Contact us