Parent training programs for preventing and treating antisocial behavior in children and adolescents: A comprehensive meta-analysis of international studies

This article presents a comprehensive meta-analysis of international studies on the effects of parent training programs (PTP) on antisocial behavior (ASB) in children and adolescents. From systematic literature searches of 7219 reports, we finally selected 239 eligible reports with 241 independent studies and 279 comparisons be-tween a program and a control condition up to the publication year 2020. Although most interventions were based on a cognitive-behavioral approach, we also found a great variety of programs and applications. Overall, the mean effect for PTP was positive for parent/family and ASB outcomes (d = 0.46 and d = 0.47, respectively using the random effect model at postintervention). We also found higher effects on more proximal parental outcomes such as parental stress, parental competencies, and parent-child interaction/relation. However, more distal outcomes such as marital satisfaction or parent psychopathology revealed lower effect sizes. In addition, the link between changes in parental/family outcomes and changes in ASB was significant across several outcome types, thus confirming the general causal assumption of PTP. Postintervention effects were stable across several moderators, although clinical applications revealed slightly higher effect sizes than preventive applica-tions. Several findings cast some doubt on these generally positive results: For example, effect sizes decreased considerably in not only short-(3 to 12 months) but also especially long-term follow ups (12 months or more), and the vast majority of outcome assessments stemmed from parent ratings. Finally, we found a clear negative connection between sample and effect size. Whether this is due to publication bias or indicates a better imple-mentation quality in smaller studies remains an open question.