Review

The clinical effectiveness of different parenting programmes for children with conduct problems: a systematic review of randomised controlled trials

Janine Dretzke¹ , Clare Davenport¹ , Emma Frew² , Jane Barlow³ , Sarah Stewart-Brown³ , Sue Bayliss¹ , Rod S Taylor⁴ , Josie Sandercock¹ and Chris Hyde¹

¹  Unit of Public Health, Epidemiology and Biostatistics, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK

²  Unit of Health Economics, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK

³  Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK

⁴  PenTAG, Institute for Health Services Research, Peninsula Medical School, Noy Scott House, Royal Devon and Exeter Hospital, Exeter EX2 5DW, UK

author email corresponding author email

Child and Adolescent Psychiatry and Mental Health 2009, 3:7doi:10.1186/1753-2000-3-7

Published:	4 March 2009

Abstract

Background

Conduct problems are common, disabling and costly. The prognosis for children with conduct problems is poor, with outcomes in adulthood including criminal behaviour, alcoholism, drug abuse, domestic violence, child abuse and a range of psychiatric disorders.

There has been a rapid expansion of group based parent-training programmes for the treatment of children with conduct problems in a number of countries over the past 10 years. Existing reviews of parent training have methodological limitations such as inclusion of non-randomised studies, the absence of investigation for heterogeneity prior to meta-analysis or failure to report confidence intervals.

The objective of the current study was to systematically review randomised controlled trials of parenting programmes for the treatment of children with conduct problems.

Methods

Standard systematic review methods were followed including duplicate inclusion decisions, data extraction and quality assessment. Twenty electronic databases from the fields of medicine, psychology, social science and education were comprehensively searched for RCTs and systematic reviews to February 2006.

Inclusion criteria were: randomised controlled trial; of structured, repeatable parenting programmes; for parents/carers of children up to the age of 18 with a conduct problem; and at least one measure of child behaviour. Meta-analysis and qualitative synthesis were used to summarise included studies.

Results

57 RCTs were included. Studies were small with an average group size of 21. Meta-analyses using both parent (SMD -0.67; 95% CI: -0.91, -0.42) and independent (SMD -0.44; 95% CI: -0.66, -0.23) reports of outcome showed significant differences favouring the intervention group. There was insufficient evidence to determine the relative effectiveness of different approaches to delivering parenting programmes.

Conclusion

Parenting programmes are an effective treatment for children with conduct problems. The relative effectiveness of different parenting programmes requires further research.