Evaluating the impact of parent/caregiver behavioral health interventions on child outcomes
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[EMBARGOED UNTIL 08/01/2026] When parents experience behavioral health (BH) problems including psychiatric disorders, problematic substance use, adjustment difficulties, and marital or interparental dysfunction, their children are more likely to experience a wide range of adverse outcomes. It may often be assumed that treating parents’ BH problems will reduce these intergenerational risks, but strong evidence to support this assumption has been lacking. Previous reviews investigating the impact of parent-focused BH interventions on children have been limited in scope and have not produced robust or generalizable conclusions. The current project sought to overcome these limitations by conducting a series of two broad-based reviews, a scoping review and a meta-analysis, integrating findings from primary research that has tested interventions for the full spectrum of parent BH problems and full range of relevant child outcomes. The scoping review was conducted first to identify and describe the available body of evidence and guide design of the subsequent meta-analysis. Included studies were 42 published, peer-reviewed randomized controlled trials (RCTs) that tested 45 unique parent-focused BH interventions in an experimentally-isolated manner and reported at least one child outcome. All studies included in the scoping review were also included in the meta-analysis. Results indicated that interventions had a significant, beneficial mean effect on child outcomes (g = 0.16, 95% CI: [0.09-0.22], t(232) = 4.67, p < .0001), comparable in magnitude to effects that other common population health interventions have been found to have on distal outcomes. There was no association between intervention effects on parent BH outcomes and intervention effects on child outcomes (β = 0.065, 95% CI: [-0.096, 0.226], t(228) = 0.79, p = 0.429). Several other variables including characteristics of the study design, participant samples, interventions, and outcome measures were significantly associated with the magnitude of intervention effects on child outcomes. Overall, findings indicate that studied parent-focused BH interventions have beneficial impacts on the children of parents who receive them, but interventions targeting other risk and protective factors are also likely needed to fully mitigate adverse child outcomes associated with parent BH problems. The current evidence base predominantly consists of trials of interventions for pregnant or postpartum mothers with depression and/or anxiety. Additional research is needed to evaluate the generalizability of findings to other populations of parents and their children.
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Ph. D