Practice Profile: Parent Training Programs for Juvenile Antisocial Behavior

Evidence Rating for Outcomes

Juvenile Problem Behaviors or At-Risk Behaviors | Other Problem Behaviors

Juvenile Problem Behaviors or At-Risk Behaviors | Other problem behaviors

Crime/Delinquency | Multiple crime/delinquency types

Juvenile Problem Behaviors or At-Risk Behaviors | Multiple juvenile problem behaviors or at-risk behavior

Family | Parenting skills

Family | Other Family

Family | Family functioning

Family | Other Family

Practice Goals

Up to 20 percent of children and adolescents exhibit antisocial behavior [e.g., aggression, violence, delinquency] at least once during their formative years (Beelmann et al. 2023). Antisocial behavior has implications in both the short-and long-term. In the short-term, antisocial behavior manifests on a spectrum ranging from disruptive conduct to violent and criminal behavior. In the long-term, when unaddressed, these behaviors are associated with diminished educational attainment, increased likelihood of unemployment, increased risk of alcohol and substance use disorders, and elevated levels of criminal activity, which can ultimately lead to incarceration. Antisocial behavior is also linked with higher rates of school dropout, hospitalization, and early mortality, as well as family instability and the intergenerational transmission of antisocial behavior (Beelmann et al. 2023; see also Farrington 2007; Moffitt 1993;).

In response, parent training programs have been developed and applied as a method to address antisocial behavior in youth. The overall goal of parent training programs is to prevent and reduce antisocial behavior in children and adolescents by promoting positive parenting skills and behaviors.

Practice Components

Parent training programs are curriculum- or manual-based interventions designed to enhance parenting skills and promote a positive parent-child relationship. For example, interventions might develop and strengthen skills such as providing age-appropriate supervision, positive reinforcement, emotional and social support, and non-aggressive limit setting. The programs might also instruct parents in how to perceive and adequately respond to a child’s verbal and nonverbal communication. Two parent training programs illustrative of this practice are The Incredible Years BASIC–Parent Training and Parent Child Interaction Therapy.

Incredible Years BASIC–Parent Training is a group-based program that fosters the use of positive parenting and behavior management strategies. During the group sessions, parents are shown video vignettes and asked by coaches to work together to problem-solve the scenarios, which cover a variety of topics (e.g., child-directed play, praise and rewards, effective limit setting). Parents are also guided to set weekly goals, practice parenting strategies at home, and have a weekly telephone call with another parent from their group (Little et al. 2012).

Parent Child Interaction Therapy is a two-phase training program that teaches parents to use positive interaction and discipline skills, thereby reducing children’s problem behaviors and parental physical abuse. Parents receive instruction and coaching on enhancing their relationship with their child, increasing positive interactions with their child, and giving their child specific commands, such as timeouts (Nixon et al. 2003).

As these two examples highlight, the features of parent training programs can vary regarding content, setting, format, and other modalities, but the programs focus on increasing positive parenting and relationship-building skills to reduce antisocial behavior in children and adolescents.

Practice Theory

Parent training programs are largely based on social learning theory, which maintains that parents and caregivers play a strong role in shaping children’s behavior. Social learning theory posits that children learn behaviors from their parents through observation, imitation, and modeling (Bandura 1969; Beelmann et al. 2023). For example, low parental supervision might lead a child to believe that there are no consequences for their misbehaviors. Parent training programs also use elements of coercive interaction theory, which holds that the relationship between child and parent is bidirectional. Thus, a parent scolding their child for misbehavior might cause the child to escalate their behavior, leading the parent to scold with more intensity and causing the cycle to repeat. Coercive interaction theory suggests that ineffective parent discipline in problem situations establishes a cycle of negative and forced interactions, which, over time, can lead to antisocial behavior (Granic and Patterson 2006; Patterson et al. 1992). Taken together, parent training programs leverage principles of social learning theory and coercive interaction theory to shape behavior in a constructive way with the overall goal of preventing and treating antisocial behavior (Beelman et al. 2023).

Juvenile Problem Behaviors or At-Risk Behaviors | Other Problem Behaviors

Analyzing the results across eight comparisons, Beelmann and colleagues (2023) found that parent training programs had a statistically significant effect on measures of oppositional/disruptive behavior in children and adolescents at the long-term follow-up (i.e., at greater than 12 months). These results suggest that parents who participated in a parent training program reported a greater reduction in their child’s oppositional/disruptive behavior at the long-term follow up, compared with parents in the control groups.

Juvenile Problem Behaviors or At-Risk Behaviors | Other problem behaviors

Examining the results across five comparisons, Beelmann and colleagues (2023) found no statistically significant differences on measures of aggressive behavior in children and adolescents at the long-term follow up (i.e., at greater than 12 months) between parents who participated in a parent training program and comparison-group parents.

Crime/Delinquency | Multiple crime/delinquency types

Analyzing the results across seven comparisons, Beelmann and colleagues (2023) found no statistically significant differences in measures of delinquent behavior in children and adolescents at the long-term follow up (i.e., at greater than 12 months) between parents who participated in a parent training program and comparison-group parents.

Juvenile Problem Behaviors or At-Risk Behaviors | Multiple juvenile problem behaviors or at-risk behavior

Examining the results across 32 comparisons, Beelmann and colleagues (2023) found that parent training programs had a statistically significant effect on measures of general antisocial behavior in children and adolescents at the long-term follow-up (i.e., at greater than 12 months). These results suggest that parents who participated in a parent training program reported a greater reduction in their child’s antisocial behavior at the long-term follow up compared with parents in the control groups.

Family | Parenting skills

Analyzing the results across 20 comparisons, Beelmann and colleagues (2023) found a statistically significant increase in measures of parental competence for parents at the long-term follow up (i.e., at greater than 12 months). These results suggest that parents who participated in a parent training program reported increased parental competence at the long-term follow up compared with parents in the control groups.

Family | Other Family

Examining the results across seven comparisons, Beelmann and colleagues (2023) found no statistically significant differences on measures of parental cognitions at the long-term follow up (i.e., at greater than 12 months) between parents who participated in a parent training program and comparison-group parents.

Family | Other Family

Analyzing the results across seven comparisons, Beelmann and colleagues (2023) found no statistically significant differences on measures of parental stress at the long-term follow up (i.e., at greater than 12 months) between parents who participated in a parent training program and comparison-group parents.

Family | Family functioning

Examining the results across 14 comparisons, Beelmann and colleagues (2023) found that parent training programs had a statistically significant effect on parent-child interaction/relation at the long-term follow-up (i.e., at greater than 12 months). These results suggest that parents who participated in a parent training program reported a greater increase in parent-child interaction/relation at the long-term follow up compared with parents in the control groups.

Family | Other Family

Analyzing the results across nine comparisons, Beelmann and colleagues (2023) found that parent training programs had a statistically significant effect on measures of aversive parental behavior at the long-term follow-up (i.e., at greater than 12 months). These results suggest that parents who participated in a parent training program reported a greater decrease in the use of aversive parental behavior at the long-term follow up, compared with parents in the control groups.

Family | Other Family

Examining the results across six comparisons, Beelmann and colleagues (2023) found no statistically significant differences on measures of parent relation/family quality at the long-term follow up (i.e., at greater than 12 months) between parents who participated in a parent training program and comparison-group parents.

Family | Other Family

Analyzing the results across four comparisons, Beelmann and colleagues (2023) found no statistically significant differences on measures of parental psychopathology at the long-term follow up (i.e., at greater than 12 months) between parents who participated in a parent training program and comparison-group parents.

Meta-Analysis Snapshot
	Literature Coverage Dates	Number of Studies	Number of Study Participants
Meta Analysis	1974-2019	241	0

Meta Analysis

Beelmann and colleagues (2023) conducted a meta-analysis to examine the effectiveness of parent training programs for antisocial behavior in children and adolescents. The research team searched for all published and unpublished studies, up to the year 2020, written in English or another main European language. To identify these studies, the meta-analysis authors conducted an electronic search in Google and Google Scholar, and in bibliographic databases such as PsycINFO, PsycARTICLES, Criminal Justice Abstracts, Web of Science, ERIC, PubMed, ProQuest Dissertations and Theses, and Cochrane Central Register of Controlled Trials (CENTRAL). The search categories included parent training, antisocial behavior, and effectiveness, as well as brand-name parent training programs (e.g., Parent Management Training, Triple P). Reference lists of systematically and nonsystematically identified articles were also examined for relevant studies.

Eligible studies included evaluations of parent training programs using randomized–controlled designs and quasi–experimental designs, with a minimum of two assessment points (pre-post) and in which participants were allocated to an experimental or comparison group. Comparison groups were untreated, treatment as usual, or service-as-usual groups. Comparison groups could not be an alternative program, an intensive treatment applied to more than 50 percent of the group and tested against parent training programs, or parent training programs delivered to a full treatment. Studies were excluded if the comparison group differed on more than one demographic factor at the pretest. To be included, both the parent training program treatment group and the comparison group had to have a minimum sample size of 10.

There were no restrictions on the intervention context, setting, and modalities. All samples were included as long as the intervention’s primary aim was to prevent and treat antisocial behavior in children and adolescents up to the average age was 18 or lower. Studies could also include interventions in which the child participated in the parent training. The target audience could be parents or anyone else currently raising the child. The intervention could target parents with no risk present (prevention approach), selective risk, or indicated risk. To be eligible for inclusion, the study had to contain at least one measure of antisocial behavior during at least one post-program assessment. Studies were excluded if the intervention was an open format or if the intervention primarily focused on promoting parent or family relationships. Studies were also excluded if the focus was on parenting skills related to physical care and nutrition within the first years of life or if the parent training program was tested in combination with other interventions.

Using these criteria, the authors identified 239 eligible research reports. They included 241 separate studies and 279 comparisons between the treatment condition and a control condition. Effect sizes were calculated for antisocial behavior outcomes (i.e., oppositional/disruptive behavior, aggressive behavior, delinquent behavior, and general antisocial behavior) and parent/family outcomes (i.e., parental competence, parent cognitions, parent stress, parent-child interaction/relation, aversive parental behavior, parent relation/family quality, and parental psychopathology). Outcomes could be measured across different assessments (e.g., behavioral ratings or observations), different informants (e.g., parents or teachers), and different follow-up periods. There were three follow-up periods: 1) post-intervention effects, which included measures up to 3 months after program termination; 2) short-term follow-up, which included measures between 3 and up to 12 months after program termination; and 3) long-term follow-up effects, which included measures more than 12 months after program termination (the CrimeSolutions review of the meta-analysis focused on the long-term follow-up effects). Nearly half of the comparisons were conducted in the United States, followed by Australia. Programs predominately targeted both parents and were delivered in a group format; however, they varied in intensity, setting, and facilitator.

The unbiased standardized mean differences from means and standard deviations of treatment and control groups or from test statistics were calculated. Pooled pre-test standard deviations were used to calculate effect sizes. Effect sizes were analyzed using a random effects model, weighting by the inverse of the squared standard error.