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Parenting and child mental health

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      This paper reviews parenting programmes and their effectiveness with families of young children and highlights additional resources for primary care practitioners. Typically, 30% of GP consultations concern child behaviour problems and established behaviour problems can have lasting effects on children’s life chances. These problems can be identified in infancy and toddlerhood.Parenting is a key risk factor in their development and maintenance, yet is also amenable to change. In this paper we consider six parenting programmes that are widely evaluated and/or available in the U.K. and their evidence base . These include two NICE recommended parenting programmes ( Incredible Years and Triple P), which offer tiered and flexible parenting programmes; predominantly for parents of school-age children. We also review Parent– Infant Psychotherapy, which is typically for parents of younger children. Fourth is Family Nurse Partnership, an intensive programme to support young, first-time mothers. Finally we consider, video feedback programmes which use video to focus in detail on parents’ interactions with their children, including Video Feedback to Promote Positive Parenting and Video Interactive Guidance. These interventions demonstrate the range of approaches which are being used to intervene early in children’s lives to try to prevent the development of enduring behavioural problems.

      Why this matters to me

      It is becoming increasingly clear that the origins of many mental health problems lie in childhood. Family factors, including the quality of care that parents provide for their children, can make a huge difference to children’s early life pathways, for better or for worse. Understanding how best to intervene to support parents is a key challenge. In this article, we critically review the most widely used parenting programmes for parents of young children. It is imperative that we judge these early interventions to high standards so that we are offering children the best start in life.

      Key message

      Parenting programmes offer a means to intercept behaviour problems in early childhood before they become established.

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      Most cited references 74

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      Less is more: Meta-analyses of sensitivity and attachment interventions in early childhood.

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        The Triple P-Positive Parenting Program: a systematic review and meta-analysis of a multi-level system of parenting support.

        This systematic review and meta-analysis examined the effects of the multilevel Triple P-Positive Parenting Program system on a broad range of child, parent and family outcomes. Multiple search strategies identified 116 eligible studies conducted over a 33-year period, with 101 studies comprising 16,099 families analyzed quantitatively. Moderator analyses were conducted using structural equation modeling. Risk of bias within and across studies was assessed. Significant short-term effects were found for: children's social, emotional and behavioral outcomes (d=0.473); parenting practices (d=0.578); parenting satisfaction and efficacy (d=0.519); parental adjustment (d=0.340); parental relationship (d=0.225) and child observational data (d=0.501). Significant effects were found for all outcomes at long-term including parent observational data (d=0.249). Moderator analyses found that study approach, study power, Triple P level, and severity of initial child problems produced significant effects in multiple moderator models when controlling for other significant moderators. Several putative moderators did not have significant effects after controlling for other significant moderators. The positive results for each level of the Triple P system provide empirical support for a blending of universal and targeted parenting interventions to promote child, parent and family wellbeing. Copyright © 2014 Elsevier Ltd. All rights reserved.
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          Trajectories leading to school-age conduct problems.

          The present study applied a semiparametric mixture model to a sample of 284 low-income boys to model developmental trajectories of overt conduct problems from ages 2 to 8. As in research on older children, 4 developmental trajectories were identified: a persistent problem trajectory, a high-level desister trajectory, a moderate-level desister trajectory, and a persistent low trajectory. Follow-up analyses indicated that initially high and low groups were differentiated in early childhood by high child fearlessness and elevated maternal depressive symptomatology. Persistent problem and high desister trajectories were differentiated by high child fearlessness and maternal rejecting parenting. The implications of the results for early intervention research are discussed, with an emphasis on the identification of at-risk parent-child dyads.

            Author and article information

            [a ]The Centre for Psychiatry, Department of Medicine, Imperial College London, London, UK
            [b ]Central and North West London (CNWL) Foundation NHS Trust, London, UK
            Author notes
            Corresponding author. Email: p.ramchandani@
            London J Prim Care (Abingdon)
            London J Prim Care (Abingdon)
            London Journal of Primary Care
            Taylor & Francis
            November 2017
            10 August 2017
            : 9
            : 6
            : 86-94
            5694794 tlpc-9-86 10.1080/17571472.2017.1361630
            © 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group

            This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.



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