Individual and Group-Based Parenting Programmes for the Treatment of Physical Child Abuse and Neglect

Division of Health in the Community, Warwick Medical School, Dept of Public Health and Epidemiology, 108 Medical School Building, Gibbett Hill Campus, University of Warwick, Coventry, UK CV4 7AL.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 02/2006; 3(3):CD005463. DOI: 10.1002/14651858.CD005463.pub2
Source: PubMed


Physical abuse and neglect of children are significant problems and changing parenting practices may be an important means of addressing them. This review examines the extent to which parenting programmes (relatively brief and structured interventions that are aimed at changing parenting practices) are effective in treating physically abusive or neglectful parenting. A total of seven studies of mixed quality were included in the review. The findings show that there is insufficient evidence to support the use of parenting programmes to reduce physical abuse or neglect (i.e. using objective assessments of abuse such as reports of child abuse; children on the children protection register etc). There is, however, limited evidence to show that some parenting programmes may be effective in improving some outcomes that are associated with physically abusive parenting. There is an urgent need for further rigorous evaluation of the effectiveness of parenting programmes that are specifically designed to treat physical abuse and neglect, either independently or as part of broader packages of care.

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    • "Thus, we argue that parenting interventions are vital for preventing violence both against and by children, and our review focuses on parenting for both intersecting purposes. The substantial literature on parenting interventions, with many high-quality trials and systematic reviews (Barlow et al. 2006; Furlong et al. 2012; Piquero et al. 2008), comes from high-income countries, and includes many studies that target low-income families and diverse cultural groups. The evidence suggests that effective parenting interventions are potentially adaptable and applicable across cultures, countries and income groups (Kumpfer et al. 2008; Leung et al. 2003; Martinez and Eddy 2005; Matsumoto et al. 2010; Reid et al. 2001). "
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    ABSTRACT: Family and youth violence are increasingly recognized as key public health issues in developing countries. Parenting interventions form an important evidence-based strategy for preventing violence, both against and by children, yet most rigorous trials of parenting interventions have been conducted in high-income countries, with far fewer in low- and middle-income countries (LMICs). This systematic review, conducted in line with Cochrane Handbook guidelines, investigated the effectiveness of parenting interventions for reducing harsh/abusive parenting, increasing positive parenting practices, and improving parent-child relationships in LMICs. Attitudes and knowledge were examined as secondary outcomes. A range of databases were systematically searched, and randomized trials included. High heterogeneity precluded meta-analysis, but characteristics of included studies were described according to type of delivery mode and outcome. Twelve studies with 1580 parents in nine countries reported results favoring intervention on a range of parenting measures. The validity of results for most studies is unclear due to substantial or unclear risks of bias. However, findings from the two largest, highest-quality trials suggest parenting interventions may be feasible and effective in improving parent-child interaction and parental knowledge in relation to child development in LMICs, and therefore may be instrumental in addressing prevention of child maltreatment in these settings. Given the well-established evidence base for parenting interventions in high-income countries, and increasingly good evidence for their applicability across cultures and countries, there is now an urgent need for more rigorously evaluated and reported studies, focusing on youth outcomes as well as parenting, adapted for contexts of considerable resource constraints.
    Full-text · Article · Jan 2013 · Prevention Science
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    • "Cependant, certaines familles n'ont pas la chance de bénéficier de ces programmes préventifs ou n'en tirent pas les bénéfices escomptés. Pour ces parents, il devient particulièrement difficile de modifier leur réponse aux besoins développementaux de leur enfant une fois que la négligence s'est installée, comme le démontre l'échec des programmes actuels à produire des résultats signifiants avec ces familles (Allin et al., 2005; Barlow et al.; 2006, MacMillan et al., 2009). Cette situation soulève l'importance de reconsidérer la façon d'évaluer certaines interventions afin de mieux comprendre quelles conditions sont nécessaires pour faire une différence dans la vie de ces enfants et de leurs parents. "
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    ABSTRACT: Aucun consensus clair n'a encore été établi quant à l'efficacité des programmes en négligence. Le présent article propose différents éléments à considérer dans l'évaluation de ces programmes. D'abord, l'évaluation doit documenter plusieurs changements intermédiaires, la négligence étant une problématique écosysté-mique bien plus que parentale. Ensuite, l'aspect personnalisé et multimodal des interventions commande une évaluation de la fidélité de l'implantation. De plus, l'évaluation doit renseigner sur les facteurs qui soutiennent l'implantation, le maintien, et la diffusion de l'intervention. Enfin, l'évaluation doit porter sur les retombées perçues par une variété d'acteurs afin d'établir un portrait des répercussions directes et indirectes de l'intervention. Abstract: There is as yet no clear consensus about the effectiveness of interventions targetting child neglect. This article presents proposals for what to consider when evaluating those programs. First of all, child neglect is more an ecosystemic than a parental problem. An evaluation should therefore focus on changes within and outside the family. The individualized, multimodal nature of the programs makes an implementation fidelity evaluation necessary. Further, the evaluation should examine the factors that support the implementation, sustainability, and distribution of the program. Finally, an evaluation must be based on the
    Full-text · Article · Jan 2013 · Canadian Journal of Program Evaluation
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    • "The broad term 'child abuse' was used, in combination with specifi c limits in each database designed to identify RCTs (and clinical trials generally ). In addition, the reference lists of recent systematic reviews were searched to identify additional RCTs (Allin et al., 2005; Barlow et al., 2006; Lundahl et al., 2006; MacLeod and Nelson, 2000). Full details of all search strategies are available from the authors. "
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    ABSTRACT: Despite the significant financial and human resources invested in child protection services (CPS), it is unknown whether these services are effective in preventing recurrence of child physical abuse and neglect. This paper reviews available studies evaluating the effectiveness of these interventions and identifies methodological limitations and factors that may contribute to these limitations. We searched databases to identify randomised controlled trials published in peer-reviewed journals in the past five decades that evaluated interventions to reduce recurrence of physical abuse and neglect. We outlined ten methodological standards that are important for rigorous testing of psychosocial interventions and applied them in critically appraising identified studies. Thirteen randomised controlled trials were reviewed. This review identified methodological limitations (e.g. small sample size, lack of standardisations, contamination) that made it difficult to draw reliable conclusions as to the effectiveness of interventions. Field-specific factors that contributed to methodological limitations (e.g. heterogeneity of sample, multiple family problems, psychosocial nature of interventions) were identified and recommendations were provided for improvement. It was concluded that it is possible to implement high-quality trials that are ethical and feasible in the child welfare field. Copyright
    Full-text · Article · Jan 2010 · Child Abuse Review
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