Research Review: Harnessing the power of individual participant data in a meta-analysis of the benefits and harms of the Incredible Years parenting program
Parenting programs aim to reduce children's conduct problems through improvement of family dynamics. To date, research on the precise benefits and possible harms of parenting programs on family well-being has been unsystematic and likely to be subject to selective outcome reporting and publication bias. Better understanding of program benefits and harms requires full disclosure by researchers of all included measures, and large enough numbers of participants to be able to detect small effects and estimate them precisely.
We obtained individual participant data for 14 of 15 randomized controlled trials on the Incredible Years parenting program in Europe (total N = 1,799). We used multilevel modeling to estimate program effects on 13 parent-reported outcomes, including parenting practices, children's mental health, and parental mental health.
Parental use of praise, corporal punishment, threats, and shouting improved, while parental use of tangible rewards, monitoring, or laxness did not. Children's conduct problems and attention deficit hyperactivity disorder (ADHD) symptoms improved, while emotional problems did not. Parental mental health (depressive symptoms, self-efficacy, and stress) did not improve. There was no evidence of harmful effects.
The Incredible Years parenting program improves the aspects of family well-being that it is primarily designed to improve: parenting and children's conduct problems. It also improves parent-reported ADHD symptoms in children. Wider benefits are limited: the program does not improve children's emotional problems or parental mental health. There are no signs of harm on any of the target outcomes.
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Appendix S1. Data Harmonizing Procedures.
Appendix S2. Available Data for Each Outcome per Trial.
Appendix S3. Items Included in Each of the Self-reported Parenting Practices Constructs.
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- 1995). Parenting Stress Index, 3rd ed. Odessa, FL: Psychological Assessment Resources.
- 1991). Manual for the Child Behavior Checklist/4-18 and 1991 profile. Burlington, VT: Department of Psychiatry, University of Vermont.
- 1993). The Parenting Scale: A measure of dysfunctional parenting in discipline situations. Psychological Assessment, 5, 137–144.
- 2012). Evaluation of “The Incredible Years” in Sweden: The transferability of an American parent-training program to Sweden. Scandinavian Journal of Psychology, 53, 224–232.
- 2013). The Incredible Years Basic Parent Training for Portuguese preschoolers with AD/HD behaviours: Does it make a difference? Child & Youth Care Forum, 42, 403–424.
- 2014). Group-based parent training programmes for improving parental psychosocial health. Cochrane Database of Systematic Reviews, 1–156.
- 1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.
- 2015). ‘Dark logic’: Theorising the harmful consequences of public health interventions. Journal of Epidemiology and Community Health, 69, 95–98.
- Conduct Problems Prevention Research Group (1996). Parenting Practices Inventory. Unpublished document. Seattle, WA: University of Washington.
- 2016). Improving transparency and reproducibility through registration: The status of intervention trials published in clinical psychology journals. Journal of Consulting and Clinical Psychology, 84, 753–767.
- 1982). The Brief Symptom Inventory: Administration, scoring and procedures manual 1. Baltimore, MD: Clinical Psychometrics Research.
- 2008). Systematic review of the empirical evidence of study publication bias and outcome reporting bias. PLoS ONE, 3, e3081.
- 1978). Assessment of child behavior problems: The validation of a new inventory. Journal of Clinical Child Psychology, 7, 113–116.
- 2012). The Incredible Years Parenting program in Ireland: A qualitative analysis of the experience of disadvantaged parents. Clinical Child Psychology and Psychiatry, 17, 616–630.
- 2012). Behavioral and cognitive-behavioural group-based parenting interventions for early-onset conduct problems in children age 3-12 years. Cochrane Database of Systematic Reviews, 1–240.
- 2006). Randomised controlled trial of a parenting intervention in the voluntary sector for reducing child conduct problems: Outcomes and mechanisms of change. Journal of Child Psychology and Psychiatry, 47, 1123–1132.
- 2002). Family-based treatment of childhood anxiety disorders. International Review of Psychiatry, 14, 143–154.
- 1997). The Strengths and Difficulties Questionnaire: A research note. Journal of Child Psychology and Psychiatry, 38, 581–586.
- 2009). Efficacy of the Chicago Parent Program with low-income African American and Latino parents of young children. Prevention Science, 10, 54–65.
- 1992). Externalizing behavior problems and academic underachievement in childhood and adolescence: Causal relationships and underlying mechanisms. Psychological Bulletin, 111, 127–155.
- 2007). Parenting intervention in Sure Start services for children at risk of developing conduct disorder: Pragmatic randomised controlled trial. British Medical Journal, 334, 678–682.
- 2017). Evaluating the Incredible Years Toddler Parenting Programme with parents of toddlers in disadvantaged (Flying Start) areas of Wales. Child: Care, Health and Development, 43, 104–113.
- 1989). A measure of parenting satisfaction and efficacy. Journal of Clinical Child Psychology, 18, 167–175.
- 2007). Efficacy of the Incredible Years Basic Parent Training Programme as an early intervention for children with conduct disorder and ADHD. Child: Care, Health and Development, 33, 749–756.
- 2016). Distilling common history and practice elements to inform dissemination: Hanf-model BPT programs as an example. Clinical Child and Family Psychology Review, 19, 236–258.
- 2009). Treatment of oppositional defiant and conduct problems in young Norwegian children: Results of a randomized controlled trial. European Child & Adolescent Psychiatry, 18, 42–52.
- 2016). Transported versus homegrown parenting interventions for reducing disruptive child behavior: A multilevel meta-regression study. Journal of the American Academy of Child and Adolescent Psychiatry, 55, 233–243.
- 2017). Effectiveness of the Incredible Years parenting intervention for families with socioeconomically disadvantaged and ethnic minority backgrounds. Journal of Clinical Child and Adolescent Psychology, 46, 59–73.
- 2015). Externalizing and internalizing comorbidity. In T.P. Beauchaine & S.P. Hinshaw (Eds.), The Oxford handbook of externalizing spectrum disorders (pp. 443–460). Oxford: Oxford University Press.
- 2008). Systematic reviews and meta-analysis. Oxford: Oxford University Press.
- 2012). A parenting intervention for childhood behavioral problems: A randomised controlled trial in disadvantaged community-based settings. Journal of Consulting and Clinical Psychology, 80, 116–127.
- 2012). Parent psychopathology and offspring mental disorders: Results from the WHO World Mental Health Surveys. The British Journal of Psychiatry, 200, 290–299.
- 2013). Effectiveness of the Incredible Years parent training to modify disruptive and prosocial child behavior: A meta-analytic review. Clinical Psychology Review, 33, 901–913.
- 2014). A trial of parent training for mothers being released from incarceration and their children. Journal of Clinical Child & Adolescent Psychology, 43, 381–396.
- 2017). The effectiveness of the Incredible Years pre-school parenting programme in the United Kingdom: A pragmatic randomised controlled trial. Child Care in Practice, 23, 141–161.
- National Collaborating Centre for Mental Health (2009). Attention deficit hyperactivity disorder: Diagnosis and management of ADHD in children, young people and adults. London: The Royal College of Psychiatrists and The British Psychological Society.
- 2002). Improving mental health through parenting programmes: Block randomised controlled trial. Archives of Disease in Childhood, 87, 472–477.
- 2016). Effectiveness of a nurse-led intensive home-visitation programme for first-time teenage mothers (Building Blocks): A pragmatic randomised controlled trial. The Lancet, 387, 146–155.
- 2012). Parenting quality and children's mental health: Biological mechanisms and psychological interventions. Current Opinion in Psychiatry, 25, 301–306.
- 2010). Impact of a parenting program in a high-risk, multi-ethnic community: The PALS trial. Journal of Child Psychology and Psychiatry, 51, 1331–1341.
- 2001). Multicentre controlled trial of parenting groups for childhood antisocial behaviour in clinical practice. British Medical Journal, 323, 194–198.
- 2013). Which type of parenting programme best improves child behaviour and reading? The Helping Children Achieve trial. Follow-up of the helping children achieve trial. London: Nuffield Foundation.
- 2010). Randomised controlled trial of parent groups for child antisocial behaviour targeting multiple risk factors: The SPOKES project. Journal of Child Psychology and Psychiatry, 51, 48–57.
- 2016). Psychotherapies should be assessed for both benefit and harm. The British Journal of Psychiatry, 208, 208–209.
- 1996). Assessment of parenting practices in families of elementary school-age children. Journal of Clinical Child Psychology, 25, 317–329.
- 2013). Nonpharmacological interventions for ADHD: Systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. American Journal of Psychiatry, 170, 275–289.
- 2015). Preferred reporting items for a systematic review and meta-analysis of individual participant data: The PRISMA-IPD statement. JAMA, 313, 1657–1665.
- 1986). Conduct disorder and hyperactivity: I. Separation of hyperactivity and antisocial conduct in British child psychiatric patients. The British Journal of Psychiatry, 149, 760–767.
- 2008). The impact of parent behavior-management training on child depressive symptoms. Journal of Counseling Psychology, 55, 473–484.
- 2010). The Incredible Years Parents, Teachers, and Children Training Series: A multifaceted treatment approach for children with conduct disorders. In J.R. Weisz & A.E. Kazdin (Eds.), Evidence-based psychotherapies for children and adolescents (pp. 194–210). New York: Guilford Press.
- 2010). Evidence-based psychotherapies for children and adolescents, 2nd ed.. New York, NY: Guildford Press.
- 1988). A user's guide to the General Health Questionnaire. Berkshire: NFER, Nelson.
Note. References marked with an asterisk indicate studies included in the IPD meta-analysis.