The effect of relationship-based interventions for maltreated children and adolescents: a systematic review and meta-analysis

Abstract

Child maltreatment is characterized by a harmful relational environment which can have negative cascading consequences for the child’s development. Relationship-based interventions may improve maltreated children’s functioning by addressing key aspects of the parent-child relationship at various stages of development. The objective of the current study was to perform a systematic review on relationship-based interventions for maltreated children and a meta-analysis on the impact of these interventions on observed parent-child relational behavior. Data collection consisted of a comprehensive literature search in six databases and contacting experts in the field and hand searching relevant publications. In total, 5,802 abstracts were screened, of which 81 relevant publications were identified, representing 4,526 participants. The meta-analysis found large improvements in observed parent interactive behavior (g = 0.888), smaller improvements in child attachment (g = 0.403) and child interactive behavior (g = 0.274). The effect on parent interactive behavior was larger in interventions addressing middle childhood. Risk of bias assessments showed that a large number of studies suffer from poor reporting, which limits the conclusions of the findings. Future research should examine parent-child relationship behavior across multiple developmental stages, as well as the impact of developmentally appropriate intervention elements on maltreated children.

Universal Digital Programs for Promoting Mental and Relational Health for Parents of Young Children: A Systematic Review and Meta‐Analysis

“…Notably, no digital programs focused primarily on strengthening the parent-child relationship, and few studies evaluated program impacts on parent-child interaction, despite the health of this relationship being seminal to the future mental health and well-being of both generations. This highlights an important gap in knowledge and practice in universal parenting programs, and is in stark contrast to significant research investments in relational health in high-risk populations (Bergsund et al, 2021). It may be that universal relational programs have been examined in less depth, due to the perceived non-critical nature of these dyads.…”

“…The dearth of universal programs focused primarily on strengthening the parent-child relationship is of concern, given health economic evidence highlighting the centrality of this relationship to the well-being of both generations, and the importance of early intervention (Heckman, 2012). This underscores an important gap in knowledge and practice in universal parenting programs, in contrast to significant research investments in relational health in high-risk populations (selective prevention, indicated prevention, and treatment programs) (Bergsund et al, 2021). Finally, there is a lack of clarity in program evaluation and what a robust approach should include before public dissemination (e.g., relational assessment looking at attachment outcomes, interactional quality using observational measures, and longitudinal child development including socioemotional functioning).…”

Principles, policies, and practices: Thoughts on their integration over the rise of the developmental psychopathology perspective and into the future

“…Notably, there are indications that in our current decade, researchers are taking up the mantle. In 2023, for instance, in the most recent volume of the journal (Volume 35), we counted eight articles that included a focus on intervention effects, including two meta-analyses (Bergsund et al, 2023;Van IJzendoorn et al, 2023).…”

Preventing child welfare reinvolvement: The efficacy of the Reminiscing and Emotion Training intervention

“…There are several reasons relational interventions for child maltreatment warrant attention. Microsystem-level parenting processes are proximal to the child, relative to processes at other ecological levels, and they are also malleable targets for prevention programs (Valentino, 2017) one recent meta-analysis demonstrated that relationship-based interventions for maltreated children are associated with large improvements in observed parent interactive behavior (Bergsund et al, 2021). Furthermore, since many victims of child maltreatment remain in or eventually return to their family homes after child welfare investigations, it is important for programs to treat the parent-child relationship and enhance parent-child relational behavior to ensure children's ongoing safety and security (Valentino, 2017).…”