What evidence is there that parenting interventions reduce child abuse and neglect among maltreating families? A systematic review

Abstract

In families where child abuse and neglect have already occurred, there is a strong imperative to provide interventions that reduce or eliminate harm done to children. Parenting programs lack tailoring for the needs of maltreating parents, and maltreating parents themselves are a heterogeneous group with varying needs. The literature on the effectiveness of parenting interventions for high-risk parents is limited, and this scarcity of knowledge can result in child protection cases being treated as a natural experiment. For children who experience ongoing maltreatment by their parents, the most stringent test for effectiveness goes beyond an improvement in positive parenting skills—child abuse and neglect must reduce or be eliminated. The present review addressed the research question What evidence is there that parenting interventions conducted with parents who maltreat their children, reduce the incidence of further child maltreatment? Databases were searched for trials of parenting interventions where participants were maltreating parents and outcome data included an objective measure of child abuse and neglect. Nine studies satisfied the selection criteria and are summarized. Four studies reported a statistically significant difference between groups in favor of the intervention group for two parenting interventions, Parent–Child Interaction Therapy and SafeCare. However, the review concludes that none of the reviewed parenting interventions have been demonstrated to be effective at reducing all types of child maltreatment through a high-quality RCT. Previous research is compromised by several critical methodological limitations, including low participant recruitment and retention, and narrow selection criteria. Recommendations are offered for future research on parenting interventions that aim to reduce child abuse and neglect.

Using systemic interventions to reduce intimate partner violence or child maltreatment: A systematic review of publications between 2010 and 2019

“…Future research should examine the relative efficacy of different empirically supported programs with varying levels of family risk. Research in this area would be instrumental in informing stepped treatment decision making and in maximizing cost‐effectiveness of services (Whitcomb‐Dobbs & Tarren Sweeny, 2019). One aspect of this line of research might examine the relative effectiveness of treatment providers with different training levels.…”

“…A number of reviews on parenting prevention and intervention programs targeting child abuse and neglect have been published (e.g. Barlow et al, 2006; Chen & Chan, 2016; Euser et al, 2015; Whitcombe‐Dobbs & Tarren‐Sweeney, 2019). A majority of studies in these reviews are either focused on the prevention of child maltreatment, as opposed to treating families already exposed to maltreatment, or lack an objective outcome measure of child maltreatment recidivism.…”

“…Due to the high prevalence of child abuse and neglect (Stoltenborgh et al, 2015), it is critical that effective interventions be identified that reduce maltreatment recidivism in maltreating populations. Improving parenting skills is not sufficient unless child maltreatment re‐reports are substantially reduced (Witcombe‐Dobbs et al, 2019). Only a handful of papers before 2010 examine programs for maltreating families with maltreatment recidivism as an outcome.…”

Structures of Oppression in the U.S. Child Welfare System: Reflections on Administrative Barriers to Equity

“…Psychiatric assessment, as well as family, individual, and child therapy, are all common components of service plans [55]. While research empirically validates many of these approaches, it is less common for these interventions to be rigorously studied in child welfare populations or across cultures [56][57][58]. The use of "mis-cultured" psychological tools and assessments may not only be counteractive in providing genuine and effective family support and recommendations for (child welfare) system involved families, but can also dispense significant and consequential decisions that affect court-involved families [59].…”

Home-Based Parent–Child Interaction Therapy to Prevent Child Maltreatment: A Randomized Controlled Trial

“…In previous research, PCIT has been found to be effective in reducing further physical abuse in families where physical abuse was present [10,17]. So far, PCIT is not tailored for the specific needs of maltreating parents, and the current discussion in the literature is what this heterogeneous group actually needs to prevent, reduce, or eliminate child maltreatment [18,19]. Therefore, the question is to which degree the improvement of positive parenting skills and the reduction in child disruptive behavior problems is enough to prevent maltreatment in the future.…”