European Child & Adolescent Psychiatry

, Volume 28, Issue 8, pp 1025–1036 | Cite as

Treatment of child externalizing behavior problems: a comprehensive review and meta–meta-analysis on effects of parent-based interventions on parental characteristics

  • Linda WeberEmail author
  • Inge Kamp-Becker
  • Hanna Christiansen
  • Tanja Mingebach


This is the first meta–meta-analysis examining the effects of parent-based interventions for children with externalizing behavior problems on parental characteristics (parenting, parental perceptions, parental mental health, parental relationship quality). Parent training interventions are recognized as evidence-based interventions for the treatment of externalizing behavior problems, although meta-analytic effects are heterogeneous. The objective of the present study was to comprehensively combine meta-analytic results on parent training interventions to arrive at valid effect predictions. Electronic databases were searched (PsycINFO, Medline, PubMed). In total, 11 meta-analyses were included that mainly comprised parents of children under the age of 13 years. Analyses were based on random effects models. Effect estimates were transformed to standardized mean differences (SMD) and corrected for primary study overlap. Results revealed a significant moderate overall effect for parenting (SMD 0.53) as well as for parents’ report of parenting (SMD 0.60) and parental perceptions (SMD 0.52). Effects remained stable to follow-up. Results for observational data, parental mental health and parental relationship quality were small and only partially significant. Considerable heterogeneity within results was revealed. Overall, parent training interventions proved to be effective in improving parental characteristics for parents of children with externalizing behavior problems. Effectiveness was stronger regarding characteristics explicitly targeted by interventions. The findings should encourage health-care providers to apply evidence-based parent training interventions.


Meta–meta-analysis Parent training effectiveness Externalizing behavior problems Parents 


Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Supplementary material

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Supplementary material 1 (DOCX 318 kb)
787_2018_1175_MOESM2_ESM.doc (78 kb)
Supplementary material 2 (DOC 78 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Child and Adolescent Psychiatry, Psychosomatics and PsychotherapyMarburgGermany
  2. 2.Department of Clinical Child and Adolescent PsychologyPhilipps University MarburgMarburgGermany

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