Online parent programs for children’s behavioral problems: a meta-analytic review


A recent increase in the development of online parent programs calls for the need to understand how effective these strategies are for improving children’s mental health. We meta-analyzed the effects of online parent programs on children’s behavioral problems. Moreover, we explored the combinations of program components to yield stronger program effects. Medline, PsycINFO, Web of Science, and the Cochrane Library were searched. We included peer-reviewed randomized studies evaluating the effect of an online parent program. Effect sizes (Hedges’ g) were calculated from post intervention means and standard deviations. We used Qualitative Comparative Analysis (QCA) to identify pathways to effectiveness and individual content and delivery components that seem sufficient or necessary for yielding high effectiveness. Of 2941 articles, 12 articles with a total of 2025 participants met the inclusion criteria. Online parent programs have significant effects on children’s behavioral problems (g =   − 0.32; 95% CI, − 0.47 to − 0.17), emotional problems (g =  − 0.22; 95% CI, − 0.31 to − 0.13), and parental mental health problems (g =  − 0.30; 95% CI, − 0.42 to − 0.17). In the QCA, sending parents reminders to work on the program was the only one sufficient component. In conclusion, online support programs reduce children’s behavioral and emotional problems and improve parental mental health. Sending parents reminders to work on the program seems to contribute to high effectiveness. Review Registration This study was registered with PROSPERO, number CRD42017080051.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5


  1. 1.

    Lavigne JV, Lebailly SA, Hopkins J, Gouze KR, Binns HJ (2009) The prevalence of ADHD, ODD, depression, and anxiety in a community sample of 4-year-olds. J Clin Child Adolesc Psychol 38(3):315–328.

    Article  Google Scholar 

  2. 2.

    Polanczyk GV, Salum GA, Sugaya LS, Caye A, Rohde LA (2015) Annual research review: a meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatr 56(3):345–365.

    Article  Google Scholar 

  3. 3.

    Loeber R, Capaldi DM, Costello E (2013) Gender and the development of aggression, disruptive behavior, and early delinquency from childhood to early adulthood. In: Tolan PH, Leventhal BL (eds) Advances in development and psychopathology brain research foundation symposium series. Disruptive behavior disorders. Springer, New York, pp 137–160

    Google Scholar 

  4. 4.

    Lavigne JV, Arend R, Rosenbaum D, Binns HJ, Christoffel KK, Gibbons RD (1998) Psychiatric disorders with onset in the preschool years, I: stability of diagnoses. J Am Acad Child Adolesc Psychiatry 37(12):1246–1254.

    CAS  Article  Google Scholar 

  5. 5.

    Vaughan EL, Feinn R, Bernard S, Brereton M, Kaufman JS (2013) Relationships between child emotional and behavioral symptoms and caregiver strain and parenting stress. J Fam Issues 34(4):534–556.

    Article  Google Scholar 

  6. 6.

    Kaminski JW, Valle LA, Filene JH, Boyle CL (2008) A meta-analytic review of components associated with parent training program effectiveness. J Abnorm Child Psychol 36(4):567–589.

    Article  Google Scholar 

  7. 7.

    Van Aar J, Leijten P, Orobio de Castro B, Overbeek G (2017) Sustained, fade-out or sleeper effects? a systematic review and meta-analysis of parenting interventions for disruptive child behavior. Clin Psychol Rev 51:153–163.

    Article  Google Scholar 

  8. 8.

    Patterson GR (1982) A social learning approach: coercive family process. Castalia, Eugene, OR

    Google Scholar 

  9. 9.

    Pilling S, Gould N, Whittington C, Taylor C, Scott S (2013) Recognition, intervention, and management of antisocial behaviour and conduct disorders in children and young people: summary of NICE-SCIE guidance. BMJ 346:f1298.

    Article  Google Scholar 

  10. 10.

    Kataoka SH, Zhang L, Wells KB (2002) Unmet need for mental health care among US children: variation by ethnicity and insurance status. Am J Psychiatry 159(9):1548–1555.

    Article  Google Scholar 

  11. 11.

    Owens PL, Hoagwood K, Horwitz SM, Leaf PJ, Poduska JM, Kellam SG et al (2002) Barriers to children’s mental health services. J Am Acad Child Adolesc Psychiatry 41(6):731–738.

    Article  Google Scholar 

  12. 12.

    Baker CN, Arnold DH, Meagher S (2011) Enrollment and attendance in a parent training prevention program for conduct problems. Prev Sci 12(2):126–138.

    Article  Google Scholar 

  13. 13.

    Lebo H, Dunahee M (2017) The world internet project international report, 7th edn. Center for the Digital Future, Los Angeles, CA

    Google Scholar 

  14. 14.

    Love SM, Sanders MR, Metzler CW, Prinz RJ, Kast EZ (2013) Enhancing accessibility and engagement in evidence-based parenting programs to reduce maltreatment: conversations with vulnerable parents. J Public Child Welf 7(1):20–38.

    Article  Google Scholar 

  15. 15.

    Baggett KM, Davis B, Feil EG, Sheeber LL, Landry SH, Carta JJ et al (2010) Technologies for expanding the reach of evidence-based interventions: Preliminary results for promoting social-emotional development in early childhood. Topics Early Child Spec Educ 29:226–238.

    Article  Google Scholar 

  16. 16.

    Nordgren LB, Hedman E, Etienne J, Bodin J, Kadowaki A, Eriksson S et al (2014) Effectiveness and cost-effectiveness of individually tailored Internet-delivered cognitive behavior therapy for anxiety disorders in a primary care population: a randomized controlled trial. Behav Res Ther 59:1–11.

    Article  Google Scholar 

  17. 17.

    Becci AA, Yueqi Y, Thomas M, Jungrim M (2017) Changes in parenting practices during Parent Management Training Oregon model with parents of children in foster care. Child Youth Serv Rev 76:181–191.

    Article  Google Scholar 

  18. 18.

    Billings D (2012) Efficacy of adaptive feedback strategies in simulation-based training. Mil Psychol 24(2):114–133.

    Article  Google Scholar 

  19. 19.

    Davis WD (2005) The interactive effects of goal orientation and feedback specificity on task performance. Hum Perform 18(4):409–426.

    Article  Google Scholar 

  20. 20.

    MacDonell KW, Prinz RJ (2017) A review of technology-based youth and family–focused interventions. Clin Child Fam Psychol Rev 20:185–200.

    Article  Google Scholar 

  21. 21.

    Taylor TK, Webster-Stratton C, Feil EG, Broadbent B, Widdop CS, Severson HH (2008) Computer-based intervention with coaching: an example using the incredible years program. Cogn Behav Ther 37:233–246.

    Article  Google Scholar 

  22. 22.

    McGoron L, Ondersma SJ (2015) Reviewing the need for technological and other expansions of evidence-based parent training for young children. Child Youth Serv Rev 59:71–83.

    Article  Google Scholar 

  23. 23.

    Murray L, Pella JE, De Pascalis L, Arteche A, Pass L, Percy R et al (2014) Socially anxious mothers’ narratives to their children and their relation to child representations and adjustment. Dev Psychopathol 26(4):1531–1546.

    Article  Google Scholar 

  24. 24.

    Webster-Stratton C, Herman KC (2008) The impact of parent behavior-management training on child depressive symptoms. J Couns Psychol 55:473–484.

    Article  Google Scholar 

  25. 25.

    Gross D, Garvey C, Julion W, Fogg L, Tucker S, Mokros H (2009) Efficacy of the Chicago parent program with low-income African American and Latino parents of young children. Prev Sci 10:54–65.

    Article  Google Scholar 

  26. 26.

    Axberg U, Broberg AG (2012) Evaluation of “The Incredible Years” in Sweden: the transferability of an American parent-training program to Sweden. Scand J Psychol 53:224–232.

    Article  Google Scholar 

  27. 27.

    Baumel A, Pawar A, Kane JM, Correll CU (2016) Digital parent training for children with disruptive behaviors: systematic review and meta-analysis of randomized trials. J Child Adolesc Psychopharmacol 26(8):740–749.

    Article  Google Scholar 

  28. 28.

    Barlow J, Smailagic N, Huband N, Roloff V, Bennett C (2014) Group-based parent training programmes for improving parental psychosocial health. Cochrane Database Syst Rev 17(5):CD002020.

    Article  Google Scholar 

  29. 29.

    Furlong M, McGilloway S, Bywater T, Hutchings J, Smith SM, Donnelly M (2012) Behavioral and cognitive-behavioural group-based parenting interventions for early-onset conduct problems in children age years. Cochrane Database Syst Rev 15(2):CD008225.

    Article  Google Scholar 

  30. 30.

    Lau Y, Htun TP, Wong SN, Tam WSW, Klainin-Yobas P (2017) Therapist-supported internet-based cognitive behavior therapy for stress, anxiety, and depressive symptoms among postpartum women: a systematic review and meta-analysis. J Med Internet Res 19(4):e138.

    Article  Google Scholar 

  31. 31.

    Taylor-Richardson KD, Heflinger CA, Brown TN (2006) Experience of strain among types of caregivers responsible for children with serious emotional and behavioral disorders. J Emot Behav Disord 14:157–168.

    Article  Google Scholar 

  32. 32.

    Hedges LV (1981) Distribution theory for Glass’s estimator of effect size and related estimators. J Educ Stat 6:107–128.

    Article  Google Scholar 

  33. 33.

    Higgins J, Green S (2011) Cochrane Handbook for Systematic Reviews of Interventions. Wiley-Blackwel, Chichester, England

    Google Scholar 

  34. 34.

    Morgan AJ, Rapee RM, Salim A, Goharpey N, Tamir E, McLellan LF et al (2017) Internet-delivered parenting program for prevention and early intervention of anxiety problems in young children: randomized controlled trial. J Am Acad Child Adolesc Psychiatry 56(5):417–425.

    Article  Google Scholar 

  35. 35.

    Thomas J, O'Mara-Eves A, Brunton G (2014) Using qualitative comparative analysis (QCA) in systematic reviews of complex interventions: a worked example. Syst Rev 3(1):1–14.

    Article  Google Scholar 

  36. 36.

    Longest KC, Vaisey S (2008) Fuzzy: a program for performing qualitative comparative analyses (QCA) in Stata. Stata J 8:79–84.

    Article  Google Scholar 

  37. 37.

    Hedges LV, Hedberg EC (2007) Intraclass correlation values for planning group-randomized trials in education. Educ Eval Policy Anal 29:60–87.

    Article  Google Scholar 

  38. 38.

    Sourander A, McGrath PJ, Ristkari T, Cunningham C, Huttunen J, Lingley-Pottie P et al (2016) Internet-assisted parent training intervention for disruptive behavior in 4-year-old children a randomized clinical trial. JAMA Psychiatry 73(4):378–387.

    Article  Google Scholar 

  39. 39.

    Sanders MR, Dittman CK, Farruggia SP, Keown LJ (2014) A comparison of online versus workbook delivery of a self-help positive parenting program. J Prim Prev 35:125–133.

    Article  Google Scholar 

  40. 40.

    Baker S, Sanders MR, Turner KMT, Morawska A (2017) A randomized controlled trial evaluating a low-intensity interactive online parenting intervention, Triple P online brief, with parents of children with early onset conduct problems. Behav Res Ther 91:78–90.

    Article  Google Scholar 

  41. 41.

    Porzig-Drummond R, Stevenson RJ, Stevenson C (2015) Preliminary evaluation of a self-directed video-based 1–2-3 magic parenting program: a randomized controlled trial. Behav Res Ther 66:32–42.

    Article  Google Scholar 

  42. 42.

    Sanders MR, Baker S, Turner KMT (2012) A randomized controlled trial evaluating the efficacy of Triple P online with parents of children with early-onset conduct problems. Behav Res Ther 50:675–684.

    Article  Google Scholar 

  43. 43.

    Morawska A, Tometzki H, Sanders MR (2014) An evaluation of the efficacy of a Triple P-positive parenting program podcast series. J Dev Behav Pediatr 35(2):128–137.

    Article  Google Scholar 

  44. 44.

    Enebrink P, Högström J, Forster M, Ghaderi A (2012) Internet-based parent management training: a randomized controlled study. Behav Res Ther 50:240–249.

    Article  Google Scholar 

  45. 45.

    Breitenstein SM, Fogg L, Ocampo EV, Acosta DI, Gross D (2016) Parent use and efficacy of a self-administered, tablet-based parent training intervention: a randomized controlled trial. JMIR Mhealth Uhealth 4(2):e36.

    Article  Google Scholar 

  46. 46.

    Jones SH, Jovanoska J, Calam R, Wainwright LD, Vincent H, Asar O et al (2017) Web-based integrated bipolar parenting intervention for parents with bipolar disorder: a randomized controlled pilot trial. J Child Psychol Psychiatry 58(9):1033–1041.

    Article  Google Scholar 

  47. 47.

    Antonini TN, Raj SP, Oberjohn KS, Cassedy A, Makoroff KL, Fouladi M et al (2014) A pilot randomized trial of an online parenting skills program for pediatric traumatic brain injury: improvements in parenting and child behavior. Behav Ther 45:455–468.

    Article  Google Scholar 

  48. 48.

    Franke N, Keown LJ, Sanders MR (2016) An RCT of an online parenting program for parents of preschool-aged children with ADHD symptoms. J Atten Disord.

    Article  Google Scholar 

  49. 49.

    Menting ATA, Orobio DC, Matthys W (2013) Effectiveness of the incredible years parent training to modify disruptive and prosocial child behavior: a meta-analytic review. Clin Psychol Rev 33:901–913.

    Article  Google Scholar 

  50. 50.

    Sanders MR, Kirby JN, Tellegen CL, Day JJ (2014) The triple P-positive parenting program: a systematic review and meta-analysis of a multi-level system of parenting support. Clin Psychol Rev 34(4):337–357.

    Article  Google Scholar 

  51. 51.

    Teubert D, Pinquart M (2011) A meta-analytic review on the prevention of symptoms of anxiety in children and adolescents. J Anxiety Disord 25:1046–1059.

    Article  Google Scholar 

  52. 52.

    Ginsburg GS, Schlossberg MC (2002) Family-based treatment of childhood anxiety disorders. Int Rev Psychiatry 14:143–154.

    Article  Google Scholar 

  53. 53.

    Kellam SG, Rebok GW, Mayer LS, Ialongo N, Kalodner CR (1994) Depressive symptoms over first grade and their response to a developmental epidemiological based preventive trial aimed at improving achievement. Dev Psychopathol 6:463–481.

    Article  Google Scholar 

  54. 54.

    Ahn H, Wampold BE (2001) Where oh where are the specific ingredients? A meta-analysis of component studies in counseling and psychotherapy. J Couns Psychol 48:251–257.

    Article  Google Scholar 

  55. 55.

    Bell EC, Marcus DK, Goodlad JK (2013) Are the parts as good as the whole? A meta-analysis of component treatment studies. J Consult Clin Psychol 81:722–736.

    Article  Google Scholar 

  56. 56.

    Tarver J, Daley D, Lockwood J, Sayal K (2014) Are self-directed parenting interventions sufficient for externalising behaviour problems in childhood? A systematic review and meta-analysis. Eur Child Adolesc Psychiatry 23(12):1123–1137.

    Article  Google Scholar 

  57. 57.

    Andersson G, Titov N (2014) Advantages and limitations of internet-based interventions for common mental disorders. World Psychiatry 13:4–11.

    Article  Google Scholar 

  58. 58.

    Barak A, Hen L, Boniel-Nissim M, Shapira N (2008) A comprehensive review and a meta-analysis of the effectiveness of internet-based psychotherapeutic interventions. J Tech Hum Serv 26:109–160.

    Article  Google Scholar 

  59. 59.

    Sonuga-Barke E, Brandeis D, Cortese S, Daley D, Ferrin M, Holtmann M et al (2013) Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. Am J Psychiatry 170(3):275–289.

    Article  Google Scholar 

Download references


No external funding for this manuscript. The authors have indicated they have no financial relationships relevant to this article to disclose.

Author information



Corresponding author

Correspondence to Therdpong Thongseiratch.

Ethics declarations

Conflict of interest

The authors have indicated they have no potential conflicts of interest to disclose.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 28 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Thongseiratch, T., Leijten, P. & Melendez-Torres, G.J. Online parent programs for children’s behavioral problems: a meta-analytic review. Eur Child Adolesc Psychiatry 29, 1555–1568 (2020).

Download citation


  • Online parent program
  • Behavioral problem
  • Emotional problem
  • Parental mental health
  • Meta-analysis
  • Qualitative comparative analysis