Systematic reviews have shown attachment-based parenting programs to lead to improvements in parenting sensitivity and infant attachment, but none have focused specifically on the impact of attachment-based parenting programs on externalizing symptoms in young children.
The objective of this study was to review published randomized controlled trial evidence regarding the impact of attachment-based early parenting interventions on externalizing behaviors in children aged 1–5 years.
A systematic search of published literature available through to May 2020 was conducted. Seven published papers reporting results from trials testing six attachment-based parenting interventions were identified.
Three of the seven programs were shown to be associated with statistically significant improvements in child externalizing behavior (Helping Encourage Affect Regulation, Child-Parent Psychotherapy, Parent–Child Interaction Therapy—Toddlers). For one program (Child-Parent Psychotherapy), there was also evidence in one study that improvements in child externalizing behaviors were sustained at 6-month follow-up. A number of methodological limitations were present among the studies identified, most commonly reliance on parent-report measures of externalizing behavior.
Taken together, results indicate that parenting interventions designed to promote secure parent–child attachment relationships may be effective in reducing externalizing behaviors in children aged 1–5 years of age. Further research is required to test programs in different populations and with longer follow-up times.
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Conflict of interest
Jane Kohlhoff declares that she was the first author on one of the papers included in the review (Kohlhoff et al., 2021), and a co-developer of the PCIT-T intervention (Girard et al., 2018), which this paper reported on. Sara Cibralic reports no conflicts of interest.
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Kohlhoff, J., Cibralic, S. The Impact of Attachment-Based Parenting Interventions on Externalizing Behaviors in Toddlers and Preschoolers: A Systematic Narrative Review. Child Youth Care Forum 51, 1005–1029 (2022). https://doi.org/10.1007/s10566-021-09667-5
- Attachment-based intervention
- Externalizing behaviors
- Systematic review