A Manchester Study shows the right early parenting support is better for children experiencing anxiety and depression.
New research into how parenting programmes may benefit children with mental health difficulties found that placing parents on waiting lists for support services can actually offset any benefit gained from professional help.
This is thought to be driven by parents’ expectation that professional support would be coming, and they withdraw from other support communities or self-help processes.
These are the findings of an extensive new study from an international collaboration of psychologists and epidemiologists published today in BMJ Mental Health.
The research team looked at various early parenting interventions used to support parents with children younger than four who may have mental health problems, such as anxiety or depression, known as ‘internalising problems’.
They also found that professional help where both the child and parent are involved in the support process, rather than just the parents on their own, had better outcomes for the child.
Researchers found that giving parents relational support at the earliest stage in a child’s life could help to increase both the child’s and their family’s quality of life.
Given the previously known impact of the early years on later child development, this could have major societal and economic benefits.
The findings follow a World Health Organization (WHO) study in 2022 that identified child internalising problems as a priority concern when evaluating the effectiveness of parenting interventions.
The study, which was authored by Manchester Metropolitan University, the University of Bristol and Kings College London, as well as authors in Chile, Spain, and South Africa, may help to inform shared decision-making between families, clinicians, and policymakers about early years support for parents and young children.
Professor of Psychology at Manchester Met and the study’s senior author, Rebecca Pearson said: “Parenting interventions are costly because they involve lots of different parts, most of which have been developed to reduce child ‘behavioural’ problems. It is, therefore, important to look at what specific parts of support work to reduce emotional problems.
“What was striking to me was the finding that waiting list control groups may make things worse. Scientifically, this is important because most previous evidence is based on the ‘wrong’ comparison. In other words, some parenting support programs may seem to be good at reducing child mental health problems, but these positive findings are really caused by comparing them against a comparator that has negative effects. One interpretation of the negative impact of waiting lists is that it could reflect parents’ losing confidence in their own parenting while they await the ‘expert’ support. Future work is important to understand this.”
Using data extracted from 59 randomised controlled trials conducted in 18 countries around the globe, many of which were not previously published, the researchers investigated the effects of different types of support for parents with children aged under four on future mental health outcomes.
They explored whether youngsters were going on to have emotional and behavioural problems, as well as how likely parents were to feel less or more depressed and confident in their own parenting, after receiving different types of parenting support or usual care.
Parenting support that focused on the parent-child relationship and directly included both the parent and child in support sessions, was found to be most successful in preventing children developing emotional and behavioural problems.
In contrast, the families that were assigned to waiting lists for support reported worse symptoms – suggesting that leaving parents to it may be better than offering them support but then making them wait many months for it.
‘Internalising problems’ are among the most common mental health disorders in children worldwide, representing a major risk factor for later psychopathology, including for adult internalising problems, which are leading causes of serious conditions and even death globally.
Ilaria Costantini at the University of Bristol, lead author of the study, added: “While this work and findings represent a good first step in showing which type of parenting support works best in reducing child emotional distress, the work also exposes the limitations and biases of some of the included studies.
“The small positive effect of the parenting support programmes tells us that there is still a lot of work to be done to develop effective parenting interventions with long-lasting positive effects in preventing or lessening children’s emotional problems. Improving the way studies measure child emotions (most rely on parent report), making it easier for scientists to access clinical trial data, together with better descriptions of the features of parenting support programs will allow researchers, policy makers and families to gain a clearer and more reliable picture of what works and what does not.”
