Systematic review and meta-analysis of parent and family-based interventions for children and adolescents with chronic medical conditions

J Pediatr Psychol. 2014 Sep;39(8):866-86. doi: 10.1093/jpepsy/jsu032. Epub 2014 May 30.

Abstract

Objective: To quantify the effects of parent- and family-based psychological therapies for youth with common chronic medical conditions on parent and family outcomes (primary aim) and child outcomes (secondary aim).

Methods: MEDLINE, EMBASE, and PsycINFO were searched from inception to April 2013. 37 randomized controlled trials were included. Quality of the evidence was evaluated using GRADE criteria. Data were extracted on parent, family, and child outcomes.

Results: Pooled psychological therapies had a positive effect on parent behavior at posttreatment and follow-up; no significant improvement was observed for other outcome domains. Problem-solving therapy (PST) improved parent mental health and parent behavior at posttreatment and follow-up. There was insufficient evidence to evaluate cognitive-behavioral and systems therapies for many outcome domains.

Conclusions: Parent- and family-based psychological therapies can improve parent outcomes, with PST emerging as particularly promising. Future research should incorporate consensus statements for outcomes assessment, multisite recruitment, and active comparator conditions.

Keywords: asthma; cancer; cardiovascular disease; children; chronic illness; chronic pain; cystic fibrosis; diabetes mellitus; epilepsy; family; meta-analysis; parent; psychological therapies; randomized controlled trials; solid organ transplant; spina bifida; systematic review; traumatic brain injury.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Child
  • Chronic Disease / psychology
  • Chronic Disease / therapy*
  • Cognitive Behavioral Therapy / methods*
  • Family Therapy / methods*
  • Humans
  • Parents / psychology*
  • Treatment Outcome