A Meta-Analysis of Parenting Practices and Child Psychosocial Outcomes in Trauma-Informed Parenting Interventions

Introduction: Extensive literature has documented the detrimental effects of trauma on children’s social and emotional development and subsequent treatment of such trauma. The majority of extant research has examined the effectiveness of individual and child-parent treatments such as cognitive behavioral therapy (and its variants) and child-parent psychotherapy. Despite promising research findings from parent-involved treatment and practice recommendations emphasizing the importance of parents, there is little widespread dissemination of evidence-based trauma-informed parenting interventions for children exposed to trauma. In order to empirically support the effectiveness of these interventions as well as suggest parenting practices that might be particularly beneficial for children exposed to violent trauma, we seek to synthesize the existing literature through a meta-analysis.

Methods: Twenty-one trauma-informed parenting interventions were identified that quantitatively assessed intervention effects on parenting and child outcomes. Six meta-analyses were conducted to assess intervention effects on (1) positive parenting practices, (2) negative parenting practices, (3) parenting stress, (4) children’s internalizing problems, (5) children’s externalizing problems, and (6) trauma symptoms, respectively. Where there was evidence of between-study variability in the effect sizes, moderator and subgroup analyses were conducted to determine if effect sizes varied as a function of the type of trauma addressed in the intervention, the intervention duration, intervention intensity, and the study design.

Results: Studies focused on a variety of trauma types, including trauma stemming from intimate partner violence (IPV; k = 11, 50%), child maltreatment such as sexual or physical abuse and neglect (k = 10, 45%), PTSD as the result of non-specific violence exposure (k = 4, 18%), and community violence exposure (k = 2, 9%). Moderate to large effect sizes were found for greater positive parenting practices (d = .62), as well as for the reduction of child internalizing problems, externalizing problems, and trauma symptoms (d = .48 – .59). Validity tests indicated robust findings for positive parenting and for all child outcomes. Additional moderator analyses support the importance of informed intervention design, showing differential findings by trauma type as well as by duration of the intervention.

Conclusion: While more work needs to be done to understand how, and for whom, trauma-focused parenting interventions are effective; these interventions broadly appear to have promise in ameliorating child psychosocial outcomes through improving parenting practices. These findings support models of trauma-informed care that situate treatment in the broader social context, particularly the family. They also suggest the importance of current evidence-based parenting interventions to begin to address their influence on the trauma system.