Abstract
ObjectivesChildren and youth in low-and middle-income countries (LMIC) are at greater risk for poor mental health. Adverse circumstances including poverty, violence, and lack of available psychological treatments increase their vulnerability. Given the importance of the family environment for child and youth wellbeing, family interventions are a powerful mode of treatment; however, their development and evaluation has received relatively little attention in LMIC.MethodsThis review presents evidence for family- and parent-focused interventions on mental health outcomes for children and youth in LMIC and identifies treatment components present in promising interventions. A systematic search was conducted using comprehensive search terms in five databases (Global Health, PubMed, PsychINFO, PILOTS, and Cochrane Library). Reporting follows PRISMA guidelines. Independent raters screened and retrieved articles for inclusion, completed quality ratings, conducted data extraction, and coded common practice elements.ResultsThis review included 36 papers representing 32 unique studies of family or parenting interventions in LMIC. Study designs covered: RCTs (50% of studies), pre-to-post studies (38%), and other (12%). The majority of interventions showed positive outcomes for child and youth mental health and wellbeing. The two most frequently used treatment techniques were caregiver psychoeducation and caregiver coping skills; the next most common were treatment processes of providing between-session homework and accessibility promotion.ConclusionsEvidence for family-focused interventions for child and youth mental health in LMIC is growing with several promising approaches that should be more rigorously evaluated. Further research into effects of specific intervention components will ensure targeted and optimally effective interventions.
Highlights
Reasons for exclusion of the other 65 studies included: programme only looking at a parent’s own psychological well-being, programme only looking at child cognitive variables, only physical outcomes, programmes working primarily with the child and involve parents in adjunctive sessions, parents or family with offspring aged 25 years or older, single case studies, qualitative data only, not a psychosocial intervention, not an intervention study, families living in high-income countries (HICs), studies without pre or post quantitative data, or it was the wrong population
This review sought to identify the evidence for parent- and family-focused interventions for child and youth mental health and well-being outcomes in low-and middle-income countries (LMIC)
By organising the results into categories, this review was able to conduct a narrative synthesis on 14 parent-focused interventions and 18 familyfocused interventions
Summary
Children and youth in low-and middle-income countries (LMIC) are at greater risk for poor mental health. Violence, and lack of available psychological treatments increase their vulnerability. Given the importance of the family environment for child and youth wellbeing, family interventions are a powerful mode of treatment; their development and evaluation has received relatively little attention in LMIC
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