What works in the psychological treatment of child conduct problems? An umbrella review of meta-analytic studies

Abstract

Conduct problems (CP) constitute a major field for child clinical psychology, in terms of not only prevalence, but also developmental, social, and clinical relevance. This study carried out an umbrella review of meta-analyses on the efficacy of treatment/indicated prevention of child CP (mean age range up to 12 years). Following a registered protocol, several databases (i.e., Web of Science, PsycINFO, PROSPERO, and The Cochrane Library) were searched for meta-analyses published from January 2002 to March 2022. Nine meta-analytic publications met the required criteria, and the main characteristics and findings of the studies were systematically described. Weighted effect sizes (ESs) were calculated through RStudio program. Analyses of heterogeneity, publication bias, quality (AMSTAR-2), and credibility were also conducted. Results indicate that parent training has been the most studied intervention, with a weighted ES of d = -0.49 (95% CI -.67 to -.32). The reviewed studies identified several moderators for the efficacy of parent training, including individual (severity of CP), family (financial disadvantage), and intervention (delivery format) characteristics. Results from child-centered play therapy were also analyzed, d = -.34 (95% CI -.40 to -.28), but the reduced number of meta-analyses and the weakness detected by quality assessment suggest the need of cautiously considering the pooled effects. In general, evidence seems to be suggestive of the efficacy of treatment of CP, particularly for parent training. Nevertheless, efficacy seems to be moderate, heterogeneity indexes are high, and quality assessments of meta-analyses are often suboptimal. This study suggests several avenues to strengthen knowledge in this field