A Systematic Review of the Evidence for Family and Parenting Interventions in Low- and Middle-Income Countries:Child and Youth Mental Health Outcomes

Objectives: Children 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. Methods: This 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. Results: This 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. Conclusions: Evidence 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.