(PS8-B29) Parental Involvement in Adolescent Psychological Interventions: A Meta-analysis and Systematic Review

Background. Adolescence is characterized as a period of significant biological and psychosocial change, coinciding with an increased risk for the development of psychopathology. Current psychological interventions for adolescents have shown mixed efficacy, and including parents in interventions may be an important avenue to improve treatment outcomes. Although adolescents strive for independence and spend an increasing amount of time with peers, parents remain a critical influence (Steinberg & Morris, 2001). Evidence from recent meta-analyses examining the role of parents in interventions for youth are mixed (Peris et al., 2021; Thulin et al., 2014) and have typically combined findings for both children and adolescents together (Dowell & Ogles, 2010). No prior meta-analysis has examined the specific role of parents in adolescent interventions as compared with interventions focused solely on adolescents across several internalizing and externalizing disorders.

Method. Systematic literature reviews were conducted in psycINFO utilizing a combination of searches among keywords including (parent* OR family) AND (intervention OR therap* OR treatment OR prevent*) AND (adolescen*). Main inclusion criteria were 1) all participants were ages 10-19 years old, 2) study design must include a randomized controlled trial of an individual psychological intervention compared to the same individual intervention with an additional parental component, and 3) adolescents involved in the trial must have at least current symptoms or risk to be included. The standardized mean difference between interventions was used as the effect size, and all analyses were conducted in Comprehensive Meta-Analysis Program version 4 (Borenstein et al., 2022) using random effects models.

Results. Literature searches yielded 7,533 published articles to screen, resulting in a total of 20 trials meeting inclusion criteria (N=1,251). Summary statistics suggest that interventions that involved parents in treatment have a significantly greater impact on adolescent psychopathology when compared to interventions that targeted adolescents alone (g = -0.137, p = .02, 95% CI

[-0.253, -0.022]). Results were examined further with diagnosis (internalizing or externalizing) included as a moderator. The significant intervention difference remained for externalizing (g = -0.2, p = .008, 95% CI [-0.348, -0.051]) but was no longer significant for internalizing psychopathology (p > .05). Tests of heterogeneity and publication bias were both non-significant (Q-value = 12.99, p = .7; Egger’s intercept = 0.27, p = .3)

Conclusions. Findings provide direct evidence of the importance of including parents in adolescent therapy, particularly for externalizing psychopathology. Given adolescents’ desire for autonomy and independence, additional work is needed to understand the most beneficial ways to include parents in psychological interventions for youth.