Key messages

• Mindfulness-enhanced parent training programmes may improve some child and parent outcomes, including child emotional and behavioural adjustment, parenting skills, parental depression or anxiety, parenting stress, and parent mindfulness.

• When mindfulness parent training is combined with a skills-based parent training programme, this may decrease parenting stress.

• The current body of evidence is limited, with more research needed to be confident in our findings.

Children's emotional and behavioural difficulties

Emotional and behavioural difficulties in children are common, and are characterised by a range of externalising and/or internalising behaviours that can be highly stable over time. They are an important cause of functional disability in childhood, and predictive of poor psychosocial, academic, and occupational functioning into adolescence and beyond. The prevalence, stability, and long-term consequences of emotional and behavioural difficulties highlight the importance of intervening in childhood when behavioural patterns are more easily modified.

Why mindfulness-enhanced parent training?

Parenting plays an important role in the development and/or maintenance of emotional and behavioural difficulties in children. Traditional behavioural or skills-based parent training programmes have been shown to have a positive impact on a range of child and parent outcomes, but they do not work for all parents. One reason for this might be that parents' emotional reactions could prevent them from using parenting skills effectively. Including additional components into parenting training that aim to improve parental emotional responses may enhance the outcomes of these programmes. Recent research shows that mindful parenting interventions may promote positive outcomes for parents and children by improving parents' ability to regulate emotions and stress. Combining mindful parenting approaches with traditional parent training programmes may therefore be beneficial for both parents and their children.

What did we want to find out?

We explored whether behavioural or skills-based parent training programmes with a mindfulness component – 'mindfulness-enhanced' parent training programmes – can improve outcomes for children and their caregivers.

What did we do?

We searched a range of sources for literature that evaluated the effectiveness of mindfulness-enhanced parent training programmes, including electronic databases, trial registries, and organisations and experts in the field. We included studies evaluating these interventions using randomised controlled trials (studies where participants are randomly assigned to one of two or more treatment groups) or quasi experimental designs (where participants are assigned to different treatment groups using a method that is not truly random). We included studies that assessed child emotional and behavioural adjustment, and/or a range of parent outcomes, including parenting skills, parenting stress, depression or anxiety, mindfulness or self-compassion.

What did we find out?

We included 11 studies and data from 2118 participants in the review. The studies compared the outcomes of children or parents (or both) who participated in a mindfulness-enhanced parent training programme to the outcomes of children or parents (or both) who did not participate in parent training, or who participated in an alternate behavioural or skills-based parent training programme. When we combined the findings from these studies, we found that mindfulness-enhanced parent training, when compared to no intervention, may improve child emotional and behavioural adjustment, parenting skills, parenting stress, parental depression and anxiety, and mindfulness, but we are very uncertain about these results. Evidence for the added value of mindfulness training when included in a skills-based parent training programme suggests that mindfulness training may further promote reductions in parenting stress, and may also further reduce parental depression or anxiety, but we are uncertain about these results. It is unclear from the current body of evidence whether adding mindfulness training to a skills-based parent training intervention has any further effect on child emotional and behavioural adjustment, parenting skills, or mindfulness. No studies reported adverse effects or measured self-compassion.

What are the limitations of the evidence?

We are not confident in the overall body of evidence. This is primarily because there was a lot of variation across the interventions and the participant groups, as well as how the outcomes were measured. The studies were also usually quite small, and participants were likely to be aware of what intervention they were receiving, which can sometimes influence the results. It is likely that these findings will change as more studies are undertaken in this area of research.

How up-to-date is this evidence?

We searched for and included research up to April 2023.