Parenting interventions support overall psychosocial adjustment of children in foster and adoptive families
Adopted children and children placed in foster care are at increased risk of developing a range of mental health, behavioural and psychosocial adjustment problems. Previous studies suggest that the quality of the attachment between the child and the adoptive/foster parents are important for the child’s psychological development. This review finds that attachment-based interventions for adoptive/foster parents increase child psychosocial adjustment and positive parent-child behaviours.
For attachment security, parental depressive symptoms, and child internalising and externalising behaviour, the results were inconclusive.
What is this review about?
Adopted children and children placed in foster care are at increased risk of developing a range of mental health, behavioural and psychosocial adjustment problems. By definition, foster and adopted children have experienced a separation from their biological parents. Furthermore, foster and adopted children have often experienced adverse events such as insufficient medical care, malnutrition, physical and emotional abuse and neglect prior to their initial placement. Theory therefore suggests that the attachment relationship between the child and the adoptive/foster parents may become a source of psychological vulnerability.
To prevent placement breakdown and adverse child outcomes, a number of interventions aim to support foster and adoptive families. This systematic review synthesises the research on a range of interventions commonly offered to foster and adoptive parents. Findings from the review are thus relevant for child protection and adoption agencies around the world.
What is the aim of this review?
This Campbell systematic review assesses the effects of attachment-based parenting interventions on parent/child attachment, psychosocial adjustment and placement stability within foster and adoptive families. It summarises findings from 27 different samples, including 19 randomised trials. The studies are primarily from the USA.
What studies are included?
The included studies examined parenting interventions aimed at helping 0- to 17-year-old foster/adopted children and their parents to form or sustain a secure attachment relationship.
The intervention could be offered in any setting (i.e. clinic, hospital or home) and in any format (i.e. family or multi-family therapy), but had to be at least partly based on attachment theory. Families had to be living in the Western world, defined as the OECD countries. Studies types in this review are: randomised controlled trials, quasi-randomised controlled trials or quasi-experimental studies. The review does not include pre-post studies without a control group.
This review includes 44 studies reporting on 27 different samples (19 randomised trials and eight non-randomised studies). The meta-analyses are based on 24 high-quality studies reporting on 16 populations (14 randomised trials and two non-randomised studies). The studies were from Belgium (1), Italy (2),The Netherlands (7), the UK (6) and the USA (28), and were published between 1977 and 2020.
What are the main findings of this review?
This review finds that overall, attachment-based parenting interventions increase the psychosocial adjustment of children in foster and adoptive families and increase positive parent/child behaviours.
Evidence regarding the effects of attachment-based parenting interventions on attachment security was inconclusive, as we did not find enough studies. Similarly, the evidence on the long-term effects of attachment-based parenting interventions on most outcomes was inconclusive due to very few studies, but findings suggest that attachment-based interventions increase positive parenting behaviour three to six months after the intervention.
No study provided a measure of placement stability or breakdown that could be used in the meta-analysis.
What do the findings of this review mean?
Attachment-based parenting interventions show promising short-term effects within foster and adoptive families, which is relevant for therapists and agencies that provide support to foster and adoptive parents.
Future research should explore the long-term effects of interventions on measures of parent/child attachment, psychosocial adjustment and most importantly on placement stability.
How up-to-date is this review?
The review authors searched for studies up to 2020.