Pia Enebrink

Background: There are few current comprehensive meta-analyses and systematic reviews of the literature on universal parental support programs. The aim of this meta-analysis was therefore to examine the effects of universal parental support programs on children’s externalizing and internalizing problems, as well as on parental mental health, and to evaluate the possible importance of theoretical frameworks in achieving better outcomes. Methods: The meta-analysis included randomized controlled trials of universal parental support programs for parents to children and adolescents aged 2–17 years. A search in five databases was conducted from inception to December 2020 and updated in April 2024. The abstracts and subsequent full-text articles were independently reviewed by two pairs of authors, resulting in 31 original studies (36 articles) with a total of 7635 participants. To evaluate risk of bias, we used the Cochrane risk-of-bias tool for randomized trials. Results: Small positive short-term effects were obtained for the included universal parental support programs on parental ratings of children’s externalizing ( d = 0.18: 95% CI 0.07–0.29) and internalizing problems ( d = 0.16: 95% CI 0.03–0.30), parental stress ( d = 0.22: 95% CI 0.04–0.40) and parental depression ( d = 0.13: 95% CI 0.01–0.25). Subgroup analyses showed that significant effects on primary outcomes were only found when interventions were compared to waitlist, not to an active control group. The long-term between-group effects were positive but small and non-significant. Most of the programs were based on social learning theory, no differences emerged between programs with different theoretical frameworks. Conclusion: This meta-analysis indicates that universal parental support programs, when compared to waitlist only, may have a small positive impact on children’s externalizing and internalizing problems as well as on parental stress and depression in the short time frame.

Forced migration has reached unprecedented levels worldwide. Involuntarily migration creates stressors for families that require systematic action at a societal level. Our premise is that parenting programmes have an untapped potential to enhance psychosocial health among parents and children. The aim of this study, therefore, was to review existing studies to evaluate the efficacy of preventive parenting programmes for parents who were refugees, asylum seekers or internally displaced. We included 20 publications from 3 electronic databases (Ovid MEDLINE, Ovid PsycINFO and Web of Science Core Collection): 16 on parenting interventions (13 original trials, N = 1191) and 4 on combined interventions (parents and youth, N = 1284). We compared a range of outcomes including child internalizing and externalizing symptoms, as well as parental competence (positive/negative parenting), self-efficacy, well-being and mental health/psychological distress. Between-group analyses indicated less externalizing behaviour (Hedge's g = 0.43, p < 0.05, k = 2) at post measurement for parents participating in the interventions, compared with those in the control conditions, as well as enhanced positive parenting strategies ( g = 0.89, p < .01, k = 2), self-efficacy ( g = 1.94, p < .001, k = 2) and parental psychological distress ( g = 0.67, p < .05, k = 4). Within-group analyses of pre and post measurements supported that parents participating in the interventions reported improvements over time in all primary outcomes: parent-rated child internalizing and externalizing behaviours, negative and positive parenting, self-efficacy and the secondary outcome psychological distress. Analyses of combined studies suggested a small increase in positive parenting strategies ( g = 0.17, p < .05, k = 2). Although our sample of reviewed studies was relatively small, and the study outcomes varied considerably, the results indicate that parenting programmes might be an underutilized resource to promote health among forcibly displaced families. Systematic review registration: PROSPERO (CRD42022330521).

A systematic review and meta-analysis was conducted of different types of CBTs for ID in adults treated in routine clinical care. Ovid MEDLINE, Embase OVID, and PsycINFO were systematically searched for studies published until January 2025. The effectiveness of CBT, methodological quality, and moderators of treatment outcomes were examined and benchmarked by meta-analytically comparing them with efficacy studies for ID. Thirty-two studies were included, comprising 5231 participants. Very large within-group effect sizes (ES; Hedges' g) were obtained for ID-severity at post-treatment (1.87), and follow-up (1.68), on average 12 months post-treatment. Remission rates were 45% post-treatment and 51% at follow-up. Attrition rate was 13.9%. Risk of bias was considerable in the majority of studies. The benchmarking analysis showed that effectiveness studies (1.83) had almost exactly the same ES as efficacy studies (1.82) at post-treatment. Furthermore, there was no significant difference between effectiveness and efficacy studies on sleep diary measures, remission rates, and self-ratings of depression and anxiety. CBTs for ID are effective when delivered in routine clinical care, with ESs comparable to those found in efficacy studies. However, the evidence needs to be interpreted with caution because of the risk of bias in a high proportion of studies.Prospero registration id: CRD420251032141.

Family therapy for eating disorders (ED) is well-established and represents the treatment choice for ED in children and adolescents according to guidelines, with cognitive behavior therapy (CBT) as a second line treatment. There is limited knowledge about how these treatments work in routine clinical care. The goal of the present meta-analysis is to investigate the effectiveness of family therapy and CBT for various EDs in children and adolescents when carried out in routine clinical care. Ovid MEDLINE, Embase OVID, and PsycINFO were searched for articles published until December 2023. The outcome of family therapy and CBT, methodological quality, risk of bias, and moderators of treatment outcome were examined and benchmarked by meta-analytically comparing with ED efficacy studies. Forty-four effectiveness studies comprising 3251 family therapy or CBT patients were included. Large to very large within-group effect sizes (ES) were found for ED-psychopathology (0.80) and weight measures for AN (1.64) at post treatment. The attrition rate was 15%. Risk of bias was considerable. Moderate to large ES were found for family therapy and CBT, respectively. The benchmarking analysis showed that effectiveness studies had comparable ESs to efficacy studies (0.80 and 0.84 for the ED-psychopathology at post treatment). The findings support family therapy and CBT for ED in children and adolescents as effective treatments when delivered in routine clinical care, with effects comparable with those found in efficacy studies. The evidence needs to be interpreted with caution because of the risk of bias in a high proportion of studies. PROSPERO [CRD42023441794].

Background and purpose: Parenting concerns can be a major source of distress for patients with cancer who are parents of dependent children; however, these are often not addressed in health care. The Parenting Concerns Questionnaire (PCQ) is an instrument designed to assess parents’ worries about the impact of cancer on their children and their ability to parent during this time. The Swedish version of the PCQ has, however, not been evaluated. This study therefore aimed to examine the psychometric properties of the PCQ in a sample of Swedish parents with cancer. Material and methods: A sample of 336 patients with cancer having dependent children (≤18 years) were included in a cross-sectional web-based survey. Participants completed questionnaires assessing parenting concerns, depression, anxiety, and stress symptoms (DASS); self-efficacy, family functioning (FAD-GF); and sociodemographic and clinical characteristics. Descriptive analyses, as well as reliability and validity analyses, were conducted followed by a confirmatory factor analysis of the factor structure proposed by the authors of the original version of the PCQ. Results: The majority were mothers (94.9%) with breast cancer (66.4%) aged 40–50 years (59.5%). The results showed evidence for convergent, criterion, and known group’s validity, but the original three-factor structure of the PCQ was not fully supported by confirmatory factor analysis. Interpretation: Evaluating parenting concerns may be an important step towards identifying patients who could benefit from targeted psychosocial interventions. However, the PCQ may require some further refinement to fully capture the breadth of parenting concerns in parents with cancer in different settings.

Background and purpose: As many as one in four adults with cancer have children under 18 years. Balancing parenting and cancer is challenging and can be a source of psychological distress. This study aimed to examine psychological distress in parents with cancer and its associations with parenting concerns, self-efficacy, and emotion regulation. Materials and methods: This was a cross-sectional questionnaire study of 406 parents (aged 25–60 years) diagnosed with cancer within the last 5 years, with at least one dependent child (≤ 18 years). Parents completed questionnaires on psychological distress (DASS-21), parenting concerns (PCQ), self-efficacy (GSE), emotion regulation (ERQ), mental and physical health, and sociodemographics. Data were analysed using multiple logistic regressions on depression (yes/no), anxiety (yes/no), and stress (yes/no). Results: Higher parenting concerns were associated with greater odds of depression (OR = 2.33, 95% CI: 1.64–3.31), anxiety (OR = 2.30, 95% CI: 1.64–3.20), and stress (OR = 3.21, 95% CI: 2.20–4.69) when adjusting for health and sociodemographic factors. Poorer self-efficacy was associated with increased odds of anxiety (OR = 0.94, 95% CI: 0.89–0.99, p < 0.05), whereas lower use of cognitive reappraisal and higher use of expressive suppression increased the odds of depression (OR = 0.76, 95% CI: 0.59–0.98 | OR = 1.46, 95% CI: 1.18–1.80). Interpretation: The findings highlight the complexity of parental well-being in relation to parenthood and cancer, stressing the need for interventions that address relevant psychological factors to improve overall mental health in this population.

Background: Parents given a diagnosis of cancer must balance the demands of their illness and caregiving responsibilities. This can result in parental stress and have a negative impact on the well-being of the whole family. A greater understanding of the experiences of parents with cancer is necessary to provide adequate support. Objective: The aim of this study was to explore parenting concerns and challenges among parents with cancer who were caring for dependent children younger than 18 years. Methods: Semistructured interviews were carried out with 22 parents with cancer. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis. Results: Parental concerns and challenges affected parents in their parental role and their everyday family life. Three overarching themes described the struggles in balancing life as a parent and as a patient: navigating dual roles as a parent with cancer, impact of cancer on parenting, and impact on family life. Parents’ primary focus was on their children’s well-being, and they struggled to manage their own expectations of parenting and the demands on their role in the family. Conclusion: The results highlight the complexity of being a parent with cancer while caring for dependent children. To support parents during the cancer journey, it is important to understand the consequences of their illness on their parental role and the family. Implications for Practice: Supporting parents to feel secure in their parental role and providing support to them during their cancer journey should be integrated into routine cancer care, where parenting concerns and challenges are addressed.