Peer-reviewed article

What are the Optimal Combinations of Parenting Intervention Components to Reduce Physical Child Abuse Recurrence? Reanalysis of a Systematic Review using Qualitative Comparative Analysis

G. J. Meléndez‐Torres, Patty H. O. Leijten, Frances E. M. Gardner · 1 May 2019

Abstract

Parenting interventions are widely used to reduce physical child abuse, but evidence for their effectiveness is mixed, partly because standard methods for synthesising the effectiveness of interventions do not address complex causation. We addressed this by using qualitative comparative analysis to understand pathways to effectiveness in social learning theory‐based parenting interventions. After a systematic search of nine databases and independent and duplicate study selection, we included 14 interventions from ten evaluations. We categorised nine as most effective and five as least effective. We labelled interventions as to the presence or absence of parental self‐management, attachment‐based, alternative punishment or proactive parenting components. We examined how these combined in the most effective and least effective interventions, and identified common pathways to most effectiveness and least effectiveness. The final pathways revealed the importance of two components: alternative punishment strategies and parental self‐management strategies. It was not clear that adding more components to an intervention necessarily translated to more effectiveness; indeed, this could backfire, as many of the least effective interventions combined multiple strategies without teaching parental self‐management. Our findings may be useful to intervention developers and implementers when considering new interventions. Future research should seek to test combinations of components for differential effectiveness between the most effective pathways. ‘[A] qualitative comparative analysis to understand pathways to effectiveness in social learning theory‐based parenting interventions’ Key Practitioner Messages The effectiveness of social learning theory‐based parenting interventions for physical child abuse is variable. We identified two key, but not necessary, components: alternative punishment strategies and parental self‐management strategies. Adding more components did not necessarily lead to high effectiveness, and in some cases this could backfire when parental self‐management was not included.