Parenting programmes for attachment and conduct problems

Parenting programmes are one of the best researched treatments for childhood psychiatric problems. As well as being proven effective for symptoms of conduct disorders in over 200 trials, there have now also been more than 60 trials, proving their effectiveness for insecure attachment patterns in infants. Their mechanism of action is now being confirmed, with both a reduction in harsh parenting and an increase in positive parenting appearing necessary to reduce conduct symptoms, and an increase in sensitive responding being necessary to promote secure attachment in infants. However, the less good news is that in ‘real-life’ everyday clinical conditions, as opposed to trials run in university clinics, the effects are often more modest. This is partly due to therapists having less well-developed skills, and partly due to cases being more difficult, with more comorbid conditions. The challenge now is to disseminate training in high-quality programmes and to develop these so that they are tailored to individual parenting needs, rather than offered as ‘one size fits all’.