Dyadic approaches to treating individual functioning: A review and dual meta-analysis of the effects of attachment-based interventions on caregiver and child psychopathology.

Attachment-based Interventions (ABIs) refer to treatments that leverage tenets of Attachment Theory in clinical work with caregivers and children. Integrating Attachment Theory and developmental psychopathology frameworks, this meta-analysis reports the efficacy of ABIs for reducing both caregiver and child psychopathology. We screened studies from PsycInfo, PubMed, and Web of Science, identifying 70 unique studies (Ntotal = 6645 families) that met inclusion criteria. We report 19 meta-analytic effects (8 for caregivers, 11 for children). We observed large Pre-Post effects of ABIs on changes in caregiver posttraumatic stress (d = -0.986), caregiver depression at later follow-up (d = -0.828), child posttraumatic stress (d = -0.744) and child total problems both at post-treatment (d = - 0.728) and follow-up (d = -1.143). We observed medium Pre-Post effects of ABIs on caregiver depression (d = -0.623), global distress (d = -0.621), anxiety (d = -0.553), and child internalizing (d = -0.485), as well as medium RCT effects of ABIs on changes in caregiver global distress (d = -0.408) and depression at follow-up (d = -0.588). We found small RCT effects for for caregiver depression, child internalizing, externalizing, and total problems, as well as child internalizing, externalizing, and total problems at later follow-up (ds = -0.355 to -0.066). Ten studies (Noverlap = 795) that met both caregiver and child inclusion criteria were included in exploratory dyadic analyses which revealed reductions in caregiver and child psychopathology were significantly correlated (r = 0.480, p < .001). Results underscore benefits of ABIs for broader treatment targets beyond attachment security.