Efficacy of Emotion-Focused Parenting Programs for Children's Internalizing and Externalizing Symptoms: A Randomized Clinical Study

J Clin Child Adolesc Psychol. 2022 Nov-Dec;51(6):923-939. doi: 10.1080/15374416.2022.2079130. Epub 2022 Jun 1.


Objective: Emotion-Focused Skills Training (EFST) is a 12-week parental program based on Emotion-Focused Therapy, developed to improve children and adolescents' mental health problems.

Methods: In a randomized clinical dismantling study, including parents of 236 children and adolescents (ages 6-13, Mage 8.9, 60.6% boys, 95.8% Caucasian) with externalizing and/or internalizing problems within clinical range, we examined the efficacy of two versions of EFST: one experiential condition (n = 120) involving emotionally evocative techniques and two-chair interventions, and one psychoeducational only condition (n = 116) involving didactic teaching of emotion skills. Both groups received a 2-day group training and 6 hours of individual supervision. Outcomes were parent- and teacher-reported symptoms at baseline, posttreatment, and 4-, 8-, and 12-month follow-up. Analyses were conducted using multilevel growth curve modeling and Bayesian post hoc analysis.

Results: EFST showed efficacy in reducing parent-reported externalizing (b = -1.72, p < .001, d = 1.0) and internalizing (b = -1.71, p < .001, d = 0.9) symptoms, and teacher-reported externalizing (b = -.96, p < .001, d = 0.4), but not internalizing (b = -.13, p > .05, d = 0.2) symptoms. Multilevel analyses showed nonsignificant differences between conditions (all p's > .05), although a Bayesian longitudinal sensitivity analysis indicated a better outcome for the experiential condition.

Conclusion: EFST showed efficacy in symptom reduction for children and adolescents with internalizing and externalizing symptoms. Outcomes were maintained over 12 months for both conditions, supporting EFST as a transdiagnostic parental approach for early intervention.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Bayes Theorem
  • Child
  • Child of Impaired Parents* / psychology
  • Emotions
  • Female
  • Humans
  • Male
  • Parenting* / psychology
  • Parents / psychology