A Systematic Review of Courses, Training, and Interventions for Adoptive Parents

Adoption requires thorough preparations prior to the arrival of the child and support post-adoption among parents, to promote a positive parent-child relationship and healthy family functioning. The purpose of our study was, therefore, to systematically review the literature on pre- and post-adoption interventions for caregivers, and determine the possibility for conducting a meta-analysis. We searched 12 electronic databases and identified 7574 references that were considered for inclusion by two independent raters. Articles meeting the following criteria were retrieved in full-text; studies that examined the effects of (a) a pre- and/or post-adoption intervention, (b) against a comparator (including quasi-experimental studies), and (c) report on outcomes for parents. Finally, we included 10 studies that met our inclusion criteria and which were assessed in terms of reported intervention effects and study quality using Cochrane's Risk of Bias tool. All studies were associated with a high risk of bias in at least one out of seven domains and unclear reporting on several domains. Eight studies examined intervention effects related to interpersonal functioning; three of which found positive effects. In addition, three studies investigated effects on parenting and stress, respectively; however, only one study demonstrated effects on parenting and none on parental stress. Overall, the study designs, interventions, and results were characterized by substantial heterogeneity, making a meta-analysis unfeasible. In conclusion, the results from the included studies in our review does not point in any particular direction. The most consistent finding across studies was the lack of studies on pre-adoption interventions, and poor design and unclear reporting. Consequently, future studies should evaluate pre-adoption interventions, and need to use more rigorous design, transparent and comprehensible reporting, as well as more homogenous interventions and methods, to move the field forward in support of adoptive parents.