Effectiveness of Family-Involved Interventions in Reducing Co-Occurring Alcohol Use and Mental Health Problems in Young People Aged 12–17: A Systematic Review and Meta-Analysis

Abstract

There is a high prevalence rate of co-occurring alcohol use and mental health problems in young people. This is associated with adverse outcomes and poses a substantial public health concern. We identified and synthesized evidence on the effectiveness of family-involved interventions in reducing alcohol use and mental health problems in young people aged 12–17. Seven databases were searched from inception to January 2023. Data from 19 articles reporting on 14 trials were pooled through random-effects meta-analysis for each outcome using Review Manager 5.3. Pooled estimates resulted in non-significant findings for alcohol use (SMD −0.60; 95% CI −1.63 to 0.42; p = 0.25; 6 trials; 537 participants), internalizing symptoms (SMD −0.13; 95% CI −0.37 to 0.10; p = 0.27), externalizing symptoms (SMD −0.26; 95% CI −0.66 to 0.15; p = 0.22) and substance use (SMD −0.33; 95% CI −0.72 to 0.06; p = 0.10). In contrast, significant intervention effects were identified for the mechanism of change, family conflict (SMD −0.30; 95% CI −0.51 to −0.09; p = 0.005). Consequently, addressing family functioning may not be sufficient in reducing co-occurring alcohol use and mental health problems. Non-significant intervention effects could be due to a lack of content addressing the relationship between alcohol use and mental health problems. Future intervention development could explore whether to incorporate such content and how best to involve the family.