Highlights in child mental health research: August 2025

This month’s highlights include:

Exploring links between parents’ insight into their child’s mind, parental stress and parent–child relationships

This study examined the relationship between parental ‘mind-mindedness’ (i.e. a parent’s ability to treat their child as an individual with a mind of their own and how they describe their child mental states), parenting stress, and perceived closeness and conflict in the parent–child relationship for families where the child had received professional support for emotional, behavioural or mental health difficulties. The authors surveyed 151 parents of children aged four to 16 years; 67 of whom had received professional support and 84 who had not received support. Parents of children who required professional support reported higher stress, more conflict and more negative descriptions of their child. Positive mind-mindedness was linked to lower stress, less conflict and more closeness, with negative mind-mindedness linked to higher stress levels.

Improving social communication in autistic children through online developmental support

Conducted in the United States, this mixed-methods pilot study measured the effects of a caregiver-mediated naturalistic developmental behavioural intervention titled Project ImPACT. This intervention was delivered via telehealth by early-career community clinicians to 21 Medicaid-enrolled autistic children aged two to six years old and their parents/caregivers. Families received 24 weekly sessions, and child outcomes (communication, social reciprocity and peer interaction) were assessed through parent/caregiver reports using the Autism Impact Measure at five timepoints. The authors found that after the intervention there were significant decreases in peer interaction challenges, a trend towards decreases in communication challenges, but no differences in social reciprocity (i.e. understanding and reacting to social cues).

Relationships between parental factors and children’s symptoms of anxiety and depression

This study examined the relationship between parental symptoms of anxiety and depression, family functioning and parental practices, and children’s symptoms of anxiety and depression. The authors used randomised factorial trial data from the Norwegian ECHO trial study, which aims to improve a child anxiety and depression preventative intervention called Emotion. The authors used five waves of data from 1,043 parents of 650 children, aged eight to 12 years. Parents provided reports over three timepoints (baseline, post-intervention and 12 months post-intervention). Child anxiety and depression were closely linked to their parents’ symptoms of anxiety and depression as well as to poor family functioning. Supportive parenting practices were linked to lower levels of child anxiety and depression.

Elder-governed cultural therapy for Aboriginal and Torres Strait Islander young people with mental health conditions

This study conducted a qualitative evaluation of a cultural therapy program delivered to 20 Aboriginal and Torres Strait Islander children and young people, aged seven to 18 years. The authors used a community-based participatory action method. Data was collected through participant observation, photography and an Indigenist method of yarning. Cultural therapy was conducted at two sites in Victoria, Australia, and included activities such as walking in Country, art, music, dance and animal-assisted therapy. Each young person, their parent(s)/caregiver(s) and a cultural therapist participated in a yarn before, immediately after and three months after completion of the program. The authors found that all participants thoroughly enjoyed the program and reported improvements to their social and emotional wellbeing, including improvements in emotion regulation, increased resilience and a reduction in symptoms associated with attention-deficit hyperactivity disorder (ADHD).

Why is this important?

• Parents of children with mental health or behavioural difficulties often face higher stress levels. This can negatively affect parenting and child development.
• How parents think about and describe their child’s mind (‘mind-mindedness’) may buffer or worsen stress and influence relationship quality.

What did they do?

• The authors surveyed 151 parents of children aged four to 16 years; 67 had children who had received professional support for emotional, behavioural or mental health difficulties (clinical group), 84 had not (comparison group).
• They collected data online about parents’ descriptions of their child (coded for positive or negative mental attributes), parenting stress and perceived relationship closeness and conflict (relationship quality).
• Survey instruments to assess stress and relationship quality included Parenting Stress Index, Child–Parent Relationship Scale, Strengths and Difficulties Questionnaire.
• Parents rated how close they feel to their child and how much conflict they experience using statements like ‘My child and I always seem to be struggling with each other’ (for conflict) and ‘My child values their relationship with me’ (for closeness). Higher scores meant more closeness or more conflict.
• The authors then analysed how levels of perceived conflict or closeness were associated with parental stress and how parents described their child’s mental state, testing for differences between clinical and comparison groups.

What did they find?

• Parents in the clinical group reported higher stress, more conflict and more negative descriptions of their child compared to the comparison group.
• Closeness with children was similar across groups, suggesting warmth can remain despite difficulties.
• Parents in the clinical group who described their child’s mental state using positive language (e.g. words such as ‘considerate’ or ‘loving’) experienced lower stress, less conflict and more closeness.
• A tendency to describe their child’s mental state using negative attributes such as ‘spiteful’ or ‘manipulative’ (negative mind-mindedness) was associated with higher stress, but this was not explained by relationship closeness or conflict.
• Analysis showed that when parents had more positive descriptions of their child’s mental states (thoughts and feelings), they experienced less stress and fewer conflicts. There was also an association with feeling close to their child for families receiving professional support.

What does this mean for practice?

• Supporting parents to focus on their child’s positive mental characteristics (e.g. intentions, emotions, abilities) may reduce conflict and help manage stress.
• Interventions that reduce negative mind-mindedness and enhance positive mind-mindedness could strengthen parent–child relationships and lower parental distress.
• Practitioners should attend to parent–child conflict as a key mechanism linking parental stress and perceptions of the child’s mental states.

Why is this important?

• Caregiver-mediated naturalistic developmental behavioural interventions (NDBIs) are an evidence-based approach for supporting autistic children’s social communication. However, families from low-income and minoritised backgrounds often face barriers to accessing these supports.
• Telehealth delivery of these supports may overcome challenges with transportation and scheduling, yet little is known about its effectiveness in community mental health settings serving under-resourced families.

What did they do?

• This was a mixed-methods study conducted in the United States with 21 Medicaid-enrolled autistic children aged two to six years and their caregivers. The intervention was delivered by early-career community clinicians.
• Families participated in Project ImPACT, a caregiver-mediated NDBI, via telehealth over 24 weekly sessions (60 minutes). The intervention involved a combination of directive strategies (e.g. expectant waiting, prompting) and responsive strategies (e.g. following the child’s lead).
• Child outcomes (communication, social reciprocity, peer interaction) were assessed through caregiver-reports using the Autism Impact Measure at five timepoints.
• Six caregivers also participated in qualitative interviews about their experiences.

What did they find?

• Child communication and social reciprocity skills did not change significantly. However, peer interaction improved despite it not being a direct focus of the Project ImPACT intervention.
• Caregivers reported changes in how they communicated and engaged with their child after participating in Project ImPACT. These included longer one-on-one playtime, introducing new activities, being more animated and patient, and allowing the child to lead during play.
• Caregivers described greater child initiated social engagement, improved peer interaction and growth in communication through strategies such as ‘following the child’s lead’, expectant waiting and modelling language.
• Caregivers liked that strategies could be taught to other parents, grandparents and siblings to support their learning and skill development. They recommended including additional family members in intervention strategies.
• Caregivers appreciated being given caregiver manuals to use but recommended using more videos in the project delivery that talk about the range of children’s communication abilities and developmental levels.

What does this mean for practice?

• Interventions delivered via telehealth may be beneficial to families who face barriers in accessing in-person support (e.g. transportation, location, lack of time).
• Training caregivers in simple, responsive strategies (e.g. following the child’s lead, expectant waiting) may be especially effective for helping them to support their child.
• Practitioners should consider involving wider family members in NDBI strategies to extend learning opportunities.

Why is this important?

• Parents who have anxiety and depressive symptoms are likely to have children who also experience anxiety and depressive symptoms.
• Other factors that have been linked to children experiencing anxiety and depressive symptoms include family functioning (i.e. how family members interact, cooperate and support one another) and parenting practices (i.e. managing emotions, setting goals, dealing with problems and managing negative emotions).
• Most recent research has focused on clinical samples (i.e. a group that has received a formal diagnosis and/or is receiving treatment). However, this study has focused on an indicated sample (i.e. a broader population group chosen for possession of recognised risk factors but may not be in treatment or have received a diagnosis).

What did they do?

• The authors used randomised factorial trial data from the ECHO trial, a study that aimed to improve a preventative intervention called Emotion, which is designed to address child anxiety and depression.
• Emotion is a transdiagnostic, indicated preventive, manual-based intervention. It was completed over eight to 10 weeks by children aged eight to 12 years. Children received either 16 face-to-face sessions or eight sessions face-to-face alternated with eight sessions delivered automated online.
• 1,043 parents of 650 children, aged eight to 12 years, were recruited from 58 public schools in Norway. Five waves of data were obtained from parents who provided reports over three timepoints (baseline, post-intervention and 12 months following the intervention).
• Parents reported on their own symptoms of anxiety and depression, family functioning, parental practices, and their children’s symptoms of anxiety and depression.

What did they find?

• Parents’ symptoms of anxiety and depression were associated with child anxiety and depression across all three timepoints.
• Poorer family functioning was associated with child anxiety and depressive symptoms.
• Children whose parents who scored higher in emotion regulation and resilience were less likely to experience depressive symptoms one year after the intervention.
• Children whose parents helped them set realistic goals, solve problems and persevere through challenges were less likely to experience anxiety and depressive symptoms post-intervention, and less likely to experience anxiety 12 months following the intervention.
• At the baseline time period, children whose parents were dealing with negative emotions were more likely to experience symptoms of anxiety and depression. However, this changed post-intervention and children experienced lower levels of anxiety and depression.

What does this mean for practice?

• Providing early support to parents for their own mental health may improve mental health outcomes for children. Therefore, practitioners should consider assessing parental mental health and provide further information to parents on how to access support.
• There is evidence to suggest that preventative interventions for parents that focus on family functioning, emotional regulation, resilience and coping skills can help with child mental health outcomes.

Why is this important?

• Aboriginal and Torres Strait young people are more likely to experience poorer mental health than their non-Indigenous young peers.
• Aboriginal and Torres Strait Islander young people’s mental health is impacted by disconnection from Country, kin and culture.
• The Western model of mental health care does not align with Aboriginal and Torres Strait Islander understandings of health and wellbeing in which mental health cannot be separated from physical and spiritual health and wellbeing.

What did they do?

• The authors conducted a qualitative evaluation of a cultural therapy program for young people, delivered on Country between October 2021 and April 2024. The program was delivered by two cultural therapists and prioritised Aboriginal and Torres Strait Islander ways of knowing, being and doing.
• A community-based participatory action method was used. Data was collected through participant observation, photography and an Indigenist method of yarning (i.e. a non-hierarchical, circular, multilayered style of conversation).
• Twenty Aboriginal and Torres Strait Islander young people aged seven to 18 years took part in the program, which consisted of six to eight sessions (approximately eight hours in total) and included activities like walking in Country, art, music, dance and animal-assisted therapy.
• The young people who participated had multiple diagnoses, including autism spectrum disorder, attention-deficit disorder, hyperactivity disorder, anxiety, depression and post-traumatic stress disorder.
• Cultural therapy was conducted at two sites: Royal Park, which is a traditional camping ground for members of the Kulin nation, and an animal-assisted therapy practice located 50 kilometres north-west of Melbourne, Australia.
• Each young person, their parent(s)/carer(s) and a cultural therapist participated in a yarn before, immediately after and three months after the completion of the program.
• The authors used a constructivist grounded theory method to analyse the data.

What did they find?

• Young people and their parents/carers all enjoyed the program and reported improvements in emotion regulation, increased resilience and a reduction in symptoms associated with attention-deficit hyperactivity disorder (ADHD).
• The three-month follow-up indicated that social and emotional wellbeing improvements lasted well beyond the cultural therapy sessions.
• Young people, their parents/carers and therapists found cultural therapy effective as it took place on Country. Other elements that contributed towards the effectiveness of cultural therapy included that all activities occurred outdoors; parents/carers and family members were allowed to be present for all activities; and there was no hierarchy, as cultural therapists, young people, parents/carers and families all learnt from one another and from Country.
• Country was described an active co-therapist as participants described being and walking in Country, as well as learning about Country, to be regulating experiences and a key component in the cultural therapy program. They also believed that these practices could be easily incorporated into their everyday lives.

What does this mean for practice?

• Training in cultural therapy for Aboriginal and Torres Strait Islander counsellors may be useful in providing therapy to Aboriginal and Torres Strait young people.
• There may be value in cultural therapists working alongside other primary care professionals, including general practitioners and mental health care practitioners, when providing support to Aboriginal and Torres Strait Islander people.
• Increasing practitioner knowledge on the benefits of cultural therapy may improve the support provided to Aboriginal and Torres Strait Islander young people.