Quantitative and Qualitative Outcomes of Non-Violent Resistance (NVR) Interventions for Children and Adolescents with Emotional and Behavioural Difficulties and their Caregivers – A Systematic Review

BackgroundNon-Violent Resistance (NVR) is an approach of parent training developed to respond to child behavioural difficulties including aggression and risk-taking behaviours. NVR is offered in child and adolescent mental health services across Europe. There has been no published systematic review exploring the effectiveness of this intervention to date. We therefore aimed to examine the outcomes of NVR training for children, adolescents and their caregivers.MethodsA systematic literature search was conducted using multiple databases. Critical appraisal skills programme checklists were used to appraise the quality of studies.ResultsWe identified five randomised controlled trials, two simple ‘before and after’ studies, two qualitative studies, one study reporting mixed outcomes and nine articles including case reports. A range of different outcome measures were reported. Overall, the review suggests that NVR shows promise in improving parent-reported child behavioural difficulties, such as externalising symptoms. There is also evidence of improvement in areas of parents’ helplessness, stress and behaviours. However, it is unclear if these outcomes are maintained in the longer term.ConclusionsOverall, the evidence base for NVR is relatively limited, especially for informing service provision and commissioning decisions. Further research with RCTs, larger sample sizes and longer follow-up is required to enhance the evidence base.