A Scoping Review of Family-Based Prevention Strategies in Adolescent Mental Health

Adolescence is a critical developmental stage with increased risk for mental health problems, where family dynamics and parental involvement play key protective roles. Family-based prevention emerges as a key approach to addressing adolescent needs by preventing the onset and escalation of mental health difficulties, particularly in at-risk but often non-clinical populations. This scoping review systematically synthesizes evidence to examine the roles, characteristics, and reported outcomes of family-based prevention interventions for adolescent mental health across different prevention levels. A comprehensive search was undertaken in multiple scholarly databases, including PubMed, ScienceDirect, Scopus, EBSCOhost, SAGE Journals, Wiley Online Library, and Taylor & Francis Online, and 16 studies were included in the review. The included studies spanned universal, selective, and indicated prevention, as well as programmes framed as primary, secondary, and tertiary prevention. The review identified four primary themes characterizing the interventions of family-based prevention, including parenting skill training programs, family therapy and communication enhancement interventions, risk-specific targeted interventions, and socioeconomic and self-directed family interventions. These thematic strategies highlight different pathways to impact, from strengthening parenting practices and family communication to addressing risk-specific vulnerabilities and socioeconomic stressors. Most studies reported improvements in at least one adolescent mental health or behavioural outcome, although effect sizes and study quality varied and were not formally appraised. The findings reinforce that families remain a powerful context for preventive interventions. Family-based strategies show promise in enhancing adolescent mental health outcomes in various worldwide contexts. Future research should integrate approaches, such as combining parenting skills with economic support or family therapy with digital resources, and address carer well-being to conceptualise the family as a unit of care. In practice, these findings may inform stakeholders seeking to prioritise and refine family-based prevention strategis for adolescent mental health.