Strengths-Based Programs for Youth at Risk for Toxic Stress: A Scoping Review of Programs Targeting Mental Health, Substance Use, Parenting Skills, and Family Functioning

Abstract

This scoping review explores and describes recent strengths-based programs for use among youth (ages 12–24) at risk for toxic stress that target mental health (MH) or substance use (SU) outcomes through improving family functioning (FF) and/or parenting skills (PS). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, seven databases were searched for peer-reviewed articles published between 2018 and 2023. Inclusion criteria included articles describing programs delivered to both youth and caregivers that targeted MH or SU outcomes through improving FF and/or PS. Thirty-three articles describing 33 programs were identified, 25 of which were research studies. Programs predominantly employed behavioral frameworks with varied duration and caregiver involvement. Most targeted MH outcomes, with fewer addressing SU. Positive outcomes included reductions in youth depression and anxiety, and improvements in emotional regulation and FF. Gaps identified included a majority of studies conducted in high-income countries, a prevalence of non-experimental designs, and a lack of standardized outcome measures. Results highlight the potential of family-centered, relational health-based interventions in promoting youth resilience and identify a need for more rigorous evaluations, culturally-responsive interventions, and increased research in low- and middle-income countries. This review underscores the promise of these interventions while revealing significant areas for future research to enhance effectiveness and applicability among adversity-impacted youth.