Relating to studies’ design, two considerations for future research
should be noted. First, our systematic review revealed a lack
of randomized trials comparing digital led and therapist led behavioral
programs (individual or group behavioral interventions,
but without a technological component), which is necessary to
understand the therapeutic impact of digital programs. Another
relevant yet missing comparator would be the usual care of youth
with disruptive behavioral problems that all too often do not include
formal evidence-based psychological interventions (Knapp et al.
2012; Rosato et al. 2012). Comparison with usual care would enable
us to gauge the real-world clinical utility of digital-based
parent training. Such studies should focus not only on efficacy but
also on sustainability and cost effectiveness of the face-to-face and
digitally based approaches. Second, while the reviewed programs’
efficacy was evaluated using standardized methods, none of these
studies provided data suggesting that the program resulted in earlier
engagement with services, or engagement with care of a population
that would not otherwise receive these services due to causes such
as stigma, lack of access, or costs. Hence, following the establishment
of these programs’ efficacy, their promise in providing
different pathways to care that enable better access and use of
services should clearly be examined.