Cognitive behavioral training was also consistently effective in six studies reviewed in this synthesis. Unlike the BPT studies, reductions in parental distress were the primary target of these interventions. CBT was used to provide parents with coping skills for reducing or preventing the effects of environmental stress associated with parenting children with developmental disabilities. Rather than attempting to effect parent–child behavior change, these interventions were designed for parents to learn and support the use of self-management skills that would directly impact their own well being. When CBT was the sole treatment approach, the average unweighted effect size was d 5 0.34, evidence for relatively small but consistent benefits. These interventions for the most part were transferred from stress management and psychotherapy treatments for people in the general population.