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A meta-analysis of studies measuring PRF using the Parental Reflective Functioning Questionnaire (PRFQ) indicated small, non-significant effects, with high heterogeneity across studies. Narrative synthesis of 19 studies suggested generally positive outcomes, including improvements in PRF, child emotional regulation and parental stress, though findings were inconsistent. The variability in outcomes likely reflects methodological limitations, including lack of control groups, limited fidelity reporting, and diversity in intervention protocols and outcome measures. Only a minority of studies clearly adhered to manualised MBT models. While some high-quality studies showed sustained benefits, the evidence remains inconclusive regarding PRF as a primary mechanism of change. 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