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Meta-Analysis
. 2022 Dec;25(4):720-736.
doi: 10.1007/s10567-022-00402-7. Epub 2022 Jul 7.

Impact of Psychotherapy for Children and Adolescents with Anxiety Disorders on Global and Domain-Specific Functioning: A Systematic Review and Meta-analysis

Sophie J Dickson  1 , Rebecca-Lee Kuhnert  1 , Cassie H Lavell  1 , Ronald M Rapee  2
Affiliations
Meta-Analysis

Impact of Psychotherapy for Children and Adolescents with Anxiety Disorders on Global and Domain-Specific Functioning: A Systematic Review and Meta-analysis

Sophie J Dickson et al. Clin Child Fam Psychol Rev. 2022 Dec.

Abstract

A substantial empirical base supports the use of psychotherapy to alleviate anxiety symptoms and diagnoses in children and adolescents. However, focusing only on symptom or diagnostic reduction provides an incomplete picture of clinically meaningful efficacy given that anxiety disorders in this age group are integrally associated with problems in functioning. A systematic review and meta-analysis (N studies = 40, N participants = 3094) evaluating the impacts of psychotherapy for anxiety was conducted on the following outcomes: global functioning, social functioning, academic functioning, and school attendance. Randomised controlled trials with a passive control condition, a child and/or adolescent sample (7-17 years) with a primary anxiety diagnosis, and receiving anxiety-focused psychotherapy were eligible for inclusion if they reported suitable outcome data. Results from the meta-analysis indicated that from pre- to post-treatment, psychotherapy led to significant improvements in global functioning according to clinician (d = 1.55), parent (d = 0.67), and child (d = 0.31) reports and on social functioning according to parent (d = 0.51), but not child (d = 0.31) reports. The qualitative review provided preliminary support psychotherapy's efficacy in increasing family functioning and school attendance, but not so much in enhancing academic performance. These results indicate that psychotherapy improves daily functioning in anxious children and adolescents. The study also highlighted the limited attention paid to measures of functioning in the empirical literature on treatment of childhood anxiety.Trial Registry: This study is registered with PROSPERO under the identification number CRD42021246565.

Keywords: Adolescents; Anxiety; Children; Functioning; Meta-analysis; Psychotherapy.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of literature search and study selection. From Page et al., (2021)
Fig. 2
Fig. 2
Risk of bias summary: review authors’ judgements about each risk of bias item for each included study
Fig. 3
Fig. 3
Forest plot of comparison: psychotherapy vs control, outcome: global functioning—clinician report by therapy intensity
Fig. 4
Fig. 4
Forest plot of comparison: psychotherapy vs control, outcome: global functioning—clinician report by delivery format
Fig. 5
Fig. 5
Forest plot of comparison: psychotherapy vs control, outcome: global functioning—parent report
Fig. 6
Fig. 6
Forest plot of comparison: psychotherapy vs control, outcome: global functioning—child report
Fig. 7
Fig. 7
Forest plot of comparison: psychotherapy vs control, outcome: social functioning—parent report
Fig. 8
Fig. 8
Forest plot of comparison: psychotherapy vs control, outcome: social functioning—child report
See this image and copyright information in PMC

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