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Review
. 2025 May 8.
doi: 10.1007/s10578-025-01847-x. Online ahead of print.

Cognitive Behavioral Interventions for School Attendance Problems: A Systematic Review and Meta-analysis

Sarah Jakobsen  1 , Katrine B Tølbøll  2   3 , Mikael Thastum  4 , Johanne J Lomholt  4
Affiliations
Review

Cognitive Behavioral Interventions for School Attendance Problems: A Systematic Review and Meta-analysis

Sarah Jakobsen et al. Child Psychiatry Hum Dev. .

Abstract

This pre-registered (#CRD42024509947) systematic review synthesized evidence on cognitive behavioral interventions (CBTs) for youths with school attendance problems (SAPs). The PsycINFO, PubMed, ERIC, and Scopus databases were searched through 1985-2024 for randomized controlled trials (RCTs), non-RCTs, and open trials (OTs) evaluating SAP-focused CBT. Data were synthesized narratively and through meta-analysis. Four RCTs and eleven OTs met eligibility criteria, including 932 youths. Meta-analyses revealed small to large uncontrolled pre- to post-intervention effects for school attendance (g = 1.02), anxiety (g = - 0.57), depression (g = - 0.66), and behavioral problems (g = - 0.40), which were maintained at follow-up. When compared to a control, CBT had a medium effect on school attendance (g = 0.44) but non-significant effects on anxiety (g = - 0.09) and depression (g = - 0.14). While the results hold promise for SAP-focused CBTs, evidence was limited by study heterogeneity, bias risks, methodological limitations, and inconsistent outcome measures, highlighting the needed for further RCTs.

Keywords: Cognitive behavioral therapy; Meta-analysis; School attendance problems; Systematic review.

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Conflict of interest statement

Declarations. Competing Interests: The authors declare no competing interests.

References

    1. Attwood G, Croll P (2006) Truancy in secondary school pupils: prevalence, trajectories and pupil perspectives. Res Papers Educ 21(4):467–484. https://doi.org/10.1080/02671520600942446 - DOI
    1. Australian Curriculum Assessment and Reporting Authority (2024) National report on schooling in Australia: student attendance. Student attendance. https://www.acara.edu.au/reporting/national-report-on-schooling-in-austr... . (Last accessed 22 Sep 2024)
    1. Balduzzi S, Rücker G, Schwarzer G (2019) How to perform a meta-analysis with R: a practical tutorial. Evid Based Ment Health, 153–160
    1. Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50(4):1088–1101 - DOI - PubMed
    1. Chockalingam M, Skinner K, Melvin G, Yap MBH (2023) Modifiable parent factors associated with child and adolescent school refusal: A systematic review. Child Psychiatry Hum Dev 54(5):1459–1475. https://doi.org/10.1007/s10578-022-01358-z - DOI - PubMed

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