Effectiveness of psychotherapy with children and adolescents: A meta-analysis for clinicians.

Abstract

How effective is psychotherapy with children and adolescents? The question was addressed by metaanalysis of 108 well-designed outcome studies with 4-18-year-old participants. Across various outcome measures, the average treated youngster was better adjusted after treatment than 79% of those not treated. Therapy proved rnore effective for children than for adolescents, particularly when the therapists were paraprofessionals (e.g., parents, teachers) or graduate students. Professionals (with doctor's or master's degrees) were especially effective in treating overcontrolled problems (e.g., phobias, shyness) but were not more effective than other therapists in treating undercontrolled problems (e.g., aggression, impulsivity). Behavioral treatments proved more effective than nonbehavioral treatments regardless of client age, therapist experience, or treated problem. Overall, the findings revealed significant, durable effects of treatment that differed somewhat with client age and treatment method but were reliably greater than zero for most groups, most problems, and most methods. In the late 1970s and early 1980s, experts raised diverse concerns about child and adolescent psychotherapy research. Some complained of insufficient information about therapy outcomes (e.g., Achenbach, 1982). Others suggested that outcome studies revealed few or no effects of therapy (e.g., Gelfand, Jenson, & Drew, 1982). Still others (e.g., Barrett, Hampe, & Miller, 1978) argued that researchers were too preoccupied with the global question of psychotherapy effects per se and should instead study outcomes as a function of treatment approach, type of child, and therapist characteristics. In recent years, the prospects for addressing these concerns have improved considerably. With the development of meta-analytic techniques (Smith, Glass, & Miller, 1980), it is now possible to aggregate findings across multiple studies and to systematically compare findings across dimensions such as treatment approach and client characteristics. The basis for analysis is the effect size, which is computed separately for the treatment group versus control group comparisons of interest. The effect size is an estimate of the magnitude of the treatment effect (treatment group versus control group scores on measures of psychological functioning) adjusted for sample variability. Meta-analyses of adult outcome studies (Shapiro & Shapiro, This project was facilitated by support from the North Carolina Division of Mental Health, Mental Retardation, and Substance Abuse Services (Department of Human Resources) and by National Institute of Mental Health Grant R01 MH 38240-01. We are grateful to David Langmeyer for his support and suggestions, to Gary Bornstein, Larry Crum, and Lynn Fisher for their assistance in data collection and computation, and to Thomas Achenbach for his thoughtful review of an earlier draft of this article.

Effects of psychotherapy for depression in children and adolescents: A meta-analysis.

“…When we entered each of the treatment versus control group ES values separately, as some previous meta-analyses have done, the mean was 0.38 (SD = 0.42; range was from −0.66 to 2.02, reflecting 44 treatment-control group comparisons), also significantly different from zero ( p < .01). Comparison with nondepression studies in previous meta-analyses-To compare the mean ES for depression with the mean ES found for treatment of problems and disorders other than depression, we pooled data from two previous broad-based meta-analyses encompassing treatments for diverse child and adolescent conditions (Weisz et al, 1995;Weisz, Weiss, Alicke, & Klotz, 1987). We identified all studies in those two meta-analyses that tested treatments for conditions other than depression (e.g., aggression, disruptive behavior, attention-deficit/hyperactivity disorder, fears).…”

Transtornos ansiosos na infância e adolescência: aspectos clínicos e neurobiológicos

“…16 Review studies suggest that cognitive-behavioral therapy (CBT) is a provably efficient psychological treatment for ADCA. [17][18][19][20][21] Although no comparative studies exist on the efficacy of different cognitive-behavioral techniques for the treatment of anxiety disorders in this specific age group, treatments that combine CBT with target symptoms (e.g. : relaxation in predominantly tense children and exposure in children with phobias) are more efficient than those that randomly use a collection of techniques.…”

The Relations among Measurements of Informant Discrepancies within a Multisite Trial of Treatments for Childhood Social Phobia

“…However, most discrepancies typically fall in the moderate-to-large range (De Los Reyes and Kazdin 2005). Second, informant discrepancies frequently translate into inconsistent outcomes within controlled treatment trials (e.g., De Los Reyes and Kazdin 2008;Weisz et al 2006;Weisz et al 1987), making it difficult to definitively determine treatment efficacy. Third, discrepancies may indicate the development of poor child and family psychosocial outcomes.…”