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, Rebecca-Lee Kuhnert, Cassie H. Lavell, Ronald M. Rapee*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

13 Citations (Scopus)
112 Downloads (Pure)

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.

Original languageEnglish
Pages (from-to)720–736
Number of pages17
JournalClinical Child and Family Psychology Review
Volume25
Issue number4
Early online date7 Jul 2022
DOIs
Publication statusPublished - Dec 2022

Bibliographical note

Copyright the Author(s) 2022. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

  • functioning
  • psychotherapy
  • anxiety
  • children
  • adolescents
  • meta-analysis

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