Targeted psychotherapies work best for children and adolescents with anxiety disorders, according to major new meta-analysis


Around 10% of children are diagnosed with anxiety disorders before the age of 16 and for many this can be a long lasting problem that has a major impact on their development.

There’s lots of research in this field and many systematic reviews have been conducted to assess the effectiveness of talking treatments for this population. However, many of the reviews have excluded certain conditions (e.g. OCD and PTSD) and the broad range of talking therapies from their analysis.

This new systematic review is the first to bring together all of the various anxiety disorders and psychotherapies into one well conducted meta-analysis.

The authors carried out a systematic search and found 55 trials to include in their review. The quality of trials was variable, some were underpowered, it was unusual for side effects to be measured and follow-up was rarely carried out. Recently conducted trials seemed to be of better quality than older studies, but the authors emphasised the importance of future research following trial reporting standards such as CONSORT.

Here’s what they found:

  • Psychotherapies for anxiety in children and young people were moderately effective overall, but effect sizes were lower in trials where psychotherapies were compared to an active control condition
  • Non-CBT psychotherapies were not effective
  • Parental involvement in therapy was not associated with better outcomes
  • Targeted treatments were more effective than therapies that were aimed at a range of disorders

The reviewers concluded:

Anxiety disorders in children can be treated effectively and there is sufficient evidence to recommend psychological therapy, specifically behavioural or cognitive behavioural therapy. The current evidence is adequate to provide broad guidance for service development and service delivery as well as in guiding parents and young people themselves. However the moderate effect sizes derived from treatment studies mean that there is considerable room for improvement in treatment outcomes.

Reynolds S, Wilson C, Austin J, Hooper L. Effects of psychotherapy for anxiety in children and adolescents: A meta-analytic review. Clin Psychol Rev. 2012 Feb 13;32(4):251-262. [PubMed abstract].

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