What five decades of research tells us about the effects of youth psychological therapy: A multilevel meta-analysis and implications for science and practice

John R. Weisz, Sofie Kuppens, Mei Yi Ng, Dikla Eckshtain, Ana M. Ugueto, Rachel Vaughn-Coaxum, Amanda Jensen-Doss, Kristin M. Hawley, Lauren S. Krumholz Marchette, Brian C. Chu, V. Robin Weersing, Samantha R. Fordwood

Research output: Contribution to journalArticle

167 Scopus citations

Abstract

Across 5 decades, hundreds of randomized trials have tested psychological therapies for youth internalizing (anxiety, depression) and externalizing (misconduct, attention deficit and hyperactivity disorder) disorders and problems. Since the last broad-based youth metaanalysis in 1995, the number of trials has almost tripled and data-analytic methods have been refined. We applied these methods to the expanded study pool (447 studies; 30,431 youths), synthesizing 50 years of findings and identifying implications for research and practice. We assessed overall effect size (ES) and moderator effects using multilevel modeling to address ES dependency that is common, but typically not modeled, in meta-analyses. Mean posttreatment ES was 0.46; the probability that a youth in the treatment condition would fare better than a youth in the control condition was 63%. Effects varied according to multiple moderators, including the problem targeted in treatment: Mean ES at posttreatment was strongest for anxiety (0.61), weakest for depression (0.29), and nonsignificant for multiprob lem treatment (0.15). ESs differed across control conditions, with "usual care" emerging as a potent comparison condition, and across informants, highlighting the need to obtain and integrate multiple perspectives on outcome. Effects of therapy type varied by informant; only youth-focused behavioral therapies (including cognitive-behavioral therapy) showed similar and robust effects across youth, parent, and teacher reports. Effects did not differ for Caucasian versus minority samples, but more diverse samples are needed. The findings underscore the benefits of psychological treatments as well as the need for improved therapies and more representative, informative, and rigorous intervention science.

Original languageEnglish (US)
Pages (from-to)79-117
Number of pages39
JournalAmerican Psychologist
Volume72
Issue number2
DOIs
StatePublished - Feb 1 2017

Keywords

  • Children
  • Meta-analysis
  • Psychological therapy
  • Treatment outcome
  • Youth

ASJC Scopus subject areas

  • Psychology(all)

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    Weisz, J. R., Kuppens, S., Ng, M. Y., Eckshtain, D., Ugueto, A. M., Vaughn-Coaxum, R., Jensen-Doss, A., Hawley, K. M., Krumholz Marchette, L. S., Chu, B. C., Robin Weersing, V., & Fordwood, S. R. (2017). What five decades of research tells us about the effects of youth psychological therapy: A multilevel meta-analysis and implications for science and practice. American Psychologist, 72(2), 79-117. https://doi.org/10.1037/a0040360