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Review: evidence-based psychotherapies are more effective than usual care for young people with psychopathology: effects are influenced by location of care and participant characteristics

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Question

Question: Are evidence-based psychotherapies better than usual care for treating psychopathology in children and adolescents?

Outcomes: Improvement in psychopathology (symptoms, functioning or other outcomes) as assessed by the included studies.

Methods

Design: Systematic review and meta-analysis.

Data sources: PubMed, PsychoINFO and the Dissertation Abstracts International Database (search from 1 January 1960 to 31 December 2010), supplemented by hand search of reference lists of reviews and meta-analyses of youth psychotherapy and contact with investigators in the field.

Study selection and analysis: Randomised controlled trials (RCTs) that compared evidence-based psychotherapies (EBPs, defined as treatments listed in at least one systematic review of EBPs for youths) with usual care for psychopathology in children and adolescents (age 3–18 years). Usual care included psychotherapy, counselling or other non-medical intervention provided through outpatient clinics, public programmes and agencies or residential facilities. Psychopathology included internalising as well as externalising disorders, either meeting Diagnostic and Statistical Manual (DSM) criteria or showing elevated behavioural/emotional symptoms. Effect sizes (reflecting standardised mean difference between EBP and usual care) were calculated for each trial, …

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