This pre-registered (#CRD42024509947) systematic review synthesized evidence on cognitive behavioral interventions (CBTs) for youths with school attendance problems (SAPs). The PsycINFO, PubMed, ERIC, and Scopus databases were searched through 1985-2024 for randomized controlled trials (RCTs), non-RCTs, and open trials (OTs) evaluating SAP-focused CBT. Data were synthesized narratively and through meta-analysis. Four RCTs and eleven OTs met eligibility criteria, including 932 youths. Meta-analyses revealed small to large uncontrolled pre- to post-intervention effects for school attendance (g = 1.02), anxiety (g = - 0.57), depression (g = - 0.66), and behavioral problems (g = - 0.40), which were maintained at follow-up. When compared to a control, CBT had a medium effect on school attendance (g = 0.44) but non-significant effects on anxiety (g = - 0.09) and depression (g = - 0.14). While the results hold promise for SAP-focused CBTs, evidence was limited by study heterogeneity, bias risks, methodological limitations, and inconsistent outcome measures, highlighting the needed for further RCTs.
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