Meta-analysis: The Effectiveness of Youth Psychotherapy Interventions in Low- and Middle-Income Countries

Meta-analysis: The Effectiveness of Youth Psychotherapy Interventions in Low- and Middle-Income Countries

Venturo-Conerly, K. E. Eisenman, D. Wasil, A. R. Singla, D. R. Weisz, J. R.
Journal of the American Academy of Child & Adolescent Psychiatry
OBJECTIVE Because most youth psychotherapies are developed and tested in high-income countries, relatively little is known about their effectiveness or moderators in low- and middle-income countries (LMICs). To address this gap, we conducted a meta-analysis of randomized controlled trials (RCTs) testing psychotherapies for youth with multiple psychiatric conditions in LMICs, and we tested candidate moderators. METHOD We searched nine international databases for RCTs of youth psychotherapies in LMICs published through January 2021. The RCTs targeted elevated symptoms of youth anxiety (including post-traumatic stress disorder [PTSD] and obsessive compulsive disorder [OCD]), depression, conduct, and attention problems. Using robust variance estimation, we estimated the pooled effect sizes (Hedges g) at post-treatment and follow-up for intervention versus control conditions. RESULTS Of 5,145 articles identified, 34 (with 43 treatment-control comparisons and N=4176 participants) met methodological standards and were included. The overall pooled g with winsorized outliers was 1.01 (95% CI=0.72 1.29, p<.001) at post-treatment and 0.68 (95% CI=0.29 1.07, p=.003) at follow-up. Interventions delivered by professional clinicians significantly outperformed those delivered by lay-providers (g=1.59 vs. 0.53). Interventions developed non-locally were more effective if not adapted to local contexts than if adapted locally (g=2.31 vs. 0.66), highlighting a need for further research on effective adaptations. Significant risk of bias was identified. CONCLUSION Overall pooled effects of youth psychotherapies in LMICs were markedly larger than those in recent comparable non-LMIC meta-analyses, which have shown small-to-medium effects for youth psychotherapies. Findings highlight the potential benefits of youth psychotherapies in LMICs as well as a need for more RCTs and improved study quality.

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Behandling og hjelpetiltak


Psykiske vansker og lidelser


Antisosial atferd (vold/aggresjon, ungdomskriminalitet)

Følelsesmessige problemer

Depresjon og nedstemthet (inkl. både vansker og lidelse)


Angst og engstelighet (inkl. både vansker og lidelse)

Tvangsforstyrrelser (OCD)

Traumatiske belastninger/stress (PTSD)


Psykologiske behandlingsmetoder

Foreldreveiledning/-terapi (feks COS, ICDP)

Kognitiv atferdsterapi, atferdsterapi og kognitiv terapi


Barn i førskolealder (3-5 år)

Barn i skolealder (6-12 år)

Ungdom (13-18 år)

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