Technology Delivered Interventions for Depression and Anxiety in Children and Adolescents: A Systematic Review and Meta-analysis

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Abstract

Depression and anxiety are common during adolescence. Whilst effective interventions are available treatment services are limited resulting in many adolescents being unable to access effective help. Delivering mental health interventions via technology, such as computers or the internet, offers one potential way to increase access to psychological treatment. The aim of this systematic review and meta-analysis was to update previous work and investigate the current evidence for the effect of technology delivered interventions for children and adolescents (aged up to 18 years) with depression and anxiety. A systematic search of eight electronic databases identified 34 randomized controlled trials involving 3113 children and young people aged 6–18. The trials evaluated computerized and internet cognitive behavior therapy programs (CBT: n = 17), computer-delivered attention bias modification programs (ABM: n = 8) cognitive bias modification programs (CBM: n = 3) and other interventions ( n = 6). Our results demonstrated a small effect in favor of technology delivered interventions compared to a waiting list control group: g = 0.45 [95% CI 0.29, 0.60] p < 0.001. CBT interventions yielded a medium effect size ( n = 17, g = 0.66 [95% CI 0.42–0.90] p < 0.001). ABM interventions yielded a small effect size ( n = 8, g = 0.41 [95%CI 0.08–0.73] p < 0.01). CBM and ‘other’ interventions failed to demonstrate a significant benefit over control groups. Type of control condition, problem severity, therapeutic support, parental support, and continuation of other ongoing treatment significantly influenced effect sizes. Our findings suggest there is a benefit in using CBT based technology delivered interventions where access to traditional psychotherapies is limited or delayed.

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Author and article information

Contributors

Rebecca Grist:

ORCID: http://orcid.org/0000-0002-4285-5272

+44225 385086 , r.grist@brighton.ac.uk

Journal

Journal ID (nlm-ta): Clin Child Fam Psychol Rev

Journal ID (iso-abbrev): Clin Child Fam Psychol Rev

Title: Clinical Child and Family Psychology Review

Publisher: Springer US (New York )

ISSN (Print): 1096-4037

ISSN (Electronic): 1573-2827

Publication date (Electronic): 18 September 2018

Publication date PMC-release: 18 September 2018

Publication date (Print): 2019

Volume: 22

Issue: 2

Pages: 147-171

Affiliations

[1 ]ISNI 0000 0001 2162 1699, GRID grid.7340.0, Department for Health, , University of Bath, ; 6.19 Wessex House, Bath, BA2 7AY UK

[2 ]ISNI 0000 0004 0573 576X, GRID grid.451190.8, Oxford Health NHS Foundation Trust, Child, and Adolescent Mental Health Service, ; Temple House, Keynsham, UK

[3 ]ISNI 0000000121073784, GRID grid.12477.37, School of Applied Social Science, , University of Brighton, ; Mayfield House, Falmer, Brighton, BN1 9PH UK

Author information

Rebecca Grist http://orcid.org/0000-0002-4285-5272

Article

Publisher ID: 271

DOI: 10.1007/s10567-018-0271-8

PMC ID: 6479049

PubMed ID: 30229343

SO-VID: d8152c76-ff30-42cb-aaa3-307cb3c56a03

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.