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Computerised therapies for anxiety and depression in children and young people: A systematic review and meta-analysis
Open accessAbstract
One quarter of children and young people (CYP) experience anxiety and/or depression before adulthood, but treatment is sometimes unavailable or inadequate. Self-help interventions may have a role in augmenting treatment and this work aimed to systematically review the evidence for computerised anxiety and depression interventions in CYP aged 5-25 years old. Databases were searched for randomised controlled trials and 27 studies were identified. For young people (12-25 years) with risk of diagnosed anxiety disorders or depression, computerised CBT (cCBT) had positive effects for symptoms of anxiety (SMD -0.77, 95% CI -1.45 to -0.09, k = 6, N = 220) and depression (SMD -0.62, 95% CI -1.13 to -0.11, k = 7, N = 279). In a general population study of young people, there were small positive effects for anxiety (SMD -0.15, 95% CI -0.26 to -0.03; N = 1273) and depression (SMD -0.15, 95% CI -0.26 to -0.03; N = 1280). There was uncertainty around the effectiveness of cCBT in children (5-11 years). Evidence for other computerised interventions was sparse and inconclusive. Computerised CBT has potential for treating and preventing anxiety and depression in clinical and general populations of young people. Further program development and research is required to extend its use and establish its benefit in children.
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“Furthermore, computerized CBT, such as MoodGym, SPARX, and “Think, Feel, Do” generally have small but positive effects on mental health.96 , 97”
From Rapid Systematic Review: The Impact of Social Isolation and Loneliness on the Mental Health of Children and Adolescents in the Context of COVID-19 (2020) · cites this paper as [96]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Importantly, reviews have tended to conclude that effects are better if there is some therapist input97 , 101 and if parents are involved especially for younger children.96 , 97”
From Rapid Systematic Review: The Impact of Social Isolation and Loneliness on the Mental Health of Children and Adolescents in the Context of COVID-19 (2020) · cites this paper as [96]
Experimental — accuracy not yet measuredIn the citing paper
“The efficacy of DHIPSY for some common mental disorders in children and adolescents has been established using meta-analyses [12,16-19].”
From Mechanisms of Change in Digital Health Interventions for Mental Disorders in Youth: Systematic Review (2021) · cites this paper as [17]
In the citing paper
“In the past 5 years, a number of literature reviews have highlighted the increase in research and development activities for eMental healthcare technologies for children and adolescents [18-22].”
From eMental Healthcare Technologies for Anxiety and Depression in Childhood and Adolescence: Systematic Review of Studies Reporting Implementation Outcomes (2018) · cites this paper as [21]
In the citing paper
“Most importantly, DMH tools do not remotely approximate the level of attractiveness and interactivity to which young “digital natives” have grown accustomed [17,32,43].”
From Use of the Principles of Design Thinking to Address Limitations of Digital Mental Health Interventions for Youth: Viewpoint (2019) · cites this paper as [32]
In the citing paper
“However, analyses comparing DMH interventions for both anxiety and depression with active nontherapeutic controls have generally failed to show superiority of DMH interventions [31,32].”
From Use of the Principles of Design Thinking to Address Limitations of Digital Mental Health Interventions for Youth: Viewpoint (2019) · cites this paper as [32]
In the citing paper
“In contrast, Pennant and colleagues [32] showed that face-to-face CBT was more effective than DMH interventions.”
From Use of the Principles of Design Thinking to Address Limitations of Digital Mental Health Interventions for Youth: Viewpoint (2019) · cites this paper as [32]
In the citing paper
“In the understandable and commendable effort to remain “evidence-based,” most DMH interventions for youth are a little-more-than modified and uploaded CBT manuals and workbooks (eg, MoodGym, Cool Kids, Camp Cope-a-lot, and BRAVE; for a review discussing the evidence base of these DMH interventions, see [32,44]).”
From Use of the Principles of Design Thinking to Address Limitations of Digital Mental Health Interventions for Youth: Viewpoint (2019) · cites this paper as [32]
In the citing paper
“Furthermore, problems such as insufficient search processes of the literature, small sample sizes, differences at baseline in study samples, and publication bias play important roles in the quality of these studies [32,39].”
From Use of the Principles of Design Thinking to Address Limitations of Digital Mental Health Interventions for Youth: Viewpoint (2019) · cites this paper as [32]
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Metadata
- Authors
- Pennant, M. E., Loucas, C. E., Whittington, C., Creswell, C., Fonagy, P., Fuggle, P., Kelvin, R., Naqvi, S., Stockton, S., & Kendall, T.
- Affiliations
- Royal College of Psychiatrists (GB)
- University College London (GB)
- University of Reading (GB)
- Anna Freud Centre (GB)
- University of Cambridge (GB)
- Corresponding author
- Pennant, Mary E.
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2015-04
- Volume
- 67
- Pages
- 1-18
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W1985615249
- Cited by
- 269
- References
- 68
- Citations by year
- 2026: 16 · 2025: 19 · 2024: 22 · 2023: 18 · 2022: 29 · 2021: 35 · 2020: 30 · 2019: 34 · 2018: 19 · 2017: 24 · 2016: 16 · 2015: 7
- FWCI
- 3.03
- Type
- journal article
- Language
- en
- Open access
- green
- discovery.ucl.ac.uk
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Department of Health and Social Care
- National Institute for Health and Care Excellence
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- computerized cognitive behavioral therapy, childhood anxiety, adolescent depression, children and young people, self-help intervention, anxiety symptoms, depressive symptoms, prevention of mental disorders
- MeSH terms
- Adolescent, Adult, Anxiety Disorders, Child, Child, Preschool, Computers, Depressive Disorder, Female, Humans, Male, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome, Internet, Young Adult, Mobile Applications
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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