The Efficacy of Transdiagnostic Cognitive Behavioral Therapy Compared to a Waitlist Control for Emotional Disorders in Adolescents: A Meta-Analysis of Randomized Controlled Trials.

LEARNING

OBJECTIVES

After participating in this CME activity, the psychiatrist should be better able to:• Explain the evidence supporting the efficacy of tCBT in reducing anxiety and depression symptoms in adolescents.• Discuss the impact of tCBT on adolescent's overall functioning.• Identify factors that may influence treatment outcomes, including the role of parental involvement.

INTRODUCTION

Transdiagnostic cognitive behavioral therapy (tCBT) is an emerging treatment modality that targets shared psychological mechanisms across disorders. Use of tCBT for treating emotional disorders in adolescents compared to a waitlist control, however, remains underexplored. This study assessed the efficacy of tCBT in treating emotional disorders among adolescents through a meta-analysis of randomized controlled trials (RCTs).

METHODS

This meta-analysis included RCTs that examined tCBT interventions delivered to adolescents (aged 10-19) with clinically diagnosed anxiety, depression, and/or mixed emotional disorders. Eligible studies used standardized cognitive behavioral therapy-based transdiagnostic protocols and compared outcomes with waitlist control groups. Searched databases included PubMed, Cochrane Library, and ClinicalTrials.gov. Seven trials with a combined sample of 324 participants met inclusion criteria. Primary outcomes included changes in anxiety and depression symptoms, with overall functioning as a secondary outcome. Standardized mean differences (SMDs) were pooled using a random-effects model. Subgroup analyses were performed based on parental involvement.

RESULTS

tCBT significantly improved anxiety (SMD = -0.59; 95% CI: -0.95, -0.23; p= 0.001), depression (SMD = -0.57; 95% CI: -0.98, -0.16; p = 0.006), and overall functioning (SMD = -0.56; 95% CI: -0.99, -0.13; p = 0.01) compared to waitlist controls. Subgroup analyses indicated that greater parental involvement associated with stronger treatment effects, particularly for depressive symptoms. The risk of bias was low in most included studies.

CONCLUSIONS

Transdiagnostic CBT appears to be an effective intervention for managing emotional disorders in adolescents, offering benefits across anxiety, depression, and functioning.