Multi-component interventions combining psychotherapy and physical activity for children and young peoples' mental health: A scoping review.

Multi-component mental health interventions, combining psychotherapy and physical activity (PA), have shown potential with adult populations, but their use with children and young people (CYP) remains unclear. This scoping review aimed to synthesize existing evidence on interventions that incorporate both psychotherapy and PA for CYP (4-18 years). Using Arksey and O'Malley's framework, and incorporating revisions from Levac, Colquhoun and O'Brien, Joanna Briggs Institute (JBI) methodology for scoping reviews, and PRISMA Extension for Scoping Reviews (PRISMA-ScR) recommendations, the review explored academic literature using five databases, as well as grey literature sources and clinical trial registries. Twenty-eight sources of evidence met the inclusion criteria and highlighted three main approaches to PA integration within the interventions: concurrent integration, asynchronous integration, and integration through PA planning and psychoeducation. A mixed pattern emerged, with six of twelve randomised controlled trials (RCTs) demonstrating statistically significant improvements in mental health and well-being outcomes. This review also raises critical questions about the development of theoretically grounded PA components and exploration of strategies for long-term sustainability and highlights the need for a structured approach to PA integration. Future research should prioritise understanding CYP's perspectives on the feasibility and acceptability of multi-component interventions. Addressing these areas will support the development of more robust and sustainable interventions, which could become vital in future CYP mental health initiatives. Overall, this review offers novel insights into the integration of psychotherapy and PA in CYP mental health interventions and informs future research and practice in this area.