Who determines the outcome? A three-level meta-analysis on systemic therapy in children and adolescents
- Forfatter(e)
- Braus, N., Flückiger, C., Wichmann, J., Frankman, C., Gräfenkämper, R., Zemp, M., Hunger-Schoppe, C.
- År
- 2025
- Tidsskrift
- Psychotherapy Research
- Sider
- 15
- Kategori(er)
- Depresjon og nedstemthet (inkl. både vansker og lidelse) Rus (alkohol, illegale rusmidler) Angst og engstelighet (inkl. både vansker og lidelse) Autismespekter ADHDSpiseforstyrrelser
- Tiltakstype(r)
- FamilieterapiNettverksbaserte tiltak
- Abstract
Objective
Systemic therapy (ST) is a well-established treatment approach to reduce symptoms, yet its effects across outcome domains, informants, and assessment methods remain underexplored.
Method
We conducted a systematic literature review in multiple databases (PsycINFO, Pubmed, Embase, Cochrane CENTRAL), including RCT-studies comparing ST with a psychosocial control treatment for diagnosed children or adolescents. We conducted a three-level meta-analysis. Risk of bias was assessed using an adaptation for psychotherapy.
Results
Overall, we included 44 studies, 370 effect sizes, and 4617 families. The overall effect size was small but significant (g = .16, CI [.09, .23], p < .0001). Contrary to expectations, informants and assessment methods were no significant moderators. Effects were comparable across outcome domains including family functioning (g = .12), caregivers' psychopathology (g = .12) and patient symptoms (g = .19). Outcomes were mostly based on self-report symptom questionnaires, limiting interpretability.
Conclusion
Findings support that ST improves family functioning and caregivers' psychopathology, underscoring the need for more diverse outcomes.