Who determines the outcome? A three-level meta-analysis on systemic therapy in children and adolescents.
Niels Braus, Christoph Flückiger, Johanna Wichmann et al.
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In 30 seconds
This systematic review and three-level meta-analysis examined randomised controlled trials comparing systemic therapy (ST) with psychosocial control treatments in children and adolescents with diagnosed conditions. Across 44 studies involving 4617 families, ST had a small but statistically significant overall effect (g = .16, CI [.09, .23], p < .0001). Effects were comparable across outcome domains, including family functioning, caregivers’ psychopathology and patient symptoms. Informants and assessment methods were not significant moderators, although outcomes relied mostly on self-report symptom questionnaires.
Key findings
- Across 44 studies and 4617 families, the overall effect was small but significant (g = .16, CI [.09, .23], p < .0001).
- Effects were similar for family functioning (g = .12), caregivers’ psychopathology (g = .12) and patient symptoms (g = .19).
- Informants and assessment methods were not significant moderators of treatment effects.
Why it matters
The findings suggest that systemic therapy’s benefits in this population extend beyond patient symptoms to family functioning and caregivers’ psychopathology. However, the predominance of self-report symptom questionnaires limits how fully these outcomes can be interpreted, highlighting the value of broader and more diverse assessment in evaluating therapy effects.
What to keep in mind
Outcomes were mostly based on self-report symptom questionnaires, limiting interpretability.