Cognitive behavioral therapy (CBT) has received considerable empirical support for internalizing disorders including anxiety, depression, obsessive-compulsive disorder, and post-traumatic stress disorder in children and adolescents. However, there is less knowledge regarding how CBT performs when delivered in routine clinical care. A systematic review and meta-analysis was conducted of CBT for internalizing disorders in children and adolescents in routine clinical care. Ovid MEDLINE, Embase OVID, and PsycINFO were systematically searched for articles published until October 2019. The effectiveness of CBT, methodological quality, and moderators of treatment outcome were examined. The effects of CBT in routine clinical care were benchmarked by comparing with efficacy studies for the same disorders. Fifty-eight studies were included, comprising 4618 participants. Large effect sizes for outcome were detected at post-treatment (g = 1.28–2.54), and follow-up (g = 1.72–3.36). Remission rates across diagnoses ranged from 50.7% - 77.4% post-treatment, to 53.5% -83.3% at follow-up. Attrition rate across the disorders was 12.2%. Quality of the included studies was fair, and heterogeneity was high. Similarities between the effectiveness and efficacy studies were greater than the differences in outcome. CBT delivered in routine clinical care is efficacious in reducing internalizing disorders and symptoms. The outcomes are comparable with results obtained in efficacy studies.

PROSPERO registration: ID CRD42019128709.

认知行为疗法 (CBT) 已获得相当多的经验支持，用于内化障碍，包括儿童和青少年的焦虑、抑郁、强迫症和创伤后应激障碍。然而，关于 CBT 在常规临床护理中的表现如何，知之甚少。对常规临床护理中儿童和青少年内化障碍的 CBT 进行了系统评价和荟萃分析。系统搜索了 Ovid MEDLINE、Embase OVID 和 PsycINFO，以查找截至 2019 年 10 月发表的文章。检查了 CBT 的有效性、方法学质量和治疗结果的调节因素。通过与相同疾病的疗效研究进行比较，对 CBT 在常规临床护理中的效果进行了基准测试。共纳入 58 项研究，包括 4618 名参与者。在治疗后 (g = 1.28–2.54) 和随访 (g = 1.72–3.36) 中检测到结果的大效应量。整个诊断的缓解率从治疗后的 50.7% - 77.4% 到随访时的 53.5% -83.3% 不等。各种疾病的流失率为 12.2%。纳入研究质量一般，异质性高。有效性和功效研究之间的相似性大于结果的差异。在常规临床护理中提供的 CBT 可有效减少内化障碍和症状。结果与功效研究中获得的结果相当。3% 随访。各种疾病的流失率为 12.2%。纳入研究质量一般，异质性高。有效性和功效研究之间的相似性大于结果的差异。在常规临床护理中提供的 CBT 可有效减少内化障碍和症状。结果与功效研究中获得的结果相当。3% 随访。各种疾病的流失率为 12.2%。纳入研究质量一般，异质性高。有效性和功效研究之间的相似性大于结果的差异。在常规临床护理中提供的 CBT 可有效减少内化障碍和症状。结果与功效研究中获得的结果相当。

PROSPERO 注册：ID CRD42019128709。