Reports on remote psychotherapies for youth (e.g., technology-based treatment) suggest it is acceptable, feasible, and useful in overcoming logistical barriers to treatment. But how effective is remote care? To find out, PsycINFO and PubMed were searched from 1960 through 2020, supplemented by journal searches and reference trails, to identify randomized controlled trials of youth psychotherapy for anxiety (including obsessive–compulsive disorder and trauma), depression, attention-deficit/hyperactivity disorder (ADHD), or conduct problems, in which all therapeutic contact occurred remotely. Articles (N = 37) published from 1988 through 2020, reporting 43 treatment-control group comparisons, were identified. Robust variance estimation was used to account for effect size dependencies and to synthesize overall effects and test candidate moderators. Pooled effect size was .47 (95% confidence interval [CI: .26, .67], p < .001) at posttreatment, .44 (95% CI [.12, .76], p < .05) at follow-up—comparable to effects reported in meta-analyses of in-person youth psychotherapy. Effects were significantly (a) larger for remote psychotherapies supported by therapeutic provider contact (.64) than for those accessed by youths, with only logistical support (.22), (b) larger for treatments with phone contact (.65) than for those without (.25), (c) larger for treatment of anxiety (.62) and conduct problems (.78) than ADHD (–.03), and (d) smaller for therapies involving attention/working memory training (–.18) than for those without (.60). Among studies with therapeutic contact, effects were significantly larger when therapists facilitated skill-building (e.g., practicing exposures or problem solving [.68]) than when therapists did not (.18). These findings support the effectiveness of remote psychotherapies for youths, and they highlight moderators of treatment benefit that warrant attention in future research. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

中文翻译：

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远程进行青少年心理治疗的有效性：荟萃分析。


关于青少年远程心理治疗（例如基于技术的治疗）的报告表明，它是可以接受的、可行的，并且有助于克服治疗的后勤障碍。但远程护理的效果如何？为了找到答案，我们对 1960 年至 2020 年的 PsycINFO 和 PubMed 进行了检索，并辅以期刊检索和参考线索，以确定针对焦虑（包括强迫症和创伤）、抑郁症、注意力缺陷/多动症的青少年心理治疗的随机对照试验（多动症），或行为问题，其中所有治疗接触都是远程发生的。确定了 1988 年至 2020 年发表的文章（ N = 37），报告了 43 项治疗组与对照组的比较。使用稳健方差估计来解释效应大小依赖性并综合总体效应并测试候选调节剂。治疗后的汇总效应大小为 0.47（95% 置信区间 [CI: .26, .67], p < .001），随访时为 0.44（95% CI [.12, .76], p < .05） -up——与面对面青少年心理治疗的荟萃分析中报告的效果相当。 (a) 由治疗提供者联系支持的远程心理治疗 (0.64) 的效果明显大于仅由后勤支持的年轻人接受的远程心理治疗 (0.22)，(b) 通过电话联系的治疗 (0.65) 大于通过电话联系的治疗 (0.65)那些没有 (.25)，(c) 治疗焦虑 (.62) 和品行问题 (.78) 比 ADHD (–.03) 更大，(d) 涉及注意力/工作记忆训练的治疗更小 (–. 18) 比那些没有 (.60) 的人要好。在涉及治疗性接触的研究中，治疗师促进技能培养（例如练习暴露或解决问题[.68]）时的效果明显大于治疗师不促进技能培养时的效果（.18）。 这些发现支持了远程心理治疗对青少年的有效性，并强调了治疗益处的调节因素，值得在未来的研究中予以关注。（PsycInfo 数据库记录 (c) 2021 APA，保留所有权利）