A substantial empirical base supports the use of psychotherapy to alleviate anxiety symptoms and diagnoses in children and adolescents. However, focusing only on symptom or diagnostic reduction provides an incomplete picture of clinically meaningful efficacy given that anxiety disorders in this age group are integrally associated with problems in functioning. A systematic review and meta-analysis (N studies = 40, N participants = 3094) evaluating the impacts of psychotherapy for anxiety was conducted on the following outcomes: global functioning, social functioning, academic functioning, and school attendance. Randomised controlled trials with a passive control condition, a child and/or adolescent sample (7–17 years) with a primary anxiety diagnosis, and receiving anxiety-focused psychotherapy were eligible for inclusion if they reported suitable outcome data. Results from the meta-analysis indicated that from pre- to post-treatment, psychotherapy led to significant improvements in global functioning according to clinician (d = 1.55), parent (d = 0.67), and child (d = 0.31) reports and on social functioning according to parent (d = 0.51), but not child (d = 0.31) reports. The qualitative review provided preliminary support psychotherapy’s efficacy in increasing family functioning and school attendance, but not so much in enhancing academic performance. These results indicate that psychotherapy improves daily functioning in anxious children and adolescents. The study also highlighted the limited attention paid to measures of functioning in the empirical literature on treatment of childhood anxiety.

Trial Registry: This study is registered with PROSPERO under the identification number CRD42021246565.

大量的经验基础支持使用心理治疗来减轻儿童和青少年的焦虑症状和诊断。然而，鉴于该年龄段的焦虑症与功能问题密切相关，仅关注症状或诊断的减少无法全面了解具有临床意义的疗效。系统评价和荟萃分析（ N项研究 = 40， N名参与者 = 3094）评估了心理治疗对焦虑的影响，对以下结果进行了评估：全球功能、社会功能、学术功能和入学率。具有被动控制条件、具有原发性焦虑诊断的儿童和/或青少年样本（7-17岁）并接受以焦虑为中心的心理治疗的随机对照试验，如果报告了合适的结果数据，则有资格纳入。荟萃分析的结果表明，根据临床医生 ( d = 1.55)、父母 ( d = 0.67) 和儿童 ( d = 0.31) 的报告以及相关报告，从治疗前到治疗后，心理治疗使整体功能显着改善。社会功能根据父母（ d = 0.51）报告，但不是儿童（ d = 0.31）报告。定性审查提供了初步支持心理治疗在提高家庭功能和入学率方面的功效，但在提高学业成绩方面却没有那么大的作用。这些结果表明，心理治疗可以改善焦虑儿童和青少年的日常功能。该研究还强调，在儿童焦虑治疗的实证文献中，对功能测量的关注有限。

试验登记：本研究已在 PROSPERO 注册，识别号为 CRD42021246565。