Experiential Interventions for Externalizing Behavior: A Multilevel Meta-Analysis of Adolescents and Adults.

Abstract

This meta-analysis examined the effectiveness of experiential interventions in reducing persistent externalizing behavior among adolescents and adults, and whether integrating cognitive-behavioral therapy (CBT) components enhances outcomes. Following PRISMA guidelines, a systematic search of ERIC, MEDLINE, PsycINFO, and Ovid identified 39 studies, yielding 123 effect sizes (N = 2,323). A three-level meta-analytic model with moderator analyses was conducted. Experiential interventions showed a significant medium effect in favor of the interventions compared to control conditions (g = 0.66). Interventions integrating CBT produced larger effects (g = 0.83) than those without CBT (g = 0.43), with the strongest effects for responsive CBT (g = 1.04 vs. g = 0.59). Treatment fidelity and active system involvement significantly moderated outcomes. Findings support integrating CBT within experiential approaches while ensuring high treatment fidelity and system involvement. Clinicians should combine CBT with experiential techniques and engage others to enhance responsiveness and therapeutic safety.