Therapeutic Homework and Treatment Outcomes in Youth Cognitive-Behavioral Therapy for Internalizing Disorders: A Meta-Analysis.

IF 7.9 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Child and Family Psychology Review Pub Date : 2026-07-17 DOI:10.1007/s10567-026-00579-1

Abigail E Pine,Mary A Gum,Michelle M Liu,Joseph F McGuire

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Abstract

Homework adherence represents a salient, modifiable target for improving cognitive behavioral therapy (CBT) outcomes for pediatric internalizing disorders. While the adult literature has found a clear connection between CBT homework adherence and treatment outcomes, the evidence among youth have been mixed regarding the extent to which between-session homework adherence predicts CBT outcomes. The present study conducted a systematic review and meta-analysis that examines the association between homework adherence and CBT outcomes in clinical trials of internalizing disorders for youth. Fourteen studies met prespecified inclusion criteria, comprising a total sample of 1179 participants (M age = 11.33 years, 53.79% female). Random-effects meta-analytic models identified a small-to-moderate association between greater homework adherence and lower post-treatment symptoms (r = -0.23, p < 0.001). Interestingly, disorder type significantly moderated this association, such that the association between homework adherence and CBT outcomes was strongest in obsessive-compulsive disorder (OCD) samples (r = -0.42), compared to anxiety (r = -0.14) and depression (r = -0.06). Findings underscore the importance of homework adherence as a mechanism of youth CBT, particularly for OCD. Enhancing homework adherence may help optimize CBT outcomes in pediatric populations.

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青少年内化障碍认知行为疗法的治疗作业与治疗效果：一项荟萃分析。

家庭作业依从性是改善儿童内化障碍的认知行为治疗（CBT）结果的一个显著的、可修改的目标。虽然成人文献已经发现CBT家庭作业依从性与治疗结果之间存在明确的联系，但在青少年中，关于间歇家庭作业依从性对CBT结果的预测程度的证据却参差不齐。本研究进行了系统回顾和荟萃分析，以检验青少年内化障碍临床试验中作业依从性与CBT结果之间的关系。14项研究符合预定的纳入标准，共纳入1179名参与者（M年龄= 11.33岁，53.79%为女性）。随机效应荟萃分析模型发现，更强的作业依从性与更低的治疗后症状之间存在小到中度的关联（r = -0.23, p < 0.001）。有趣的是，障碍类型显着调节了这种关联，例如强迫症（OCD）样本中作业依从性和CBT结果之间的关联最强（r = -0.42），而焦虑（r = -0.14）和抑郁（r = -0.06）。研究结果强调了家庭作业依从性作为青少年认知行为治疗机制的重要性，特别是对于强迫症。加强家庭作业依从性可能有助于优化儿科人群的CBT结果。

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来源期刊

Clinical Child and Family Psychology Review PSYCHOLOGY, CLINICAL-

CiteScore

10.50

自引率

4.30%

发文量

期刊介绍： Editors-in-Chief: Dr. Ronald J. Prinz, University of South Carolina and Dr. Thomas H. Ollendick, Virginia Polytechnic Institute Clinical Child and Family Psychology Review is a quarterly, peer-reviewed journal that provides an international, interdisciplinary forum in which important and new developments in this field are identified and in-depth reviews on current thought and practices are published. The Journal publishes original research reviews, conceptual and theoretical papers, and related work in the broad area of the behavioral sciences that pertains to infants, children, adolescents, and families. Contributions originate from a wide array of disciplines including, but not limited to, psychology (e.g., clinical, community, developmental, family, school), medicine (e.g., family practice, pediatrics, psychiatry), public health, social work, and education. Topical content includes science and application and covers facets of etiology, assessment, description, treatment and intervention, prevention, methodology, and public policy. Submissions are by invitation only and undergo peer review. The Editors, in consultation with the Editorial Board, invite highly qualified experts to contribute original papers on topics of timely interest and significance.