Efficacy of child cognitive-behavioral interventions for antisocial behavior: A meta-analysis

The present meta-analysis reviewed 30 studies comparing child-based cognitive-behavioral therapy (CBT) for antisocial behavior with no-treatment, attention or wait-list control groups. The mean effect size d of CBT interventions was 0.48 (median 0.26) unweighted and 0.23 weighted at post-treatment. The mean effect size at follow-up was 0.66 (median = 0.32) unweighted and 0.51 weighted. Hence, child-based CBT interventions have a small to moderate effect in decreasing antisocial behavior. Study quality was negatively correlated with post-treatment effect size. A trend was found for child age to correlate positively with post-treatment effect size, suggesting that current child-based CBT interventions for antisocial behavior are more effective for adolescents and older elementary-school aged children than fur younger elementary-school aged children. Treatment components, number of treatment sessions, session length, sessions per week, use of a clinical vs. nonclinical sample, type of control group, source of outcome ratings and publication year were unrelated to treatment efficacy. Future research directions, including the integration of individual training into group therapy and the examination of antisocial behavior subtypes (i.e., reactive vs. proactive), are discussed.