Therapy for young people works — most reliably for anxiety, least for depression
A multilevel meta-analysis of 447 randomised trials across fifty years
Reviewed by Sian Trombley, CCCFounder, Thrive Family Company
Strong confidence
Source citation
Weisz J. R., Kuppens S., Ng M. Y., Eckshtain D., Ugueto A. M., Vaughn-Coaxum R., et al. (2017). What five decades of research tells us about the effects of youth psychological therapy: A multilevel meta-analysis and implications for science and practice. American Psychologist. https://doi.org/10.1037/a0040360
Published 1 January 2017 · Added to Thrive 26 July 2026 · Reviewed 26 July 2026
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This is the broadest look we have at whether therapy helps children, and where it helps least.
Published research findings
The study
Weisz and colleagues pooled 447 randomised controlled trials of psychological therapy for young people spanning five decades.
What researchers examined
Average effects by problem type, informant, and whether effects had improved over time.
What they found
Overall effects were modest but real. Anxiety treatments performed strongest, conduct and ADHD treatments were intermediate, and depression treatments were weakest. Effects had not improved substantially over fifty years.
Thrive editorial interpretation
What this may mean for families
Realistic expectations help. Therapy is likely to help, unlikely to be transformative on its own, and works best alongside changes at home and school.
What this doesn't tell us
Important limitations
Trial conditions differ from routine practice, and outcome measures varied.
Evidence confidence describes how much weight this study's design can carry — not how strongly the finding applies to any individual child or family.
Therapist perspective — Thrive interpretation, not a finding of the study
Therapist Perspective
I would rather families begin with accurate expectations than be disappointed by good treatment.
Practical family considerations
Expect meaningful improvement, not a cure — and support it at home.
This research summary is educational and does not replace individualized medical, psychological or therapeutic advice.
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Half of all mental health conditions begin before age fifteen
2021 · Meta-analysis
Strong confidence
Why it matters
Early recognition is not overreaction. It aligns with when these conditions actually start.