Across five decades, hundreds of randomized trials have tested psychological therapies for youth internalizing (anxiety, depression) and externalizing (misconduct, ADHD) disorders and problems. Since the last broad-based youth meta-analysis, in 1995, the number of trials has almost tripled, and data-analytic methods have been refined. We applied these methods to the expanded study pool (447 studies; 30,431 youths) synthesizing 50 years of findings and identifying implications for research and practice. We assessed overall effect size (ES) and moderator effects, using multilevel modeling to address ES dependency that is common, but typically not modeled in meta-analyses. Mean posttreatment ES was 0.46; the probability that a youth in the treatment condition would fare better than a youth in the control condition was 63%. Effects varied according to multiple moderators, including the problem targeted in treatment: mean ES at posttreatment was strongest for anxiety (0.61), weakest for depression (0.29), and nonsignificant for multi-problem treatment (0.15). ESs differed across control conditions, with "usual care" emerging as a potent comparison condition, and across informants, highlighting the need to obtain, and integrate, multiple perspectives on outcome.Effects of therapy type varied by informant; only youth-focused behavioral therapies (including CBT) showed similar and robust effects across youth, parent, and teacher reports.Therapy effects did not improve over the years. Effects did not differ for Caucasian versus minority samples, but more diverse samples are needed. The findings underscore the benefits of psychological treatments as well as the need for improved therapies and more representative, informative, and rigorous intervention science.Keywords: children, adolescents, youth, psychological therapy, treatment outcome, metaanalysis YOUTH PSYCHOLOGICAL THERAPY: FIVE DECADES OF RESEARCH What Five Decades of Research Tells Us about the Effects of Youth Psychological Therapy:A Multilevel Meta-Analysis and Implications for Science and Practice Mental health problems are both prevalent and disabling in children and adolescents (herein "youths"). At any one time, about one in six will meet criteria for a disorder, and at least one in three will have a disorder by age 16 (Costello, Mustillo, Erkanli, Keeler, & Angold, 2003). A recent Lancet report (Gore et al., 2011) ranked neuropsychiatric disorders as the most prominent cause of the global burden of disease in young people, expressed in "years lost because of disability" (p. 2093). For many of these conditions, psychological therapy has been identified as the primary resource, highlighted as a path to promoting and protecting youth mental health, and advocated in government policy documents (US Department of Health & Human Services, 2003; US Public Health Service, 2000;Weisz, Sandler, Durlak, & Anton, 2005). Indeed, psychological therapy is often recommended as the first-line treatment of choice for young people, even within the practice guidelin...

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Although parenting styles constitute a well-known concept in parenting research, two issues have largely been overlooked in existing studies. In particular, the psychological control dimension has rarely been explicitly modelled and there is limited insight into joint parenting styles that simultaneously characterize maternal and paternal practices and their impact on child development. Using data from a sample of 600 Flemish families raising an 8-to-10 year old child, we identified naturally occurring joint parenting styles. A cluster analysis based on two parenting dimensions (parental support and behavioral control) revealed four congruent parenting styles: an authoritative, positive authoritative, authoritarian and uninvolved parenting style. A subsequent cluster analysis comprising three parenting dimensions (parental support, behavioral and psychological control) yielded similar cluster profiles for the congruent (positive) authoritative and authoritarian parenting styles, while the fourth parenting style was relabeled as a congruent intrusive parenting style. ANOVAs demonstrated that having (positive) authoritative parents associated with the most favorable outcomes, while having authoritarian parents coincided with the least favorable outcomes. Although less pronounced than for the authoritarian style, having intrusive parents also associated with poorer child outcomes. Results demonstrated that accounting for parental psychological control did not yield additional parenting styles, but enhanced our understanding of the pattern among the three parenting dimensions within each parenting style and their association with child outcomes. More similarities than dissimilarities in the parenting of both parents emerged, although adding psychological control slightly enlarged the differences between the scores of mothers and fathers.

With the development of empirically supported treatments over the decades, have youth psychotherapies grown stronger? To investigate, we examined changes over time in treatment effects for four frequently treated youth mental-health problems: anxiety, depression, attention-deficit hyperactivity disorder (ADHD), and conduct disorders. We used PubMed and PsycINFO to search for randomized controlled trials (RCTs) that were published between January 1960 and May 2017 involving youths between the ages of 4 and 18 years. We also searched reviews and meta-analyses of youth psychotherapy research, followed reference trails in the reports we identified, and obtained additional studies identified by therapy researchers whom we contacted. We identified 453 RCTs (31,933 participants) spanning 53 years (1963–2016). Effect sizes for the problem-relevant outcome measures were synthesized via multilevel meta-analysis. We tracked temporal trends for each problem domain and then examined multiple study characteristics that might moderate those trends. Mean effect size increased nonsignificantly for anxiety, decreased nonsignificantly for ADHD, and decreased significantly for depression and conduct problems. Moderator analyses involving multiple study subgroups showed only a few exceptions to these surprising patterns. The findings suggest that new approaches to treatment design and intervention science may be needed, especially for depression and conduct problems. We suggest intensifying the search for mechanisms of change, making treatments more transdiagnostic and personalizable, embedding treatments within youth ecosystems, adapting treatments to the social and technological changes that alter youth dysfunction and treatment needs, and resisting old habits that can make treatments unduly skeuomorphic.