Comparative Meta-Analysis of the Effectiveness of Systems-Based Family Therapy (SBFT) and Cognitive-Behavioral Therapy (CBT) on Adolescent Depression and Anxiety: Examining the Moderating Roles of Symptom Severity and Parental Involvement

This meta-analysis systematically compares the effectiveness of Systems-Based Family Therapy (SBFT) and Cognitive-Behavioral Therapy (CBT) in treating depression and anxiety among adolescents. Drawing on ۱۷ randomized controlled trials (RCTs) published between ۲۰۲۰ and ۲۰۲۵ from global databases including Google Scholar, PubMed, and Iranian scientific journals, the study synthesized data from a total of ۱,۲۴۵ participants. Results indicated that while both interventions significantly reduced symptoms, SBFT showed a slight but statistically significant advantage over CBT in reducing depressive symptoms (Hedges’ g = ۰.۲۴, ۹۵% CI [۰.۱۲, ۰.۳۶]), particularly when symptom severity was high and parental involvement was active. For anxiety symptoms, the difference between the two modalities was negligible (Hedges’ g = ۰.۱۴, ۹۵% CI [-۰.۰۲, ۰.۳۰]). Moderator analysis revealed that baseline symptom severity and the degree of parental participation significantly influenced treatment outcomes, with higher parental involvement correlating with sustained recovery in the SBFT groups. These findings suggest that a systemic approach may offer unique benefits for adolescents with complex clinical presentations and emphasize the critical role of the family unit in therapeutic success.

کلیدواژه ها:

Systems-Based Family Therapy ، Cognitive-Behavioral Therapy ، Adolescent Depression ، Adolescent Anxiety ، Meta-analysis ، Parental Involvement ، Symptom Severity