Psychological school-based interventions for anxiety: a systematic review and meta-analysis

Abstract

Childhood anxiety is one of the most common emotional problems during the school years, characterized by early onset, high chronicity, and significant consequences for children’s academic, social, and emotional functioning. Given the central role that schools play in development, psychological interventions in the school setting have emerged as a promising strategy for the prevention and treatment of anxiety. This systematic review and meta-analysis examined the effectiveness of school-based psychological programs aimed at reducing anxiety in elementary school children (6–12 years). Following the PRISMA guidelines and a protocol registered in PROSPERO, bibliographic searches were conducted in PubMed and Web of Science, supplemented by manual searches. Thirteen articles (comprising 14 independent studies) met the inclusion criteria for the systematic review. Of these, 13 studies (from 12 articles) were included in the meta-analysis due to insufficient data in one study. A random-effects meta-analysis showed a small, but statistically significant, overall effect after treatment (d = − 0.236) that was maintained during the follow-up period (d = − 0.21). Moderator analyses revealed that interventions delivered by psychologists produced stronger effects than those implemented by teachers, partially explaining the observed heterogeneity. Overall, the results support the implementation of psychological interventions in school settings to reduce childhood anxiety and underscore the importance of involving trained mental health professionals. Finally, limitations and implications for research and educational practice are addressed.