Journal Article

The impact of extended reality cognitive behavioral therapy on mental disorders among children and youth: A systematic review and meta-analysis protocol

Patel, Jamin, Katapally, Tarun Reddy, Li, Madeline

2025

Overview

The prevalence of mental disorders among children and youth has significantly increased, with rising rates of anxiety, depression, and other psychological disorders globally. Despite the widespread adoption of cognitive behavioral therapy (CBT) as a standardized treatment for various mental disorders, its efficacy can be constrained due to limited patient engagement, lack of commitment, and stigma, all challenges pronounced among children and youth. In this context, extended reality (XR) technologies (including virtual, augmented, and mixed reality) have emerged as innovative therapeutic tools offering immersive and engaging environments to overcome the limitations of traditional CBT. This protocol aims to outline the methodology for conducting a systematic review and meta-analysis to evaluate the impact of XR-CBT on symptoms of mental disorders among children and youth. This systematic review and meta-analysis will follow PRISMA-P 2015 guidelines. A comprehensive search will be conducted in PsycINFO, PubMed, EMBASE, Scopus, and Web of Science to identify relevant studies published between January 2014 and June 2024. Eligible studies must involve children and youth (ages 24 years or younger) diagnosed with a mental disorder (e.g., anxiety, depression, ADHD, PTSD) and compare XR-CBT interventions (virtual, augmented, or mixed reality) with traditional therapy or control groups (e.g., no treatment). The primary outcome will be the change in symptoms of mental disorders, measured using standardized instruments (e.g., PHQ-9, GAD-7, PSS). Data will be extracted on post-intervention means, standard deviations, and 95% confidence intervals. Effect sizes, calculated using Hedges' g, will be pooled with a random-effects model. Moreover, an a priori meta-regression within a random-effects framework will be conducted to examine how study-level characteristics influence effect sizes and address heterogeneity across studies. Heterogeneity will be assessed using the I2 statistic and the Cochran's Q test. Risk of bias in individual studies will be evaluated using the Cochrane risk-of-bias tool. This protocol establishes a structured approach for assessing the efficacy of XR-CBT interventions on mental disorders among children and youth. The results of the systematic review and meta-analysis will fill a gap in current research and inform future therapeutic applications for mental health interventions among children and youth.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adolescent / Analysis / Anxiety / Attention deficit hyperactivity disorder / Behavior modification / Behavioral health care / Bias / Care and treatment / Child / Child psychopathology / Children / Children & youth / Clinical trials / Cognitive behavioral therapy / Cognitive Behavioral Therapy - methods / Cognitive therapy / Computer and Information Sciences / Confidence intervals / Diagnosis / Effectiveness / Engineering and Technology / Evaluation / Fear & phobias / Generalized anxiety disorder / Health aspects / Health promotion / Heterogeneity / Humans / Intervention / Medical innovations / Medicine and Health Sciences / Mental depression / Mental disorders / Mental Disorders - psychology / Mental Disorders - therapy / Mental health care / Mentally disabled teenagers / Mentally disabled youth / Meta-analysis / Meta-Analysis as Topic / Mixed reality / Patient compliance / Patient outcomes / Patients / People and Places / Physical instruments / Physical Sciences / Post traumatic stress disorder / Research and Analysis Methods / Signs and symptoms / Statistical analysis / Study Protocol / Systematic review / Systematic Reviews as Topic / Technology application / Teenagers / Therapeutic applications / Therapy / Virtual reality