The effectiveness of the FRIENDS programs for children and adolescents: A meta-analytic review

FRIENDS is an internationally recognized program designed to prevent anxiety and improve resilience skills. More specifically, the program is grounded in cognitive-behavioral therapy (CBT) and is activity/play based, and variations of the program have been adapted for all age groups (i.e., preschool through adulthood). Numerous clinical trials have been conducted to examine the efficacy of these programs. The purpose of this study was to conduct a meta-analytic review of the FRIENDS program for children and adolescents. A total of 41 controlled trials met inclusion criteria, and findings indicated that, relative to comparison groups, those who took part in FRIENDS exhibited lower scores on measures of anxiety (d= -0.20) and measures of depression (d= -0.24) at post-intervention. In addition, the effect sizes were maintained at 6- to 12-month follow-up. Based on moderator analyses, larger effect sizes were found for trials conducted by mental health clinicians relative to other professionals. Although not statistically significant, there was a trend towards larger effect sizes for targeted programs (d= -0.41) relative to universal programs (d= -0.14). Results of other moderator analyses, results of uncontrolled trials, and directions for future research are also discussed.