Twenty-five studies were included in the review, comprising 19 randomised studies, five non-randomised studies and one partially randomised study. Sample sizes ranged from 12 to 375 patients. Methodological quality was found to be high, with quality scores ranging from 42.3 to 96.2%.
Emotional/peer support interventions (four studies): Three studies reported significant effects on at least one psychological measure. These studies included a mentoring programme, and two residential camps delivering peer support and education.
Educational/psychoeducational interventions (eight studies): Seven interventions showed small to very large effects on at least one outcome measure including coping, quality of life and symptoms of distress, areas of reproductive/sexual knowledge, health focus of control and paediatric coping measures. The interventions included psychosexual/reproductive health interventions and computer-mediated interventions. One multi-session counselling intervention showed no differences between groups.
Skills-based interventions for adolescents and young adults alone (seven studies): Four studies showed medium to large significant effects. The interventions included cognitive restructuring, problem solving, goal setting, coping strategies, and multi-session motivational interviewing programmes.
Skill-based programmes with multi-familial/parent involvement (six studies): Five studies achieved medium to large significant benefits in quality of life, parent-adolescent dimensions. The interventions used elements of behavioural systems therapy and utilised multi-family discussion formats.
Interventions that were more likely to achieve positive outcomes were those that taught communication skills, were at least three months in duration, and were delivered by a professional.