Digital interventions for emotion regulation in children and early adolescents: systematic review and meta-analysis

Sally Reynard*, João Dias, Marija Mitic, Beate Schrank, Kate Woodcock

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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Background: Difficulties in emotion regulation are common in adolescence and are associated with poor social and mental health outcomes. However, psychological therapies that promote adaptive emotion regulation may be inaccessible and unattractive to youth. Digital interventions may help address this need.

Objective: The aim of this systematic review and meta-analysis was to synthesize evidence on the efficacy, feasibility, and acceptability of emotion regulation digital interventions in children and early adolescents aged 8 to 14 years.

Methods: Systematic searches of Web of Science, MEDLINE, PsycINFO, EMBASE, Education Resources Information Centre, ACM Digital Library, and IEEE Xplore up to July 2020 identified 39 studies, of which 11 (28%) were included in the meta-analyses (n=2476 participants). A bespoke tool was used to assess risk of bias.

Results: The studies evaluated digital games (27/39, 69%), biofeedback (4/39, 10%), virtual or augmented reality (4/39, 10%), and program or multimedia (4/39, 10%) digital interventions in samples classified as diagnosed, at risk, healthy, and universal. The most consistent evidence came from digital games, which reduced negative emotional experience with a small significant effect, largely in youth at risk of anxiety (Hedges g=–0.19, 95% CI –0.34 to –0.04). In general, digital interventions tended to improve emotion regulation, but this effect was not significant (Hedges g=0.19, 95% CI –0.16 to 0.54).

Conclusions: Most feasibility issues were identified in diagnosed youth, and acceptability was generally high across intervention types and samples. Although there is cause to be optimistic about digital interventions supporting the difficulties that youth experience in emotion regulation, the predominance of early-stage development studies highlights the need for more work in this area.
Original languageEnglish
Article numbere31456
Number of pages24
JournalJMIR Serious Games
Issue number3
Publication statusPublished - 19 Aug 2022

Bibliographical note

The Die Offene Tür (German for The Open Door) team of coinvestigators—Adam Barnard (playwright and theater director), JD (computer scientist), MM (medical doctor and researcher), BS (practicing and research psychiatrist), and KW (research psychologist)—grew during a sandpit event organized by the Open Innovation Center of Ludwig Boltzmann Society and facilitated by Know Innovation. The team would like to thank these organizations for their role in its formation. Die Offene Tür teamwork is jointly conceived and led by the coinvestigators. The team sees this as a fully meaningful interdisciplinary collaboration. This work was partially supported by national funds through Fundação para a Ciência e a Tecnologia (UIDB/04326/2020, UIDB/50021/2020, UIDP/04326/2020, and LA/P/0101/2020).

© Sally Reynard, Joao Dias, Marija Mitic, Beate Schrank, Kate Anne Woodcock. Originally published in JMIR Serious Games (, 19.08.2022.


  • emotion regulation
  • digital interventions
  • youth
  • systematic review
  • meta-analysis
  • children
  • early adolescents
  • serious games
  • training
  • biofeedback
  • mobile phone


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