. 2026 Aug 27;33(5):e70330. doi: 10.1002/cpp.70330

TABLE 2.

GRADE certainty of evidence table.

Outcomes	N of studies	Risk of bias	Inconsistency	Indirectness	Imprecision	Other considerations	Certainty
Pre–post internalizing symptoms^a	21	Serious	Very serious	Not serious	Not serious	Publication bias strongly suspected All plausible residual confounding would reduce the demonstrated effect	⨁◯◯◯ Very low
Prefollow‐up Internalizing symptoms^a	9	Serious	Serious	Not serious	Not serious	All plausible residual confounding would reduce the demonstrated effect	⨁◯◯◯ Very low
Pre–post self‐perception and coping ability^b	15	Serious	Very serious	Not serious	Not serious	All plausible residual confounding would reduce the demonstrated effect	⨁◯◯◯ Very low

Outcomes

N of studies

Risk of bias

Inconsistency

Indirectness

Imprecision

Other considerations

Certainty

Pre–post internalizing symptoms^a

Serious

Very serious

Not serious

Publication bias strongly suspected

All plausible residual confounding would reduce the demonstrated effect

⨁◯◯◯

Very low

Prefollow‐up Internalizing symptoms^a

Serious

Not serious

All plausible residual confounding would reduce the demonstrated effect

⨁◯◯◯

Very low

Pre–post self‐perception and coping ability^b

Serious

Very serious

Not serious

All plausible residual confounding would reduce the demonstrated effect

⨁◯◯◯

Very low

Note: ^a Internalizing symptoms: Aggregated from scales assessing depression (e.g., BDI‐II, CDI, CES‐DC, PHQ‐9, SMFQ and PFC), anxiety (e.g., SCARED, STAI, SCAS, RCMAI, SPIN, SASC‐R, ASI‐3 and BFNE‐S) and general distress or trauma‐related symptoms (e.g., DASS‐21, YSR, CBCL‐YSR, PTCI, PANAS, PANAS‐C, STAXI and DTS); ^b Self‐perception and coping ability: Aggregated from scales assessing self‐concept/worth (e.g., SPPC, SPPA, RSES, GSW and SCS), coping strategies (e.g., PCI‐A, SRCS and CERQ‐short) and resilience/functional health (e.g., BRS, PROMIS, GHSQ and ATSPPHS).