Do psychological interventions reduce paranoia in adolescents? A systematic review

Research suggests that paranoia is common in adolescents and can contribute to impaired wellbeing and psychological difficulties. Although best practice recommendations endorse early preventative intervention as the favoured treatment option, interventions targeting paranoia in adolescence are under-developed. This systematic review aimed to synthesise and appraise psychological interventions that measure changes in paranoia in adolescents. Seven databases were searched up to January 2026 for relevant studies. Included studies were those that evaluated a psychological intervention for adolescents (≤ 25 years old) and measured at least pre-post changes in paranoia using a validated measure/subscale. A total of 30 studies were included, which comprised 10 RCTs, 13 single arm studies and seven case designs. Although many of the interventions were associated with improvements in paranoia, most did not target paranoia as their primary outcome. Cognitive behavioural therapy-based interventions evidenced the most promising effects. Conclusions were limited by the weak methodological quality of many of the reviewed studies. Future research would benefit from developing targeted paranoia interventions for adolescents using rigorous, well-controlled methods.