Over 600 randomized controlled trials (RCTs) prove youth psychotherapies’ effectiveness. Decades of meta-analyses reveal scientifically and clinically significant patterns despite limitations. They reveal the mental health issues our interventions work on (e.g., anxiety over depression), where remote interventions work, and where societal sexism and racism reduce treatment benefits. Disappointingly, the average treatment benefit hasn’t increased over five decades of research, prompting the need for new strategies. Future opportunities include improving policy relevance, identifying mechanisms of change, and personalizing treatment.