Child And Adolescent Mental Health Services (child + and_adolescent_mental_health_services)

Distribution by Scientific Domains


Selected Abstracts


Annotation: The therapeutic alliance , a significant but neglected variable in child mental health treatment studies

THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 5 2006
Jonathan Green
Background:, There has been relatively little research into therapeutic alliance in child and adolescent mental health and virtually no incorporation of alliance measures as a variable in treatment trials in Child and Adolescent Mental Health Services (CAMHS). Method:, A selective literature review on studies in therapeutic alliance in adulthood and childhood along with a theoretical formulation of possible mechanisms of alliance. Results:, Therapeutic alliance is reliably measurable both by observation and questionnaire methods at all points in the treatment cycle. In both adult and child studies it shows a consistent, albeit modest, association with treatment outcome. In specific adult studies it has shown a high predictive validity in relation to outcome compared to other variables. In child studies alliance is particularly salient in externalising disorder and predicts outcome of inpatient treatment. Child alliance and parental alliance are independent factors. Theoretical models of alliance outlined in this paper suggest testable hypotheses regarding predictors for positive and negative alliance. Conclusions:, Therapeutic alliance in CAMHS is measurable and worth measuring. It is likely to be an important variable for treatment outcome studies and should be included in future trial designs. [source]


Emotional well-being and mental health of looked after children in England

CHILD & FAMILY SOCIAL WORK, Issue 2 2009
Colette McAuley
ABSTRACT The national prevalence studies of the mental health of looked after children in Great Britain provide sobering reading. Forty-five per cent of looked after children in England were found to have a diagnosable mental health disorder. In contrast, this is to one in 10 in the general population. Carers estimated that mental health problems were even more widespread. Children with mental health disorders were also more likely to have education, health and social issues. This paper discusses the findings and argues for early intervention along with inter-departmental and interdisciplinary approaches. The recent Child and Adolescent Mental Health Services Review clearly indicates that issues of access to appropriate and timely Child and Adolescent Mental Health Services remain. However, the introduction of evidence-based approaches is encouraging. Young people's views on the services they want and on what is important for emotional well-being and mental health are important considerations. [source]


Computer Use and Attitudes Towards Computerised Therapy Amongst Young People and Parents Attending Child and Adolescent Mental Health Services

CHILD AND ADOLESCENT MENTAL HEALTH, Issue 2 2010
Paul Stallard
Background:, There has been little research examining attitudes towards computerised therapy in young people. Method:, A self-report survey of 37 young people and 31 parents using Child and Adolescent Mental Health Services (CAMHS). Results:, Young people reported high levels of computer usage and online help-seeking behaviour. Young people were cautious about computerised therapy whereas parents were more positive, identifying more benefits than concerns. Conclusions:, Mental health professionals need to be aware of young people's online help-seeking behaviour in order to correct inaccuracies and maximise uptake of computerised therapy. [source]


The Impact of Governmental Guidance on the Time Taken to Receive a Prescription for Medication for ADHD in England

CHILD AND ADOLESCENT MENTAL HEALTH, Issue 1 2010
David M. Foreman
The National Health Service in England has deployed guidance from the National Institute of Clinical Excellence (NICE) to assist practitioners in the diagnosis and treatment of Attention Deficit Hyperactivity Disorder (ADHD) but, though the number of prescriptions has risen since its introduction, the impact of the guidance on prescribing practice has not been studied. Clinic records of all open ADHD cases (296) in three English Child and Adolescent Mental Health Services were examined. The time from referral to either prescription or data collection was extracted for a survival analysis. It was hypothesised that NICE guidance, clinic, patient and referral characteristics would all influence the speed and likelihood of prescription. Following the introduction of NICE guidance, the median time to start prescribing medication fell from 1262 to 526 days: the minimum realistic time to complete a routine assessment was approximately 70 days. Overall, 70% were prescribed medication. Most of the wait was after face-to-face appointments at the clinic had been initiated. Waiting times differed between clinics and shorter waits were likely for older children and those referred from an educational source. While the introduction of NICE guidance has increased the rate of prescription, the time taken before prescription suggests that the tendency in England is still to postpone treatment by medication. The reasons for this require further research. [source]


Eliciting Children's and Young People's Views of Child and Adolescent Mental Health Services: A Systematic Review of Best Practice

CHILD AND ADOLESCENT MENTAL HEALTH, Issue 1 2008
Anne Worrall-Davies
Background:, A systematic review of children's and young people's views of Child and Adolescent Mental Health Services (CAMHS) was undertaken to identify the methods used, the ,best practice' methods, and the methods most effective in leading to service changes. Method:, Electronic databases and grey literature were systematically searched. Both authors independently quality-appraised studies using a standard framework. Of 381 studies identified, only 13 were both relevant and of sufficient quality to be included in the review. Interviews, focus groups, brainstorming exercises, and questionnaires were the methods used. Results:, No study reported a change of practice as a result of hearing children's and young people's views. [source]


Evidence-Based Child and Adolescent Mental Health Services: Oxymoron or Brave New Dawn?

CHILD AND ADOLESCENT MENTAL HEALTH, Issue 2 2001
Paul Ramchandani
Professionals working in child and adolescent mental health services are increasingly encouraged to examine the evidence underlying their clinical practice. Embracing evidence-based practice can present difficulties, as barriers to changing practice exist. These difficulties are examined, along with the meaning of evidence-based practice in a multidisciplinary speciality, and the potential benefits that develop from it. [source]


Commentary: Evidence-Based Child and Adolescent Mental Health Services

CHILD AND ADOLESCENT MENTAL HEALTH, Issue 2 2001
Richard Harrington
No abstract is available for this article. [source]


Social Workers in Child Mental Health: Securing a Future

CHILD AND ADOLESCENT MENTAL HEALTH, Issue 3 2000
Philip Messent
A study was conducted to investigate reductions in the numbers of social work posts located within Child and Adolescent Mental Health Services in the UK. Results suggested that reductions in posts noted in earlier studies are continuing. Interviewees' ideas about factors contributing to the survival of such posts are summarised. The significance of the loss of posts is discussed, with an account of changing ideas about the role of social workers within CAMHS teams, and of an audit undertaken of one service lacking such a post. Conclusions are drawn concerning ways of ensuring the preservation of such posts. [source]


The Health of the Nation Outcome Scales for Child & Adolescent Mental Health (HoNOSCA)

CHILD AND ADOLESCENT MENTAL HEALTH, Issue 2 2000
Simon Gowers
The child and adolescent version of the Health of the Nation Outcome Scales (HoNOSCA) represents the first attempt at a routine outcome measure for Child and Adolescent Mental Health Services in the U.K. Extensive field trials suggested that the scales were both acceptable to clinicians from the various disciplines working in this area and also valid and reliable. A growing number of services are now using the scales in audit and research, supported by the national HoNOSCA base that provides training and co-ordinates further developments. [source]


Primary mental health workers in child and adolescent mental health services

JOURNAL OF ADVANCED NURSING, Issue 1 2004
Wendy Macdonald BSc PhD
Background., The interface between primary care and specialist services is increasingly seen as crucial in the effective management of child and adolescent mental health (CAMH) problems. In the United Kingdom, a new role of primary mental health worker (PMHW), has been established in order to achieve effective collaboration across the interface through the provision of clinical care in primary care settings and by improving the skills and confidence of primary care staff. However, little is known about the development of this innovative role in service contexts. Issues raised during the early stages of implementation may have important implications for the preparation and development of professionals who undertake the role. Aims., The aim of this paper is to report on a study that examined key issues in implementation of the PMHW role in six health authorities in England. Methods., Case study evaluation was conducted, using thematic analysis of 75 qualitative interviews with key stakeholders from different professions (e.g. PMHWs, general practitioners, health visitors, psychiatrists and service managers) and representing different sectors (primary care, specialist services and community child health services). Findings., The study identified three models of organization (outreach, primary care-based and teams). Each was associated with different advantages and disadvantages in its effects on referral rates to specialist services and the development of effective working relationships with primary care providers. Problems associated with accommodation and effective integration of PMHWs with specialist services, and tensions caused by the two different roles that PMHWs could undertake (direct clinical care vs. consultation-liaison) were common across all sites. Conclusions., The PMHW role is an important development that may go some way towards realizing the potential of primary care services in CAMH. The implementation of new roles and models of working in primary care is complex, but may be facilitated by effective planning with primary care providers, clear goals for staff, and a long-term perspective on service development. [source]


Practitioner Review: How can epidemiology help us plan and deliver effective child and adolescent mental health services?

THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 9 2008
Tamsin Ford
This review focuses on ways in which epidemiological research can inform mental health service development and clinical practice. Data from epidemiological studies can provide cross-sectional and secular estimates of the prevalence of psychopathology to support rational service development. Epidemiological surveys have difficulties in finding large enough samples of children with rare disorders, although these disorders are often severely debilitating and require extensive service input. Systematic surveillance provides a rigorous method for studying rare disorders and events. Only a minority of children with impairing psychopathology reach mental health services, although a larger proportion have mental health related contacts with other services. The gap in provision is such that an expansion of mental health services is unlikely to reach all children who could benefit, suggesting that mental health professionals need to develop innovative strategies to increase the number of children seen and the effectiveness of interventions that they receive. Training and supervision of non-mental-health professionals working with children in the identification and management of mental health problems is also extremely important. Most studies suggest that the children with the severest problems are getting to specialist mental health services, and service contact is more likely if important adults can perceive the child's difficulty or find it to be burdensome. The latter suggests that education of key adults would improve detection if services had the capacity to cope. Studies consistently suggest that the region in which the child lives affects the likelihood of service contact, but studies of other characteristics predicting service contact are so contradictory that studies should only be (cautiously) applied to similar populations to assess which types of children may currently be falling through gaps in service provision. Academics are beginning to explore the use of structured measures developed for epidemiological studies in clinical assessment and outcome monitoring. [source]


Practitioner Review: The effectiveness of systemic family therapy for children and adolescents

THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 5 2002
David Cottrell
Background: Systemic family therapy has become a widely used intervention in child and adolescent mental health services over the last twenty years. Methods: This paper reviews the development of systemic family therapy, briefly describes the theory and techniques associated with the most prominent contemporary strands of systemic practice, and examines the empirical justification for using systemic family therapies with children and adolescents. Results: There is a paucity of well-designed randomised controlled trials of systemic therapies with children and adolescents and those trials that do exist evaluate older structural and strategic therapies. Methodological limitations of existing research include the use of unrepresentative participants, small sample sizes and wide age ranges. There is a lack of credible no-treatment or alternative treatment controls, tests of clinical as opposed to statistical significance, and conceptually relevant outcome measures that examine underlying interactional mechanisms. The term `family therapy' encompasses a wide range of interventions and it is not always clear what treatment intervention has been delivered. Nevertheless, there is good evidence for the effectiveness of systemic family therapies in the treatment of conduct disorders, substance misuse and eating disorders, and some support for their use as second-line treatments in depression and chronic illness. Conclusions: Systemic family therapy is an effective intervention for children and adolescents but further well-designed outcome studies are needed using clearly specified, manualised forms of treatment and conceptually relevant outcome measures. [source]


Parental Perceptions of the Assessment of Autistic Spectrum Disorders in a Tier Three Service

CHILD AND ADOLESCENT MENTAL HEALTH, Issue 3 2009
Latha Hackett
Background:, Little is known about the satisfaction of the parents of children receiving child and adolescent mental health services in general, and autistic spectrum services in particular. Method:, This audit examined parent and carer perceptions of the Autistic Spectrum Disorder assessments undertaken by the multi-agency team in a Tier Three CAMHS in Manchester. Forty families completed a brief questionnaire. Results:, The majority of parents and carers reported satisfaction with the service (95%), although responses highlighted areas in both the assessment process and the service facilities that needed improvement. Conclusions:, Useful information with both local and national applications can be gathered quickly in an easily replicated manner. [source]


Evidence-Based Child and Adolescent Mental Health Services: Oxymoron or Brave New Dawn?

CHILD AND ADOLESCENT MENTAL HEALTH, Issue 2 2001
Paul Ramchandani
Professionals working in child and adolescent mental health services are increasingly encouraged to examine the evidence underlying their clinical practice. Embracing evidence-based practice can present difficulties, as barriers to changing practice exist. These difficulties are examined, along with the meaning of evidence-based practice in a multidisciplinary speciality, and the potential benefits that develop from it. [source]