Child and adolescent psychiatry training and mental health care in Southeast Europe

2019 ◽  
Vol 29 (1) ◽  
pp. 29-39 ◽  
Author(s):  
H. Gregoric Kumperscak ◽  
C. Clausen ◽  
D. Anagnostopoulos ◽  
Z. Barac Otasevic ◽  
V. Boricevic Marsanic ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Adolescent Psychiatry ◽  
Child And Adolescent ◽  
Child And Adolescent Psychiatry ◽  
Psychiatry Training ◽  
Southeast Europe

Transference and Countertransference Dynamics in a Multifamily Group for Transgender Adolescents

2021 ◽  
Vol 108 (4) ◽  
pp. 457-474
Author(s):  
Nicolas Rabain
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Sexual Identity ◽  
Adolescent Psychiatry ◽  
Care Setting ◽  
Child And Adolescent Psychiatry ◽  
Consultation Service ◽  
Free Associate ◽  
Transference And Countertransference

This article is an account of a pioneering multifamily group for transgender adolescents. Meetings were conducted in a Sexual Identity Consultation Service in a Child and Adolescent Psychiatry Department in Paris. In addition to enabling both teenagers and their parents to escape a certain form of isolation, this novel mental health care setting also reinforced the ability of participants to free associate and to cathect substitute objects. The author highlights specific characteristics of transference movements and countertransference reactions of the therapists in this framework. An additional goal is to promote these innovative groups and to recommend similar groups for transgender adolescents and their parents.

scholarly journals Primary Care Practitioner Training in Child and Adolescent Psychiatry (PTCAP): A Cluster-Randomized Trial

2019 ◽  
Vol 65 (5) ◽  
pp. 319-329
Author(s):  
Stacey D. Espinet ◽  
Sandra Gotovac ◽  
Sommer Knight ◽  
Larry Wissow ◽  
Merrick Zwarenstein ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Adolescent Psychiatry ◽  
Child And Adolescent Psychiatry ◽  
Practitioner Training ◽  
Attitudes And Knowledge ◽  
Cluster Randomized ◽  
Pediatric Mental Health

Objectives Rural primary care practitioners (PCPs) have a pivotal role to play in frontline pediatric mental health care, given limited options for referral and consultation. Yet they report a lack of adequate training and confidence to provide this care. The aim of this study was to test the effectiveness of the Practitioner Training in Child and Adolescent Psychiatry (PTCAP) program, which was designed to enhance PCPs’ pediatric mental health care confidence. The program includes brief therapeutic skills and practice guidelines PCPs can use to address both subthreshold concerns and diagnosable conditions, themselves. Methods The study design was a pilot, cluster-randomized, multicenter trial. Practices were randomly assigned to intervention ( n practices = 7; n PCPs = 42) or to wait-list control ( n practices = 6; n PCPs = 34). The intervention involved 8 hr of training in practice guidelines and brief therapeutic skills for depression, anxiety, attention deficit hyperactivity disorder, and behavioral disorders with case discussion and video examples, while the control practiced as usual. A linear random-effects model controlling for clustering and baseline was carried out on the individual-level data to examine between-group differences in the primary (i.e., confidence) and secondary (i.e., attitude and knowledge) outcomes at 1-week follow-up. Results Findings were a statistically significant difference in the primary outcomes. Compared to the control group, the intervention group indicated significantly greater confidence in managing diagnosable conditions ( d = 1.81) and general concerns ( d = 1.73), as well as in making necessary referrals ( d = 1.27) and obtaining consults ( d = 0.74). While the intervention did not significantly impact secondary outcomes (attitudes and knowledge), regression analysis indicated that the intervention may have increased confidence, in part, by ameliorating the adverse impact of negative mental health care attitudes. Conclusion PTCAP enhances PCPs’ child/youth mental health care confidence in managing both general and diagnosable concerns. However, an 8-hr session focused on applying brief therapeutic skills was insufficient to significantly change attitudes and knowledge. Formal testing of PTCAP may be warranted, perhaps using more intensive training and including outcome assessments capable of determining whether increased PCP confidence translates to more effective management and better patient outcomes.

Cost-effectiveness of intensive home treatment enhanced by inpatient treatment elements in child and adolescent psychiatry in Germany: A randomised trial

2015 ◽  
Vol 30 (5) ◽  
pp. 583-589 ◽  
Author(s):  
I. Boege ◽  
N. Corpus ◽  
R. Schepker ◽  
R. Kilian ◽  
J.M. Fegert
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Cost Effectiveness ◽  
Health Care Costs ◽  
Adolescent Psychiatry ◽  
Inpatient Treatment ◽  
Child And Adolescent ◽  
Child And Adolescent Psychiatry ◽  
Care Costs

AbstractBackgroundAdmission rate to child and adolescent mental health inpatient units in Germany is high (54 467 admissions in 2013), resources for providing necessary beds are scarce. Alternative pathways to care are needed. Objective of this study was to assess the cost-effectiveness of inpatient treatment versus Hot-BITs-treatment (Hometreatment brings inpatient-treatment outside), a new supported discharge service offering an early discharge followed by 12 weeks of intensive support.MethodsOf 164 consecutively recruited children and adolescents, living within families and being in need of inpatient mental health care, 100 patients consented to participate and were randomised via a computer-list into intervention (n = 54) and control groups (n = 46). Follow-up data were available for 76 patients. Primary outcome was cost-effectiveness. Effectiveness was gathered by therapist-ratings on the Children's Global Assessment Scale (CGAS) at baseline (T1), treatment completion (T2) and an 8-month-follow-up (T3). Cost of service use (health care costs and non–health care costs) was calculated on an intention-to-treat basis at T2 and T3.ResultsSignificant treatment effects were observed for both groups between T1/T2 and T1/T3 (P < 0.001). The Hot-BITs treatment, however, was associated with significantly lower costs at T2 (difference: −6900.47€, P = 0.013) and T3 (difference: −8584.10€, P = 0.007). Bootstrap cost-effectiveness ratio indicated that Hot-BITs was less costly and tended to be more effective at T2 and T3.ConclusionsHot-BITs may be a feasible cost-effective alternative to long inpatient stays in child and adolescent psychiatry. Further rigorous evaluations of the model are required. (Registration number: ISRCTN02672532, part 1, Current Controlled Trials Ltd, URL: http://www.controlled-trials.com).

Child and Adolescent Mental Health Care

2014 ◽  
Author(s):  
Michael Kölch ◽  
Jörg M. Fegert ◽  
Ulrike M.E. Schulze
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Low Socioeconomic Status ◽  
Ethical Problem ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Child And Adolescent Psychiatry ◽  
Care Assessment ◽  
Assessment And Treatment

In child and adolescent mental health care, the competing goals of protecting young people as a vulnerable population and their increasing legal autonomy constitute a specific ethical problem. Improving care, assessment, and treatment interventions requires research. Research that includes this vulnerable underage population has to be minimally burdensome and harmful and requires the informed consent of both children and parents. Therefore, adherence to evidence-based interventions and weighing the risks and benefits of interventions are of utmost importance in child and adolescent psychiatry. While access to mental health care can vary widely, it is crucial for at-risk populations such as children from families of low socioeconomic status, children of the mentally ill, and, in particular, children in youth welfare systems.

The Use of Mobile and Wearable Artificial Intelligence in Child and Adolescent Psychiatry – A Scoping Review (Preprint)

2021 ◽  
Author(s):  
Victoria Welch ◽  
Tom Joshua Wy ◽  
Anna Ligezka ◽  
Leslie C. Hassett ◽  
Paul E. Croarkin ◽  
...  
Keyword(s):  
Mental Health ◽  
Artificial Intelligence ◽  
Scoping Review ◽  
Adolescent Psychiatry ◽  
Child And Adolescent ◽  
Mental Health Disorders ◽  
Wearable Devices ◽  
Autism Spectrum ◽  
Child And Adolescent Psychiatry ◽  
Health Disorders

BACKGROUND Mental health disorders across the life span are a leading cause of medical disabilities. This burden is particularly significant in children and adolescents due to challenges in diagnoses and lack of precision medicine approaches. The advent and widespread adoption of wearable devices (e.g., smartwatches) that generate large volumes of passively collected data that are conducive for artificial intelligence applications to remotely diagnose and manage child and adolescent mental health disorders is promising. OBJECTIVE This study conducted a scoping review to study, characterize and identify areas of innovations with wearable devices that can augment current in-person physician assessments to individualize diagnosis and management of mental health disorders in child and adolescent psychiatry. METHODS This scoping review used PRISMA’s information as a guide. A comprehensive search of several databases from 2011 to June 25, 2021, limited to English language and excluding animal studies, was conducted. The databases included Ovid MEDLINE (R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, Web of Science, and Scopus. RESULTS The initial search yielded 344 articles. 19 articles were left on the final source list for this scoping review. Articles were divided into three main groups: Studies with the main focus on Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorders (ADHD) and Internalizing disorders such as anxiety disorders. Majority of the studies used either ECG strap or wrist worn biosensor. CONCLUSIONS Our scoping review found large heterogeneity of methods and findings in artificial intelligence studies in child psychiatry. Overall, the largest gaps identified in this scoping review are the lack of randomized control trials, most available studies are pilot feasibility trials.

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