NICE Guidelines on Treatment of Depression in Childhood and Adolescence: Implications from a CBT Perspective

2006 ◽  
Vol 34 (2) ◽  
pp. 129-137 ◽  
Author(s):  
James Murray ◽  
Sam Cartwright-Hatton
Keyword(s):  
Young People ◽  
Clinical Excellence ◽  
Evidence Base ◽  
Childhood And Adolescence ◽  
Wait List ◽  
Limited Information ◽  
Nice Guidelines ◽  
Children And Young People ◽  
Psychological Therapies ◽  
Treatment Of Depression

The National Institute for Clinical Excellence recently published their guidelines on the treatment of depression in children and young people. This article critically reviews these guidelines in terms of their likely impact on BABCP members and the services in which they work. The evidence base that underpins the guideline is very sparse. There is particularly limited information on which to base guidance to therapists working with younger children. The use that has been made of this evidence is discussed, and some controversial interpretations are criticized. Implications for services and therapists are outlined. In particular, attention is drawn to the pressing need for very substantial additional training if the guidelines are to be implemented correctly. Some suggestions for deployment of staff with differing levels of knowledge and expertise in CBT are offered. Finally, challenges for the field as a whole are discussed. In particular, a great deal more research is needed into the effectiveness of psychological therapies versus wait list and versus each other and medications, and into the levels of training required to provide competent CBT to children and adolescents.

scholarly journals Practitioner review: health anxiety in children and young people in the context of the COVID-19 pandemic

2020 ◽  
pp. 1-15 ◽  
Author(s):  
A. Haig-Ferguson ◽  
K. Cooper ◽  
E. Cartwright ◽  
M.E. Loades ◽  
J. Daniels
Keyword(s):  
Young People ◽  
Health Anxiety ◽  
Developmentally Appropriate ◽  
Evidence Base ◽  
Physical Symptoms ◽  
Children And Young People ◽  
Global Pandemic ◽  
Assessment And Treatment ◽  
Health Related ◽  
The Face

Abstract Health-related fear is a normal and common response in the face of the global pandemic of COVID-19. Children and young people are frequently being exposed to messages about the threat to health, including from the media and authorities. Whilst for most, their anxiety will be proportionate to the threat, for some, existing pre-occupation with physical symptoms and illness will become more problematic. There is a growing body of evidence that health anxiety may occur in childhood, however much of the literature is taken from research using adult samples. This practitioner review aims to give an overview of the assessment and treatment of health-related worries in children and young people in the context of the COVID-19 pandemic. This review is based on the limited existing evidence in this population and the more substantial evidence base for treating health anxiety in adults. We consider the adaptations needed to ensure such interventions are developmentally appropriate.

Principles of clinical examination in children

2016 ◽  
Author(s):  
Sharmila Jandial ◽  
Helen Foster
Keyword(s):  
Young People ◽  
Clinical Examination ◽  
Clinical Assessment ◽  
Clinical Skills ◽  
Detailed Examination ◽  
Evidence Base ◽  
Clinical Findings ◽  
Whole Child ◽  
Children And Young People ◽  
Musculoskeletal Development

The clinical examination of children and adolescents is an essential component of assessment, facilitates appropriate interpretation of investigations and is integral to the process of making a diagnosis. The clinical assessment of children and young people differs from that of adults, requiring greater reliance on physical examination as the history may be vague and illocalized and requires knowledge of normal musculoskeletal development, normal motor milestones and different patterns of clinical presentations across the ages. The interpretation of clinical findings needs to be in the context of the whole child and the clinical presentation. The degree of expertise required in clinical skills varies with the clinical practice of the examiner and ranges from the basic screening assessment to a more detailed examination of joints, muscles and anatomical regions. The evidence base for clinical assessment in children and young people is accruing and undoubtedly, competent clinical skills requires learning to be embedded in core child health teaching and assessment starting at medical school and reinforced in postgraduate training.

scholarly journals How adolescents understand their values: A qualitative study

2020 ◽  
pp. 135910452096450 ◽  
Author(s):  
Iona Lewis-Smith ◽  
Laura Pass ◽  
Shirley Reynolds
Keyword(s):  
Decision Making ◽  
Young People ◽  
Qualitative Study ◽  
Behaviour Change ◽  
Thematic Analysis ◽  
Personal Values ◽  
Childhood And Adolescence ◽  
Growing Up ◽  
Individual Interviews ◽  
Psychological Therapies

An important component of some psychological therapies is the use of clients’ values to motivate behaviour change. Values are understood to be developed during childhood and adolescence but there has been limited exploration of how young people experience values and their function across contexts. This study aimed to explore adolescents’ understanding of the concept of ‘values’ and to elicit their experiences of values. Semi-structured, individual interviews were conducted with 11 adolescents aged 12–17 years. Thematic analysis was used to identify themes. Young people were readily able to discuss the meaning of ‘values’ and their own personal values. Three main themes were identified: (1) what values are (in general, and specific to themselves), (2) where values come from (relationships, education, growing up), and (3) why values are important (prioritising/decision making, reflecting on values is helpful). The adolescents in this study demonstrated an in-depth understanding of the meaning, origins and functions of values. The results suggest young people may welcome and benefit from opportunities to discuss their values, including in therapy.

scholarly journals Children and Young People's Improving Access to Psychological Therapies: inspiring innovation or more of the same?

2015 ◽  
Vol 39 (2) ◽  
pp. 57-60 ◽  
Author(s):  
Sami Timimi
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Mental Health Problems ◽  
Children And Young People ◽  
Psychological Therapies ◽  
Common Mental Health Problems ◽  
Uk Government ◽  
The Uk

SummaryIn 2007 the UK Government announced a substantial expansion of funding for psychological therapies for those presenting with common mental health problems. This ‘Improving Access to Psychological Therapies’ (IAPT) project was widely welcomed, however, evidence backed, economic, and conceptual critiques were voiced from the start and the project remains controversial. In 2011, the UK government announced it was extending the IAPT project to encompass services for children and young people with the aim of ‘transforming’ the way mental health services are delivered to them. Here I critically reflect on the problems associated first with IAPT and then with CYP-IAPT and ponder whether CYP-IAPT is significantly different to the problematic adult IAPT project or more of the same.

scholarly journals Management of obesity in Scotland: development of the latest evidence-based recommendations

2010 ◽  
Vol 69 (2) ◽  
pp. 195-198 ◽  
Author(s):  
J. Thompson
Keyword(s):  
Young People ◽  
Clinical Excellence ◽  
Evidence Base ◽  
Evidence Based ◽  
Healthy Weight ◽  
Guideline Adaptation ◽  
Lifestyle Measures ◽  
Scottish Government ◽  
Clinical Conditions ◽  
The Cost

The problem of obesity in Scotland has reached epidemic proportions and this reality is recognised at Scottish Government level. The financial impact of treating obesity and obesity-related disease is substantial and in Scotland the cost was estimated at £171×106 in 2001 but only a small proportion of this estimate included weight-loss interventions. The Scottish Intercollegiate Guidelines Network (SIGN) define clinical guidelines as ‘systematically developed statements to help practitioner and patient decisions’ that ‘provide recommendations for effective practice in the management of clinical conditions where variations in practice are known to occur and where effective care may be known not to occur’. The evidence base for successful interventions has progressed since the publication by SIGN of Obesity in Scotland: Integrating Prevention with Weight Management in 1996 and Management of Obesity in Children and Young People in 2003. In 2007 SIGN commissioned a review of these two publications. In 2006 the National Institute for Health and Clinical Excellence (NICE) published a comprehensive obesity guideline and to avoid duplication of effort SIGN used the ADAPTE guideline adaptation framework to utilise and update evidence tables produced by NICE (where appropriate) as a basis for considered judgement. The new SIGN guideline is due for publication in 2010 and addresses children, young people (<18 years old) and adults. It will provide evidence-based recommendations on primary prevention of obesity (defined as intervention when individuals are at a healthy weight and/or overweight to prevent or delay the onset of obesity) within the clinical setting and treatment by lifestyle measures, drugs and surgery.

scholarly journals Evaluation of Treatment Descriptions and Alignment With Clinical Guidance of Apps for Depression on App Stores: Systematic Search and Content Analysis (Preprint)

2019 ◽  
Author(s):  
Dionne Bowie-DaBreo ◽  
Sandra I Sünram-Lea ◽  
Corina Sas ◽  
Heather Iles-Smith
Keyword(s):  
Content Analysis ◽  
Treatment Strategies ◽  
Treatment Fidelity ◽  
Evidence Base ◽  
Great Promise ◽  
Nice Guidelines ◽  
Safety Issues ◽  
Clinical Guidance ◽  
App Store ◽  
Treatment Of Depression

BACKGROUND The use of apps for the treatment of depression shows great promise. However, there is uncertainty regarding the alignment of publicly available apps for depression with clinical guidance, their treatment fidelity and evidence base, and their overall safety. OBJECTIVE Built on previous analyses and reviews, this study aims to explore the treatment and safety issues of publicly available apps for depression. METHODS We conducted a content analysis of apps for depression in the 2 main UK app stores (Google Play and Apple App Store). App store listings were analyzed for intervention content, treatment fidelity, and fit with the National Institute for Health and Care Excellence (NICE) guidelines for the treatment of depression in adults. RESULTS A total of 353 apps for depression were included in the review. App descriptions reported the use of 20 treatment approaches and 37 treatment strategies. Many apps used transdiagnostic (155/353, 43.9%) and multitheoretical interventions to treat multiple disorders including depression. Although many interventions appeared to be evidence-informed, there were issues with treatment fidelity, research evidence, and fit with clinical guidelines. None of the apps fully aligned with the NICE guidelines for depression. CONCLUSIONS App developers have adopted many evidence-informed treatments in their interventions; however, more work is needed to improve clinical validity, treatment fidelity, and the safety of apps. We urge developers to consult relevant guidelines and standards, and to engage in reflective questioning on treatment and safety to address these issues and to improve treatment content and intervention design.

scholarly journals Assessment and treatment of depression in children and young people in the United Kingdom: Comparison of access to services and provision at two time points

2019 ◽  
Vol 25 (1) ◽  
pp. 119-132
Author(s):  
Victoria Pile ◽  
Diana Shammas ◽  
Patrick Smith
Keyword(s):  
United Kingdom ◽  
Young People ◽  
Clinical Excellence ◽  
Population Data ◽  
Age Group ◽  
Time Points ◽  
The United Kingdom ◽  
Treatment Of Depression ◽  
Assessment And Treatment ◽  
Nice Guidance

Depression in young people is common and impairing. There have been significant service changes in the United Kingdom in the last decade, aiming to improve access to evidence-based interventions for depression. However, it is unclear whether youth with depression, first, access services and, second, receive appropriate interventions. In the current study, anonymised data from child and adolescent mental health services were extracted from a 1-year period at two time points (time 1: n = 770; time 2: n = 733). First, these were compared with prevalence and population data. Second, a subsample ( n = 45 at each time point) was evaluated against National Institute for Clinical Excellence (NICE) guidelines. Approximately, one-quarter of the expected number of cases (according to population and prevalence data) were seen in the 12 to 18-years age group, and only 2% of expected cases were seen in the 0 to 11-years age group. This was consistent across time points. Adherence to NICE guidance was mostly good at both time points, but there were concerns raised by this evaluation, in particular the use of medication in this population. From time 1 to 2, there was an increase in use of questionnaire measures, but a decrease in the correct completion of risk assessments.

scholarly journals A systematic review of effectiveness and cost-effectiveness of school-based identification of children and young people at risk of, or currently experiencing mental health difficulties

2018 ◽  
Vol 49 (1) ◽  
pp. 9-19 ◽  
Author(s):  
Joanna K. Anderson ◽  
Tamsin Ford ◽  
Emma Soneson ◽  
Jo Thompson Coon ◽  
Ayla Humphrey ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Cost Effectiveness ◽  
Young People ◽  
Evidence Base ◽  
Bibliographic Databases ◽  
Children And Young People ◽  
Presenting Symptoms ◽  
School Based ◽  
Mental Health Difficulties

AbstractBackgroundAlthough school-based programmes for the identification of children and young people (CYP) with mental health difficulties (MHD) have the potential to improve short- and long-term outcomes across a range of mental disorders, the evidence-base on the effectiveness of these programmes is underdeveloped. In this systematic review, we sought to identify and synthesise evidence on the effectiveness and cost-effectiveness of school-based methods to identify students experiencing MHD, as measured by accurate identification, referral rates, and service uptake.MethodElectronic bibliographic databases: MEDLINE, Embase, PsycINFO, ERIC, British Education Index and ASSIA were searched. Comparative studies were included if they assessed the effectiveness or cost-effectiveness of strategies to identify students in formal education aged 3–18 years with MHD, presenting symptoms of mental ill health, or exposed to psychosocial risks that increase the likelihood of developing a MHD.ResultsWe identified 27 studies describing 44 unique identification programmes. Only one study was a randomised controlled trial. Most studies evaluated the utility of universal screening programmes; where comparison of identification rates was made, the comparator test varied across studies. The heterogeneity of studies, the absence of randomised studies and poor outcome reporting make for a weak evidence-base that only generate tentative conclusions about the effectiveness of school-based identification programmes.ConclusionsWell-designed pragmatic trials that include the evaluation of cost-effectiveness and detailed process evaluations are necessary to establish the accuracy of different identification models, as well as their effectiveness in connecting students to appropriate support in real-world settings.

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