scholarly journals Telephone-guided self-help for mental health difficulties in neurological conditions: a randomised pilot trial

2021 ◽  
pp. archdischild-2019-318577
Author(s):  
Sophie D Bennett ◽  
Isobel Heyman ◽  
Anna E Coughtrey ◽  
Sophia Varadkar ◽  
Terence Stephenson ◽  
...  
Keyword(s):  
Mental Health ◽  
Young People ◽  
Primary Outcome ◽  
Outcome Measure ◽  
Mental Health Problems ◽  
Pilot Trial ◽  
Primary Outcome Measure ◽  
Self Help ◽  
Mental Health Difficulties ◽  
Neurological Conditions

ObjectiveThis study aimed to conduct a randomised pilot trial to assess the feasibility of a randomised controlled trial (RCT) to investigate the effect of telephone-guided self-help for the treatment of mental health difficulties in children with neurological conditions.DesignPreliminary RCT. The primary outcome measure was the Strengths and Difficulties Questionnaire.SettingNeurology clinics in a national tertiary paediatric hospital.PatientsYoung people attending neurology clinics who met criteria for mental health difficulties according to the Development and Wellbeing Assessment.Interventions12 weeks of telephone-guided self-help based on a modular approach to psychological therapy for children delivered to children and/or their parents (n=17; eight males; mean age 12.04 years, SD=3.34) or a waiting list for telephone-guided self-help with no additional intervention over 12 weeks (n=17; nine males; mean age 10.53 years, SD=3.14).Results124 participants completed the DAWBA, and 34 children and young people were entered into the trial. 65% of those randomised to the intervention arm completed the full intervention, and the intervention was acceptable to those completing it. However, there were significant problems related to lack of data completion (38% data loss for primary outcome measure), choice of control comparator and outcome measures. Due to significant loss of data at follow-up, the effect size findings are considered unreliable.ConclusionsFurther feasibility work should be conducted to improve data completeness before progression to a definitive trial of guided self-help for mental health problems in children with neurological conditions can be recommended.Trial registration numberISRCTN21184717.

scholarly journals MyHealthPA: Development and Pilot Testing of a Mobile-Based Monitoring Tool to Reduce Cardio-Vascular Disease Risk in People with Mental Health Problems (Preprint)

2018 ◽  
Author(s):  
Louise Thornton ◽  
Frances Kay-Lambkin ◽  
Bree Tebbutt ◽  
Tanya L Hanstock ◽  
Amanda L Baker
Keyword(s):  
Mental Health ◽  
Young People ◽  
Mental Health Problems ◽  
Pilot Trial ◽  
Health Problems ◽  
Treatment Assessment ◽  
End Of Treatment ◽  
Cardio Vascular Disease ◽  
Cardio Vascular

BACKGROUND Background: People with mental health disorders live on average 20 years less than those without, often due to poor physical health including cardio-vascular disease (CVD). Evidence-based interventions are required to reduce this lifespan gap. OBJECTIVE Objective: This study aimed to develop, trial, and evaluate a mobile-based lifestyle program (MyHealthPA) to help people with mental health problems improve key health risk behaviors and reduce their risk of CVD. METHODS Methods: The development of MyHealthPA occurred in three stages: (1) a review of the literature; (2) a scoping survey (n=251) among people with and without experience of mental health problems; and (3) program development informed by stages (1) and (2). A small pilot trial among young people with and without mental health (MH) disorders was also conducted. Participants completed a baseline assessment and given access to the MyHealthPA program for a period of eight weeks. They were then asked to complete an end-of-treatment assessment and a follow-up assessment one month later. RESULTS Results: Twenty-eight young people aged 19 to 25 years were recruited to the pilot trial. Of these, 12 (43%) had been previously diagnosed with a MI. Twelve participants (43%) completed the end-of-treatment assessment and six (21%) completed the follow-up assessment. Small improvements in fruit and vegetable consumption, level of physical activity, alcohol use, and mood were found between baseline and end-of-treatment and follow-up, particularly among people with experience of MH issues. Most participants (57-60%) reported the program had above average usability, however only 29-40% of participants reported that they would like to use the program frequently and would recommend it to other young people. Participants also identified a number of ways in which the program could be improved. CONCLUSIONS Conclusions: This article describes the formative research and process of planning that formed the development of MyHealthPA and the evidence base underpinning the approach. The MyHealthPA program represents an innovative approach to CVD risk reduction among people with mental health problems. MyHealthPA appears to be an acceptable, easy to use, and potentially effective mHealth intervention to assist young people with mental illness to monitor risk factors for CVD. However, ways in which the program could be improved for future testing and dissemination were identified and are discussed.

Pathways to and from state care: The experiences of eight young people

2006 ◽  
Vol 31 (3) ◽  
pp. 34-41 ◽  
Author(s):  
John Frederick ◽  
Chris Goddard
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Drug Abuse ◽  
Young People ◽  
Mental Health Problems ◽  
Supportive Services ◽  
Abuse And Neglect ◽  
Mental Health Difficulties ◽  
Clinically Significant ◽  
Depth Interviews

Children enter state care because their parents are unable to care for them or because of abuse and neglect. Invariably they experience considerable distress and emotional trauma with many having clinically significant mental health problems. Few, however, receive the assessment, counselling and supportive services that they need. When they leave care, many experience extensive problems including mental health difficulties, unemployment, poverty, homelessness, drug abuse, relationship difficulties and lack of social support.This paper will discuss the findings of a qualitative study utilising in-depth interviews with young people who have been in state care. Illustrations of their pathways to and from care will highlight their experiences, and direct quotations from the participants will provide particular insights into the complex issues they have had to confront.The paper will outline key opportunities for prevention and intervention approaches at various points along these pathways.

scholarly journals Therapist- and parent-guided Internet-delivered behaviour therapy for paediatric Tourette’s Disorder: a pilot randomised controlled trial with long-term follow-up

2018 ◽  
Author(s):  
Per Andrén ◽  
Kristina Aspvall ◽  
Lorena Fernández de la Cruz ◽  
Paulina Wiktor ◽  
Sofia Romano ◽  
...  
Keyword(s):  
Young People ◽  
Primary Outcome ◽  
Outcome Measure ◽  
Primary Outcome Measure ◽  
Behaviour Therapy ◽  
Tourette’S Disorder ◽  
Tourette's Disorder ◽  
Tic Severity ◽  
Randomised Controlled

Objective: Behaviour therapy (BT) for Tourette’s Disorder (TD) and Persistent Motor or Vocal Tic Disorder (PTD) is rarely available. We evaluated the feasibility of adapting two existing BT protocols for TD/PTD (habit reversal training [HRT] and exposure and response prevention [ERP]) into a therapist- and parent-guided online self-help format.Design: A pilot, single-blind, parallel group randomised controlled trial.Setting: A university hospital in Sweden.Participants: Twenty-three young people with TD/PTD, aged 8-16.Interventions: Two 10-week therapist- and parent-guided Internet-delivered programmes (called BIP TIC HRT and BIP TIC ERP).Outcome: The primary outcome measure was the Yale Global Tic Severity Scale (YGTSS). Blinded evaluators rated symptoms at baseline, post-treatment, and 3-month follow-up (primary endpoint). All participants were naturalistically followed-up to 12 months after treatment.Results: Patients and parents rated the interventions as highly acceptable, credible, and satisfactory. While both interventions resulted in reduced tic-related impairment, parent-rated tic severity, and improved quality of life, only BIP TIC ERP resulted in a significant improvement on the primary outcome measure. Within-group effect sizes and responder rates were, respectively: d=1.12 and 75% for BIP TIC ERP, and d=0.50 and 55% for BIP TIC HRT. The therapeutic gains were maintained up to 12 months after the end of the treatment. Adverse events were rare in both groups. The average therapist support time was around 25 minutes per participant per week.Conclusions: Internet-delivered BT has the potential to greatly increase access to evidence-based treatment for young people with TD/PTD. Further evaluation of the efficacy and cost-effectiveness of this treatment modality is warranted.Trial registration number: NCT02864589 (ClinicalTrials.gov).Funding: The trial was supported by the Stockholm County Council (PPG project 2016-0108).

scholarly journals Therapist-guided and parent-guided internet-delivered behaviour therapy for paediatric Tourette’s disorder: a pilot randomised controlled trial with long-term follow-up

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e024685 ◽  
Author(s):  
Per Andrén ◽  
Kristina Aspvall ◽  
Lorena Fernández de la Cruz ◽  
Paulina Wiktor ◽  
Sofia Romano ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Young People ◽  
Primary Outcome ◽  
Outcome Measure ◽  
Controlled Trial ◽  
Primary Outcome Measure ◽  
Behaviour Therapy ◽  
Tic Severity ◽  
Randomised Controlled

ObjectiveBehaviour therapy (BT) for Tourette’s disorder (TD) and persistent (chronic) motor or vocal tic disorder (PTD) is rarely available. We evaluated the feasibility of adapting two existing BT protocols for TD/PTD (habit reversal training (HRT) and exposure and response prevention (ERP)) into a therapist-guided and parent-guided online self-help format.DesignA pilot, single-blind, parallel group randomised controlled trial.SettingA specialist outpatient clinic in Sweden.ParticipantsTwenty-three young people with TD/PTD, aged 8–16.InterventionsTwo 10-week therapist-guided and parent-guided internet-delivered programmes (called BIP TIC HRT and BIP TIC ERP).OutcomeThe primary outcome measure was the Yale Global Tic Severity Scale. Blinded evaluators rated symptoms at baseline, post-treatment and 3-month follow-up (primary endpoint). All participants were naturalistically followed up to 12 months after treatment.ResultsPatients and parents rated the interventions as highly acceptable, credible and satisfactory. While both interventions resulted in reduced tic-related impairment, parent-rated tic severity and improved quality of life, only BIP TIC ERP resulted in a significant improvement on the primary outcome measure. Within-group effect sizes and responder rates were, respectively: d=1.12 and 75% for BIP TIC ERP, and d=0.50 and 55% for BIP TIC HRT. The therapeutic gains were maintained up to 12 months after the end of the treatment. Adverse events were rare in both groups. The average therapist support time was around 25 min per participant per week.ConclusionsInternet-delivered BT has the potential to greatly increase access to evidence-based treatment for young people with TD/PTD. Further evaluation of the efficacy and cost-effectiveness of this treatment modality is warranted.Trial registration numberNCT02864589; Pre-results.

Supporting self-management amongst young people with acne vulgaris: feasibility randomised trial of a web-based behavioural intervention (Preprint)

2020 ◽  
Author(s):  
Athena Ip ◽  
Ingrid Muller ◽  
Adam Geraghty ◽  
Kate Rumsby ◽  
Beth Stuart ◽  
...  
Keyword(s):  
Young People ◽  
Usual Care ◽  
Primary Outcome ◽  
Outcome Measure ◽  
Randomised Trial ◽  
Intervention Group ◽  
Primary Outcome Measure ◽  
Self Management ◽  
Web Based ◽  
Topical Treatments

BACKGROUND Acne is a common skin condition that is most prevalent in young people. It can have substantial impact on quality of life, which can be minimised with appropriate use of topical treatments. Nonadherence to topical treatments for acne is common often leading to treatment failure. OBJECTIVE The objective of this study was to develop a web-based behavioural intervention to support self-management of acne and to assess the feasibility of recruitment, retention and engagement in a parallel unblinded randomised trial of the intervention compared with usual care alone. METHODS The intervention was developed iteratively using LifeGuide software and following the Person-Based Approach (PBA) to intervention development. The target behaviour was ‘Appropriate use of topical treatments’ and barriers and facilitators identified from the qualitative research and evidence from the wider literature were used to identify techniques to improve and promote their use. Young people with acne aged 14-25 years who had received treatment for acne within the last 6 months were invited to participate through mail-out from primary care practices in the South of England. Participants were randomised to: (1) usual care, or (2) usual care plus access to web-based intervention. Usage data was collected and a series of questionnaires including the primary outcome measure for skin specific quality of life (Skindex-16) were collected at baseline, 4-weeks and 6-weeks follow-up. RESULTS A total of 1193 participants were invited and 53 young people with acne were randomised to usual care (n=27) or usual care plus intervention (n=26). The response rate for the primary outcome measure (Skindex-16) was 87% at 4-weeks, 6-weeks or both time points. The estimate of mean scores between groups (with 95% confidence) using linear regression showed a trend in the direction of benefit for the web-based intervention group in the primary outcome measure (Skindex-16), and secondary measures (Patient Health Questionnaire 4 and the Problematic Experiences of Therapy Scale). Intervention usage data showed a high uptake of the core module in the usual care plus web-based intervention group with 23 of 26 (88%) completing the module. Uptake of the optional modules were low with less than half visiting each (Myth-busting quiz: 27%; Living with spots or acne: 42%; Oral antibiotics: 19%; What are spots or acne: 27%; Other treatments: 27%; Talking to your GP: 12%). CONCLUSIONS This study demonstrated the feasibility of delivering a trial of a web-based intervention to support self-management for young people with acne. Additional work is needed prior to a full definitive trial including enhancing engagement with the intervention, recruitment and follow-up rates. CLINICALTRIAL International Standard Randomized Controlled Trial Number (ISRCTN): 78626638; https://doi.org/10.1186/ISRCTN78626638.

P07 Identifying the primary outcome measure and protocol components for a prospective feasibility study of corticosteroid regimens for CYP with JIA using consensus methods with young people, families and professionals

Rheumatology ◽  
2019 ◽  
Vol 58 (Supplement_4) ◽  
Author(s):  
Simon R. Stones ◽  
Heather Bagley ◽  
Michael W. Beresford ◽  
Ashley Jones ◽  
Flora McErlane ◽  
...  
Keyword(s):  
Young People ◽  
Outcome Measures ◽  
Feasibility Study ◽  
Primary Outcome ◽  
Outcome Measure ◽  
Conflicts Of Interest ◽  
Rapid Onset ◽  
Primary Outcome Measure ◽  
Feasibility Trial ◽  
Consensus Methods

Abstract Background Juvenile idiopathic arthritis (JIA) is an umbrella term for seven relapsing-remitting inflammatory conditions in children and young people (CYP). Early, intensive treatment can prevent long-term damage; however, established drugs exhibit a delayed response, prompting the need for rapid-onset treatment in the form of corticosteroids. Given a lack of consensus as to which corticosteroid induction regimen should be used for CYP with JIA, a feasibility trial of different regimens is needed. The aim was to achieve consensus among CYP, families, and healthcare professionals (HCPs) about the primary outcome measures and protocol components to include in a prospective feasibility study. Methods A modified Nominal Group Technique was used to achieve consensus on the most appropriate primary outcome measure to be included in a prospective feasibility study, in addition to other protocol components such as inclusion/exclusion criteria. Fifteen participants participated in the process, including a combination of CYP with JIA, families (n = 9) and HCPs (n = 6). Results In the first vote, participants agreed that Juvenile Arthritis Disease Activity Score (JADAS) and Physician Global Assessment Score were most meaningful. During sub-group discussions, the need for a composite score which captured the voice of CYP and families was emphasised. In the second vote, JADAS and the JIA Core Set were identified as the most important. Further discussions led to the results of the third vote, agreeing JADAS as the primary outcome measure of choice being measured at 6 weeks after commencement of treatment. The majority of HCPs, CYP and families voted for all JIA sub-types to be included in a prospective feasibility study, with some queries about the inclusion of systemic JIA given its unique presentation. Participants also identified the need for more frequent data collection time points to capture the rapid onset of corticosteroid action, while CYP and families opted for accessible mechanisms for participation, such as digital follow-up strategies. Conclusion It is feasible to include CYP, families and HCPs in synthesising complex concepts to agree by consensus the design components of clinical research. The primary outcome measure for inclusion in a prospective feasibility study of corticosteroid regimens in CYP with JIA was co-prioritised, with CYP and families taking a leading role in the ultimate selection of an appropriate outcome measure and other study protocol components. Using consensus methods with CYP, families and HCPs is a systematic and rigorous way in which to select outcome measures that are both meaningful and relevant to everyone involved in the care and treatment of CYP with JIA. Conflicts of Interest The authors declare no conflicts of interest.

scholarly journals Prevalence of mental health problems in schools: poverty and other risk factors among 28 000 adolescents in England

2019 ◽  
Vol 215 (3) ◽  
pp. 565-567 ◽  
Author(s):  
Jessica Deighton ◽  
Suzet Tanya Lereya ◽  
Polly Casey ◽  
Praveetha Patalay ◽  
Neil Humphrey ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Young People ◽  
Conduct Problems ◽  
Large Scale ◽  
Mental Health Problems ◽  
Health Problems ◽  
Community Based ◽  
School Based ◽  
Mental Health Difficulties

SummaryCurrent mental health provision for children is based on estimates of one in ten children experiencing mental health problems. This study analyses a large-scale community-based dataset of 28 160 adolescents to explore school-based prevalence of mental health problems and characteristics that predict increased odds of experiencing them. Findings indicate the scale of mental health problems in England is much higher than previous estimates, with two in five young people scoring above thresholds for emotional problems, conduct problems or hyperactivity. Gender, deprivation, child in need status, ethnicity and age were all associated with increased odds of experiencing mental health difficulties.Declarations of interestNone.

scholarly journals Self-blaming emotions in major depression: a randomised pilot trial comparing fMRI neurofeedback training with self-guided psychological strategies (NeuroMooD)

2019 ◽  
Author(s):  
Tanja Jaeckle ◽  
Steven C.R. Williams ◽  
Gareth J. Barker ◽  
Rodrigo Basilio ◽  
Ewan Carr ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Primary Outcome ◽  
Outcome Measure ◽  
Psychological Intervention ◽  
Pilot Trial ◽  
Self Esteem ◽  
Primary Outcome Measure ◽  
Neurofeedback Training ◽  
Self Blame ◽  
Clinical Potential

AbstractBackgroundOvergeneralised self-blame and worthlessness are key symptoms of major depressive disorder (MDD) and were previously associated with self-blame-selective changes in connectivity between right superior anterior temporal lobe (rSATL) and subgenual frontal areas. In a previous study, remitted MDD patients successfully modulated guilt-selective rSATL-subgenual cingulate connectivity using real-time functional magnetic resonance imaging (rtfMRI) neurofeedback training, thereby increasing their self-esteem. The feasibility and potential of using this approach in symptomatic MDD were unknown.MethodsThis single-blind pre-registered randomised controlled pilot trial tested the clinical potential of a novel self-guided psychological intervention with and without additional rSATL-posterior subgenual cortex (SC) rtfMRI neurofeedback, targeting self-blaming emotions in insufficiently recovered people with MDD and early treatment-resistance (n=43, n=35 completers). Following a diagnostic baseline assessment, patients completed three self-guided sessions to rebalance self-blaming biases and a post-treatment assessment. The fMRI neurofeedback software FRIEND was used to measure rSATL-posterior SC connectivity, while the BDI-II was administered to assess depressive symptom severity as a primary outcome measure.ResultsBoth interventions were demonstrated to be safe and beneficial, resulting in a mean reduction of MDD symptom severity by 46% and response rates of more than 55%, with no group difference. Secondary analyses, however, revealed a differential response on our primary outcome measure between MDD patients with and without DSM-5 defined anxious distress. Stratifying by anxious distress features was investigated, because this was found to be the most common subtype in our sample. MDD patients without anxious distress showed a higher response to rtfMRI neurofeedback training compared to the psychological intervention, with the opposite pattern found in anxious MDD. We explored potentially confounding clinical differences between subgroups and found that anxious MDD patients were much more likely to experience anger towards others as measured on our psychopathological interview which might play a role in their poorer response to neurofeedback. In keeping with the hypothesis that self-worth plays a key role in MDD, improvement on our primary outcome measure was correlated with increases in self-esteem after the intervention and this correlated with the frequency with which participants employed the strategies to tackle self-blame outside of the treatment sessions.ConclusionsThese findings suggest that self-blame-selective rtfMRI neurofeedback training may be superior over a solely psychological intervention in non-anxious MDD, although further confirmatory studies are needed. The self-guided psychological intervention showed a surprisingly high clinical potential in the anxious MDD group which needs further confirmation compared versus treatment-as-usual. Future studies need to investigate whether self-blame-selective rSATL-SC connectivity changes are irrelevant in anxious MDD, which could explain their response being better to the psychological intervention without interfering neurofeedback.https://doi.org/10.1186/ISRCTN10526888

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