scholarly journals The Long-Term Impact of Multisystemic Therapy: An Experiential Study of the Adolescent-Young Adult Life Transition

2021 ◽  
pp. 074355842110253
Author(s):  
Dominic Conroy ◽  
Jonathan A. Smith ◽  
Stephen Butler ◽  
Sarah Byford ◽  
David Cottrell ◽  
...  
Keyword(s):  
Young People ◽  
Interpretative Phenomenological Analysis ◽  
Adult Life ◽  
Numerical Data ◽  
Multisystemic Therapy ◽  
Life Transition ◽  
Practical Applications ◽  
Long Term Impact ◽  
Forward Looking

This qualitative study examines the possible long-term impact of multisystemic therapy (MST) as young people experience the transition from adolescence to young adulthood. MST is an intensive intervention aimed at reducing antisocial behavior among young people. Interviews were conducted with 32 young people aged 16 to 22 years at their 48-month follow-up as part of the Systemic Therapy for At-Risk Teens (START) evaluation trial in the United Kingdom. Sixteen participants had received MST while 16 received management as usual (MAU). Interviews addressed participants’ current life experiences and were analyzed with interpretative phenomenological analysis (IPA). The inductive qualitative analysis data were transformed into numerical data. Interview extracts were coded as either forward-looking and hopeful (“mature”) or static and frustrated (“stuck”). Among males, significantly more mature outcomes were found among participants who had received MST compared with MAU. No differences were seen between the female groups. A detailed qualitative commentary shows how the constructs, mature and stuck, are manifest across the four domains. The findings suggest that working with an MST therapist during adolescence helped young men cultivate more mature, forward-looking viewpoints and life activities 4 years later when transitioning into adulthood. Findings are discussed in relation to relevant theory and practical applications.

Aftercare

2020 ◽  
pp. 78-104
Author(s):  
Tom Boterberg ◽  
Yen-Ch’ing Chang ◽  
Karin Dieckmann ◽  
Mark Gaze ◽  
Helen Woodman
Keyword(s):  
Young People ◽  
Adult Life ◽  
Response Assessment ◽  
Malignant Neoplasms ◽  
Children And Young People ◽  
Long Term Follow Up ◽  
Second Malignant Neoplasms ◽  
Ongoing Surveillance ◽  
Treatment Summary

Chapter 5 discusses care during and after radiotherapy for children and young people. During and immediately after treatment, children and young people receiving radiotherapy need monitoring for acute complications of treatment and may require supportive care. Following completion of treatment, a response assessment is needed, followed by ongoing surveillance for recurrence. If relapse occurs, consideration can be given to further treatment, which may be radical or palliative in intent. With the passing of time, the risks of relapse recede and monitoring for the late effects of treatment becomes more important. As the majority of patients will have some long-term sequelae, some of which can be ameliorated by timely intervention, patients should be followed in a multidisciplinary clinic. A detailed treatment summary will help predict the risk of complications and guide long-term follow-up. Patients, when they reach adult life, should be aware of possible problems, including fertility issues and second malignant neoplasms.

scholarly journals Multisystemic therapy compared with management as usual for adolescents at risk of offending: the START II RCT

2020 ◽  
Vol 8 (23) ◽  
pp. 1-114
Author(s):  
Peter Fonagy ◽  
Stephen Butler ◽  
David Cottrell ◽  
Stephen Scott ◽  
Stephen Pilling ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Young People ◽  
Multisystemic Therapy ◽  
Self Report ◽  
Second Phase ◽  
Secondary Outcomes ◽  
Start Trial ◽  
The Cost

Background The Systemic Therapy for At Risk Teens (START) trial is a randomised controlled trial of multisystemic therapy (MST) compared with management as usual (MAU). The present study reports on long-term follow-up of the trial (to 60 months). Objectives The primary objective was to compare MST and MAU for the proportion of young people in each group with criminal convictions up to 60 months post baseline. Secondary outcomes included group comparisons of psychological and behavioural factors. An economic analysis was carried out to determine the cost-effectiveness of MST compared with MAU. Two qualitative studies were conducted to better understand the subjective experiences of the participants. Design Primary outcomes (collected up to 60 months) were collected using a centralised police database. Secondary outcomes were evaluated using self-report questionnaires completed by both young people and parents or carers at the 24-, 36- and 48-month follow-ups. Research assistants were blind to treatment allocation. Setting Participants were recruited from participating MST sites in nine areas of England. Secondary outcomes were typically collected within the family home. Participants A total of 684 families were recruited into the START trial and allocated randomly to a treatment group. Of these, 487 remained in the second phase of the trial. Young people were aged, on average, 13.8 years at baseline, with 63% male and 37% female. Interventions MST is a manualised programme for young people exhibiting antisocial behaviour and their families that uses principles from cognitive–behavioural and family therapy to provide an individualised approach. MAU content was not prespecified, but consisted of the standard care offered to young people who met eligibility for the trial. Main outcome measures Young people’s offending was evaluated using the Police National Computer. Secondary measures included validated self-report measures completed by both the young person and their parent or carer. The economic evaluation took a broad perspective and outcomes were assessed in terms of quality-adjusted life-years and offending. Results No significant differences were found in the proportion of offending between the groups (hazard ratio 1.03, 95% confidence interval 0.84 to 1.26; p = 0.78). No differences were found between the groups on secondary outcome measures, with a few exceptions that did not hold up consistently across the follow-up period. The economic analysis did not find evidence to support the cost-effectiveness of MST compared with MAU. Outcomes from the qualitative studies suggest that families mostly felt positive about MST, and that MST was associated with greater maturity in young men. Limitations Some intended evaluations were not possible to deliver. Selective attrition may have influenced the nature of the sample size. It is also unclear how representative the MAU services were of reality. Future research Recommendations are made for the evaluation of MST in populations with more severe behavioural problems, as well as for identifying and testing new moderators. Conclusions The results of the second phase of the START trial do not support the long-term superiority of MST to MAU, but elements of the intervention may be adapted successfully. Trial registration Current Controlled Trials ISRCTN77132214 and London South-East REC registration number 09/H1102/55. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 23. See the NIHR Journals Library website for further project information.

scholarly journals ‘A confident parent breeds a confident child’: Understanding the experience and needs of parents whose children will transition from paediatric to adult care

2020 ◽  
pp. 136749352093642
Author(s):  
Karen L Shaw ◽  
Lydia Baldwin ◽  
Gemma Heath
Keyword(s):  
Young People ◽  
Interpretative Phenomenological Analysis ◽  
Transitional Care ◽  
Well Being ◽  
Major Theme ◽  
Adult Care ◽  
Long Term Conditions ◽  
Protective Strategies ◽  
Midlife Adults

Transitional care for young people with long-term conditions emphasizes the importance of supporting parents, particularly in relation to promoting adolescent healthcare autonomy. Yet, little practical guidance is provided, and transitional care remains suboptimal for many families. This study aimed to examine how parents understand and experience their caregiving role during their child’s transition to adult services, to identify parents’ needs, and to inform service improvements. Focus groups were undertaken with parents of young people with brittle asthma, osteogenesis imperfecta, or epilepsy. Data were analysed using interpretative phenomenological analysis. Participants ( n = 13) described how their parenting roles extended beyond what they consider usual in adolescence. These roles were presented as time consuming, stressful, and unrelenting but necessary to protect children from harm in the face of multiple risks and uncertainties. Such protective strategies were also perceived to hinder adolescent development, family functioning, and their own development as midlife adults. Finding a balance between protecting immediate health and long-term well-being was a major theme. Participants called for improved support, including improved service organization. Recommendations are provided for working with parents and young people to manage the risks and uncertainties associated with their condition, as part of routine transitional care.

scholarly journals Strategies for the Prevention of Social Exclusion: An Analysis of the Children's Fund

2008 ◽  
Vol 37 (2) ◽  
pp. 251-270 ◽  
Author(s):  
MARIAN BARNES ◽  
KATE MORRIS
Keyword(s):  
Young People ◽  
Social Exclusion ◽  
Local Authority ◽  
Children And Young People ◽  
Multiple Dimensions ◽  
Marginalised Groups ◽  
The Social ◽  
Long Term Impact

AbstractThe Children's Fund involved the development of partnerships in every local authority in England to prevent the social exclusion of children and young people. This article draws from the national evaluation of this initiative to consider the strategies used to implement the Fund, and reflect on their capacity to address the multiple dimensions of exclusion experienced by marginalised groups of children and young people. It discusses the contested nature of the concept of social exclusion, but argues that this is a useful framework for understanding the processes by which children may become excluded and for assessing the capacity of strategies to address this. It concludes that the Children's Fund is likely to have limited long-term impact in this respect.

scholarly journals “The Unheard Voices”: Lived Experiences of Sexual Abuse in Male Survivors

2020 ◽  
pp. 025371762097291
Author(s):  
Sarbopriya Das ◽  
Soma Pramanik ◽  
Deepshikha Ray ◽  
Debanjan Banerjee
Keyword(s):  
Sexual Abuse ◽  
Lived Experiences ◽  
Interpretative Phenomenological Analysis ◽  
Systematic Research ◽  
Emotional Challenges ◽  
Male Survivors ◽  
Long Term Impact ◽  
Depth Interviews ◽  
Opposite Gender

Background: Victims of sexual abuse face unique emotional challenges. Among them, the male survivors of sexual assault have largely been neglected in the literature, being traditionally considered “against the norm” and symbolic of reduced masculinity. Methods: Qualitative approach was used to study the lived experiences of five (three heterosexual and two homosexual) male survivors of sexual abuse. In-depth interviews were conducted with consent, transcribed verbatim, and analyzed using interpretative phenomenological analysis (IPA). Results: Commonality in the experiences of abuse (the identity of the abuser, nature of agony), perspectives of sharing the abuse history (lack of acceptance of “male” victimhood, the openness of the opposite gender, family reactions), and the long-term impact of abuse (withdrawal/change of interest as coping, sexual identity issues) emerged as the main superordinate theme (and subthemes). Conclusion: Society, with its patriarchy, often turns apathetic to male victimization in sexual abuse. Beliefs about masculinity and resultant trauma can cause a chronic social and psychosexual impact on the victims. More systematic research is needed to understand their perceptions, unmet needs, and experiences of recovery.

Trafalgar: Back on the Map of British Popular Culture? Assessing the 2005 Bicentenary

2007 ◽  
Author(s):  
Mark Connelly
Keyword(s):  
Popular Culture ◽  
Young People ◽  
National Curriculum ◽  
State Intervention ◽  
Current State ◽  
Wide Range ◽  
Historical Awareness ◽  
Long Term Impact

This chapter explores the current state of knowledge about, and national identification with, Nelson, Trafalgar, and Britain's maritime past, based on observations of a wide range of academic and public bicentenary events, media, and interviews with several groups of (primarily young) people over the course of 2005. The chapter strikes a sceptical note on the long-term impact of 2005 on historical awareness: without direct state intervention in the National Curriculum, it appears difficult to see how the role of the Navy, Nelson, and the sea can be more fully instilled in British life.

Adjustment disorders in child and adolescent psychiatry (DRAFT)

2018 ◽  
Author(s):  
Aisling Mulligan
Keyword(s):  
Young People ◽  
Adult Life ◽  
Adjustment Disorder ◽  
Child And Adolescent Psychiatry ◽  
Childhood And Adolescence ◽  
Children And Young People ◽  
Increased Risk ◽  
Clinical Description ◽  
Long Term Prognosis

The clinical description of adjustment disorder (AD) in children and young people is the same as in adults. However, the stressors or triggers to AD in childhood and adolescence may differ from those in adult life. Up to 30% of those presenting to acute psychiatric services for adolescents can be considered to have an AD. The diagnosis of AD is associated with an increased risk of suicide and of suicidal ideation in young people. While most young people recover from AD, the long-term prognosis of AD is different in young people than in adults—young people with AD have a higher risk of developing ongoing psychiatric illness than adults with AD.

The Legacy of Physical Education: Influences on Adult Lifestyle

2000 ◽  
Vol 12 (1) ◽  
pp. 34-50 ◽  
Author(s):  
Roy J. Shephard ◽  
François Trudeau
Keyword(s):  
Physical Education ◽  
Activity Patterns ◽  
Adult Life ◽  
Smoking Behavior ◽  
Long Term Effects ◽  
Health Value ◽  
Early Adult Life ◽  
Long Term Impact

It is now well-established that well-designed programs can induce short-term gains in aerobic fitness, muscular strength, and physical performance, although during the primary school years, gains may be somewhat less than in adults. Long-term effects have as yet had little investigation. Most studies have looked simply at the tracking of activity patterns and associated lifestyle variables, usually from mid or late adolescence into early adult life. Although statistically significant, such tracking has been relatively weak. Further, in the absence of an experimental intervention, such studies provide little information on the long-term health value of physical education. The potential for obtaining definitive information is suggested by a long-term (20+ year) follow-up of participants in the Trois Rivières study. This program was well-perceived by participants, and the data obtained on adults suggest it may have had some favorable long-term impact on activity patterns, physiological parameters, and smoking behavior.

Drug Treatments

2021 ◽  
pp. 295-334
Author(s):  
Eric Taylor
Keyword(s):  
Young People ◽  
Adverse Events ◽  
Neurodevelopmental Disorders ◽  
Sleep Problems ◽  
Pharmacological Management ◽  
Drug Treatments ◽  
Stimulant Medications ◽  
Inattention And Hyperactivity ◽  
Long Term Impact

This chapter describes the use of medication in alleviating the problems of young people with neurodevelopmental disorders. It gives special emphasis to its use in multiple overlapping conditions and to the long-term impact on functioning. Stimulant and non-stimulant medications for the control of inattention and hyperactivity are reviewed. Antipsychotics for control of agitation and aggression, as well as for the treatment of psychosis, are considered. Pharmacological management of mood and anxiety problems is covered in the context of people with neurodevelopmental disorders. Control of tics, other movement disorders, and sleep problems are included. Practical considerations of prescribing are covered, and cautions about safety include descriptions of adverse events and how to reduce them.

scholarly journals The Male Experience of Suicide Attempts and Recovery: An Interpretative Phenomenological Analysis

2021 ◽  
Vol 18 (10) ◽  
pp. 5209
Author(s):  
Cara Richardson ◽  
Adele Dickson ◽  
Kathryn A. Robb ◽  
Rory C. O’Connor
Keyword(s):  
Emotional Expression ◽  
Interpretative Phenomenological Analysis ◽  
Help Seeking ◽  
Suicide Attempts ◽  
Phenomenological Analysis ◽  
Clinical Implications ◽  
Face To Face ◽  
Male Experience ◽  
Long Term Impact

Suicidal behaviour is a complex phenomenon—its aetiology spans biological, psychological, environmental, social and cultural facets. Men’s deaths by suicide outnumber women in every country in the world. This study explored the male experience of suicide attempts and recovery as well as factors which may be protective for men. Men (n = 12) participated in semi-structured face-to-face interviews which were subjected to Interpretative Phenomenological Analysis (IPA). Four master themes were identified: (1) “characteristics of attempt/volitional factors”, (2) “dealing with suicidal thoughts and negative emotions”, (3) “aftermath” and (4) “protective factors”. The theoretical and clinical implications of this study are discussed, including help seeking, emotional expression, the long-term impact of suicide attempt as well as the applied contribution to established theories.

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