scholarly journals Supported Web-Based Guided Self-Help for Insomnia for Young People Attending Child and Adolescent Mental Health Services: Protocol for a Feasibility Assessment

10.2196/11324 ◽  
2018 ◽  
Vol 7 (12) ◽  
pp. e11324 ◽  
Author(s):  
Bethany Cliffe ◽  
Abigail Croker ◽  
Megan Denne ◽  
Paul Stallard
2018 ◽  
Author(s):  
Bethany Cliffe ◽  
Abigail Croker ◽  
Megan Denne ◽  
Paul Stallard

BACKGROUND Sleep disturbance in adolescents is common, with up to one-third reporting significant symptoms of insomnia. Research with adults has demonstrated that Web-based cognitive behavioral therapy for insomnia (CBTi) can improve both sleep and mental health. However, research with adolescents is lacking, and we know little about whether CBTi would have similar effects on this younger population. OBJECTIVE This paper summarizes the protocol of a study to assess the feasibility of adding supported Web-based CBTi to the usual care of young people aged 14-17 years attending specialist Child and Adolescent Mental Health Services (CAMHS). METHODS This is an open trial where we will recruit young people (N=50) aged 14-17 years attending specialist CAMHS with primary or comorbid symptoms of insomnia. In addition to their usual care, young people will be provided with Sleepio, a 6-session, Web-based CBTi self-help program for insomnia. Sleepio teaches a range of techniques including sleep hygiene, relaxation training, stimulus control, sleep restriction, and cognitive techniques that participants will be helped to apply through brief, weekly telephone support calls. Questionnaires and interviews will be completed at baseline and postintervention (8-10 weeks) and will assess sleep, symptoms of depression and anxiety, and acceptability of Sleepio and telephone support. RESULTS Recruitment started in May 2018 and continued until the end of October 2018. CONCLUSIONS This study will provide preliminary evidence about whether supported Web-based CBTi is acceptable to young people with mental health problems and about the postintervention effects on sleep and symptoms of anxiety and depression. This information will determine whether a randomized trial to determine the effectiveness of Sleepio should be undertaken. INTERNATIONAL REGISTERED REPOR DRR1-10.2196/11324


BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e027339 ◽  
Author(s):  
Hristina Petkova ◽  
Mima Simic ◽  
Dasha Nicholls ◽  
Tamsin Ford ◽  
A Matthew Prina ◽  
...  

ObjectivesThis study aimed to estimate the incidence of DSM5 anorexia nervosa in young people in contact with child and adolescent mental health services in the UK and Ireland.DesignObservational, surveillance study, using the Child and Adolescent Psychiatry Surveillance System, involving monthly reporting by child and adolescent psychiatrists between 1st February 2015 and 30th September 2015.SettingThe study was based in the UK and Ireland.ParticipantsClinician-reported data on young people aged 8–17 in contact with child and adolescent mental health services for a first episode of anorexia nervosa.Main outcome measuresAnnual incidence rates (IRs) estimated as confirmed new cases per 100 000 population at risk.Results305 incident cases of anorexia nervosa were reported over the 8-month surveillance period and assessed as eligible for inclusion. The majority were young women (91%), from England (70%) and of white ethnicity (92%). Mean age was 14.6 years (±1.66) and mean percentage of median expected body mass index for age and sex was 83.23% (±10.99%). The overall IR, adjusted for missing data, was estimated to be 13.68 per 100 000 population (95% CI 12.88 to 14.52), with rates of 25.66 (95% CI 24.09 to 27.30) for young women and 2.28 (95% CI 1.84 to 2.79) for young men. Incidence increased steadily with age, peaking at 15 (57.77, 95% CI 50.41 to 65.90) for young women and 16 (5.14, 95% CI 3.20 to 7.83) for young men. Comparison with earlier estimates suggests IRs for children aged 12 and under have increased over the last 10 years.ConclusionThese results provide new estimates of the incidence of anorexia nervosa in young people. Service providers and commissioners should consider evidence to suggest an increase in incidence in younger children.Trial registration numberISRCTN12676087.


2017 ◽  
Vol 5 (3) ◽  
pp. 183-194 ◽  
Author(s):  
Benjamin Hoadley ◽  
Freya Smith ◽  
Cecilia Wan ◽  
Adrian Falkov

Mental illness in children and young people is increasing in frequency and complexity, is emerging earlier and is persisting into adulthood. This is a global issue with implications for research, policy and practice. Children and young people require the experience of safe, nurturing relationships for optimal lifelong outcomes. Despite awareness of this in Child and Adolescent Mental Health services, a focus on the relational context in which children and young people present is not universal. A challenge in family focused practice is to ensure that no individual’s voice is ‘too loud’ and that children and young people’s voices are heard. This article illustrates how a balance between individual and systems understanding can be achieved in therapeutic work by incorporating the voices of children and young people and concerns of other family members. This article describes an approach to improving family focused practice in a public Child and Adolescent Mental Health service. Use of The Family Model, as a family focused practice tool, is presented across three service settings. The Family Model intervention is briefly described, outlining the way in which it supports collaborative practice and assists clinicians to achieve the balance described above. Vignettes will demonstrate how children and young people’s voices are explicitly incorporated in formulating mental health issues with two generations to generate developmentally informed care plans.


2018 ◽  
Vol 26 (2) ◽  
pp. 152-159
Author(s):  
Hiran Thabrew ◽  
Ernest Gandeza ◽  
Giselle Bahr ◽  
David Bettany ◽  
Chris Bampton ◽  
...  

Objectives: Self-harm is common in New Zealand (NZ) young people and can have short-term and long-term consequences, including suicide. This study was undertaken to examine the extent to which evidence-based approaches for addressing self-harm are offered by Infant, Child and Adolescent Mental Health Services (ICAMHS). Methods: A national survey of ICAMHS practitioners working with young people who self-harm was undertaken between May and July 2016. Results: Responses from 23 out of 30 ICAMHS confirmed self-harm was a familiar presentation and most commonly associated with diagnoses of depression, anxiety and borderline personality disorder. Cognitive behavioural therapy (47.1%, n = 8), dialectical behaviour therapy (47.1%, n = 8) and acceptance and commitment therapy (5.9%, n = 1) were the treatments of choice, but variably delivered. There were significant training gaps for all types of therapy. Conclusions: Although it is reassuring that many ICAMHS are using evidence-based approaches to address self-harm in young people, there is concerning variability in the way these therapies are delivered. Improvement in training in key modalities, further research into therapist performance and continuous evaluation of workforce development are needed to maximise the effectiveness of proven interventions and provide NZ young people with the state-of-the-art service they deserve.


BJPsych Open ◽  
2020 ◽  
Vol 6 (6) ◽  
Author(s):  
Julian Edbrooke-Childs ◽  
Jessica Deighton

Background Access to timely care is a quality standard underpinning many international healthcare models, and long waiting times for child and adolescent mental health services are often reported as a barrier to help-seeking. Aims The aim of this study was to examine whether young people with more severe problems have shorter waiting times for mental health services. Method Multilevel multinomial regression analysis controlling for service-area deprivation, age, gender, ethnicity, referral source and contextual factors was conducted on N = 21 419 episodes of care (mean age 12.37 years (s.d. = 3.71), 11 712 (55%) female) using data from child and adolescent mental health services. Results There was high variation in waiting times, which ranged from 0 days to 1629 days (mean 50.65 days (s.d. = 78.03), median 32 days). Compared with young people with less severe problems young people with severe problems, self-harm, psychosis or eating disorders were less likely to experience longer waiting times. Moreover, referrals from sources other than primary care were generally less likely to have longer waiting times than referrals from primary care sources, especially referral from accident and emergency services. Conclusions The findings suggest that young people with more severe problems had shorter waiting times. Intermediary information and resources for support before access to services is needed to prevent escalation of problems and to support individuals and families while waiting for care. Interventions to reduce waiting times should be considered without compromising on the quality and experience of care that young people and families deserve when seeking help.


2019 ◽  
Vol 216 (3) ◽  
pp. 159-162 ◽  
Author(s):  
Andrea Danese ◽  
Patrick Smith ◽  
Prathiba Chitsabesan ◽  
Bernadka Dubicka

SummaryThe mental health of children and young people can be disproportionally affected and easily overlooked in the context of emergencies and disasters. Child and adolescent mental health services can contribute greatly to emergency preparedness, resilience and response and, ultimately, mitigate harmful effects on the most vulnerable members of society.


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