Problem solving as an active ingredient in indicated prevention and treatment of youth depression and anxiety: A critical review and synthesis of trial outcomes, qualitative evidence and lived experience insights

2021 ◽  
Author(s):  
Daniel Michelson
Keyword(s):  
Problem Solving ◽  
Young People ◽  
Active Ingredient ◽  
Therapeutic Approach ◽  
Population Characteristics ◽  
Advisory Group ◽  
Depression And Anxiety ◽  
Indicated Prevention ◽  
Qualitative Evidence ◽  
Prevention And Treatment

Background: Problem solving is a key developmental capacity and a common focus of psychological interventions for young people. Despite widespread use of problem solving in practice, existing evidence syntheses of this therapeutic approach are relatively limited in their scope and conclusions. Method: We examined the role of problem solving as an active ingredient for the indicated prevention and treatment of depression and anxiety in 14-24-year-olds. Three information sources were integrated: (i) a systematic review of randomised controlled trials of problem solving; (ii) a meta-synthesis of qualitative evidence on the therapeutic experience of problem solving; and (iii) consultation with a youth advisory group. Results: Problem solving appeared to be effective as a sole intervention for depression but not anxiety. Multi-component interventions with a problem-solving element achieved moderate effect sizes for both conditions. There was no clear evidence that effectiveness varied by population characteristics, intervention formats or contextual factors. Evidence about why problem solving works was generally consistent with Lazarus & Folkman’s “stress-coping” theory.Discussion: Problem solving is a widely applicable therapeutic approach that can help young people with emotional problems to resolve specific stressors and lead to a more hopeful mindset about managing future challenges. Implications for practice are discussed.

scholarly journals Preventing depression and anxiety in young people: a review of the joint efficacy of universal, selective and indicated prevention

2015 ◽  
Vol 46 (1) ◽  
pp. 11-26 ◽  
Author(s):  
E. A. Stockings ◽  
L. Degenhardt ◽  
T. Dobbins ◽  
Y. Y. Lee ◽  
H. E. Erskine ◽  
...  
Keyword(s):  
Young People ◽  
Meta Analysis ◽  
Internalizing Disorders ◽  
Cochrane Library ◽  
Depression And Anxiety ◽  
Preventive Interventions ◽  
Post Intervention ◽  
Indicated Prevention ◽  
Shared Risk ◽  
Internalizing Disorder

Depression and anxiety (internalizing disorders) are the largest contributors to the non-fatal health burden among young people. This is the first meta-analysis to examine the joint efficacy of universal, selective, and indicated preventive interventions upon both depression and anxiety among children and adolescents (5–18 years) while accounting for their co-morbidity. We conducted a systematic review of reviews in Medline, PsycINFO and the Cochrane Library of Systematic Reviews, from 1980 to August 2014. Multivariate meta-analysis examined the efficacy of preventive interventions on depression and anxiety outcomes separately, and the joint efficacy on both disorders combined. Meta-regressions examined heterogeneity of effect according to a range of study variables. Outcomes were relative risks (RR) for disorder, and standardized mean differences (Cohen's d) for symptoms. One hundred and forty-six randomized controlled trials (46 072 participants) evaluated universal (children with no identified risk, n = 54) selective (population subgroups of children who have an increased risk of developing internalizing disorders due to shared risk factors, n = 45) and indicated prevention (children with minimal but detectable symptoms of an internalizing disorder, n = 47), mostly using psychological-only strategies (n = 105). Reductions in internalizing disorder onset occurred up to 9 months post-intervention, whether universal [RR 0.47, 95% confidence interval (CI) 0.37–0.60], selective (RR 0.61, 95% CI 0.43–0.85) or indicated (RR 0.48, 95% CI 0.29–0.78). Reductions in internalizing symptoms occurred up to 12 months post-intervention for universal prevention; however, reductions only occurred in the shorter term for selective and indicated prevention. Universal, selective and indicated prevention interventions are efficacious in reducing internalizing disorders and symptoms in the short term. They might be considered as repeated exposures in school settings across childhood and adolescence. (PROSPERO registration: CRD42014013990.)

scholarly journals Behavioral Activation as an ‘active ingredient’ of interventions addressing depression and anxiety among young people: a systematic review and evidence synthesis

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Kanika Malik ◽  
Maliha Ibrahim ◽  
Adam Bernstein ◽  
Rahul Kodihalli Venkatesh ◽  
Tara Rai ◽  
...  
Keyword(s):  
Systematic Review ◽  
Young People ◽  
Active Ingredient ◽  
Behavioral Activation ◽  
Mental Health Problems ◽  
Evidence Synthesis ◽  
Qualitative Studies ◽  
Depression And Anxiety ◽  
Multicomponent Intervention ◽  
The Impact

Abstract Background Psychological interventions such as behavioral activation (BA) that focus on overt behaviors rather than complex cognitive skills may be developmentally well-suited to address youth mental health problems. The current systematic review synthesized evidence on the characteristics, effectiveness and acceptability of behavioral activation (BA) to examine its role as a potential ‘active ingredient’ for alleviating depression and anxiety among young people aged 14 to 24 years. Methods Evidence across the following sources were synthesized: (i) randomized control trials (RCT) evaluating interventions where BA has been used as a standalone intervention or as part of a multicomponent intervention, (ii) qualitative studies examining the acceptability of BA as an intervention or as a coping strategy among young people with lived experiences. Consultations with a youth advisory group (YAG) from India were used to draw inferences from existing evidence and identify future research priorities. Results As part of the review, 23 RCTs were identified; three studies examined BA as a standalone intervention, and the remaining studies examined multicomponent intervention where BA was a constituent element. The intervention protocols varied in composition, with the number of intervention elements ranging between 5 to 18. There was promising but limited evidence in standalone interventions for thse effectiveness of BA for depression. The impact of BA in multicomponent interventions was difficult to evaluate in the absence of focal assessment of activation outcomes. Evidence from 37 additional qualitative studies of youth lived experience literature, corroborated by the YAG inputs, indicated that young people preferred using behavioral strategies similar to BA to cope with depression in their own life. Themes indicated that the activities that are important to an individual and their socio-contextual factors need to be considered in the planning and implementing BA intervention. Evidence for the use of BA in anxiety was limited across data sources. Conclusions Overall, there was preliminary empirical evidence for the effectiveness and acceptability of BA for youth depression. Further research is needed to examine the components and mechanisms that contribute to its effectiveness as an active intervention ingredient for depression and anxiety.

scholarly journals Reflective insights from developing a palliative care children and young people’s advisory group

2021 ◽  
pp. 026921632097603
Author(s):  
Anna Roach ◽  
Debbie Braybrook ◽  
Steve Marshall
Keyword(s):  
Palliative Care ◽  
Young People ◽  
Health Research ◽  
School Health ◽  
Public Involvement ◽  
After School ◽  
Advisory Group ◽  
Research Projects ◽  
Children And Young People ◽  
Care Research

Background: The importance of actively involving patient and public members throughout the different stages of palliative care and health research projects is widely acknowledged, however patient and public involvement work rarely considers insight from children and young people. Although this is becoming increasingly recognised in other areas of research, there is currently no structured guidance on how to best involve children and young people in palliative care research. Aim: To plan and deliver a Young People’s Advisory Group in palliative care and health research at a secondary school. Findings: Attending an after-school ‘Health and Social Research Methods Club’ for 11 weeks benefitted children and researchers. Children were taught about data collection methods, data analysis and ethics in health research and used these skills to provide valuable feedback which has been implemented in current palliative care research projects. Children took part in considered discussions around palliative care topics and enjoyed attending the group. Conclusion: This project has equipped researchers with skills and provided a structured template for future Young People’s Advisory Groups, ensuring the unique voices of children and young people are considered and valued in future palliative care research.

scholarly journals Speaking Softly and Listening Hard: The Process of Involving Young Voices from a Culturally and Linguistically Diverse School in Child Health Research

2021 ◽  
Vol 18 (11) ◽  
pp. 5808
Author(s):  
Nora Samir ◽  
Antonio Mendoza Diaz ◽  
Michael Hodgins ◽  
Simone Matic ◽  
Samira Bawden ◽  
...  
Keyword(s):  
Mental Health ◽  
Young People ◽  
Linguistically Diverse ◽  
Research Strategy ◽  
Health Priorities ◽  
Culturally And Linguistically Diverse ◽  
Advisory Group ◽  
Student Preference ◽  
Research Stream ◽  
New Research

The involvement of young people in the planning of research continues to be rare, particularly for young people from culturally and linguistically diverse communities. This paper describes our experience in establishing a Youth Research Advisory Group (YRAG) in South West Sydney (SWS), including barriers and successful strategies. One hundred and fifteen students between school Years 7 and 12 (ages 11–18) took part in at least one of five sessions between 2019 and 2021. In total, we carried out 26 YRAG sessions, with between five and 30 students in each. Sessions focused on mapping the health priorities of the participants and co-developing research project proposals related to their health priorities. Our work with students revealed that their main areas of concern were mental health and stress. This led to material changes in our research strategy, to include “Mental Health” as a new research stream and co-develop new mental health-related projects with the students. Important strategies that enabled our research included maintaining flexibility to work seamlessly with organisational and individual preferences, and ensuring our processes were directed by the schools and—most importantly—the students themselves. Strategies such as maintaining an informal context, responding rapidly to student preference, and regularly renegotiating access enabled us to engage with the students to deepen our understanding of their experiences.

scholarly journals Development of a Pathway for Multidisciplinary Neurodevelopmental Assessment and Diagnosis in Children and Young People

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1033
Author(s):  
Marion Rutherford ◽  
Donald Maciver ◽  
Lorna Johnston ◽  
Susan Prior ◽  
Kirsty Forsyth
Keyword(s):  
Young People ◽  
Lived Experience ◽  
Waiting Times ◽  
Complex Interventions ◽  
Assessment Tools ◽  
Advisory Group ◽  
Children And Young People ◽  
Implementation Team ◽  
Scottish Government ◽  
Assessment And Diagnosis

There is a variable standard of access to quality neurodevelopmental assessment and diagnosis. People may have negative experiences, encountering lengthy waiting times, and inconsistent practices. Practitioners need guidance on standards and practices for assessment and diagnosis matched to new ways of working. In this paper, we present a new pathway and recommendations for multidisciplinary neurodevelopmental assessment and diagnosis for children and young people (<19 years), developed by the Scottish Government funded National Autism Implementation Team (NAIT). Our research used the Medical Research Council guidance for the development of complex interventions and included several iterative stages. Stage 1: n = 44 stakeholders attended an event on developing new practices for diagnosis and assessment. Stage 2: a literature synthesis was completed by the research team of clinical guidelines and diagnosis and assessment tools. Stage 3: an event with n = 127 stakeholders included discussion and debate of the data from stages 1 and 2. Recommendations and a draft pathway were written. Stage 4: successive drafts of recommendations and the pathway documentation were circulated among an advisory group, including multidisciplinary clinical experts and people with lived experience, until the final pathway was agreed upon. The finalised pathway includes guidance on terminology, assessment, diagnosis, triage, time standards and engagement of people with lived experience. The new pathway has been adopted by the Scottish Government. The pathway and associated documentation are freely available online for use by others.

scholarly journals Hidden youth? A new perspective on the sociality of young people ‘withdrawn’ in the bedroom in a digital age

2020 ◽  
Vol 22 (7) ◽  
pp. 1227-1244
Author(s):  
Mark Wong
Keyword(s):  
Hong Kong ◽  
Young People ◽  
Online Communities ◽  
Digital Age ◽  
Online Networks ◽  
Qualitative Evidence ◽  
New Perspective ◽  
The Uk

The complexities and changing experiences of human connections have long been debated. In the digital age, technology becomes an increasingly crucial dimension of sociality. This article critically discusses the sociality of ‘hidden’ young people who shut themselves in the bedroom and are typically assumed to be socially withdrawn. This article challenges this reclusive depiction and presents qualitative evidence from the first study of this phenomenon in the UK/Scottish context, while studying this comparatively across two sites. Thirty-two interviews were conducted with Hong Kong and Scottish youth ‘withdrawn’ in the bedroom for 3 to 48 months; hidden youth’s sociality was found to be more nuanced and interconnected than previously assumed. This article argues that young people can become especially attached to online communities to seek solace and solidarity as they experience social marginalisation. Technology and online networks play an important role in enabling marginalised young people to feel connected in the digital age.

Potential phytochemicals in the prevention and treatment of esophagus cancer: A green therapeutic approach

2019 ◽  
Vol 71 (4) ◽  
pp. 644-652 ◽  
Author(s):  
Banzeer Ahsan Abbasi ◽  
Javed Iqbal ◽  
Riaz Ahmad ◽  
Sitara Bibi ◽  
Tariq Mahmood ◽  
...  
Keyword(s):  
Therapeutic Approach ◽  
Esophagus Cancer ◽  
Prevention And Treatment
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