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Roach A, Bennett S, Heyman I, Coughtrey A, Stokes I, Ndoci X, Balakrishnan S, Astle N, Drinkwater J, Evans R, Frederick U, Groszmann M, Jones S, McDonnell K, Mobley A, Murray A, O’Sullivan H, Ormrod S, Prendegast T, Rajalingam U, Webster E, Webster R, Vinton G, Shafran R. Clinical effectiveness of drop-in mental health services at paediatric hospitals: A non-randomised multi-site study for children and young people and their families - study protocol. PLoS One 2024; 19:e0302878. [PMID: 38722844 PMCID: PMC11081357 DOI: 10.1371/journal.pone.0302878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 04/14/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Despite the high prevalence of mental health difficulties in children and young people with long-term health conditions (LTCs), these difficulties and experiences are often overlooked and untreated. Previous research demonstrated the effectiveness of psychological support provided via a drop-in mental health centre located in a paediatric hospital. The aim of this prospective non-randomised single-arm multi-centre interventional study is to determine the clinical effectiveness of drop-in mental health services when implemented at paediatric hospitals in England. METHODS It is hypothesised that families who receive psychological interventions through the drop-in services will show improved emotional and behavioural symptoms. Outcomes will be measured at baseline and at 6-month follow-up. The primary outcome is the difference in the total difficulties score on the Strengths and Difficulties Questionnaire (SDQ) reported by parent or child at 6 months. Secondary outcomes include self and parent reported Paediatric Quality of Life Inventory (PedsQL), self-reported depression (PHQ-9) and anxiety measures (GAD-7) and family satisfaction (CSQ-8). DISCUSSION This trial aims to determine the clinical effectiveness of providing psychological support in the context of LTCs through drop-in mental health services at paediatric hospitals in England. These findings will contribute to policies and practice addressing mental health needs in children and young people with other long-term health conditions. TRIAL REGISTRATION ISRCTN15063954, Registered on 9 December 2022.
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Affiliation(s)
- Anna Roach
- UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Sophie Bennett
- UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Great Ormond Street Children’s Hospital, London, United Kingdom
- Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, King’s College London, De Crespigny Park, London, United Kingdom
| | - Isobel Heyman
- UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Great Ormond Street Children’s Hospital, London, United Kingdom
- Cambridge Children’s Hospital Project Team and Paediatric Psychological Medicine Service, Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - Anna Coughtrey
- UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Great Ormond Street Children’s Hospital, London, United Kingdom
| | - Isabella Stokes
- UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- University College Hospitals, London, United Kingdom
| | - Xhorxhina Ndoci
- UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Sonia Balakrishnan
- UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Nicki Astle
- Hinchingbrooke Hospital, Hinchingbrooke Park, Huntingdon, Cambridgeshire, United Kingdom
| | | | - Rebecca Evans
- Sheffield Children’s Hospital, Sheffield, United Kingdom
| | - Una Frederick
- Peterborough City Hospital, Edith Cavell Campus, Bretton Gate, Peterborough, United Kingdom
| | | | - Steve Jones
- Sheffield Children’s Hospital, Sheffield, United Kingdom
| | | | - Amanda Mobley
- Leeds Teaching Hospital Trust, Paediatric Psychology, E Floor Martin Wing, Leeds General Infirmary, Leeds, United Kingdom
| | - Abbie Murray
- Peterborough City Hospital, Edith Cavell Campus, Bretton Gate, Peterborough, United Kingdom
| | | | - Sarah Ormrod
- University College Hospitals, London, United Kingdom
| | | | - Usha Rajalingam
- Hinchingbrooke Hospital, Hinchingbrooke Park, Huntingdon, Cambridgeshire, United Kingdom
| | - Emily Webster
- Sheffield Children’s Hospital, Sheffield, United Kingdom
| | - Rebecca Webster
- Cambridge and Peterborough Foundation Trust, Child Development Centre, City Care Centre, Peterborough, United Kingdom
| | - Gareth Vinton
- University College Hospitals, London, United Kingdom
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Great Ormond Street Children’s Hospital, London, United Kingdom
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Marshall KH, Pincus HA, Tesson S, Lingam R, Woolfenden SR, Kasparian NA. Integrated psychological care in pediatric hospital settings for children with complex chronic illness and their families: a systematic review. Psychol Health 2024; 39:452-478. [PMID: 35635028 DOI: 10.1080/08870446.2022.2072843] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 03/07/2022] [Accepted: 04/27/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To synthesize and critically evaluate evidence on the effectiveness of integrated psychological care models for children with complex chronic illness within pediatric hospital settings and provide recommendations for successful implementation. DESIGN Six electronic databases (Medline, Cochrane, Embase, PsycINFO, Scopus, CINAHL) were systematically searched for English language studies including families of children aged 0-17 years with complex chronic illness. Eligible studies reported on psychology or neuropsychology screening, assessment, intervention, or services provided within a pediatric hospital setting. RESULTS Fifteen studies were identified for review; nine assessed a psychological service, five examined psychosocial screening, and one examined a neuropsychology service. Three studies demonstrated the effectiveness of integrated psychological services in improving child or parent physical, psychological, or behavioral health outcomes. Uptake of psychosocial screening was high (84-96%), but only 25-37% of children or families identified as 'at-risk' engaged with on-site psychology services. Integrated psychological services offering consultations at the same time and location as the child's medical visit reported the highest rates of uptake (77-100%). CONCLUSIONS The available evidence supports co-location of child medical and psychological services. A more consistent and comprehensive approach to the assessment of patient- and caregiver-reported outcomes and implementation effectiveness is recommended.
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Affiliation(s)
- Kate H Marshall
- Heart Centre for Children, The Sydney Children's Hospitals Network, Sydney, NSW, Australia
- Population Child Health Clinical Research Group, School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Harold A Pincus
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York, NY, USA
- Irving Institute for Clinical and Translational Research, Columbia University and New York‑Presbyterian Hospital, New York, NY, USA
| | - Stephanie Tesson
- Heart Centre for Children, The Sydney Children's Hospitals Network, Sydney, NSW, Australia
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Raghu Lingam
- Population Child Health Clinical Research Group, School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Susan R Woolfenden
- Population Child Health Clinical Research Group, School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
- Sydney Institute for Women, Children and their Families, Sydney local health District, Sydney, NSW, Australia
| | - Nadine A Kasparian
- Cincinnati Children's Center for Heart Disease and Mental Health, Heart Institute and Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Bennett SD, Rojas N, Catanzano M, Roach A, Ching BC, Coughtrey AE, Heyman I, Liang H, Project Team L, Shafran R. Feasibility, acceptability and preliminary effectiveness of a mental health drop-in centre for the siblings of young people attending a paediatric hospital. J Child Health Care 2023:13674935231206895. [PMID: 37850534 DOI: 10.1177/13674935231206895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Siblings of children with long-term conditions (LTCs) can have significantly elevated mental health needs, but these are often overlooked. A pragmatic single-arm feasibility pilot assessed feasibility, acceptability and preliminary effectiveness of a drop-in centre in a paediatric hospital addressing mental health needs of patients with LTCs, their carers and siblings. The drop-in centre accepted self-referral and supplemented existing provision offering a suite of interventions, including signposting, diagnostic assessments and/or guided self-help. This paper reports on feasibility, acceptability and preliminary outcomes of this centre for siblings. Eighteen siblings aged 2-17 used the centre. Sixteen of their parents completed the Strengths and Difficulties Questionnaires at baseline and 6 months post-baseline, and ten completed parent-reported PedsQL across two time points. Preliminary effectiveness results demonstrated a decrease in mental health symptoms with large effect size (score reduction of 3.44, 95% CI [1.25, 5.63], d = 0.84) and small effect on quality of life, with scores increasing from a median of 69.91, 95% CI [53.57, 91.67], to a median of 80.44, 95% CI [67.39, 89.13], r = 0.11 for these siblings. 88% of parents were satisfied with this provision for their sibling child. This study highlights the feasibility and value of assessing siblings for emotional and behavioural difficulties and providing them with an accessible, effective and acceptable intervention.
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Affiliation(s)
- Sophie D Bennett
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Natalia Rojas
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Matteo Catanzano
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Anna Roach
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Brian Cf Ching
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Anna E Coughtrey
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Isobel Heyman
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Holan Liang
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Lucy Project Team
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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Catanzano M, Bennett SD, Fifield K, Xu L, Sanderson C, Coughtrey AE, Kerry E, Liang H, Heyman I, Shafran R. Efficient Sufficiency: A qualitative evaluation of a 1 year pilot study of young people and parents accessing a mental health drop-in centre in a paediatric hospital. Child Care Health Dev 2023; 49:332-345. [PMID: 36006804 PMCID: PMC10087919 DOI: 10.1111/cch.13051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 08/19/2022] [Accepted: 08/20/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Children and young people with long-term physical health conditions (LTC) are known to have higher levels of co-morbid mental health problems than medically healthy children. Evidence-based treatments for mental health problems are effective in children who also have an LTC. This study aimed to explore the factors associated with participants' perceived acceptability and impact of a transdiagnostic mental health centre offering brief psychological assessment and treatment for children and young people and/or their families with mental health needs in the context of long term physical conditions. METHODS One-hundred twenty-eight patients attending the drop-in centre were invited to participate. Overall, 35 participated (31 parents/carers; 4 children and young people) in semi-structured interviews (either in person or by phone) exploring their experience of the centre. Interviews were audio-recorded, transcribed and checked. Framework analysis was then conducted on all transcripts. RESULTS Overall, participants found the drop-in centre highly acceptable and reported a positive experience. Reasons for this varied but broadly focused around four themes: (1) efficient sufficiency; (2) autonomy; (3) fusion of process and content factors and (4) (dis)parities of esteems and 'seeing both sides of the coin'. CONCLUSIONS Participants found the intervention acceptable. A mental health drop-in centre in a paediatric hospital appears to be a positive and valued adjunct to supplement existing mental health services.
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Affiliation(s)
- Matteo Catanzano
- UCL Great Ormond Street Institute of Child HealthLondonUK
- Great Ormond Street Hospital NHS Foundation TrustLondonUK
| | - Sophie D. Bennett
- UCL Great Ormond Street Institute of Child HealthLondonUK
- Great Ormond Street Hospital NHS Foundation TrustLondonUK
| | - Kate Fifield
- UCL Great Ormond Street Institute of Child HealthLondonUK
- Great Ormond Street Hospital NHS Foundation TrustLondonUK
| | - Laila Xu
- UCL Great Ormond Street Institute of Child HealthLondonUK
| | - Charlotte Sanderson
- UCL Great Ormond Street Institute of Child HealthLondonUK
- Great Ormond Street Hospital NHS Foundation TrustLondonUK
| | - Anna E. Coughtrey
- UCL Great Ormond Street Institute of Child HealthLondonUK
- Great Ormond Street Hospital NHS Foundation TrustLondonUK
| | - Ellie Kerry
- UCL Great Ormond Street Institute of Child HealthLondonUK
- Great Ormond Street Hospital NHS Foundation TrustLondonUK
| | - Holan Liang
- UCL Great Ormond Street Institute of Child HealthLondonUK
- Great Ormond Street Hospital NHS Foundation TrustLondonUK
| | - Isobel Heyman
- UCL Great Ormond Street Institute of Child HealthLondonUK
- Great Ormond Street Hospital NHS Foundation TrustLondonUK
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child HealthLondonUK
- Great Ormond Street Hospital NHS Foundation TrustLondonUK
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Imbulana DI, White M, Hiscock H, Price AMH. The feasibility of identifying financial hardship in a tertiary paediatric setting, and associations with caregiver and child mental health. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023. [DOI: 10.1016/j.jadr.2023.100485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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Wright SR, Graham CD, Houghton R, Ghiglieri C, Berry E. Acceptance and commitment therapy (ACT) for caregivers of children with chronic conditions: A mixed methods systematic review (MMSR) of efficacy, process, and acceptance. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023. [DOI: 10.1016/j.jcbs.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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White K, Belachew B. Role of Psychologists in Pediatric Subspecialties: Integrated Psychological Services Overarching Concepts Across Pediatric Subspecialties. Pediatr Clin North Am 2022; 69:825-837. [PMID: 36207095 DOI: 10.1016/j.pcl.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This article addresses, in more general terms, the overarching concepts of the role of integrated psychologists and how their services are incorporated in the medical home with the use of provider consultation, administering assessments in identifying common mental health concerns, providing interventions for treatment adherence and providing short-term therapy within pediatric subspecialties.
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Affiliation(s)
- Katie White
- Division of Pediatric Psychology, Western Michigan University School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, USA.
| | - Bethelhem Belachew
- Division of Pediatric Psychology, Western Michigan University School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, USA
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Feasibility of low-intensity psychological interventions for emotional and behavioural difficulties in children and young people with genetic conditions: a case series. COGNITIVE BEHAVIOUR THERAPIST 2022. [DOI: 10.1017/s1754470x22000551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Abstract
Children with genetic conditions may experience significant mental health difficulties such as anxiety and challenging behaviour. However, understanding of the feasibility and effectiveness of psychological interventions for emotional and behavioural problems in the context of genetic conditions is limited. Low-intensity psychological interventions have demonstrated promise in paediatric populations and may be able to address their mental health difficulties. A case series design was used to assess the feasibility of low-intensity interventions for emotional and behavioural difficulties in children and young people with genetic conditions recruited from a mental health drop-in centre at a tertiary hospital. Participants received seven weekly sessions with a trained practitioner. The intervention was based on existing modular treatments and evidence-based self-help materials. Feasibility and treatment satisfaction were assessed, as well as measures of symptoms of anxiety and challenging behaviour, treatment goals and quality of life, at baseline, during treatment and 6-month follow-up. Five participants received treatment for challenging behaviour, one for anxiety, and one for obsessive compulsive disorder. All participants completed treatment. Clinically significant change in the SDQ Total score was found in three participants. All participants demonstrated progress in goals and symptoms of emotional and behavioural difficulties over the course of treatment. Low-intensity psychological interventions for emotional and behavioural difficulties in children and young people with genetic conditions is feasible, acceptable and potentially beneficial. Further research is warranted to examine the effectiveness of the intervention and its use in clinical paediatric settings.
Key learning aims
(1)
To gain a basic understanding of low-intensity psychological intervention in children and young people with genetic conditions.
(2)
To enhance understanding of the practicalities and acceptability of delivering low-intensity psychological intervention to children and young people with genetic conditions and co-morbid emotional and behavioural difficulties.
(3)
To learn about the potential clinical benefits of delivering low-intensity psychological intervention to children and young people with genetic conditions in the context of stepped care.
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Cortese S, Arrondo G, Correll CU, Solmi M. Beyond the p factor: Is there a d factor? JCPP ADVANCES 2021; 1:e12051. [PMID: 37431404 PMCID: PMC10242841 DOI: 10.1002/jcv2.12051] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Samuele Cortese
- Centre for Innovation in Mental HealthSchool of PsychologyFaculty of Environmental and Life SciencesUniversity of SouthamptonSouthamptonUK
- Clinical and Experimental Sciences (CNS and Psychiatry)Faculty of MedicineUniversity of SouthamptonSouthamptonUK
- Solent NHS TrustSouthamptonUK
- Division of Psychiatry and Applied PsychologySchool of MedicineUniversity of NottinghamNottinghamUK
- Hassenfeld Children's Hospital at NYU LangoneNew York University Child Study CenterNew York CityNew YorkUSA
| | - Gonzalo Arrondo
- Centre for Innovation in Mental HealthSchool of PsychologyFaculty of Environmental and Life SciencesUniversity of SouthamptonSouthamptonUK
- Mind‐Brain GroupInstitute for Culture and SocietyUniversity of NavarraPamplonaSpain
| | - Christoph U. Correll
- Division of Psychiatry ResearchThe Zucker Hillside HospitalNorthwell HealthNew YorkNew YorkUSA
- Department of Psychiatry and Molecular MedicineThe Donald and Barbara Zucker School of Medicine at Hofstra/NorthwellNew YorkNew YorkUSA
- Department of Child and Adolescent PsychiatryCharité Universitäts medizinBerlinGermany
| | - Marco Solmi
- Centre for Innovation in Mental HealthSchool of PsychologyFaculty of Environmental and Life SciencesUniversity of SouthamptonSouthamptonUK
- Department of PsychiatryUniversity of OttawaOttawaOntarioCanada
- Department of Mental HealthThe Ottawa HospitalOttawaOntarioCanada
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