Goal commitment evolution in a Spanish adolescent sample with cannabis use disorder

Goal-oriented practices in youth mental health and wellbeing settings: A scoping review and thematic analysis of empirical evidence

INTRODUCTION

Goal-oriented practices involve practitioners working collaboratively with clients to identify, develop and focus on objectives for the therapeutic work. It has been suggested that the key mechanism underpinning goal-oriented practices with young people is the development of epistemic trust via the foundation of open communication, along with shared decision-making: including young people in decisions about their care. However, goal-oriented work in practice is variable in scope and content, with no research consensus on what it entails, the mechanisms of change and reported outcomes.

METHOD

This research aims to map the extent, range and nature of the evidence-base for goal-oriented practices, including gaps, through a synthesis of the available empirical evidence from the past 20 years. A scoping review of 9783 studies published from 2003 onwards was conducted.

RESULTS

In total, 116 studies were identified for inclusion in the review, focusing on goal-oriented practices specifically related to the mental health and wellbeing of children and young people aged 0-18 (including caregivers as relevant). Alongside presentation of the key elements of the included studies, three themes were developed relating to the features of mental health and wellbeing goal-oriented practice in the contexts of the studies: Conceptual and Empirical Constructs of Goal-Oriented Practices, Quality and Making 'Good' Goals, and The Socio-Cultural Contexts of Goal-Oriented Practice.

CONCLUSION

Several areas for future research are identified that will build on this evidence, and further understanding in this area. Work towards the development of best practice principles will move practice towards transparency in the understanding and delivery of goal-oriented practices.

Early onset psychosis and cannabis use: Prevalence, clinical presentation and influence of daily use

Most of the studies examining the impact of cannabis use in first episode psychosis (FEP) have been carried out in samples with adult-onset FEP. Data in persons with early onset psychosis (EOP) is scarce. The aims of the study were: To describe the prevalence of lifetime cannabis use, current use, and daily use in patients with EOP compared to healthy controls. To study the differences in clinical presentation between cannabis users and non-users. To examine the risk of presenting an EOP associated with cannabis use and the effect of doses and age of onset of use. An observational cross-sectional study was performed in 90 EOP cases and 62 healthy controls, aged between 7 and 17 years. Our results show a higher prevalence of lifetime use (p = 0002), current use (p < 0.001), and daily use (p < 0.001) in EOP cases in comparison with healthy controls. Regarding clinical presentation, we did not find significant differences in any subscale of the Positive and Negative Syndrome Scale (PANSS). Non-user patients presented more severe depressive symptoms (p = 0002) and worse social functioning than cannabis users (p = 0026). Compared with subjects who never used cannabis, the risk of an EOP was significantly higher for those with a lifetime use (OR = 2.88, p = 0.002)current use (O.R = 6.09, p < 0001), and especially in those with daily use (O.R = 42.77, p = <0001). We found a higher risk of EOP in patients that have used cannabis before 15 years of age. In conclusion, it is necessary to develop early- detection and specific treatment programs for adolescents with cannabis use.