Background: In the adult literature, perfectionism has been linked with psychopathology and poor treatment outcomes, leading to perfectionism-focussed therapies. The child and adolescent perfectionism literature is comparatively sparse. Method: A systematic search of five electronic databases (Web of Knowledge, APA PsycNET, PubMed, ERIC/ProQuest, and Scopus) was conducted to identify studies of perfectionism in children and adolescents, in the context of psychopathology. Results: The search identified 133 studies, 84 of which discussed perfectionism as a correlate of mental health problems. These studies were briefly synthesised, with the systematic review focussing on evaluating papers on the development (n = 23), assessment (n = 19), and treatment (n = 7) of perfectionism. Conclusion: Treatment studies did not reflect the phenomenology of perfectionism found in this review. Key Practitioner Message• Perfectionism-focussed therapies improve treatment outcome in adults but further research is needed with children and adolescents • Clinicians should be aware of the role of perfectionism in psychopathology and its negative impact on treatment outcome • Where perfectionism is highlighted, contemplate targeting this early on in therapy, considering parental factors (pushy parenting style, harsh expectations, parental self-criticism and perfectionism), child factors (self-criticism, self-esteem), and attachment style • Perfectionism itself can be associated with achievement and emotional wellbeing: aiming towards supporting people to develop striving, adaptive perfectionism may be helpful • Consider publishing case studies of perfectionism treatment to add valuable knowledge to the empirical understanding of perfectionism in children

Purpose: Many children who are looked after by the state have experienced adverse and traumatic life circumstances prior to being removed from their biological parents. Previous research has highlighted that many of them experience barriers to accessing psychological therapies. The purpose of this paper is to investigate the feasibility of assessing post-traumatic stress disorder (PTSD)-like symptoms using a screening tool, and through this to determine the prevalence of PTSD-like symptoms in looked after children presenting with emotional and/or behavioural problems. Design/methodology/approach: The Child Revised Impact of Events Scale (CRIES-8) was identified as a suitable screening tool for PTSD-like symptoms. This measure was piloted for three months, and the prevalence of PTSD-like symptoms amongst respondents ( n=27) was recorded. Findings: Prevalence of PTSD-like symptoms was found to be high 75 per cent amongst respondents. The psychometric properties of the CRIES-8 were similar to those found in a previous study assessing PTSD following a single-incident trauma. Health care professionals reported finding the CRIES-8 to be a clinically useful measure. Originality/value: Prevalence of PTSD-like symptoms may be high amongst looked after children, and the CRIES-8 appears to have good psychometric properties when used with this population. It is likely that this highly treatable condition is under-detected: thus, recommendations are made for clinical practice and further research

BACKGROUND: Stiff Person Syndrome (SPS) is a rare neurological condition, characterised by rigidity in the trunk and limbs. Comorbid anxiety is common and known to exacerbate stiffness. OBJECTIVE: This case study examines the extent to which psychological treatment of comorbid anxiety alleviated stiffness in a patient whose condition was exacerbated by social anxiety. METHODS: A patient was treated using cognitive behavioural therapy, focussing on reducing anxiety and therefore stiffness by addressing rumination, self-focussed attention, and distressing cognitions relating to walking in public. The patient's walking, stiffness, and anxiety were assessed during and post-therapy using questionnaires. RESULTS: Walking, stiffness, and anxiety improved during treatment. At five months' follow up, while the improvement in anxiety was maintained, walking and stiffness had deteriorated. The patient and his Neurologist felt that this deterioration was biological, rather than psychological in nature. CONCLUSIONS: This is the first published case where SPS has been ameliorated (albeit temporarily) using psychological therapy, and has important implications for future research and treatment.

Cognitive Behavioural Therapy (CBT) including Exposure and Response Prevention (ERP) is recommended by NICE as the psychological treatment of choice for obsessive compulsive disorder (OCD). Twenty-five percent of OCD patients refuse ERP, and many psychologists advocate formulation-driven cognitive therapy, including ERP, as opposed to ERP alone. However, a recent meta-analysis suggested there is insufficient evidence to suggest ERP is improved by cognitive methods. This paper proposes to contribute to this debate by providing a detailed description of the treatment of a patient with intrusive cognitions of a sexual nature, who was treated successfully using behavioural experiments designed to test cognitions, rather than ERP. This is, arguably, the way in which most cognitive behavioural therapists would work with someone with OCD. However, this approach is not reflected in the literature at present. The authors report the patient's feedback that therapeutic change was brought about through cognitive shift, as a result of the formulation-driven behavioural experiments. Theoretical and research basis for therapyThis paper begins by reviewing pertinent literature relating to this case. Anna's presenting problem is then described, along with the cognitive behavioural hypotheses developed during treatment. The process and outcomes of treatment are outlined, and the paper then focuses on exploring the patient's views of which aspects of therapy were the most important factors in stimulating change. Literature reviewObsessive compulsive disorder (OCD) is characterized by persistent, intrusive cognitions, and/or compulsive behaviours (DSM-IV-TR; APA, 2000). OCD can be a debilitating, longterm disorder, if left untreated. The efficacy of CBT approaches for OCD has been well established in highly controlled clinical settings (e.g. NICE, 2005;Ponniah et al. 2013) and in

PurposePalliative care requires integration between services, organisations and the community. A series of community engagement programmes, named “Listening Events”, were conducted across the Isle of Man. The aim was to involve the community in the development of Hospice strategy by sharing their views on the future of palliative and end of life care.Design/methodology/approachThree Listening Event programmes were conducted in community settings, secondary schools and the Isle of Man’s University College. The investigators facilitated discussions on current knowledge of Hospice services, what would matter to people should they need to use these, and how Hospice could best serve the community in the future. Participants and investigators noted thoughts and comments. Data were analysed using thematic analysis.FindingsIn total, 899 people participated from across the community. Main themes surrounded effective care, person-centred care and integrated care. Most themes agreed across the three programmes, despite some nuances.Originality/valueThe results were used as an evidence base from which Hospice Isle of Man’s new strategy was derived in order to ensure that it aligned with the community’s needs. By initiating conversations and discussions in the community, the Listening Events may have also increased understanding about hospice care.