A brief consultation and advice (BCA) approach to dealing with routine referrals was introduced into a child and adolescent mental health service (CAMHS) over an 18-month period. This is a time-limited, client-centred and solution-focused approach to dealing with common non-complex referrals. The model proposes that all families are seen for an initial 'consultation' appointment followed by a maximum of two further appointments. A randomized controlled study compared the clinical effectiveness of BCA treatment with treatment as usual (TAU) over a 6-month period. The parents of children referred to CAMHS were eligible to participate if their child was deemed 'non-complex'. Ethical approval was granted by the relevant ethics committee. Families who consented to participate in the study were randomly allocated to either the BCA or TAU group. Sixty children enrolled in the study. Both groups showed improvements on a number of variables at 3 months post treatment, but only those receiving BCA showed continued improvement at 6 months. Participants in both groups showed high levels of satisfaction with the treatment received. Participants in the TAU group expressed dissatisfaction with long waiting times and had a higher drop out rate than the BCA treatment group. During the time frame studied, the introduction of the BCA approach did not lead to a decrease in overall mean waiting time. These results and the usefulness of a BCA model are discussed.

A B S T R A C T Children's views as service users are being increasingly sought and valued. A pictorial critical incident technique was developed to gain insights into the perceptions and experiences of children and young people (n = 30, ages 5-15 years) attending a child and adolescent outpatient mental health service for the first time. The methodology proved effective in eliciting children's views, both positive and negative. Findings show age differences in clients' anxieties about attending. The degree to which children and young people felt involved in the process of assessment also varied with age. In general, children and young people felt more positive when leaving the clinic compared with when they first arrived. Salient aspects of the initial visit emerged which may not have been tapped using a questionnaire or rating scale. Findings are discussed in the context of service delivery issues and the development of child-focused preparatory information. K E Y W O R D S child guidance, children's perceptions, critical incident technique

This paper outlines a study currently under way in two child and adolescent mental health services (CAMHSs). The study is evaluating a Brief Consultation and Advisory (BCA) approach to noncomplex referrals as a possible method of reducing waiting time while meeting service users’ needs and expectations.

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