Centering, Affective Regulation, and Exposure (CARE) Group: Mindful Meditation and Movement for Youth with Anxiety

McDowell, G.W.A.; Valleru, Jahnavi; Adams, Meredith; Fristad, Mary A.

doi:10.1080/23794925.2020.1784058

Cited by 4 publications

(5 citation statements)

References 16 publications

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“…Innovations embedding psychological therapies within acute inpatient settings included therapeutic skills training ( N = 1), meal supervision ( N = 1), and outpatient aftercare or telephone follow-up ( N = 3), which reduced readmissions between 7.7 and 37% and inpatient LOS between 3 and 31 days (see Table 3 ). Inpatient innovations included a therapeutic skills group for anxiety disorders, encompassing grounding exercises, meditation, yoga, and relaxation strategies [ 44 ], which reduced 30-day readmissions (9.5%) and 90-day readmissions (15.6%) compared to individual and family psychoeducation; 74% ( N = 64) were female and no statistical comparison was reported. A standardised meal supervision program for eating disorders ( N = 56), compared to no supervision in the control group ( N = 52), comprised a trained staff member at the bedside discussing patient-specific preferences, averting conversations about weight, body image, and calories [ 36 ].…”

Section: Resultsmentioning

confidence: 99%

Models of integrated care for young people experiencing medical emergencies related to mental illness: a realist systematic review

Otis

Barber

Amet

et al. 2022

Eur Child Adolesc Psychiatry

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Mental illness heightens risk of medical emergencies, emergency hospitalisation, and readmissions. Innovations for integrated medical–psychiatric care within paediatric emergency settings may help adolescents with acute mental disorders to get well quicker and stay well enough to remain out of hospital. We assessed models of integrated acute care for adolescents experiencing medical emergencies related to mental illness (MHR). We conducted a systematic review by searching MEDLINE, PsychINFO, Embase, and Web of Science for quantitative studies within paediatric emergency medicine, internationally. We included populations aged 8–25 years. Our outcomes were length of hospital stay (LOS), emergency hospital admissions, and rehospitalisation. Limits were imposed on dates: 1990 to June 2021. We present a narrative synthesis. This study is registered on PROSPERO: 254,359. 1667 studies were screened, 22 met eligibility, comprising 39,346 patients. Emergency triage innovations reduced admissions between 4 and 16%, including multidisciplinary staffing and training for psychiatric assessment (F(3,42) = 4.6, P < 0.05, N = 682), and telepsychiatry consultations (aOR = 0.41, 95% CI 0.28–0.58; P < 0.001, N = 597). Psychological therapies delivered in emergency departments reduced admissions 8–40%, including psychoeducation (aOR = 0.35, 95% CI 0.17–0.71, P < 0.01, N = 212), risk-reduction counselling for suicide prevention (OR = 2.78, 95% CI 0.55–14.10, N = 348), and telephone follow-up (OR = 0.45, 95% CI 0.33–0.60, P < 0.001, N = 980). Innovations on acute wards reduced readmissions, including guided meal supervision for eating disorders (P = 0.27), therapeutic skills for anxiety disorders, and a dedicated psychiatric crisis unit (22.2 vs 8.5% (P = 0.008). Integrated pathway innovations reduced readmissions between 8 and 37% including family-based therapy (FBT) for eating disorders (X2(1,326) = 8.40, P = 0.004, N = 326), and risk-targeted telephone follow-up or outpatients for all mental disorders (29.5 vs. 5%, P = 0.03, N = 1316). Studies occurred in the USA, Canada, or Australia. Integrated care pathways to psychiatric consultations, psychological therapies, and multidisciplinary follow-up within emergency paediatric services prevented lengthy and repeat hospitalisation for MHR emergencies. Only six of 22 studies adjusted for illness severity and clinical history between before- and after-intervention cohorts and only one reported socio-demographic intervention effects.

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Section: Resultsmentioning

confidence: 99%

Models of integrated care for young people experiencing medical emergencies related to mental illness: a realist systematic review

Otis

Barber

Amet

et al. 2022

Eur Child Adolesc Psychiatry

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“…Among the included studies, there was one study that was rated as high quality or provided a high level of evidence based on the NHMRC levels of evidence hierarchy scale (level of evidence I or II), 40 10 studies were rated as providing moderate evidence (level of evidence III-2: comparative studies with controls such as cohort studies) 8 , 19 , 21 , 27 , 33 , 34 , 37 , 42 , 44 and 19 studies were of lower-quality evidence (level of evidence III-3: cohort studies without a comparison group; or level of evidence IV: pre and post studies). 18 , 22 , 26 , 29 – 32 , 35 , 36 , 38 , 39 , 41 , 45 , 47 There was considerable variability between study methodologies and 30% ( n = 9/30 studies) of studies compared outcomes with a comparison group 19 , 21 , 27 , 28 , 33 , 37 , 42 , 44 (see Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Group therapy, including family therapy, psychotherapy, wellness and substance misuse counselling, demonstrated effectiveness, notably in reducing hospital readmission rates for CYP in family-based interventions. 34 Older adolescents in these therapies exhibited diverse mental health symptoms (anxiety, autism spectrum, behavioural disorders, depression, eating disorders, psychosis, self-harm/suicidal ideation) 23 , 25 , 35 , 42 , 45 …”

Section: Resultsmentioning

confidence: 99%

“…18,20,26,28,39,45,47 Group therapy Group therapy, including family therapy, psychotherapy, wellness and substance misuse counselling, demonstrated effectiveness, notably in reducing hospital readmission rates for CYP in family-based interventions. 34 Older adolescents in these therapies exhibited diverse mental health symptoms (anxiety, autism spectrum, behavioural disorders, depression, eating disorders, psychosis, self-harm/ suicidal ideation) 23,25,35,42,45 Cognitive-behavioural therapy (CBT) was evaluated in four low-level evidence studies (14%) 24,39,45,46 of CBT programmes for CYP (age range: 8-16 years). 24,44,49,51 A group-based CBT programme effectively reduced suicidal ideation at 30 days and 3 months post-intervention for adolescents aged 12-17 years.…”

Section: Crisis Interventionmentioning

confidence: 99%

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Evidence-based brief interventions targeting acute mental health presentations for children and adolescents: systematic review

Eapen,

Gerstl,

Ahinkorah

et al. 2024

BJPsych open

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Background Brief intervention services provide rapid, mobile and flexible short-term delivery of interventions to resolve mental health crises. These interventions may provide an alternative pathway to the emergency department or in-patient psychiatric services for children and young people (CYP), presenting with an acute mental health condition. Aims To synthesise evidence on the effectiveness of brief interventions in improving mental health outcomes for CYP (0–17 years) presenting with an acute mental health condition. Method A systematic literature search was conducted, and the studies’ methodological quality was assessed. Five databases were searched for peer-reviewed articles between January 2000 and September 2022. Results We synthesised 30 articles on the effectiveness of brief interventions in the form of (a) crisis intervention, (b) integrated services, (c) group therapies, (d) individualised therapy, (e) parent–child dyadic therapy, (f) general services, (g) pharmacotherapy, (h) assessment services, (i) safety and risk planning and (j) in-hospital treatment, to improve outcomes for CYP with an acute mental health condition. Among included studies, one study was rated as providing a high level of evidence based on the National Health and Medical Research Council levels of evidence hierarchy scale, which was a crisis intervention showing a reduction in length of stay and return emergency department visits. Other studies, of moderate-quality evidence, described multimodal brief interventions that suggested beneficial effects. Conclusions This review provides evidence to substantiate the benefits of brief interventions, in different settings, to reduce the burden of in-patient hospital and readmission rates to the emergency department.

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“…Psychiatrically hospitalized adolescents reported decreased distress from before to after a single yoga class (Re et al, 2014). Multicomponent programs that included yoga demonstrated acceptability and feasibility for adolescents with depression and/or anxiety disorders (Henje Blom et al, 2016), and have been associated with reduced anxiety and increased treatment engagement in anxious youth (McDowell et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Assessing feasibility and acceptability of yoga and group CBT for adolescents with depression: A pilot randomized clinical trial

Uebelacker

Wolff

Guo

et al. 2022

Clin Child Psychol Psychiatry

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Purpose: Given increasing rates of depression in adolescents, there is a clear need for innovative treatments. In this pilot randomized clinical trial, we assessed acceptability and feasibility of two group-based interventions: yoga and cognitive-behavioral therapy (CBT). The goal of this work is to prepare for a future fully powered randomized trial to test the hypothesis that yoga is not inferior to an established adolescent depression treatment, namely, group CBT. Methods: We enrolled 42 adolescents with elevated depression symptoms. Participants were randomly assigned to a 12-week group-based intervention, yoga or CBT. We had a priori feasibility and acceptability targets, including for recruitment rate, retention rate, expectancy, credibility, program satisfaction, class attendance, engagement in home practice, and instructor/leader manual adherence. We assessed adverse events, and within-subject changes in outcomes (depression, anxiety, impairment, sleep disturbance) and possible mediators (mindfulness, self-compassion). Results: Both interventions met most acceptability and feasibility targets. The only target not met related to low engagement in home practice. Participants within each study arm showed decreased depression symptoms over time and increased self-compassion. Conclusions: A yoga intervention appears to be acceptable and feasible to adolescents with depression. However, it may be challenging for this group to engage in unstructured home practice.

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Centering, Affective Regulation, and Exposure (CARE) Group: Mindful Meditation and Movement for Youth with Anxiety

Cited by 4 publications

References 16 publications

Models of integrated care for young people experiencing medical emergencies related to mental illness: a realist systematic review

Models of integrated care for young people experiencing medical emergencies related to mental illness: a realist systematic review

Evidence-based brief interventions targeting acute mental health presentations for children and adolescents: systematic review

Assessing feasibility and acceptability of yoga and group CBT for adolescents with depression: A pilot randomized clinical trial

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