Improving the mental health and mental health support available to adolescents with social care-experience via low-intensity life story work: a realist review protocol

Abstract

IntroductionAdolescents are the fastest growing group entering social care and are most at risk of mental ill-health. Life Story Work (LSW) is an existing transdiagnostic intervention thought to improve the well-being and mental health of children and adolescents under the care of a local authority by assisting the processing of trauma. Yet LSW is poorly evidenced, lacks standardisation and focuses on younger children. LSW is also high-intensity, relying on specialist input over several months. Adolescent-focused low-intensity-LSW is a promising alternative. However, there is poor evidence on how LSW, let alone low-intensity-LSW should be delivered to adolescents. We aim to identify why, how, in what contexts, for whom and to what extent low-intensity-LSW interventions can be delivered to adolescents with care-experience.Methods and analysisUndertaking a realist review, we will: (1) develop an initial programme theory (PrT) of adolescent-focused low-intensity-LSW by consulting with two key expert panels (care-experienced and professional stakeholders), and by searching the literature to identify existing relevant theories; (2) undertake a comprehensive literature search to identify secondary data to develop and refine our emerging PrT. Searches will be run between 12/2021-06/2022 in databases including MEDLINE, PsycINFO, ASSIA and relevant sources of grey literature; (3) select, extract and organise data; (4) synthesise evidence using a realist logic of analysis and undertake further iterative data searching and consultation with our expert panels; (5) write up and share the refined PrT with our expert panels for their final comments. From this process guidance will be developed to help improve the delivery of LSW to support the mental health needs of adolescents with care-experience.Ethics and disseminationEthical approval is not required. Dissemination will include input from expert panels. We will develop academic, practice and youth focused outputs targeting adolescents, their carers, social, healthcare, and educational professionals, academics, and policymakers.PROSPERO registration numberCRD42021279816.

Understanding how and why upskilling programmes for unregulated care providers can support health equity in underserved communities: a realist review protocol

“…Second, the full text of all potentially relevant articles will be obtained and reviewed. Third, we will use the concept of rigour as a quality appraisal tool to judge the rigour of all full texts and decide on the inclusion of articles in the review 35 54 55. In this quality appraisal tool, rigour is assessed based on critical appraisal work, which stratifies articles either as conceptually rich or poor in description 35 54.…”

“…In this quality appraisal tool, rigour is assessed based on critical appraisal work, which stratifies articles either as conceptually rich or poor in description 35 54. This tool is practical and was repeatedly used in realist reviews 35 54 55. This tool includes a list of questions focusing on the relevance and the rigour of the work.…”

Improving the mental health and mental health support available to adolescents in out-of-home care via Adolescent-Focused Low-Intensity Life Story Work: a realist review

“…A five-step process for conducting the realist review was undertaken following published standards 32 33. These steps are summarised in table 1 below, with table 2 showing eligibility criteria, with full details about our methods available in our open-access protocol paper 9…”

“…As per our protocol paper, 9 electronic database searches were performed between December 2021 and March 2022. Eight databases were searched: MEDLINE, Embase, PsycINFO, Sociology Collection (ProQuest), CINAHL, CDAS, Web of Science and Social Care Online.…”

“…Life Story Work (LSW) is an existing transdiagnostic intervention thought to improve the mental health and well-being of those living in care 8. It aims to improve individuals’ sense of identity, relationships with important adults, ethnic heritage, placement stability and mental health, by addressing gaps in self-knowledge, reframing past events and increasing positive future expectations 7–13. Typical LSW components include a therapeutic alliance (relationship with caring adults), procedures (prompts to action), products (materials/artefacts/life story books), and therapeutic activities (rescripting/reframing).…”