Randomized Controlled Trial of an Early Intervention Programme for Adolescent Anxiety Disorders

Hunt, Caroline; Andrews, Gavin; Sakashita, Chika; Crino, Rocco; Erskine, Alicia

doi:10.1080/00048670902721152

Cited by 37 publications

(29 citation statements)

References 21 publications

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“…232 A consideration of the attributes and skills of the self-care support agent inevitably raises the issue of education and training. None of the attributes and skills required of the support agent necessitate mental health training, and it was interesting to note that our effectiveness data suggested that there is no specific advantage in the agent being mental health trained, although there is some evidence 82 in the literature to counter this, and it was notable that around three-quarters of those delivering interventions in the effectiveness studies were specifically trained for the role. What seems to be essential is the ability to understand the CYP's perspective, and to focus on their needs and the needs of their families, rather than on the needs of the service or the people leading the service.…”

Section: Qualities Of the Self-care Support Agentmentioning

confidence: 78%

“…A further 82 duplicates were identified within the Access database, leaving a pool of 3242 abstracts for consideration. This was a substantial number of abstracts to deal with in the time available, so one team member (Elvey) used the search function in Access to speed the process of finding terms which would allow us to remove articles 82,196 …”

Section: Search Results and Study Selectionmentioning

confidence: 99%

“…Sixteen of the interventions were individual child/young person or individual family interventions; 48,65,[69][70][71]74,[83][84][85][86][87][95][96][97][98]111,[121][122][123][124][125][126][127][129][130][131]133,135 the remainder were group interventions or group interventions with occasional individual sessions. Of those studies where a delivery location was given, most of the interventions (33/71) took place in a school setting, 39,[45][46][47]49,50,53,[57][58][59][60]62,63,65,73,82,[90][91][92][93][94]…”

Section: Description Of the Included Effectiveness Studiesmentioning

confidence: 99%

“…running summer camps and liaising with teachers (MTA 1999 95 ), or facilitating the child in the home-school environment (Pfiffner 2007 102 ). In three-quarters (53/71) of the studies, the agents were trained specifically for the intervention, 39,[45][46][47][48][49][50][51][53][54][55][56][57][58][59][62][63][64][65][66][67][68][72][73][74][77][78][79][82][83][84][85][86][87][88][89][90]93,94,99,100,[103][104][105][106][108][109]…”

Section: Description Of the Included Effectiveness Studiesmentioning

confidence: 99%

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Developing a model of mental health self-care support for children and young people through an integrated evaluation of available types of provision involving systematic review, meta-analysis and case study

Pryjmachuk

Elvey

Kirk

et al. 2014

Health Services and Delivery Research

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BackgroundThe mental health of children and young people (CYP) is a major UK public health concern. Recent policy reviews have identified that service provision for CYP with mental health needs is not as effective, responsive, accessible or child-centred as it could be. Following on from a previous National Institute for Health Research (NIHR) study into self-care support for CYP with long-term physical health needs, this study explored self-care support’s potential in CYP’s mental health.ObjectivesTo identify and evaluate the types of mental health self-care support used by, and available to, CYP and their parents, and to establish how such support interfaces with statutory and non-statutory service provision.DesignTwo inter-related systematic literature reviews (an effectiveness review with meta-analysis and a perceptions review), together with a service mapping exercise and case study.SettingGlobal (systematic reviews); England and Wales (mapping exercise and case study).Participants (case study)Fifty-two individuals (17 CYP, 16 family members and 19 staff) were interviewed across six sites.Main outcome measures (meta-analysis)A measure of CYP’s mental health symptomatology.Data sources (literature reviews)MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, All Evidence-Based Medicine (EBM) Reviews, Applied Social Sciences Index and Abstracts (ASSIA) and Education Resources Information Center (ERIC).Review methodsTitles and abstracts of papers were screened for relevance then grouped into studies. Two independent reviewers extracted data from studies meeting the inclusion criteria. A descriptive analysis and meta-analysis were conducted for the effectiveness review; descriptive analyses were conducted for the perceptions review. These analyses were integrated to elicit a mixed-methods review.ResultsSixty-five of 71 included studies were meta-analysable. These 65 studies elicited 71 comparisons which, when meta-analysed, suggested that self-care support interventions were effective at 6-month [standardised mean difference (SMD) = −0.20; 95% confidence interval (CI) −0.28 to −0.11] and 12-month (SMD = −0.12; 95% CI −0.17 to −0.06) follow-ups. However, judged against Cochrane criteria, the studies were mostly low quality. Key elements of self-care support identified in the perceptions review were the acquisition of knowledge and skills, peer support and the relationship with the self-care support agent; CYP also had different perceptions from adults about what is important in self-care support. The mapping exercise identified 27 providers of 33 self-care support services. According to the case study data, effective self-care support services are predicated on flexibility; straightforward access; non-judgemental, welcoming organisations and staff; the provision of time and attention; opportunities to learn and practise skills relevant to self-care; and systems of peer support.ConclusionsMental health self-care support interventions for CYP are modestly effective in the short to medium term. Self-care support can be conceptualised as a process which has overlap with ‘recovery’. CYP and their families want choice and flexibility in the provision of such interventions and a continued relationship with services after the nominal therapy period. Those delivering self-care support need to have specific child-centred attributes.Future workFuture work should focus on under-represented conditions (e.g. psychosis, eating disorders, self-harm); the role of technology, leadership and readiness in self-care support; satisfaction in self-care support; the conceptualisation of self-care support in CYP’s mental health; and efficacy and cost-effectiveness.Study registrationPROSPERO number (for the effectiveness review) CRD42012001981.FundingThe NIHR Health Services and Delivery Research programme.

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Section: Qualities Of the Self-care Support Agentmentioning

confidence: 78%

Section: Search Results and Study Selectionmentioning

confidence: 99%

Section: Description Of the Included Effectiveness Studiesmentioning

confidence: 99%

Section: Description Of the Included Effectiveness Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Developing a model of mental health self-care support for children and young people through an integrated evaluation of available types of provision involving systematic review, meta-analysis and case study

Pryjmachuk

Elvey

Kirk

et al. 2014

Health Services and Delivery Research

View full text Add to dashboard Cite

show abstract

“…The above study was conducted by psychologists. To assess the effectiveness of an indicated early intervention and prevention program for anxiety disorders when conducted by school staff, Hunt et al, (2009) conducted a randomized controlled trial. A total of 1120 children in their first year of high school were recruited from 19 schools.…”

Section: Targeted Prevention Strategiesmentioning

confidence: 99%