Ending treatment with children and young people when clinical improvement is unlikely: considering curability and chronicity
PhD researcher: Holly Bear
The topics of interest within this project are: clinical treatment response following routine mental health care, better understanding the association between cognitive illness representations and treatment response expectations among practitioners, children and families, practitioners’ shared or incongruent experiences, feelings and insights surrounding treatment failure and treatment endings across mental and physical healthcare contexts.
Finally, the project will look at the ways in which we can improve understanding, consideration and communication about the limitations of interventions in child and adolescent mental health services in order to inform clinical decision making.
Power Up for Parents: parental involvement and shared decision making through technology
PhD researcher: Shaun Liverpool
This project addresses policy calls to promote shared decision making in services for young people with long-term conditions. It builds on prior research by the Anna Freud National Centre for Children and Families to develop a mobile app called Power Up supporting shared decision making with young people, caregivers and therapists. Crucially, this project will develop and evaluate a new app (Power Up for Parents) that enables greater involvement of mothers and fathers (or caregivers) in their child’s therapy.
A community-led and co-produced intervention to support and promote resilience in schools and services
PhD researcher: Bettina Moltrecht
What constitutes a good outcome in child and adolescent mental health?
PhD researcher: Karolin Krause
Over the past decade, there has been a push towards the routine measurement of treatment outcomes in child and adolescent mental health services (CAMHS). At the same time, there is a lack of consensus about the types of change that constitute a ‘good outcome’ and that should be prioritised when evaluating treatments effectiveness.
This PhD project explores what outcomes are considered important by different stakeholders, including clinicians, commissioners and young people themselves, in the UK and overseas. It will look at the importance of symptom change relative to other possible changes in young people’s lives, such as in their interpersonal relationships, identity and self-esteem, or physical health.
The PhD will take a mixed-methods approach combining qualitative interviews, Q-methodology, and quantitative analysis of routine monitoring CAMHS data.
How can investigations into risk, stressors, and protective factors inform the development of initiatives for the promotion of mental wellbeing?
PhD researcher: Mia Eisenstadt
This PhD aims to examine stressors, risk-factors and protective factors and effects on mental wellbeing from the perspectives of adolescents to inform intervention design. The term ‘risk factors’ refers to variables associated with the increased likelihood of a negative outcome and ‘protective factors’ are those variables that decrease the likelihood of said outcome (Kazdin et al., 1997). The PhD analyses data from a longitudinal qualitative study that involves annual interviews with adolescents in six regions across England as part of HeadStart. HeadStart is a national programme seeking to reduce the rate of mental disorder and promote emotional wellbeing in English adolescents.
Understanding and facilitating self-management in child and youth mental health for LGBTQ+ young people
PhD researcher: Rosa Town
This PhD project aims to explore the barriers and facilitators to self-management in young people with mental health difficulties from a socially excluded group, and from this, develop an intervention to facilitate self-management. One in eight young people will experience a mental health difficulty (NHS Digital, 2018), yet many choose not to access professional help (Demyttenaere et al., 2004). When help is accessed, reliable change is found in only around half of cases (Edbrooke-Childs et al., 2018). As such, greater emphasis is being placed on the need for effective self-management strategies to make best use of the limited resources available and encourage patient empowerment (Future in Mind, 2015; National Institute for Health and Care Excellence [NICE] 2019; Wolpert et al., 2016).
Specifically, this project will investigate how LGBTQ+ young people can self-manage their mental health. Recent evidence suggests that one in three young people who identify as lesbian, gay, bisexual or a sexual orientation other than heterosexual will have a mental health disorder (NHS Digital, 2018), and many people who identify as LGBTQ+ perceive traditional mental health services to be discriminatory (Hudson-Sharp & Metcalf, 2016). Additionally, one in seven LGBT people have avoided health services due to fear of discrimination, with this statistic increasing to approximately a third for trans and non-binary people (Stonewall, 2018). The newly developed intervention to facilitate self-management will be underpinned by the Behaviour Change Wheel, a method for characterising, understanding, and designing behaviour change interventions (Michie, Atkins, & West, 2012).
This project is funded by a PhD Studentship from NIHR ARC North Thames and sponsored by University College London.
How far can data from routine outcome measurement be used to inform the provision and management of children and young people's mental health services?
PhD researcher: Tom Bardsley
Factors associated with the sustainability of mental health and wellbeing programmes in schools
PhD researcher: Anna Moore
The substantial time that young people spend in schools makes them a practical context for reaching young people for early prevention and intervention, and there has been an increasing focus on effective universal approaches to supporting young people’s mental health and wellbeing. There is good evidence that well-designed and well-implemented interventions can lead to positive changes in students’ mental health and wellbeing, but increasingly reports have also shown poor sustainability of school-based interventions. Given the considerable investment of resources it is clearly in the interests of health and education systems, as well as individual schools and pupils, to achieve long-term sustainability of such interventions.
This PhD project aims to develop our understanding of this area, using mixed-methods to explore factors that affect the sustainability of mental health and wellbeing programmes in schools. The project will draw on data from the Education for Wellbeing programme, which works with over 370 schools in England to evaluate different type mental health and wellbeing support for primary and secondary pupils.