Jälkihuolto mielenterveydellistä tukea tarvitsevien nuorten itsenäistymisen tukena

Background: Group programmes are a common component of treatment in inpatient child and adolescent mental health service (CAMHS) units. There is evidence for specific group interventions, however, comparison across a multidisciplinary group programme is under-explored. Aims: This research examines young people's experiences of, and satisfaction with, a multidisciplinary group programme on an acute inpatient CAMHS unit. Methods: Weekly surveys were distributed to young people, and 37 responses were gathered across four months in 2018. Rates of attendance, enjoyment and perceived helpfulness of groups were calculated. Content analysis was used to explore key themes in qualitative responses. Results: Young people rated a creative activities and games group (54.05%) and the art therapy group (48.95%) as the two most enjoyable groups. Art therapy was reported to be the most helpful group overall (45.65%). Young people also expressed their dislike for verbal psychotherapy groups (43.24%), finding these confronting relative to other modalities in the programme. Conclusions: Art therapy and arts-based groups received the highest positive feedback relative to predominantly verbal psychotherapy groups. A multidisciplinary group programme which integrates art therapy and other creative modalities has the potential to enhance engagement in acute inpatient settings which may result in improved mental health outcomes for young people. Implications for future research and practice: Future research should aim to foreground young people's perspectives and experiences of therapeutic programmes, and provide opportunities for clinicians to redevelop programmes responsively to service user feedback. Survey findings support advocacy for consistent art therapy roles and services within inpatient CAMHS units.

The aim of this systematic review was to synthesise qualitative evidence on young people's conceptualisation, utilisation and experiences of the therapeutic alliance in individual psychotherapy or counselling and its role in bringing about change. The thematic synthesis method was used to synthesise data. The methodological quality of included studies was assessed using the CASP checklist for qualitative research. Four superordinate analytical themes were generated: (1) valuable therapist qualities, (2) conditions for the development and maintenance of the therapeutic alliance, (3) therapeutic processes and (4) barriers to the development of the therapeutic alliance. Findings indicate that young people appreciated the uniqueness of the therapeutic relationship that provided a sense of safety, choice and autonomy. Flexibility and accessibility were noted as important elements of therapeutic alliance building as they elicited a sense of agency. Young people emphasised the non-linear nature of therapy and prioritised process variables such as improvement in self-understanding, self-efficacy and self-worth. The current systematic review is a comprehensive overview of qualitative studies of experiences of therapy from young people's perspectives. Important practical implications derived from this review as the role of autonomy in the change process and the formation and maintenance of the therapeutic relationship were outlined as important elements in youth therapy.

The stories behind stories: Reflections on the role of voice in research with unaccompanied refugee youth

Modern social work practice increasingly emphasizes the inclusion of service users in decision making during the service provision process. There is a growing movement within the child welfare system to include parents and the wider family network in decision making. However, children and young people's roles in child welfare system participatory processes where decisions are made about their lives have been understudied. The family group conference (FGC) is one such decision‐making process, which has been adopted internationally with the expectation that children and young people's voices and perspectives, along with their family members, will be elevated and influence decisions. As part of a 3‐year federal project of FGCs in one jurisdiction, this study collected fidelity data from professional and family member participants of FGCs, including children and young people. Descriptive data from a small sample of child and young people participating in FGC suggest differences in their perspectives regarding family empowerment, transparency, and inclusion in decision making, when compared with the perspectives of other family members and professionals for whom data are available. Suggestions for further reflection on FGC practice and additional ways to understand children and young people's perspectives about their involvement are noted.

Nitrous oxide (N2O) use for intoxication among young people has increased in many parts of the Western world, including Denmark. The literature, however, primarily focusses on harms related to N2O use, and not on other aspects, for example modes of administration or effects such as different forms of pleasure or fun. Therefore, despite this increase, we still know very little about how and why young people use nitrous oxide for intoxication, including their experiences of N2O intoxication. Based on 45 qualitative interviews with young Danes age 18-25 years, who all were former or present N2O users, we explore their experiences of N2O intoxication. We do this by analyzing in-depth descriptions of where, how and with whom they use N2O. When analyzing these descriptions in relation to different modes of administration, intensity of use, combination with other substances (e.g. alcohol, cannabis), and use in different settings, we argue that N2O intoxication is experienced differently by the young participants. Some of the participants also searched for particular intoxication experiences with N2O. We unfold the participants' various descriptions of intoxication by differentiating between moderate and intensive use. Overall, our study shows that these differences in N2O use for intoxication are not equally risky or harmful. In general, young people's own perspectives and experiences with (illegal) drug use is increasingly emphasized as important to include when developing preventive interventions. Our analysis of the young participants' differing experiences with N2O for intoxication can inform future prevention initiatives in relation to harms of N2O intoxication.

Research on childhood epilepsy has predominantly used quantitative methodologies to examine the impact of epilepsy on young people and their families. These studies generally give a negative picture of the condition, which is at odds with a strengths-based social work perspective, and provide little understanding of young people's experiences of living with epilepsy. A systematic review of qualitative studies that explored young people's perspectives was conducted. Inclusion criteria were as follows: young people ages 13 to 18 years diagnosed with epilepsy, qualitative data collection methods, studies published in English-language peer-reviewed journals, and gray literature. Of 501 abstracts identified, 52 full-length texts were reviewed, with 17 studies being included for final analysis. The emergent themes were seizures and medications; relationships; issues and concerns involving their families, peers, and schools; and young people's reactions to epilepsy. It is essential to understand issues presented by young people for improving practice and developing services, as these issues highlight areas for potential social work interventions. It is also essential to adopt a strengths perspective when considering these findings and implications for hospital social work, as young people's experiences were not always negative.

<p>Aim </p> <p>Critically review research methods used to elicit children and young people's views and experiences in the first year of COVID-19, using an ethical and child rights lens. </p> <p>Methods </p> <p>A systematic search of peer-reviewed literature on children and young people's perspectives and experiences of COVID-19. LEGEND (Let Evidence Guide Every New Decision) tools were applied to assess the quality of included studies. The critical review methodology addressed four ethical parameters: (1) Duty of care; (2) Children and young people's consent; (3) Communication of findings; and (4) Reflexivity. </p> <p>Results </p> <p>Two phases of searches identified 8131 studies; 27 studies were included for final analysis, representing 43,877 children and young people's views. Most studies were from high-income countries. Three major themes emerged: (a) Whose voices are heard; (b) How are children and young people heard; and (c) How do researchers engage in reflexivity and ethical practice? Online surveys of children and young people from middle-class backgrounds dominated the research during COVID-19. Three studies actively involved children and young people in the research process; two documented a rights-based framework. There was limited attention paid to some ethical issues, particularly the lack of inclusion of children and young people in research processes. </p> <p>Conclusion </p> <p>There are equity gaps in accessing the experiences of children and young people from disadvantaged settings. Most children and young people were not involved in shaping research methods by soliciting their voices.</p> <p> </p>

<p>Aim </p> <p>Critically review research methods used to elicit children and young people's views and experiences in the first year of COVID-19, using an ethical and child rights lens. </p> <p>Methods </p> <p>A systematic search of peer-reviewed literature on children and young people's perspectives and experiences of COVID-19. LEGEND (Let Evidence Guide Every New Decision) tools were applied to assess the quality of included studies. The critical review methodology addressed four ethical parameters: (1) Duty of care; (2) Children and young people's consent; (3) Communication of findings; and (4) Reflexivity. </p> <p>Results </p> <p>Two phases of searches identified 8131 studies; 27 studies were included for final analysis, representing 43,877 children and young people's views. Most studies were from high-income countries. Three major themes emerged: (a) Whose voices are heard; (b) How are children and young people heard; and (c) How do researchers engage in reflexivity and ethical practice? Online surveys of children and young people from middle-class backgrounds dominated the research during COVID-19. Three studies actively involved children and young people in the research process; two documented a rights-based framework. There was limited attention paid to some ethical issues, particularly the lack of inclusion of children and young people in research processes. </p> <p>Conclusion </p> <p>There are equity gaps in accessing the experiences of children and young people from disadvantaged settings. Most children and young people were not involved in shaping research methods by soliciting their voices.</p> <p> </p>

AimCritically review research methods used to elicit children and young people's views and experiences in the first year of COVID‐19, using an ethical and child rights lens.MethodsA systematic search of peer‐reviewed literature on children and young people's perspectives and experiences of COVID‐19. LEGEND (Let Evidence Guide Every New Decision) tools were applied to assess the quality of included studies. The critical review methodology addressed four ethical parameters: (1) Duty of care; (2) Children and young people's consent; (3) Communication of findings; and (4) Reflexivity.ResultsTwo phases of searches identified 8131 studies; 27 studies were included for final analysis, representing 43,877 children and young people's views. Most studies were from high‐income countries. Three major themes emerged: (a) Whose voices are heard; (b) How are children and young people heard; and (c) How do researchers engage in reflexivity and ethical practice? Online surveys of children and young people from middle‐class backgrounds dominated the research during COVID‐19. Three studies actively involved children and young people in the research process; two documented a rights‐based framework. There was limited attention paid to some ethical issues, particularly the lack of inclusion of children and young people in research processes.ConclusionThere are equity gaps in accessing the experiences of children and young people from disadvantaged settings. Most children and young people were not involved in shaping research methods by soliciting their voices.

BackgroundFew youth-friendly health services worldwide have been scaled up or evaluated from young people's perspectives. South Africa's Youth Friendly Services (YFS) programme is one of the few to have been scaled up. This study investigated young people's experiences of using sexual and reproductive health services at clinics providing the YFS programme, compared to those that did not, using the simulated client method.DesignFifteen primary healthcare clinics in Soweto were randomly sampled: seven provided the YFS programme. Simulated clients conducted 58 visits; young men requested information on condom reliability and young women on contraceptive methods. There were two outcome measures: a single measure of the overall clinic experience (clinic visit score) and whether or not simulated clients would recommend a clinic to their peers. The clinic visit score was based on variables relating to the simulated clients’ interactions with staff, details of their consultation, privacy, confidentiality, the healthcare workers’ characteristics, and the clinic environment. A larger score corresponds to a worse experience than a smaller one. Multilevel regression models and framework analysis were used to investigate young people's experiences.ResultsHealth facilities providing the YFS programme did not deliver a more positive experience to young people than those not providing the programme (mean difference in clinic visit score: −0.18, 95% CI: −0.95, 0.60, p=0.656). They were also no more likely to be recommended by simulated clients to their peers (odds ratio: 0.48, 95% CI: 0.11, 2.10, p=0.331). More positive experiences were characterised by young people as those where healthcare workers were friendly, respectful, knew how to talk to young people, and appeared to value them seeking health information. Less positive experiences were characterised by having to show soiled sanitary products to obtain contraceptives, healthcare workers expressing negative opinions about young people seeking information, lack of privacy, and inadequate information.ConclusionsThe provision and impact of the YFS programme are limited. Future research should explore implementation. Regular training and monitoring could enable healthcare workers to address young people's needs.

Children Looked After

There is much still to be learned regarding the outcomes of transnational parenting for young people in labour-sending countries. In particular, a significant knowledge gap exists regarding young people's perspectives on transnational parenting at the time of the parent's absence outside of Central America or Asia. Thus, the purpose of this study is to increase understanding of young people's experience in the under-researched Pacific Islands region by examining: How does a parent's international labour migration impact young people left-behind in Tonga's work, leisure, education and aspirations? A theoretical framework utilising social remittances theory was adopted. Utilising a quick, ethnographic approach, 179 secondary school students participated. This 2017 study included interviews, time diaries, short surveys, focus groups and fieldwork observations to facilitate participant-led accounts of young people's experience of transnational parenting in Tonga. This study provides an important empirical contribution regarding young people in Tonga's experience of transnational parenting. These findings demonstrate that, as a consequence of labour migration schemes that disregard family accompaniment, young people in Tonga are paying a high price, a triple loss, as their right to family is diminished, they are unable to prioritise their education, and migration goals are elevated, all of which inhibit their potential.

1. Sandra H. Jee, MD, MPH 1. Department of Pediatrics University of Rochester Rochester, NY 1. Mark D. Simms, MD, MPH 1. Department of Pediatrics Medical College of Wisconsin Milwaukee, Wisc Improving the Odds for the Healthy Development of Young Children in Foster Care . Dicker S, Gordon E, Knitzer J. National Center for Children in Poverty: Columbia University Mailman School of Public Health. Promoting the Emotional Well-Being of Children and Families (Policy Paper No. 2). January 2002;1–28 Children and Family Services Reviews, Part V: Most States Fail to Meet the Mental Health Needs for Foster Children . Huber J, Grimm B. Youth Law News . 2004;Oct-Dec:1–36 CWLA Standards for Health Care Services for Children in Out-of-Home Care . Washington, DC: Child Welfare League of America; 1988. Educational Experiences of Children in Out-of-Home Care . Smithgall C, Gladden RM, Howard E, Goerge R, Courtney M. Chicago, Ill: Chapin Hall Center for Children at the University of Chicago; 2004:1–77 Fostering Health: Health Care for Children and Adolescents in Foster Care . 2nd ed. Task Force on Health Care for Children in Foster Care, American Academy of Pediatrics, District II, New York State. Elk Grove Village, Ill: American Academy of Pediatrics: 2005 Healthy Foster Care America . www.aap.org/advocacy/HFCA/ On any given day, more than 500,000 children are living in state-supported foster home care. In the course of a year, more than 800,000 children experience placement in a foster home. Many of these children return home quickly, but for some, placement may extend for years and may involve care in multiple foster homes. Most of the children have experienced serious family dysfunction prior to placement, including exposure to domestic violence and to their parents’ mental health disorders, addiction, or criminal activity. Serious neglect and abuse are the most frequently stated reasons for removing children from their parents’ care. Children entering foster homes have extremely high rates of physical and mental health problems, developmental delays, and educational underachievement. As a group, children in foster care …

Assessment of youth-friendly health care: a systematic review of indicators drawn from young people's perspectives.

Disasters such as flooding, earthquakes and hurricanes can have devastating impacts on children and young people's lives, with evidence highlighting significant social and mental health consequences lasting many years. Yet other research highlights how children and young people actively contribute to disaster responses, supporting their families and communities to manage and overcome such impacts. Despite this evidence, very little research has been conducted directly with children and young people to explore their own perspectives on disasters, including the impacts on their social and emotional wellbeing, as well as their priorities for disaster planning programmes. This paper reports findings from a scoping review that examined the extant evidence base on research conducted directly with children investigating children and young people's (0–18 years) perspectives on disasters. The review identified thirty five relevant papers that were included for further analysis. Review findings highlighted children and young people's fears and anxieties related to their experience of a disaster, with many studies foregrounding negative outcomes and children's ‘vulnerability’. In contrast, a limited number of studies focused on children's knowledge, strengths and contributions to disaster responses. Our review highlights how such approaches underscore the importance of harnessing children and young people's perspectives within the development of disaster resilience programmes to support their socio-emotional and mental health.