Abstract
The aim of this study was to compare the efficacy of direct therapy and indirect consultation for treating mental health difficulties among looked after children (LAC), and also to identify any demographic or clinical predictor variables for outcomes in this cohort. A retrospective evaluation of mental health outcomes for 104 LAC was conducted. All children received network consultation in combination with or without direct therapeutic work. Outcomes were compared between the groups with and without direct therapeutic intervention. Those receiving both treatments displayed significantly greater Strengths and Difficulties Questionnaire (SDQ)-rated improvements than those receiving just consultation. Nonetheless, improvements in scores for the latter group were significant relative to baseline. Treatment duration, younger age at referral and start SDQ were all correlated with positive outcomes, while number of address changes predicted higher start SDQ scores. Despite the retrospective design of this study, its results can be considered as preliminary findings to guide treatment decisions in LAC.
Highlights
Keywords Looked after children; mental health; evaluation; direct intervention; consultation
The formation of secure attachment has consistently been highlighted as a crucial factor mediating mental well-being among this population of vulnerable children. This conclusion emerges from the research contrasting foster care with residential care,[3,5] the success of treatments targeting child–carer interactions,[7] and the discrepancy between outcomes for boys and girls,[3,7] and it is aligned with the apparent predictive power of placement stability and age at entry into care.[2]
In the full sample (n = 437), children waited for a mean of 27.7 days (s.d. = 18.4 days, n = 317); they had a mean age at point of referral of 11.3 years (s.d. = 4.2 years, n = 436) and mean start Strengths and Difficulties Questionnaire (SDQ) score of 17.2 (s.d. = 8.0, n = 368)
Summary
The group of LAC receiving only consultation work (n = 69) was composed of 38 males (55.1%) and 31 females (44.9%) They had a mean age of 12.2 years The group receiving both consultation and direct work, on the other hand, was composed of 17 males (60.7%) and 11 females (39.3%) They had a mean age of 11.9 years Mean change in SDQ score did not differ significantly between boys and girls These were: age at point of referral (R = −0.22, P = 0.027), treatment duration (R = 0.20, P = 0.049) and start SDQ score (R = 0.53, P < 0.001).
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