The power of recognising more: a qualitative study of young people's perspectives on broader recognition for learning and wellbeing.

Family therapy for anorexia nervosa (FT-AN) is the first-line recommended treatment for young people with anorexia nervosa. There is variability in treatment length across studies and evidence suggests treatment length and outcome are not necessarily linearly related. This makes it difficult to identify the optimum length of treatment in clinical practice. This study aimed to explore young people's perspectives on the timing of discharge and how this relates to recovery. Twenty three young people (age 12-18) diagnosed with anorexia (or atypical anorexia) nervosa participated. All had completed FT-AN with or without adjunctive multi-family therapy. Semi-structured individual qualitative interviews were conducted. Recordings were transcribed verbatim and analysed using reflexive thematic analysis. Four inter-connected themes were generated; (1) who decides?, (2) knowing what's coming, (3) things that need to be in place, (4) discharge is a necessary step towards recovery. Young people said that remaining in treatment for longer than necessary may impede recovery. Establishing clear expectations about discharge and recovery, helping young people to commit to ongoing behaviour change, and building their support network were all described as important components in helping them to feel confident about discharge and to take ownership of continuing the recovery journey post-discharge.

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.

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.

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.

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

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.

<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.

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.

Systematic reviews of quantitative research on the effects of childhood epilepsy have established its association with higher levels of psychiatric diagnosis, externalizing and internalizing problems, lower health-related quality of life, social competence, and poorer academic achievements, compared with their peers. However, much less is known about young people's experiences of living with epilepsy and its impact on their development from their own perspectives. Semistructured interviews were conducted with 15 young people aged between 13 and 16years. Participants were recruited as part of a larger mixed methods study examining individual and family influences on outcomes for young people with epilepsy. These young people attended an epilepsy clinic in KK Women's and Children's Hospital, Singapore. The framework approach to data management and analyses involved both inductive and deductive generation of themes. Findings from young people's interviews provided in-depth descriptions of stressful circumstances encountered. Interconnectedness between severity of the impairment and its impact on key developmental tasks, such as independence, autonomy, and social development, were emphasized. Seizures and illness-related demands disrupted their day-to-day functioning and challenged their abilities to meet these tasks. In addition to these impairment effects, young people's experiences of social exclusion were also affected by social and environmental factors, which act as systemic barriers to participation. In turn, this has an effect on their self-esteem. Nevertheless, young people reported positive experiences, such as support from both family and friends, which served as protective factors against the stress of living with a chronic medical condition. The demands of epilepsy affect various domains of young people's lives. In order to obtain a holistic understanding of young people's inclusion or exclusion to participation, it is necessary to consider impairment effects, barriers to doing, and barriers to being.

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

To explore if young people with higher and lower levels of metabolic control of type 1 diabetes have different perceptions about their lives and illness. Adolescence through emerging adulthood is a developmental stage made more challenging when the person has type 1 diabetes. Little research has investigated if individuals with high and low levels of metabolic control in this age group perceive their disease differently. Qualitative descriptive. In this study, 14 participants, ages 11-22years were interviewed in 2008 about their perceptions of living with type 1 diabetes. Through a process of induction, major themes were identified. Participants with high and low metabolic control levels reported similar themes related to reactions of others, knowledge about type 1 diabetes, and believed healthcare providers used authoritarian interactions. However, high metabolic control level participants believed type 1 diabetes would be cured; had negative initial responses to being diagnosed; rarely received parental support in managing their diabetes; and were negligent in self-care activities. Participants with low metabolic control levels did not believe a cure was imminent or have negative responses to being diagnosed; received parental support in managing diabetes; and were diligent in self-care activities. Nurses should give information to young people with type 1 diabetes beyond initial diagnosis and help and support this age group learn appropriate ways to manage their disease, develop positive relationships with healthcare professionals, and participate in interactions with others their age successfully managing type 1 diabetes.

Autistic young people experience poorer mental health and well-being compared to their non-autistic peers. Navigating the complex social, academic, procedural and sensory aspects of school may be particularly challenging for autistic young people and contribute to poorer mental well-being. The COVID-19 pandemic caused unprecedented school changes and provided a unique opportunity to gather caregiver's and young people's perspectives on the impact of school and pandemic-related school changes on the well-being of both autistic and non-autistic young people. We asked for the views of caregivers and young people aged 11-18 years gathered across three timepoints between May and December 2020. Their responses revealed both benefits and challenges associated with school changes. Insights into possible lessons from the pandemic and recommendations for more flexible, individualised and strengths-based educational practices are discussed.