Child Mental Health Treatment Research Articles

Dogs at school: a quantitative analysis of parental perceptions of canine-assisted activities in schools mediated by child anxiety score and use case

Canine-assisted activities in schools can benefit students’ educational, emotional, and social needs. Furthermore, they could be an effective form of non-clinical mental health treatment for children and adolescents. In the United Kingdom, school dogs are growing in popularity, however, little is known about how parents perceive canine-assisted activities as a treatment option. This is important as parental perceptions can influence engagement, whilst lack of awareness can become a barrier to treatment. This study uses a cross-sectional design to quantitatively explore the acceptability of canine-assisted activities amongst UK-based parents (n = 318) of children aged six to 16 (M = 10.12, SD = 3.22). An online survey used a treatment evaluation to determine acceptability across three use-cases. These included a child reading to dogs to improve literacy skills, a child interacting one-to-one to foster greater self-esteem and social skills, and a classroom dog to improve student behaviour and motivation. Additionally, the scale for generalised anxiety disorder was used to rank child anxiety as high or low, where high was a score equal to or above the UK clinical borderline threshold. The results found canine-assisted activities were less acceptable for the behavioural than the reading and social use-cases. Furthermore, parents of children with high anxiety had higher acceptability scores than parents of children with low anxiety for the reading and social use-cases but not for the behavioural use case. These findings suggest that UK parents' acceptability of canine-assisted activities in schools is mediated by child anxiety score. Furthermore, that parents may be less aware of the benefits of classroom dogs than other types of school-based canine-assisted activities.

Child externalising and internalising behaviour and parental wellbeing during the Covid-19 pandemic.

In this study we surveyed families' experiences with parental depression, stress, relationship conflict and child behavioural issues during 6 months of the coronavirus (Covid-19) pandemic through the Covid-19: Global Social Trust and Mental Health Study. The current analyses used data collected from online surveys completed by adults in 66 countries from 17 April 2020 to 13 July 2020 (Wave I), followed by surveys 6 months later at Wave II (17 October 2020-31 January 2021). Analyses were limited to 175 adult parents who reported living with at least one child under 18 years old at Wave I. Parents reported on children's level of externalising and internalising behaviour at Wave I. At Wave II, parents completed self-reported measures of stress, depression and inter-partner conflict. Child externalising behaviour at Wave I significantly predicted higher levels of parental stress at Wave II, controlling for covariates. Child internalising behaviour at Wave I did not predict parental stress or depression, controlling for covariates. Neither child externalising nor internalising behaviour predicted parental relationship conflict. The overall findings demonstrate that child behaviour likely influenced parental stress during the Covid-19 pandemic. Findings suggest that mental health interventions for children and parents may improve the family system during times of disaster.

Social and Relational Health Risks and Common Mental Health Problems Among US Children: The Mitigating Role of Family Resilience and Connection to Promote Positive Socioemotional and School-Related Outcomes.

Nearly 70% (67.6%) of US children with mental, emotional, and behavioral problems (MEB) experienced significant social health risks (SHR) and/or relational health risks (RHR). Shifts are needed in child mental health promotion, prevention, diagnosis, and treatment to address both RHR and SHR. Public health approaches are needed that engage families, youth, and the range of child-serving professionals in collaborative efforts to prevent and mitigate RHR and SHR and promote positive mental health at a community level. Building strong family resilience and connection may improve SR and, in turn, academic and social outcomes among all US children with or without MEB.

A gamified app on emotion recognition and anger management for pre-school children

Anger is a common reason for child mental-health referrals. Therefore, children need to develop emotion recognition and anger management skills from an early age. Gamified apps can deliver mental health interventions for children, but this research area is still in its infancy. A gamified, interactive storytelling mobile app, which was designed as a stress prevention intervention for young children was tested by 20 preprimary school children (4–6 years old) during a science festival. The study aimed to examine children’s understanding of three anger management techniques demonstrated through the app. The main data source of the study consisted of 20 individual audiotaped semi-structured children interviews. Interviews were transcribed verbatim and analyzed using a qualitative data analysis software. Findings showed that the story is comprehensible by preschool children. Eleven out of 20 children could recall at least one anger management technique but only seven (7/20) could identify or demonstrate a technique that can be applied in a stressful situation in real life. There is a need to embed additional scaffolding, prompts, or motivational rewards for children to engage with more than one anger management technique and to avoid misconceptions. Gamified apps can potentially be effective behavioral intervention technologies to deliver emotional education to young children affordably, accessibly, and engagingly.

Situation Analysis of Nation Building Efforts in Sri Lanka: From Early Years of Independence to Contemporary Days

Despite the smooth transition of power from the British colonists to the Sri Lankan Sinhalese in 1949, Sri Lanka inherited considerable challenges. There has been conflict between the Sinhalese and the Tamils post-independence which led to a long and brutal civil war from 1983 to 2009. After the culmination of the civil war, Sri Lanka confronted numerous obstacles in the reconstruction and rehabilitation of the country. Drawing from Birch’s model of national integration, this study attempts to examine the diverse political, economic, and social challenges facing Sri Lanka. The review shows that Sri Lanka needs critical nation building in the following areas: (i) Infrastructural development, (ii) Resettlements and rehabilitation of displaced populations (iii) Ethnic and religious integration, (iv) Equality in political representation, (v) Educational and employment policies, (vi) Gender equality policies, and (vii) mental health interventions for children and women. The role of international bodies, like the United Nations Human Rights Council, and neighboring countries is key to creating pressure for national integration and growth. There is fear that if national unity is not at the forefront of state and international policy for Sri Lanka, conflict and instability may arise again.

21.1 ACCESS MENTAL HEALTH CONNECTICUT: FAMILY-CENTERED PEDIATRIC MENTAL HEALTH CONSULTATIONS

The objective of this presentation is to review the family-centered, well-being-focused nature of the ACCESS (Access to all of Connecticut’s Children of Every Socioeconomic Status) Mental Health program and its contributions to improving mental health treatment for children in the state of Connecticut. ACCESS Mental Health Connecticut is a state-funded initiative created as a line item in the Department of Children and Families’ budget as a component of the gun-control legislation passed in the wake of the Sandy Hook school shooting. Initiated in June 2014 and modeled after the Massachusetts Child Psychiatry Access Project (MCPAP), the Connecticut model includes 3 Hubs to support mental health education and the well-being of pediatric primary care providers, and to support families regardless of insurance status. The model incorporates a team of child and adolescent psychiatrists, licensed social work clinicians, a program coordinator, and, uniquely, a peer specialist. The peer specialist is a parent with a child with mental health challenges who can support pediatric patients’ parents emotionally and practically as they attempt to process and navigate the mental health landscape. Since its inception in June 2014, the ACCESS Mental Health Hubs have provided over 36,700 consultations supporting over 7000 youth and their families. During the early months of the COVID-19 pandemic, the ACCESS Mental Health Teams initiated weekly well-being support Zoom meetings for the state’s pediatric primary care physicians (PPCPs). Now monthly, the Zoom “Clinical Conversations with ACCESS Mental Health” provides mental health education to address the PPCP’s unique needs. Hub child and adolescent psychiatrists also participate in Project ECHO (Extension of Community Healthcare Outcomes), AAP Connecticut webinars, grand rounds, and other venues. PPCP mental health education and early access to mental healthcare promises to identify, support, and treat children and families experiencing mental health challenges that have previously been unable to access services. The trusting personal relationships between the Hub teams and the PPCPs is a cherished component of the ACCESS Mental Health program service.

21.4 THE TEXAS CHILD MENTAL HEALTH CARE CONSORTIUM: BRINGING ACADEMIC EXPERTISE TO THE PUBLIC HEALTH ARENA

The objective of this presentation is to share with child and adolescent psychiatrists the unique nature of the Texas Child Mental Health Care Consortium (TCMHCC) and its contributions to improving mental health treatment for children in the state of Texas.

29.3 CHILD AND ADOLESCENT PSYCHIATRISTS AS MENTAL HEALTH ADVOCATES: EVERY VOICE MATTERS

During the COVID-19 pandemic, adaptations in child mental health treatment delivery methods, such as the use of telehealth, have been supported by specific changes in healthcare legislation and policy. This presentation will describe the unique role of child and adolescent psychiatrists as physician advocates in educating legislators and other decision-makers about the specific developmental needs of children and adolescents.

Overview of Ten Child Mental Health Clinical Outcome Measures: Testing of Psychometric Properties with Diverse Client Populations in the U.S.

While many standardized assessment measures exist to track child mental health treatment outcomes, the degree to which such tools have been adequately tested for reliability and validity across race, ethnicity, and class is uneven. This paper examines the corpus of published tests of psychometric properties for the ten standardized measures used in U.S. child outpatient care, with focus on breadth of testing across these domains. Our goal is to assist care providers, researchers, and legislators in understanding how cultural mismatch impacts measurement accuracy and how to select tools appropriate to the characteristics of their client populations. We also highlight avenues of needed research for measures that are in common use. The list of measures was compiled from (1) U.S. state Department of Mental Health websites; (2) a survey of California county behavioral health agency directors; and (3) exploratory literature scans of published research. Ten measures met inclusion criteria; for each one a systematic review of psychometrics literature was conducted. Diversity of participant research samples was examined as well as differences in reliability and validity by gender, race or ethnicity, and socio-economic class. All measures showed adequate reliability and validity, however half lacked diverse testing across all three domains and all lacked testing with Asian American/Pacific Islander and Native American children. ASEBA, PSC, and SDQ had the broadest testing.

Provider REport of Sustainment Scale (PRESS): development and validation of a brief measure of inner context sustainment

BackgroundImplementation scientists and practitioners often rely on frontline providers for reporting on implementation outcomes. Furthermore, measures of sustainment are few, and available sustainment measures are mainly setting or evidenced-based practice (EBP) specific, require organizational and system-level knowledge to complete, and often lack psychometric rigor. The aim of this study was to develop a brief, pragmatic, and generalizable measure for completion by frontline service providers of the implementation outcome, sustainment.MethodsWe utilized a Rasch measurement theory approach to scale the development and testing of psychometric parameters. Sustainment items were developed to be relevant for direct service providers to complete. In order to promote generalizability, data were collected and items were tested across four diverse psychosocial evidence-based practices (motivational interviewing [MI], SafeCare®, classroom pivotal response training [CPRT], and an individualized mental health intervention for children with autism spectrum disorder [AIM-HI]) and in four service settings (substance use disorder treatment, child welfare, education, and specialty mental health). Associations between the sustainment measure and sustainment leadership, sustainment climate, and attitudes towards the adoption and use of each of the EBPs were assessed to confirm construct validity.ResultsThree items for the Provider REport of Sustainment Scale (PRESS) were assessed for measuring the core component of sustainment: continued use of the EBP. Internal consistency reliability was high. The scale indicated fit to the Rasch measurement model with no response dependency, ordered thresholds, no differential item functioning, and supported unidimensionality. Additionally, construct validity evidence was provided based on the correlations with related variables.ConclusionThe PRESS measure is a brief, three-item measure of sustainment that is both pragmatic and useable across different EBPs, provider types, and settings. The PRESS captures frontline staffs’ report of their clinic, team, or agency’s continued use of an EBP. Future testing of the PRESS for concurrent and predictive validity is recommended.

The Child Mental Health Treatment Gap in an Urban Low-Income Setting: Multisectoral Service Use and Correlates.

To efficiently target capacity-building efforts for child mental health services in low- and middle-income countries (LMICs), it is critical to define how care is structured across sectors and individual-level factors. In a community-based sample of 1,408 children and adolescents (ages 6-15 years) from Itaboraí, Brazil, the authors assessed need and service use across four care systems (mental health specialty, health, welfare, and informal). Individual-level factors included child gender and age, maternal perception of child mental health need, paternal absence, maternal education, and maternal anxiety and depression. The mental health treatment gap was 88%, with only 12% of children with psychiatric problems using mental health services. Children with mental health problems were more likely than those without these problems to use health and other sectors of care and to use services in more than one sector of care. Overall, 46% of the children with any clinical mental health problems and 31% of those with only internalizing problems were identified by their mothers as having a mental health need. Among those with clinical mental health problems, factors associated with mental health service use were being a boy and paternal absence but not mental health problem type or maternal awareness. Closing the child mental health treatment gap in urban settings in LMICs where resources are scarce will likely require system-level changes, such as engagement of diverse service sectors of care. Interventions need to target increased maternal awareness about mental health problems and encourage provision of mental health services to girls.

Training Treatment Skill of Children Abuse Victims for College Students

Child abuse is a serious phenomenon that needs treatment to recover the victims. The present article aims at describing a training of giving treatments to recover children as victims from abuse and violence to show the students’ (participants) knowledge and service before they do internship program at an orphanage. The subject of research is 7th semester students of guidance and counseling program at Universitas Slamet Riyadi, Indonesia. The result of the research are the improvements of the college students’ knowledge and service in giving treatment for child abuse victims; they are familiar with six forms of treatment to recover the victims that consist of Combined Parent-Child Cognitive Behavioral Therapy (CPC-CBT), Parent Training and Multi-systemic Therapy, Project Support (Children’s Protective Services), Web-based parenting skills, Home Visiting Program, and School Based Mental Health Intervention for Children. The conclusion of the article is treatments in the form of collaboration between parents (caregivers), schools, and children (as victims) to recover child abuse and violence through a variety of phases to realize the purposes and children abuse as victims need appropriate treatment based on the condition of them and such six treatments as a choice and solution to recover the victims.

Are friends electric? The benefits and risks of human-robot relationships.

SummarySocial robots that can interact and communicate with people are growing in popularity for use at home and in customer-service, education, and healthcare settings. Although growing evidence suggests that co-operative and emotionally aligned social robots could benefit users across the lifespan, controversy continues about the ethical implications of these devices and their potential harms. In this perspective, we explore this balance between benefit and risk through the lens of human-robot relationships. We review the definitions and purposes of social robots, explore their philosophical and psychological status, and relate research on human-human and human-animal relationships to the emerging literature on human-robot relationships. Advocating a relational rather than essentialist view, we consider the balance of benefits and harms that can arise from different types of relationship with social robots and conclude by considering the role of researchers in understanding the ethical and societal impacts of social robotics.

Mental health promotion and prevention interventions in families with parental depression: A randomized controlled trial

BackgroundThe transgenerational transmission of affective disorders calls for integrating promotion of child development in the services offered to families with parental depression. The main objective of the present research was to examine the effectiveness and differences in the impact of two relevant interventions in Greece. MethodsThirty families of depressed patients were randomly assigned to the six-to-eight session Family Talk Intervention group and 32 families were included in the lower intensity parent-only two-to-three session Let's Talk about the Children group. Depressed parents and the eldest of their children were assessed prior to the interventions and 4, 10, and 18 months following baseline assessment. ResultsIn both groups there were significant improvements in parent's depression, anxiety, perceived social support, parenting and family functioning, as well as improvements in child's depression, anxiety, and child emotional/behavioral problems. Child's prosocial behavior, perceived social support, and health-related quality of life were significantly improved in both groups. All positive effects were evident four months following baseline assessment and could be still documented at 1.5-year follow-up. Mixed linear models showed that family functioning and parenting to a lesser extent were associated with the greatest changes in children's psychosocial outcomes in both interventions.. LimitationsThe lack of data regarding parents that refused to receive the interventions may limit generalizability of results. A further limitation is the lack of a no-intervention control group. ConclusionsThe study offers a preliminary evidence base for integrating preventive interventions for child mental health in routine clinical practice with adult depressed patients.

Policy Recommendations to Promote Integrated Mental Health Care for Children and Youth.

Policy Recommendations to Promote Integrated Mental Health Care for Children and Youth.

Impact of Therapist Training on Parent Attendance in Mental Health Services for Children with ASD

ABSTRACT Objective The current study explored the impact of training therapists in a mental health intervention for children with autism spectrum disorder (ASD) on parent attendance in their children’s therapy sessions. We also examined family, therapist, and program factors as potential moderators. Method Data were drawn from a cluster-randomized community effectiveness trial of “An Individualized Mental Health Intervention for ASD (AIM HI)”. Participants included 168 therapists yoked with 189 children recruited from publicly-funded mental health services. Data included family (caregiver strain, parent sense of competence, race/ethnicity), therapist (background, experience), and program (service setting) characteristics, and parent session attendance. Multilevel models were used to evaluate the effectiveness of AIM HI therapist training on caregiver attendance and identify moderators of training effects on parent attendance. Results Parents attended a higher percentage of sessions in the AIM HI training condition compared to the Usual Care condition. Program service setting moderated the effect of AIM HI training, with higher parent attendance in non-school (mostly outpatient) settings compared to school settings and a significantly smaller difference between the settings in the AIM HI condition. Conclusions Effective strategies to promote parent engagement, especially in service settings such as schools, are warranted. Findings support the effectiveness of AIM HI training in promoting parent attendance across multiple publicly-funded mental health service settings. The larger effect in school-based programs supports the utility of training in evidence-based interventions such as AIM HI to increase the feasibility of parent attendance in such services.

Socially Assistive Robots as Mental Health Interventions for Children: A Scoping Review

Socially Assistive Robots are promising in their potential to promote and support mental health in children. There is a growing number of studies investigating the feasibility and effectiveness of robot interventions in supporting children’s mental wellbeing. Although preliminary evidence suggests that Socially Assistive Robots may have the potential to help address concerns such as stress and anxiety in children, there is a need for a greater focus in examining the impact of robotic interventions in this population. In order to better understand the current state of the evidence in this field and identify critical gaps, we carried out a scoping review of the available literature examining how social robots are investigated as means to support mental health in children. We identified existing types of robot intervention and measures that are being used to investigate specific mental health outcomes. Overall, our findings suggest that robot interventions for children may positively impact mental health outcomes such as relief of distress and increase positive affect. Results also show that the strength of evidence needs to be improved to determine what types of robotic interventions could be most effective and readily implemented in pediatric mental health care. Based on our findings, we propose a set of recommendations to guide further research in this area.

Hybrid type 1 randomized controlled trial of a tablet-based application to improve quality of care in child mental health treatment

The quality of child mental health care is highly variable in community practice settings. Innovative technology-based solutions may be leveraged to improve quality of care and, in turn, treatment outcomes. This is a protocol paper that describes an innovative study design in which we rigorously evaluate the effectiveness of a tablet-assisted intervention, Supporting Providers and Reaching Kids (SPARK). SPARK consists of a collection of interactive games and activities that are designed to improve provider fidelity and child engagement in evidence-based psychotherapies. The methodology also allows us to explore the implementation and sustainability of a technology-enhanced intervention in more than two dozen community practice settings. This paper includes a description and justification for sample selection and recruitment procedures, selection of assessment measures and methods, design of the intervention, and statistical evaluation of critical outcomes. Novel features of the design include the tablet-based toolkit approach that has strong applicability to a range of child mental health interventions and the use of a hybrid type 1 effectiveness-implementation trial that allows for the simultaneous investigation of the effectiveness of the intervention and the implementation context. Challenges related to the implementation of a technology-enhanced intervention in existing mental health clinics are discussed, as well as implications for future research and practice.

A Matter of Trust

Mental health problems among children and adolescents are widespread. Parents seeking information about child mental health problems and treatments face numerous barriers, including fear of stigmatization and uncertainty about where to seek help. In this qualitative study, seven parents whose children had experienced a mental health, behavioral, or emotional problem were interviewed about their attitudes and beliefs about child mental health information sources. Analysis revealed that the concept of trust was an overarching theme in parents’ pursuit and evaluation of information. Related themes included a preference for information from other parents with experience parenting a child with a mental health problem; seeking information from knowledgeable professionals with whom the parents had personal relationships; concerns about confidentiality and protection of privacy; and involvement of school personnel when seeking mental health information and help. Findings support the need for improved mental health literacy among parents and suggest that social workers should play a more active role in educating families and service providers about child mental health.

Does your child need therapy? Maternal reflective functioning and perceived need for and use of child mental health treatment

ABSTRACT Interventions to improve reflective functioning (RF) are being delivered to parents of children with mental health needs, yet whether this population differs in RF is unknown. We examine if mothers with varying levels of child mental health (CMH) treatment need and use differ in RF in a community sample of 212 mothers. Participants completed measures of general RF, parental RF, children’s symptoms, perceived treatment need, treatment utilization, and perceptions of treatment efficacy at baseline and one year later. Low maternal RF was associated with elevated child symptoms, and a greater perceived need for treatment. Among mothers who believed their child needed services, those with low general RF were less likely to be utilizing services at baseline and in the next year. Mothers with lower parental RF also believed that CMH treatment was less effective. Findings support the use of RF-based interventions with parents identified because of their child’s mental health.