Extrait

Plain English Summary Background and aims: Childhood ‘unusual experiences’ (such as hearing voices that others cannot, or suspicions of being followed) are common, but can become more distressing during adolescence, especially for young people in contact with Child and Adolescent Mental Health Services (CAMHS). Unusual experiences associated with distress (UEDs) occur in psychosis, a rare but serious mental health condition. UEDs also occur in other common adolescent mental health problems, and make it less likely that young people will recover well. Research in adults has shown that the talking treatment cognitive behavioural therapy for psychosis (CBTp), is helpful, and saves money by reducing hospital admissions. National guidance recommends that young people with psychosis or UEDs receive CBTp, to help them feel less distressed, which may also improve their future mental health. More research in children is needed, to make sure that the recommendations suit them as well as adults. CAMHS therapists need specialist training and supervision to deliver CBTp. Services need to ask about UEDs consistently, as children may not otherwise report them. Our study aims to find out whether CBTp is helpful and cost-effective for adolescents with UEDs. We will support therapists in the service to deliver CBTp. Who can participate: The study is open to all users of adolescent community mental health services who report a UED. The ages covered by the service at entry are from the 12th birthday up to, but not including the 18th birthday. The age range of participants will therefore be 12-18 years. What does the study involve? Adolescents in CAMHS are invited to complete questionnaires about UEDs and how they are feeling. Those that have UEDs are then randomly allocated into one of two groups. Those in group 1 are offered CBTp straight away. Those in group 2 are offered it after 6 months. Participants complete questionnaires about their mood, experiences, and thinking style at the start of the study. This is repeated after 4 months, when the CBTp is finished, and again after 6 months, to see if any helpful changes are lasting. We compare the group starting CBTp straight away with the 6-month-wait group on measures of distress, UEDs and health and social costs. The CBTp lasts for up to 16 sessions and focuses on understanding and managing UEDs, emotional difficulties and social problems. We also invite families to up to four family support meetings and ask parents to complete measures of their own wellbeing and their child’s difficulties. What are the possible benefits and risks of taking part? The primary benefit will be to young people with UEDs and their families, who will have access to specialist psychological interventions. The local services will benefit from the training of front line staff in the delivery of high quality psychological work and local stakeholders will benefit from improved access and greater clarity regarding care pathways for young people with UEDs. We do not expect there to be particular risks of taking part, but if any participant finds any part of the study upsetting in anyway, an experienced clinician connected with the study can offer support. Where is the study based? In the community Child and Adolescent Mental Health Services (CAMHS) of the South London and Maudsley NHS Foundation Trust, working in collaboration with King’s College, London. When is the study starting and how long is it expected to run for? October 2014 to September 2017. Who is funding the study? The National Institute for Health Research (UK) Who is the main contact? Dr. Suzanne Jolley

Critère d'inclusion

• Distressing unusual experiences (UEDs) in adolescents presenting to community Child and Adolescent Mental Health Services (CAMHS)

Liens

• isrctn
• ictrp