Children's Mental Health Research Quarterly

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Fighting racism

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2021
Abstract: 

Background: Racism has a profound impact on children well-being. In fact, researchers have found links between experiencing racial discrimination and mental health concerns, including depression, anxiety and conduct problems. We therefore set out to identify effective interventions for reducing racism in children.

Methods: We used systematic review methods to identify randomized controlled trials (RCTs) evaluating interventions to reduce racism. After applying our rigorous inclusion criteria, we accepted five RCTs evaluating 11 interventions.

Results: Two interventions showed promising outcomes. Books that recounted close friendships between non-refugee and refugee children resulted in children having more positive attitudes towards refugees.  As well, history lessons focused on Black American’s contributions to society and their experiences of racism resulted in children having more positive attitudes towards Black people and increased their valuing of racial fairness. 

Conclusions: Two brief interventions had a positive impact on children’s attitudes towards people of colour. They offer a helpful starting point for ongoing efforts to create more equitable experiences for all children. 

File(s): 

Treating posttraumatic stress disorder in children

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2021
Abstract: 

Background: Posttraumatic stress disorder (PTSD) affects approximately 0.1% of children who have been exposed to serious adversities. We therefore set out to identify effective interventions for treating childhood PTSD.

Methods: We used systematic review methods to identify randomized controlled trials (RCTs) evaluating treatment interventions for children who had diagnosed with PTSD. After applying our rigorous inclusion criteria, we accepted five RCTs – evaluating three psychosocial interventions and one medication.

Results: Prolonged Exposure for Adolescents and KIDNET, both based on cognitive-behavioural therapy (CBT), showed significant benefits for children, including reduction of PTSD diagnoses, symptoms, and overall functioning compared to controls. In contrast, D-cycloserine failed to show benefit for children compared to controls. In a head-to-head trial, Eye Movement Desensitization and Reprocessing (EMDR) and CBT both reduced PTSD diagnoses and symptoms, with EMDR outperforming CBT in reducing diagnoses by parent-report at one-year follow-up.

Conclusions: Preventing childhood adversities is priority. But when a child develops PTSD, access to effective treatment is crucial. CBT was effective in reducing diagnoses and/or symptoms across four RCTs in our systematic review. 

File(s): 

Helping children cope with trauma

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2021
Abstract: 

Background: Experiencing adverse experiences during childhood can lead to the development of mental disorders. We therefore set out to identify that effectively help children who have experienced trauma.

Methods: We used systematic review methods to identify randomized controlled trials (RCTs) evaluating prevention interventions for children after serious adverse experiences. After applying our rigorous inclusion criteria, we accepted five RCTs – evaluating three psychosocial interventions delivered to children who had been maltreated, and one medication for children who had sustained physical injuries.

Results: It’s My Turn Now, Fostering Healthy Futures, and Multisystemic Therapy showed benefits for children who had a history of maltreatment, including reducing symptoms of mental disorders. In contrast, Propranolol failed to show benefit for children who had sustained injuries.

Conclusions: Preventing childhood adversities wherever possible is crucial and recognizes children’s rights to safety. Yet it is possible to prevent mental health symptoms from developing even after children have experienced serious adversity.

Helping young people with psychosis

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2020
Abstract: 

Background: Psychotic disorders are associated with a high degree of impairment making early intervention crucial for youth. We therefore set out to identify effective psychosis interventions for young people.

Methods: We used systematic review methods to identify randomized controlled trials (RCTs) evaluating treatment interventions. After applying our rigorous inclusion criteria, we accepted eight RCTs – evaluating five different medications and three psychosocial interventions.

Results: Aripiprazole and olanzapine showed benefits in two trials each, although both led to adverse events that require close monitoring. Cognitive Remediation Therapy, Computer-Assisted Cognitive Remediation and the Think Program showed secondary benefits of improved cognitive skills and reduced emergency room visits which can be helpful when used along with antipsychotic medications.

Conclusions: Antipsychotics should be used prudently, after careful assessment and diagnosis, and psychosocial interventions should be offered as well. Further research is needed on early interventions to help young people with psychosis.

Psychosis: Is prevention possible?

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2020
Abstract: 

Background: Controversy persists about whether or not it is possible to prevent psychotic disorders. We set out to identify if there were any effective interventions that prevent psychosis among youth.

Methods: We used systematic review methods to identify randomized controlled trials (RCTs) evaluating prevention interventions. After applying our rigorous inclusion criteria, we accepted three RCTs –  evaluating one supplement and two psychosocial interventions with youth found to be at high-risk for psychosis.

Results: Omega-3 polyunsaturated fatty acid (PUFA) supplements reduced psychosis diagnoses and symptoms use and improved overall functioning over six years follow-up. Two other interventions – Auditory Cognitive Training and Family-Focused Treatment – did not produce significant benefits post-intervention.

Conclusions: More studies are needed to replicate results for PUFAs. As well, additional research is needed to develop psychosocial interventions that may help high-risk youth. Given the high burdens and costs associated with psychosis, prevention remains an important goal for youth and families.

Mental health treatment: Reaching more kids

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2020
Abstract: 

Background: Nearly 70% of children who are in need of specialized mental health services do not access them. We set out to identify effective self-delivered interventions as a way to help bridge the gap between those in need and those being serviced.

Methods: We used systematic review methods to identify randomized control trials (RCTs) evaluating self-delivered treatments. After applying our rigorous inclusion criteria, we accepted five RCTs evaluating five treatment interventions.

Results: Three self-directed family interventions reduced anxiety diagnoses and symptoms for school age children. One self-directed parenting intervention reduced ADHD diagnoses for school age children. Additionally, one self-directed youth invention reduced depression symptoms for adolescents.

Conclusions: Strong research evidence supports the use of self-directed treatments to address three common childhood mental disorders. Greater use of these interventions can expand the number of children who are reached with effective treatments.

Prevention: Reaching more kids

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2020
Abstract: 

Background: Effective prevention programs are particularly crucial to reduce the number of children in need of mental health treatment services. Yet despite growing research evidence on effective programs, prevention efforts remain modest in many jurisdictions.  Given the high levels of unmet needs, reaching more children is a priority. One approach is to identify prevention options that are more self-directed and less reliant on direct provision by practitioners, such as online programming and self-help tools.

Methods: We used systematic review methods to identify randomized control trials (RCTs) evaluating self-directed prevention interventions. Applying our inclusion criteria, we accepted eight RCTs evaluating seven prevention interventions.

Results: The seven self-directed interventions prevented or reduce symptoms of the five most common childhood mental concerns — anxiety, ADHD, problematic substance use, behaviour problems and depression. These interventions assisted children and youth across a range of ages, from the preschool years to the teens.

Conclusions: Strong research evidence supports the use of self-directed prevention interventions as part of the continuum of care for the most common childhood mental health concerns. Including these types of interventions in overall service planning can enable providers to reach many more children, youth and families, in turn potentially lowering the need for treatment. Comprehensive children’s mental health plans should therefore include these kinds of prevention programs.

Building children’s resilience

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2008
Abstract: 

Background: Parenting has a profound impact on children’s well-being. Positive parent-child relationships can promote children’s brain development, academic functioning, social competence, mental health and self-esteem. Responsive caregiving also buffers children from the negative impacts of adversity and stress. Given this, we set out to identify interventions that can promote positive parenting.    

Methods: We used systematic review methods to identify randomized controlled trial (RCT) evaluations of parenting interventions for high-risk families. Applying our inclusion criteria, we accepted four RCTs.

Results: All four programs produced some beneficial outcomes. Familias Unidas reduced child behaviour problems and increased parent involvement. Family Check-Up similarly increased maternal involvement. Nurse Home Visitation improved children’s language development and executive functioning among particularly high-risk families. SAFEChildren improved parental involvement in children’s education as well as children’s reading skills.  

Conclusions: Programs that encourage warm and consistent parenting can improve the lives of children and families, especially among those facing significant adversities.  

Addressing bullying behaviour in children

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2008
Abstract: 

Background: When bullying occurs, children pay a significant price. Those who are bullied are at risk for impaired social developmental, mental and physical illnesses and school absenteeism. Children who bully others frequently suffer from high rates of mental disorder and from learning problems. To help avoid these detrimental outcomes, interventions that can prevent bullying are greatly needed.

Methods: We used systematic review methods to identify randomized controlled trial (RCT) evaluations of anti-bullying interventions. Applying our inclusion criteria, we accepted eight RCTs evaluating seven programs.

Results: Four programs were successful in reducing bullying: Brief Strategic Family Therapy, Integrative Family Therapy, Bullies and Dolls, and Steps to Respect. The first two programs were targeted to children who were engaging in bullying  and were delivered to families in clinics. In addition to reducing bullying, they also reduced children’s anger and engagement in risky behaviours. The latter two interventions were universal preventative interventions delivered within schools.

Conclusions: These results find that adults can intervene to help end bullying by ensuring that effective interventions are employed so children’s environments are free from the fear and intimidation that bullying creates. 

The economics of children’s mental health

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

Background: There is an increasing push towards policy-makers approving interventions for childhood mental disorders based on clinical effectiveness and cost considerations. To this end, high-quality economic evaluations of these interventions are starting to accumulate. Consequently, we set out to review the available data to help determine which prevention programs constitute the wisest use of limited public funds.

Methods: We used systematic review methods to identify randomized controlled trial (RCT) evaluations of mental disorder prevention programs that also had an economic evaluation. Applying our inclusion criteria, we accepted four RCTs.

Results: Coping With Stress resulted in significantly more depression-free days for participants with an average incremental cost-effectiveness ratio of id="mce_marker"0 per depression-free day.  Fast Track significantly lowered the incidence of conduct disorder but only among the high-risk children. However, the cost per averted case of conduct disorder was still more than $752,000 for this group of children. Nurse Home Visitation resulted in significantly fewer serious behavioural problems many years after the program ended, including fewer criminal convictions. It also resulted in a net saving among the highest risk families by reducing other service use. Finally, Perry Preschool similarly resulted in less criminal activity as well as higher educational achievement and employment earning years after the program ended. It also produced a net savings.

Conclusions: Prevention programs can not only avert needless suffering for children and families, they can also produce cost-savings for society.