Children's Mental Health Research Quarterly

Receive updates for this collection

Kinship foster care

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2014
Abstract: 

Background: Kinship care occurs when a relative other than a parent provides care for a child. It can be formal, such as when a child protection agency funds the placement, or informal, such as when parents arrange for an individual to care for their child without involvement of the child protection system. Regardless of the type of kinship care, there is a need to determine how it affects children’s outcomes.

Methods: We used systematic review methods to identify studies evaluating kinship care. Applying our inclusion criteria, we accepted one systematic review which included 102 quas-experimental studies. We also identified two quasi-experimental studies published since the systematic review that met inclusion criteria.

Results: Kinship care was associated with greater stability for children, including fewer out-of-home placements, a reduced number of placements, and greater odds of having a relative assume legal custody than typical foster care placements. Kinship care was also associated with mental health benefits for children, including better emotional well-being and improved adaptive behaviours as well as a reduction in behavioural problems and mental disorders.

Conclusions: Kinship care has many potential benefits for children when their parents are unable to care for them. Relatives willing to provide kinship care need to be provided with adequate resources to ensure they can provide the best care possible.

Enhancing mental health in schools

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2014
Abstract: 

Background: Because children spend more than a third of their waking hours in school, these institutions have tremendous potential to influence young people’s lives. In addition to academics, schools are increasingly focused on trying to enhance students’ emotional and behavioural health. We set out to determine if programs designed to improve school social environments have an impact on students’ well-being.

Methods: We used systematic review methods to identify randomized control trials (RCTs) evaluating interventions designed to improve school social environments and that measured student’s well-being as an outcome. Applying our inclusion criteria, we accepted three RCTs.

Results: The three programs — Beyondblue, Gatehouse Project and Teacher Mentoring — all produced modest results. Beyondblue led to a more positive school climate by teacher reports but not student reports. Gatehouse Project reduced cigarette smoking but only for students who had a positive connection to their schools. As well, Gatehouse Project students who did not smoke cigarettes were significantly less likely to use cannabis weekly or more. Finally, Teacher Mentoring increased grade point average.

Conclusions: Given the modest gains achieved by these programs, their widespread implementation does not appear to be justified, especially given the resources and staffing they require. Rather, schools focused on improving students’ mental health may be better served by investing in classroom-based interventions with proven efficacy in preventing mental disorders rather than  interventions that aim to change the school environment.

Parenting without physical punishment

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2015
Abstract: 

Background: Most parents use effective disciplinary strategies, such as modelling positive behaviours and setting age-appropriate expectations. Still, some parents resort to using physical punishment despite it being linked to problematic outcomes, such as injuries and emotional problems for children.

Methods: We used systematic review methods to identify randomized control trials (RCTs) evaluating parenting interventions with outcomes that included parents’ use of physical punishment and children’s wellbeing. Applying our inclusion criteria to the 48 studies identified from our searches, we accepted five RCTs evaluating three parenting programs.

Results: Our review found Chicago Parent Program and Incredible Years  reduced physical punishment and other problematic forms of discipline and also enhanced positive parenting. As well, both programs resulted in improved mental health outcomes for children, including reductions in behaviour problems.

Conclusions: This review finds that parents can be taught effective alternatives to physically punishing children. Investments in effective parenting programs can have produce long term benefits including advancing children’s wellbeing and safety.

Promoting healthy eating + preventing eating disorders in children

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2015
Abstract: 

Background: Most young people feel satisfied with their body size and shape and most do not engage in potentially problematic weight loss behaviours. However, for young people who exhibit early signs of eating or body image concerns, intervening early can help reduce symptoms of eating disorders.   

Methods: We used systematic review methods to identify randomized control trials (RCTs) evaluating interventions for preventing eating disorders in children and youth. Applying our inclusion criteria to the 38 studies identified from our searches, we accepted six RCTs.

Results: Our review found a universally-delivered Education Program to Italian girls in high school prevented new cases of bulimia nervosa. Two programs targeted to girls with body image concerns — Healthy Weight and Dissonance — reduced eating disorder symptoms. Finally, a program targeted to overweight teens — Student Bodies — reduced binge eating episodes and improved skills for managing eating and physical activity.

Conclusions: These findings suggest that eating disorders can be prevented, particularly if risks are addressed early in the lifespan. Consequently, eating disorder prevention programs should be part of the mental health program continuum for young people.

Intervening for young people with eating disorders

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2015
Abstract: 

Background: Although eating disorders are quite rare, they are associated with high levels of distress and impairment as well as early mortality making effective treatments imperative. 

Methods: We used systematic review methods to identify randomized control trials (RCTs) evaluating interventions for children and youth with eating disorders. Applying our inclusion criteria to the 32 studies identified from our searches, we accepted eight RCTs.

Results: Our review identified effective treatments for the three most common eating disorders. Family Therapy was particularly effective for youth with anorexia nervosa. Cognitive-Behavioural Therapy significantly reduced bingeing among youth with bulimia nervosa as well as youth with binge-eating disorder. In contrast, there was no evidence to support using antipsychotics to treat the core symptoms of anorexia nervosa.

Conclusions: There are effective psychosocial treatments that can greatly help young people with eating disorders. Practitioners and policy-makers need to ensure that all youth who need these treatments have ready access to them.

Promoting positive behaviour in children

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2015
Abstract: 

Background: For some children challenging behaviours, including defiance and aggression, start to impede their development and well-being. We set out to determine whether early interventions could assist these young people.

Methods: We used systematic review methods to identify randomized control trials (RCTs) evaluating interventions for preventing child behaviour disorders, including oppositional defiant disorder and conduct disorder. Applying our inclusion criteria to the 166 studies identified from our searches, we accepted 13 RCTs.

Results: We found five programs — Chicago Parent Program, Fast Track, Incredible Years, Nurse-Family Partnership, and Parent Management Training — that had positive behavioural outcomes. All either focused primarily on parenting or included parents to a substantial degree. Additionally, Fast Track and Nurse-Family Partnership were also shown to be cost-effective.

Conclusions: It is possible to avert behavioural problems early in a child’s development before they become entrenched. Doing so comes with substantial long-term benefits to children, families and society.

Helping children with behaviour problems

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2016
Abstract: 

Background: An estimated 2.4% of children experience oppositional defiant disorder (ODD), which is characterized by argumentative behaviours and frequent losses of temper. Conduct disorder (CD), which includes aggression and other serious rule violations, affects approximately 2.1% of young people. Effective interventions can substantially improve the wellbeing of these young people.

Methods: We used systematic review methods to identify randomized control trials (RCTs) evaluating interventions for children with behavioural disorders. Applying our inclusion criteria to the 82 studies identified from our searches, we accepted eight RCTs.

Results: We identified one parenting program — Incredible Years — that reduced ODD diagnoses. We also found two programs child and family programs that were effective. Project Support reduced CD/ODD diagnosis while Multidimensional Treatment Foster Care reduced symptoms of delinquency. While the medication quetiapine reduced behaviour problems, it was associated with significant side effects.

Conclusions: Given the effectiveness of psychosocial interventions in addressing clinically significant behaviour problems, they should always be offered to families first. Interventions need to include parents and teach effective parenting techniques, such as paying attention to good behaviour as well as using praise and rewards. Medication should be used as a last resort for children with behavioural disorders.

Preventing anxiety for children

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2016
Abstract: 

Background: Anxiety disorders area the most common mental health concern that young people experience. Because of the frequency of these disorders and the considerable distress they cause, effective prevention efforts are greatly needed.

Methods: We used systematic review methods to identify randomized control trials (RCTs) evaluating interventions for preventing anxiety disorders in children and youth. Applying our inclusion criteria to the 57 studies identified from our searches, we accepted five RCTs.

Results: Our review found two Cognitive-Behavioural Therapy (CBT) based interventions that successfully prevented anxiety disorders: Coping and Promoting Strength and Dutch Anxiety Prevention. These findings add to the well-established body of evidence showing the effectiveness of CBT in preventing childhood anxiety disorders.

Conclusions: CBT should be the first choice for preventing childhood anxiety. By expanding prevention efforts, more young people can be reached before anxiety disorder develop and well before these disorders become needlessly entrenched.

Helping childhood with anxiety

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2016
Abstract: 

Background: Approximately 3% of children meet diagnostic criteria for an anxiety disorder. There are effective interventions to help these young people.

Methods: We used systematic review methods to identify randomized control trials (RCTs) evaluating interventions for children and youth with anxiety disorders. Applying our inclusion criteria to the 95 studies identified from our searches, we accepted nine RCTs.

Results: Our review found a strong body of evidence indicating that Cognitive-Behavioural Therapy (CBT) is effective in treating childhood anxiety disorders. We identified eight CBT programs that reduced child anxiety diagnosis or disorder severity including: Cool Kids, Coping Cat, Friends, One-Session Treatment, Parent Education Program, Skills for Academic and Social Success, Strongest Families and Timid to Tiger.  We also found two medications – venlafaxine and sertraline – that reduced diagnosis; both, however, produced significant side effects.

Conclusions: CBT should be the first choice for treating childhood anxiety. CBT has proven evidence of success in treating all types of anxiety disorders among children as young as three. Medications should only be considered when children have not benefitted from CBT. When medications are used, they require ongoing monitoring.

Promoting self-regulation and preventing ADHD symptoms

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2016
Abstract: 

Background: Some children experience challenges with self-regulation and begin to display symptoms of attention-deficit/hyperactivity disorder (ADHD). We set out to determine whether early interventions could assist these young people.

Methods: We used systematic review methods to identify randomized control trials (RCTs) evaluating interventions for preventing ADHD symptoms. Applying our inclusion criteria to the 90 studies identified from our searches, we accepted nine RCTs.

Results: We found four programs — Legacy for Children, Incredible Years, Incredible Years + Child Literacy Program, and SAFE Children — that prevented one or more symptoms of ADHD. All focused on parents of young, at-risk children, teaching them skills to promote positive child development. 

Conclusions: It is possible to prevent ADHD symptoms and promote children’s self-regulation skills. Effective programs should be offer during the preschool and early school years to help avert symptoms from they become entrenched.