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Attuned Practice: a service user study of specialist child and adolescent mental health, UK

Published online by Cambridge University Press:  11 October 2011

Summary

Aims – Best practice emphasises user involvement. This exploratory study addresses the views of teenage clients and their parents on service delivery in a specialist Child and Adolescent Mental Health Service (CAMHS) serving a population of 250,000. It aims to explore some of the complexities inherent in children's services when parents are integral to modes of treatment. Methods — Twenty-seven teenage clients from specialist CAMHS were recruited with their parents (n=30). All were white British, 11 boys and 16 girls, from a range of socioeconomic backgrounds. Focus groups were employed using a series of structured interactive technique to elicit information, preceded by home visits. Analysis of interview data followed standard approaches to qualitative data analysis. Descriptive statistics were generated from both home interview data and focus groups. Results – Three themes emerged: the core values implicated in establishing a therapeutic alliance; the style of therapy and mode of practice (i.e. its inclusiveness of different family members). Practice implications – Core therapeutic skills are of fundamental importance. Our paper supplements a model of organisational user involvement with a model of therapeutic user involvement for use in negotiating mode of practice. Conclusions – This exploratory study was a collaboration between service users, researchers and health professionals exploring three important themes of therapy and the complexities inherent in children's services. The process of eliciting views was therapeutic in itself leading to the formation of a parent-led self-help group. The design can be replicated in other specialist CAMHS to achieve attuned practice.

Declaration of Interest: none.

Type
Inclusion and Mental Health in the New Europe
Copyright
Copyright © Cambridge University Press 2005

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References

Anderson, H. & Goolishian, H. (1988). Human sytems as linguistic systems: preliminary and evolving ideas about the implications for clincial theory. Family Process 27, 371393.CrossRefGoogle Scholar
Archer, C. & Burnell, A. (Eds.) (2003). Trauma, Attachment and Family Permanence: Fear Can Slop You Loving. Jessica Kingley Publishers: London and New York.Google Scholar
Arnstein, S. (1969). A ladder of citizen participation. Journal of the American Institute of Planners 35. 216224.Google Scholar
Boote, J.. Telford, R. & Cooper, C. (2002). Literature review: consumer involvement in health research: a review and research agenda. Health Policy 61, 213236.CrossRefGoogle ScholarPubMed
Byas, A.H.D.Meech, C.Read, L.. Stacey, K.. Thompson, E.. & Wood, A. (2002). Co-researching consumer experiences of child and adolescent mental health services: reflections and implications. Families, Systems and Health 20(1). 7589.Google Scholar
Cameron, G. (2002). Motivation to join and benefits from participation in Parent Mutual Aid Organizations. Child Welfare 81(1), 3357.Google Scholar
Charles, C. & De Maio, S. (1993). Lay participation in health care decision making: a conceptual framework. Journal of Health Politics Policy and Law 18(4). 881904.Google Scholar
Chorpita, B.F.. Yim, L.M., Donkervoet, J.C., Arensdort, A., Amundsen, M.J., Yates, A.. Burns, J. A. & Morelli, P. (2002). Towards large-scale implementation of empirically supported treatments for children: a review and observations by the Hawaii Empirical Basis to Services Task Force. Clinical Psychology: Science and Practice 9(2), 165190.Google Scholar
Clark, A.M. & Moss, P. (2001). Listening to Young Children: The Mosaic Approach. National Children's Bureau: London.Google Scholar
Cornwall, A. & Jewkes, R. (1995). What is participatory research? Social Science and Medicine 41(12), 16671676.Google Scholar
Daniels, D. & Jenkins, P. (2000). Therapy with Children: Children's Rights, Confidentiality and the Law. Sage: London.Google Scholar
Department for Education and Skills (2003). Every Child Matters (Green Paper). Stationery Office: London.Google Scholar
Department for Education and Skills and Department of Health (2004). National Sen'ice Framework for Children, Young People and Maternity Sen'ices. London.Google Scholar
Department of Health (2001). Building the Information Core: Implementing the NHS Plan. Department of Health: London.Google Scholar
Department of Health (2003). Strengthening Accountability: Involving Patients and the Public. Policy and Practice Guidance, Section 11 of the Health and Social Care Act, 2001. Department of Health Publications: London.Google Scholar
Dozier, M. (2003). Attachment based treatment for vulnerable children. Attachment and Human Developmen 5(3), 253257.CrossRefGoogle ScholarPubMed
Dozier, M., Higley, E.. Bernier, A.. Albus, K.E. & Nutter, A. (2002). Partners in Relationships: an Invention Targeting the Relationship between Foster Parent and Child. [Training programme]. University of Delaware: Delaware.Google Scholar
Farnfield, S. & Kaszap, M. (1998). What makes a helpful grown up? Children's views of professionals in the mental health services. Health Informatics Journal 4, 314.Google Scholar
Fonagy, P., Target, M., Cottrell, D., Phillips, J. & Kurtz, Z. (2001). What Works for Whom? A Critical Review of Treatments for Children and Adolescents. Guildford Press: New York.Google Scholar
Foote, R., Eyberg, S. & Schuhmann, E. (1998). Parent-child interaction approaches to the treatment of child behavior problems. Advances in Clinical Child Psychology 20, 125151.CrossRefGoogle Scholar
Ford, S., Schofield, T. & Hope, T. (2003). What are the ingredients for a successful evidence-based patient choice consultation? A qualitative study. Social Science & Medicine 56(3). 589602.CrossRefGoogle ScholarPubMed
Great Ormond Street Hospital (2003). Children and Carers of Children: Copies of Letters About Children. Areas of Consensus and Potential Conflict between Professionals, Parents and Children. Great Ormond Street Hospital: London.Google Scholar
Gross, V. (1995). A child-aware approach in systems practice. Human systems: Journal of Systemic Consultation and Management 6. 189200.Google Scholar
Hart, A. & Luckock, B. (2004). Developing Adoption Support and Therapy: New Approaches for Practice. Jessica Kingsley: London.Google Scholar
Hart, A. & Thomas, H. (2000). Controversial attachments: the indirect treatment of fostered and adopted children via parent co-therapy. Attachment & Human Development 2(3), 306327.Google Scholar
Hart, A.. Henwood, F. & Wyatt, S. (2004a). The role of the Internet in patient-practitioner relationships: Findings from a qualititative reserach study. Journal of Medical Internet Research 6(3), e36.CrossRefGoogle Scholar
Hart, A.. Saunders, A.. Booth, M.. Thomas, H.. Riodan, J., Batchelor, J. & Gillingham, T. (2004b) Child and Adolescent Mental Health Sen-ices in Brighton & Hove: What Do Young People and Their Parents/Carers Think about Them? Centre for Nursing and Midwifery Research, University of Brighton/South Downs Health NHS Trust: Brighton & Hove.Google Scholar
Henwood, F., Wyatt, S.. Han, A. & Smith, J. (2003). “Ignorance is bliss sometimes”. Constraints on the emergence of the informed patient. Sociology of Health and Illness 25(6), 589607.Google Scholar
Hughes, D.A. (1997). Facilitating Developmental Attachment: the Road to Emotional Recovery and Behavioral Change in Foster and Adopted Children. Jason Aronson: Northvale, New Jersey & London.Google Scholar
Hunter, M. (2001). Psychotherapy with Young People in Care: Lost and Found. Routledge: London.Google Scholar
Kenrick, J. (2000). “Be a kid”: the traumatic impact of repeated separations on children we are fostered and adopted. Journal of Child Psychotherapy 26(3), 393412.Google Scholar
Laugharne, R. (1999). Evidence-based medicine, user involvement and the post-modern paradigm. Psychiatric Bulletin 23, 614643.Google Scholar
Laws, S. (1998). Consulting children and young people on what they want from mental health services. Mental Health Care 2(2), 6366.Google Scholar
Lobatto, W. (2002). Talking to children about family therapy: a qualitative research study. Journal of Family Therapy 24, 330343.Google Scholar
Loff, C.D., Trigg, L.J. & Cassels, C. (1987). An evaluation of consumer satisfaction in a child psychiatric service: viewpoints of patients and parents. American Orthopsvchiatric Association 57(1), 132134.Google Scholar
Milne, D.L. (1999). Social Therapy: a Guide to Social Support Interventions for Mental Health Practitioners. Wiley: Chichester.Google Scholar
Nuttall, E.V., Nuttall, R.L., Polit, D. & Clark, K. (1977). Assessing adolescent mental health needs: The views of consumers, providers, and others. Adolescence 12(46), 277285.Google Scholar
Pleace, N., Burrows, R., Loader, B., Muncer, S. & Nettleton, S. (2003). From self-service welfare to virtual self-help. In Information and Communication Technologies in the Welfare Sen'ices (ed. Harlow, E. and Webb, S.A.). Jessica Kingsley: London/Philadelphia.Google Scholar
Pugh, R.L., Ackerman, B.J., McColgan, E.B., de Mesquita, P., Worley, P. & Goodman, N. (1994). Attitudes of adolescents toward adolescent psychiatric treatment. Journal of Child and Family Studies 3(4), 351363.CrossRefGoogle Scholar
Ramon, S. (Ed.) (2003). Users Researching Health and Social Care: An Empowering Agenda? Venture Press: Birmingham.Google Scholar
Rivett, M. & Street, E. (2003). Family Therapy in Focus. Sage Publications: London.Google Scholar
Rogers, C.R. (1951). Client-centred Therapy: Its Current Practice, Implications and Therapy. Constable: London.Google Scholar
Roose, G.J.A. (2003). A focus group investigation into young children's understanding of mental health and their views on appropriate services for their age group. In Child Care, Health & Development, Vol. 29, pp. 545550. BlackwelI Publishing: London.Google Scholar
Rushdie, S. (1999) In Guardian. Rustin, M.Q.E (Ed.) (2004). Assessment in Child Psychotherapy. Karnak: London.Google Scholar
Tsiantis, J. (2000). Work with Parents: Psychoanalytic Psychotherapy with Children and Adolescents. Karnac: London.Google Scholar
Wahl, O. (2002). Children's views of mental illness: a review of the literature. Psychiatric Rehabilitation Skills 6(2), 134158.Google Scholar
White, S. & Stancombe, J. (2003). Clinical Judgement in the Health and Welfare Professions. Open University Press: Maidenhead.Google Scholar
Wilson, J. (1998) Child-Focused Practice: a Collaborative Systemic Approach. Karnac: London.Google Scholar