Background Increasing specialisation and technical sophistication of medical tools across the 21st century have contributed to dramatic improvements in the life‐expectancy of children and adolescents with complex physical health problems. Concurrently, there is growing appreciation within the community of the extent that children and adolescents experience mental disorders, which are more prevalent in those with complex chronic, serious or life‐limiting health conditions. In this context, there are compelling reasons for paediatric services to move to a model of care that promotes greater integration of child psychiatry within the medical, somatic teams that care for children and adolescents in children’s hospitals. Aims In this article, we discuss the range of medical disorders managed by contemporary paediatrics. Materials and Methods We conducted a broad review of the literature and existing services, and use individual accounts to illustrate adolescents’ healthcare preferences in the context of the challenges they experience around their mental health. Results Relevant disorders include life‐limiting disorders, such as cancer; disorders involving the brain, such as epilepsy; common chronic disorders, such as asthma and diabetes; psychiatric emergencies, such as deliberate self‐harm; and conditions that most commonly present to paediatric services, but where psychiatric input is required, such as severe eating disorders, somatic symptom disorders and gender dysphoria. The persisting legacy of the historical separation of physical and mental health services is described. Yet there are many models of service integration that can promote more collaborative care between psychiatrists and medical specialists, including some which have been taken to scale. Discussion In essence, clinical teams in children’s hospitals require more collaborative approaches that facilitate early recognition and treatment of the psychological aspects of illness as an integral part of patient‐centred, family‐focussed paediatric care, rather than as something that is bolted on when things go wrong. Conclusion Whilst trust and goodwill between services and providers will be required for novel models of care to be implemented, evaluation of these new models and incorporation of young people’s healthcare preferences is needed.
No abstract
effectiveness through almost 25 years of treatment development and testing in randomised controlled trials. Improved access to Psychological Therapies (IAPT) is the only logical consequence of putting decades of research work into clinical practice and making it available for the wider population.Gillian Butler, Melanie Fennell and Ann Hackmann, all of whom have played a leading part in this revolution, have summarised their insights in a great book.This book is diagnosis driven, the CBT treatment models vary for each disorder, and it is essential to know the models to conduct therapy successfully. The authors though take a transdiagnostic approach to help deal with complex cases. The advanced CBT practitioner will find a wealth of practical ideas on how to progress when one gets stuck. Every step is backed up with easy-to-grasp diagrams and algorithms. Formulation of the case represents the 'map' for the 'journey' that the therapist takes with the patient through CBT to reach the 'destination', the goals of therapy. The authors suggest a generic way of using the formulation as an important step to deal with complexities. The 'surgical blade of the mental health practitioner', the appropriate concise questions targeting a particular symptom or leading guided discovery are outlined verbatim. We are being reminded that CBT, like mindfulnessbased therapeutic approaches, promotes not only a more balanced and fair content of our thinking, but also a distanced, more objective relationship with our thinking process as a whole.The book puts emphasis on overcoming common obstacles in CBT: the chapter about low self-esteem and the intolerability of uncertainty are highly useful for our understanding of factors indirectly related to anxiety. The chapter about emotional avoidance, a common and ill-understood phenomenon, is invaluable. In CBT the therapeutic relationship is generally not valued as highly as in other psychological therapies: here, the authors dedicate a whole chapter to exploring the opportunities and difficulties arising between therapist and patient.I feel that there would have been an opportunity to dedicate a chapter to the intricate psychopathology and physiology of anxiety. I also would have liked to read more about the fascinating aspects of evolutionary psychology on anxiety disorders. Both can be useful to normalise anxiety experiences to patients and validate their symptoms.
No abstract
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.