There has been a substantial increase in the number of RCTs evaluating early interventions in ASD. However, few studies, only 12.5% of the total, were rated as being at low risk of bias. Small sample size, unclear concealment of allocation and lack of clarity in the identification of the active ingredients in a diverse range of differently named treatment models were identified as challenges to the design, conduct and interpretation of studies. Improved co-ordination and design of studies is, therefore, required if future research in the field is to more clearly investigate the effects of early intervention for ASD.

Objective: The COVID-19 pandemic brought unparalleled pressure, stress, and a dramatic change in practice to health care systems across the world. National Health Service (NHS) staff have reported higher levels of burnout, stress, and other mental health issues that they relate directly to the impact of the pandemic. Burnout is often used as a "catch-all" term for psychological distress in the workplace, and it has been suggested that, during the pandemic, experience of "burnout" may be influenced by "moral injury": the distress that can arise from actions, or lack of action, that are seen to violate one's ethical code. This study investigates NHS staff experiences of burnout and betrayal-based moral injury, in which a trusted authority betrays "what is right." Method: Sixteen NHS staff members were interviewed in relation to their experiences during the COVID-19 pandemic, and data were thematically analyzed. Results: Three themes were identified: abandonment as betrayal; dishonesty and lack of accountability; and fractured relationship to management or the NHS. Conclusions: This analysis concludes that self-identified "burnout" in NHS staff may include a significant moral component, and that failure to engage in moral repair following betrayal-based moral injury may relate to a long-term loss of trust or fractured relationship with the organization. In addition to traditional trauma-informed psychological support, leadership at all levels should be trained to be aware of betrayal-based moral injury and to engage in moral repair to reduce staff intent to leave and encourage mutual trust. Clinical Impact StatementThis study suggests that self-identified "burnout" in NHS staff during COVID-19 may include a significant moral component, and staff may have experiences of "betrayal-based moral injury." Failure of leadership to engage in moral repair following betrayal-based moral injury may relate to a longterm loss of trust or fractured relationship with the organization.

Introduction Psychodynamic psychotherapy with children and adolescents is an approach to working with young people that draws on psychoanalytic ideas, whilst also integrating ideas from other disciplines, including developmental psychology, attachment theory and neuroscience (Alvarez, 2012; Kegerreis & Midgley, 2014; Lanyardo & Horne, 2009). Although the term 'psychodynamic therapy' covers a range of approaches, most of them share what Kegerreis & Midgley (2014) refer to as "the central idea ... that behaviour, emotions and responses have an inherent logic and meaning-a way in which the child's problems, despite their apparent unhelpfulness, make some kind of emotional sense. Their roots lie in the internal world of the child that has been built up from his earliest experiences and relationships" (p.38) i. In 2011, we published a critical review of the evidence base for psychodynamic therapy with children and adolescents (Midgley & Kennedy, 2011). In that paper, we identified 34 studies, published before March 2011, which formally evaluated therapy outcomes for children aged 3-18. Of these studies, nine were randomised controlled trials (RCTs), three had a quasiexperimental design, eight were controlled observation studies and fourteen were observational studies without a control group. Psychodynamic therapy

Further research is required to test the psychometric properties of measures so that robust quality measures can be used across different settings/client groups.

Personalised interventions for subgroups of children with conduct problems (Review)