Objective: Disease containment of COVID-19 has necessitated widespread social isolation. We aimed to establish what is known about how loneliness and disease containment measures impact on the mental health in children and adolescents. Method: For this rapid review, we searched MEDLINE, PsycInfo, and Web of Science for articles published between January 1, 1946, and March 29, 2020. Of the articles, 20% were double screened using predefined criteria, and 20% of data was double extracted for quality assurance. Results: A total of 83 articles (80 studies) met inclusion criteria. Of these, 63 studies reported on the impact of social isolation and loneliness on the mental health of previously healthy children and adolescents (n ¼ 51,576; mean age 15.3 years). In all, 61 studies were observational, 18 were longitudinal, and 43 were cross-sectional studies assessing self-reported loneliness in healthy children and adolescents. One of these studies was a retrospective investigation after a pandemic. Two studies evaluated interventions. Studies had a high risk of bias, although longitudinal studies were of better methodological quality. Social isolation and loneliness increased the risk of depression, and possibly anxiety at the time at which loneliness was measured and between 0.25 and 9 years later. Duration of loneliness was more strongly correlated with mental health symptoms than intensity of loneliness. Conclusion: Children and adolescents are probably more likely to experience high rates of depression and most likely anxiety during and after enforced isolation ends. This may increase as enforced isolation continues. Clinical services should offer preventive support and early intervention where possible and be prepared for an increase in mental health problems.

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Background: Teachers have a significant role to play in identifying children with mental health problems. However, teachersÕ perceptions of childrenÕs mental health problems are relatively unexplored. Method: Primary school teachers (N = 113) completed a questionnaire, composed of vignettes describing children with symptoms of a common emotional disorder and a common behavioural disorder, following which they were asked a number of questions regarding problem recognition and help-seeking. Results: Teachers were able to recognise the existence of a problem and rate its severity. They were significantly more concerned about a vignette of a child with symptoms of a behavioural disorder than an emotional disorder. The gender of the child was found to independently predict teachersÕ accurately recognising when a child had a problem. Conclusion: Teachers are good at recognising whether a child presents with a problem. However, their problem recognition is affected by both the gender of the child and the type of symptomatology being displayed (emotional versus behavioural). Key Practitioner Message:• Teachers were generally good at recognising the existence and severity of symptoms of problems (behavioural or emotional) presented by a child described in a vignette.• Teachers were significantly more concerned about a child with clinical-level symptoms of a behavioural disorder than a child with clinical-level symptoms of an emotional disorder.• Gender of the child portrayed also impacted upon teachersÕ accurate problem recognition.• It appears that teachers could benefit from further training to refine their ability to identify and act upon childrenÕs mental health problems in a timely manner, thus minimising the need for future intervention.

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Background Because of the global spread of coronavirus disease 2019 (COVID‐19), oncology departments across the world have rapidly adapted their cancer care protocols to balance the risk of delaying cancer treatments and the risk of COVID‐19 exposure. COVID‐19 and associated changes may have an impact on the psychosocial functioning of patients with cancer and survivors. This study was designed to determine the impact of the COVID‐19 pandemic on young people living with and beyond cancer. Methods In this cross‐sectional study, 177 individuals, aged 18 to 39 years, were surveyed about the impact of COVID‐19 on their cancer care and psychological well‐being. Participants also reported their information needs with respect to COVID‐19. Responses were summarized with a content analysis approach. Results This was the first study to examine the psychological functioning of young patients and survivors during the first weeks of the COVID‐19 pandemic. A third of the respondents reported increased levels of psychological distress, and as many as 60% reported feeling more anxious than they did before COVID‐19. More than half also wanted more information tailored to them as young patients with cancer. Conclusions The COVID‐19 pandemic is rapidly evolving and changing the landscape of cancer care. Young people living with cancer are a unique population and might be more vulnerable during this time in comparison with their healthy peers. There is a need to screen for psychological distress and attend to young people whose cancer care has been delayed. As the lockdown begins to ease, the guidelines about cancer care should be updated according to this population's needs.

Objectives. This paper aimed to explore client experiences of the therapeutic relationship among adolescents with good outcomes after receiving Cognitive Behaviour Therapy (CBT) for moderate to severe depression.Design. This was a qualitative study employing Interpretative Phenomenological Analysis (IPA).Methods. As part of a randomized clinical trial, 77 adolescents with moderate to severe depression were interviewed using a semi-structured interview, which was audiorecorded. Five of these interviews, with adolescents aged 14-18 years who completed CBT and had good outcomes, were purposively sampled and analysed using IPA.Results. The findings indicated that a positive therapeutic relationship was fostered with therapists who respected the adolescents' autonomy and sense of individuality, while offering experiences of emotional closeness and connection. This was achieved by balancing the dual roles of being 'friendly' and affable, with being a 'professional expert' thereby embodying a collaborative and egalitarian approach.Conclusions. The therapeutic relationship in CBT can help to motivate adolescents to engage with cognitively and emotionally challenging tasks. By providing an understanding of what helps and hinders the development of a positive therapeutic relationship, the current findings offer important insight into how therapists can foster positive relationships with depressed adolescents. This knowledge will make it more likely that adolescents will engage in the treatment process and in turn experience greater therapeutic gains.

Background The prevalence of chronic health conditions in childhood is increasing, and behavioral interventions can support the management of these conditions. Compared with face-to-face treatment, the use of digital interventions may be more cost-effective, appealing, and accessible, but there has been inadequate attention to their use with younger populations (children aged 5-12 years). Objective This systematic review aims to (1) identify effective digital interventions, (2) report the characteristics of promising interventions, and (3) describe the user’s experience of the digital intervention. Methods A total of 4 databases were searched (Excerpta Medica Database [EMBASE], PsycINFO, Medical Literature Analysis and Retrieval System Online [MEDLINE], and the Cochrane Library) between January 2014 and January 2019. The inclusion criteria for studies were as follows: (1) children aged between 5 and 12 years, (2) interventions for behavior change, (3) randomized controlled trials, (4) digital interventions, and (5) chronic health conditions. Two researchers independently double reviewed papers to assess eligibility, extract data, and assess quality. Results Searches run in the databases identified 2643 papers. We identified 17 eligible interventions. The most promising interventions (having a beneficial effect and low risk of bias) were 3 targeting overweight or obesity, using exergaming or social media, and 2 for anxiety, using web-based cognitive behavioral therapy (CBT). Characteristics of promising interventions included gaming features, therapist support, and parental involvement. Most were purely behavioral interventions (rather than CBT or third wave), typically using the behavior change techniques (BCTs) feedback and monitoring, shaping knowledge, repetition and substitution, and reward. Three papers included qualitative data on the user’s experience. We developed the following themes: parental involvement, connection with a health professional is important for engagement, technological affordances and barriers, and child-centered design. Conclusions Of the 17 eligible interventions, digital interventions for anxiety and overweight or obesity had the greatest promise. Using qualitative methods during digital intervention development and evaluation may lead to more meaningful, usable, feasible, and engaging interventions, especially for this underresearched younger population. The following characteristics could be considered when developing digital interventions for younger children: involvement of parents, gaming features, additional therapist support, behavioral (rather than cognitive) approaches, and particular BCTs (feedback and monitoring, shaping knowledge, repetition and substitution, and reward). This review suggests a model for improving the conceptualization and reporting of behavioral interventions involving children and parents.

Background: Cognitive behavioural therapy for low self-esteem (LSE) has shown promise as a trans-diagnostic model for treating mental health difficulties in adults. To ascertain the potential value of this treatment approach in working with young people with internalizing disorders, we need to develop our understanding of LSE within these mental health conditions. The aim of this review is to explore (a) the co-occurrence of clinically significant anxiety/depression and LSE in young people (aged 18 years and younger), and (b) the association between LSE in childhood and adolescence and mental health difficulties in later adolescence and emerging adulthood. Method: A systematic search of three electronic databases (PsychInfo/Pubmed/Google Scholar) was conducted to identify relevant studies. Results: Ten studies examining the association between LSE and clinically significant anxiety/depression in young people met the inclusion criteria, as did eight studies investigating the association between LSE in young people with internalizing difficulties in later adolescence/ emerging adulthood. Although relatively few studies were identified, studies consistently supported the cooccurrence of LSE and internalizing disorders in young people, particularly in young people with co-morbid anxiety and depression. LSE in childhood and adolescence appears to be a relatively weak predictor of the development of anxiety and depression in later adolescence and early adulthood. Conclusions: Further research investigating the relationship between low self-esteem and mental health difficulties in young people and its implications for treatment in this age group is indicated. Key Practitioner Message• There is a lack of literature exploring the relationship between clinically significant anxiety and depression in young people.• Evidence to date suggests that young people with clinical depression, particularly those with co-morbid anxiety disorders, report lower self-esteem compared to young people without internalizing disorders.• There is less evidence for the association between low self-esteem and the development of later internalizing symptomatology in later adolescence and young adulthood.• Further larger scale studies of young people with clinically significant anxiety and depression within child and adolescent mental health services are warranted.