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The way professionals conceptualise CD likely impacts the identity of children given the diagnosis, yet how psychiatrists conceptualise CD, and experience making the diagnosis, is under-researched. Interpretative Phenomenological Analysis explored how psychiatrists conceptualise CD and experience making the diagnosis. Semi-structured interviews captured participants’ lived experiences and associated meanings. Four superordinate themes emerged: ‘Parents and professionals are overwhelmed by their struggles with CD’; ‘What is CD? Uncertainty regarding the cause, but clarity that it is a severe problem’; ‘CD as a controversial construct’; and ‘Whose issue is it anyway? Battles with blame and responsibility’. The emerging problem-saturated narrative is discussed. Clinical implications include increased training, reflective practice and using a formulation-based approach.

Although preliminary, differences between the factors suggests that there may be perceptions of wellness specific to these groups that are distinct from the medical view of wellness promoted within early detection services. These differences may potentially impact upon engagement, particularly factors that clients feel may facilitate or aide their recovery. It is suggested that these differences need to be considered as part of the assessment and formulation process.

Children and adolescents in the UK spend increasingly more time in the digital world, raising societal fears about digital risks in this age group. Professionals are not always aware of the ever-developing research or guidance available around digital safety. This gap underscores the need to understand current experiences and determinants of digital risk assessment, including clinicians’ views on barriers and facilitators. A mixed-method design was used. Fifty-three clinicians working in child and adolescent mental health services (CAMHS) in South England took part in a survey; of these 12 took part in semi-structured interviews. A psychological model of behavioural change (COM-B: capabilities, opportunities, motivation and behaviour) guided the analyses. Survey data revealed that clinicians showed awareness and concerns for several digital risk issues but there appeared to be gaps in their knowledge and practice. Interview data revealed different factors influencing staff enquiry about digital risks in CAMHS. These included aspects of capabilities (knowledge and skills), opportunities (resources, organisational context and empowerment of youth), and motivations (habit change, emotional experiences, and professional identity/role). Targeting both staff-level and organisation-level barriers to digital risk assessments in CAMHS is crucial. This study informs service improvement to ensure that children and young people safely navigate the digital world.