Aims:Digital living is now an integral part of many children and young people’s (CYP) everyday experience. Practitioners who work with them are increasingly focused on effectively deploying technology to help those with social, emotional and mental health (SEMH) needs. Throughout all aspects and phases of work, practitioners must adhere to legal and professional best practice standards in involving service users, person-centred working and in enhancing accessibility for all.Methods:Measures introduced to reduce the spread of Covid-19 triggered significant service delivery change in a specialist multi-disciplinary child and adolescent mental health service (CAMHS) team. The majority of assessment and intervention work moved to an online audio and web conferencing platform. A shared decision-making approach was developed to support service user understanding of online appointments and to giving informed consent, in line with the i-THRIVE Framework for system change (Wolpert et al., 2019). Three Guides were developed and distributed ahead of online appointments: written, easy-read and video.Findings:Data collected within a Quality Improvement (QI) framework indicated that the Guides supported practitioners to prepare service users, as well as themselves, for digital working. The Guides supported service access, collaborative decision-making and increased CYP autonomy. Their introduction also led to conversations about equity and cultural responsiveness, as well as serving as a model for the development of aids to support shared decision-making for autism diagnostic assessments.Limitations:This paper outlines the first phase of the QI project with a small participant sample and requires further engagement with service users to review the use of Guides and shared decision-making decision aids.Conclusions:Digital approaches present new possibilities and are rapidly changing service delivery across CAMHS. The importance of involving service users in shared decision-making when developing digital practices must be held in mind as part of this change process.
Background: Cognitive analytic therapy (CAT) has diversified in its application to a broad range of presenting difficulties and formats and there has been growing interest in its use in clinical health settings including Pain Management Services. Despite its growing popularity, to date, no studies have examined the application of CAT for chronic pain. Aims: The purpose of this study was to examine the effectiveness of time-limited, individual CAT for adults with chronic pain as delivered in a publicly funded Community Pain Management Service. Methods: This was an observational service evaluation of treatment practice within a routine clinical setting. Participants were 53 adults with chronic pain who completed eight sessions of individual therapy. Individual and group-level outcomes on self-reported distress, pain-related self-efficacy, as well as changes in healthcare utilisation pre- and post-intervention were examined. Results: Large pre–post effects on wellbeing ( d = 1.50) and self-efficacy ( d = 1.13) were observed, while effects on healthcare utilisation were medium to large ( d = 0.67). Moreover, reliable change and clinical significance analyses demonstrated that results were clinically meaningful. The majority of clients (67.9%) showed reliable improvement following the CAT intervention and 28% achieved both reliable and clinically significant improvements in psychological distress. Approximately 4 of 10 clients (43.5%) showed reliably higher perceived self-efficacy at the end of therapy. Conclusion: The results of this evaluation suggest that brief CAT is an encouraging intervention for adults with persistent pain. While preliminary, our findings provide support for a brief approach to persistent pain that focuses not on controlling or eliminating pain but on elucidating and revising unhelpful relational patterns that may impinge upon one’s pain management. Directions for future research are suggested.
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.