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Background: Mindfulness-Based Cognitive Therapy (MBCT) has been shown to be effective in preventing relapse of depression in adults, but has not previously been applied to adolescents who have residual symptoms of depression following treatment. Method: An 8-week MBCT group was adapted for adolescents, and evaluated using qualitative and quantitative measures. Results: Participants report high levels of satisfaction with the group intervention. Qualitative analysis of semi-structured interviews provides areas for future development of this intervention. Pilot data indicate reductions in depressive symptoms, alongside positive change in mindfulness skills, quality of life and rumination. Conclusions: Preliminary evidence for the use of MBCT with this group of adolescents is provided. Key Practitioner Message• It is known that the course of depression from childhood is characterized by relapse and continuity into adulthood.• There is a need to develop interventions that ameliorate the course of this disorder. • Mindfulness-based approaches have good evidence in adults in reducing symptoms of depression and in relapse reduction. They have also been seen to be acceptable to children and adolescents, though not yet with a clinically referred group of adolescents with symptoms of depression.• A group programme of MBCT for adolescents with symptoms of low mood is presented here. • This research demonstrates the feasibility of this approach.

The development of treatments based on cognitive models of worry has led to improved outcomes for adults with Generalized Anxiety Disorder (GAD), and holds out the promise that similar improvements may be achieved for GAD further down the age range. The aim of the current study was to evaluate the effect of a GADspecific, cognitive treatment in a sample of children and adolescents with GAD. Sixteen youth (7-17 years of age) who were consecutive referrals to a specialty anxiety disorders clinic, with a primary diagnosis of DSM-IV GAD, and who were not undergoing concurrent pharmacological treatment for anxiety were provided 5 to 15 session (mean = 9.7) of cognitive therapy aimed at their tolerance for uncertainty, beliefs about worry, negative problem orientation, and cognitive avoidance strategies. All participants who entered the study completed treatment and 13 (81%) lost their GAD diagnosis (not blindly assessed); two were improved but still had GAD and one experienced no improvement at all. Age, gender and number of sessions received were unrelated to diagnostic outcome but age was positively correlated (r = 0.6, P \ .01) with pre-to-post reductions in worry frequency. The uncontrolled effect size for self-reported worry was 2.0 and for anxiety was 1.4. Further controlled evaluations of this cognitive treatment for GAD in children and adolescents are warranted.

Background:Outcomes for older people with cancer are poorer in the United Kingdom compared with that in other countries. Despite this, the UK oncology curricula do not have dedicated geriatric oncology learning objectives. This cross-sectional study of UK medical oncology trainees investigates the training, confidence level and attitudes towards treating older people with cancer.Methods:A web-based survey link was sent to the delegates of a national medical oncology trainee meeting. Responses were collected in October 2011.Results:The response rate was 93% (64 out of 69). The mean age of the respondents was 32.3 years (range 27–42 years) and 64.1% were female. A total of 66.1% of the respondents reported never receiving training on the particular needs of older people with cancer, 19.4% reported to have received this training only once. Only 27.1% of the trainees were confident in assessing risk to make treatment recommendations for older patients compared with 81.4% being confident to treat younger patients. Even fewer were confident with older patients with dementia (10.2%).Conclusion:This first study of the UK medical oncology trainees highlights the urgent need for change in curricula to address the complex needs of older people with cancer.

Cognitive behavioral therapy (CBT) designed to target generalized anxiety disorder (GAD) in youth was examined in a pilot feasibility trial. Participants (aged 10-18 years) were randomized to either 10 weeks of individual CBT (n = 20) or supported wait-list (n = 20). Diagnostic status (primary outcome) was assessed blindly at post-treatment for both groups, and at a 3-month follow-up for treated participants. Two participants failed to complete CBT and retained their GAD during the trial. Intention-to-treat analyses revealed large between-group differences in favor of CBT at post-treatment for remission from GAD (80% vs 0%) and comorbid disorders (83% vs 0%), and for all secondary outcomes (child and parent-reported). All gains were maintained at 3-month follow-up in the CBT group. Consistent with the treatment model, significant pre-to post-treatment reductions in several cognitive processes were found for CBT but not wait-listed participants, with these gains maintained at follow-up. Further investigations are warranted. Trial registry: ISRCTN.com Identifier ISRCTN50951795

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BackgroundRecent national policy and strategic workforce commissioning has created quality-monitored low intensity working in children and young people’s mental health (CYP-MH), that follows a stepped care model seen in adult services. This study explored the experiences of members of this new workforce to better understand factors that might support the effectiveness and sustainability of the role from a practitioner perspective.MethodsInterpretive Phenomenological Analysis was used to analyse (N=12) semi-structured interview transcripts from CYP Wellbeing Practitioners (CWPs) in London and the Southeast.ResultsFive main themes emerged from analysis, suggesting practitioners value their role and its place within the workforce, but have concerns about the low intensity remit meeting high intensity demands, their professional identity and career progression within the speciality.ConclusionsLow-intensity services provide a welcome addition to CYP-MH services with encouraging outcomes so far. Themes that emerged from practitioner experience highlighted clearly defined service remits, careful integration into existing service provision, and professional recognition with career progression as factors that might support the sustainability of the low intensity CYP-MH workforce.