Highlights in child mental health research: January 2022

Highlights

• This systematic review examines the effectiveness of interventions and practice models for improving health and psychosocial outcomes of young people in residential care and identifies knowledge gaps.
• There is a body of research that examines the wellbeing of children in residential out-of-home care; however, there is limited evidence on the ways in which interventions and practice models can improve the health and psychosocial wellbeing of these young people.

Key findings

• It is well documented that young people in out-of-home care are likely to exhibit significantly higher rates of physical, behavioural, cognitive, social, relational, and other mental health challenges compared to those in the general population.
• The evidence-base for interventions and practice models implemented in residential out-of-home care to improve health and wellbeing outcomes is sparse, with only four studies meeting the inclusion criteria. The quality of included studies was also poor.
• Interventions using therapeutic and psychosocial approaches, specifically trauma-informed care and psychoeducation, have the have the potential to have positive impacts on the health and psychosocial outcomes of young people in residential care
• Definitive conclusions about the efficacy of these interventions and practice models cannot be reached from the available evidence, and further research is needed.

Implications

• Despite the limitations with assessing the efficacy of interventions, therapeutic and psychosocial approaches show positive impacts on the health and psychosocial wellbeing of young people in residential out-of-home care.
• Specifically, interventions and practice models should incorporate trauma-informed care and psychoeducation to improve the health and psychosocial wellbeing of young people in residential out-of-home care.

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Highlights

• This study examined the receipt of evidence-based care, specifically cognitive-behavioural therapy (CBT), for children and adolescents with elevated anxiety symptoms in Australia.
• CBT is the only recommended first-line of treatment for children and adolescents with anxiety disorder in Australia. International evidence and the results of this Australia-based study indicate that a low percentage of children with anxiety disorders receive CBT.
  

Key findings

• Results show that 5% of children and adolescents with elevated anxiety symptoms received evidence-based treatment (e.g., CBT). Of those families who did seek help for anxiety in Australia, the majority (66.3%) did not receive CBT.
• The receipt of exposure and cognitive restructuring strategies (including CBT) was low across both the parent– and child-reported samples.
• Socioeconomic status and geographical location had limited effect whether individuals received evidence-based care or non-evidence-based care.
• Data was collected during the COVID-19 pandemic and should be tentatively interpreted due to the specific context.

Implications

• Children and adolescents in this study seeking support for their anxiety symptoms were not receiving adequate evidence-based care, regardless of socioeconomic status and location.
• There is a need to increase the usage of CBT for children and adolescents with anxiety symptoms in Australia.
• Widespread training of CBT may be required across professional fields, particularly for school mental health professionals and to address clinician’s negative beliefs towards exposure related interventions.

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Highlights

• Mindfulness-based parenting programs (MPPs) are increasingly popular for reducing child behaviour problems. However, the evidence for the advantages of MPP over existing behavioural parent training is unclear.
• This scoping review systematically maps the current research on MPPs in reducing behavioural problems in children aged 3–12 years and improving parent wellbeing, style, and mindfulness.

Key findings

• 16 studies were included in the review. Findings identified mostly small effect size improvements from pre- to post-intervention for MPPs across both child and parent outcome measures, with variability across studies from nil to large effects.
• Effect sizes generally improved further at follow-up, suggesting that parents continue to apply principles following parenting interventions and that behavioural change is gradual
• Most studies used face-to-face programs and evidence is emerging that online parenting interventions can be effective. However, access for disadvantaged families, user costs, and privacy is a concern when using online interventions.

Implications

• This scoping review highlights that families often experience meaningful change in a positive direction from attending MPPs, including improvements in child behaviour and parental mindfulness, well-being, and style.
• Face-to-face MPPs were used most frequently and shown to be most effective; however, evidence is shows that online MPPs are also effective.
• Further research to improve the quality of evidence on MPPs is needed. Further research on the effectiveness of MPPs when integrated with existing behavioural parent training program is also recommended.

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Highlights

• This review examines the quantitative literature on homesickness in children, including how it is assessed and its relationship to other negative states.
• Homesickness was reported in the majority of children who were separated from their home and was associated with negative emotional states.
  

Key findings

• A total of 17 studies were included in the quantitative review, with five studies included in the meta-analysis. The review literature showed that homesickness is associated with other negative emotional states, physical symptoms, and behavioural problems. The meta-analysis showed a significant relationship between homesickness and depression, and homesickness and anxiety.
• Age was not a significant moderator of homesickness severity, and no differences were observed between boys and girls.
• Longitudinal studies (up to three months) demonstrated the persistence of severe homesickness until the conclusion of the separation No studies assessed homesickness in longer or permanent separation experiences.
• Only one study examined the effectiveness of an intervention strategy (psychoeducation and social support) for homesickness. The study reported lower levels of homesickness in the intervention group; however, the findings are limited and cannot be generalised.

Implications

• Homesickness significantly impacts children’s well-being regardless of age and is associated with overall distress, depression and anxiety. It is experienced by the majority of children across a range of separation experiences.
• When homesickness is severe, it has significant adverse emotional, physical and behavioural outcomes.
• Psychoeducation around coping strategies and providing social support may reduce the frequency and severity of However, further research is needed to assess the effectiveness of interventions to address homesickness in children.
• Further longitudinal studies are needed to understand the persistence of homesickness during longer or permanent periods of separation.

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