A pilot practice-based outcomes evaluation of low-intensity cognitive behavioural interventions delivered by postgraduate trainees to children and young people with mild to moderate anxiety or low mood: an efficient way forward in mental health care?

Abstract

Abstract Anxiety and depression affect a significant number of children and young people (CYP) and can have a far reaching and long-lasting impact. Cognitive behavioural (CB) interventions can be effective for treating anxiety and depression in CYP but are difficult to access. Recent government policy in England seeks to train a non-traditional graduate workforce to deliver a range of CB interventions for mild to moderate anxiety and depression to CYP, in community settings. This practice-based evaluation aimed to estimate the effectiveness of CB interventions delivered by postgraduate trainees undertaking training in a range of CB interventions for mild to moderate anxiety and depression whilst on placement in schools or community Child and Adolescent Mental Health Services (CAMHS). Self- and parent-reported routine outcome measures (ROMS) were completed pre- and post-intervention, including measures of symptom severity, symptom impact and goal achievement. Significant improvements were demonstrated across all self and parent-reported measures post-intervention, with mean scores falling firmly in the non-clinical range, a significant reduction in the proportion of CYP in the clinical range on measures, and predominantly medium to large effect sizes. Results are promising in terms of the capacity to train a graduate workforce to deliver a range of low-intensity CB interventions to CYP experiencing mild to moderate depression or anxiety-based difficulties in either CAMHS or school settings, increasing capacity across the system. The current practice-based evaluation also supports the potential effectiveness of current training models/programmes. Further research is needed in terms of long-term outcomes and to compare outcomes between settings, interventions, and demographic groups. Key learning aims (1) To understand the potential prevalence rates of mental health difficulties in children and young people in England, and their wider impact. (2) Critical awareness of the evidence base for cognitive and behavioural interventions for depression and anxiety in children and young people. (3) Awareness of gaps in access to evidence-based psychological interventions for children and young people in England. (4) Knowledge of emerging graduate-level low-intensity psychological practitioner roles in England. (5) Awareness of the emerging evidence base for the estimated effectiveness of low-intensity cognitive and behavioural interventions delivered to children and young people by graduate-level practitioners in schools and community mental health settings.