Editorial: Short interventions and self-help interventions in child and adolescent mental health

Abstract

Welcome to the November issue of Child and Adolescent Mental Health (CAMH). In this issue, several pieces highlight the importance of researching, and in some cases, implementing short interventions and self-help interventions for children and adolescents with mental health concerns while highlighting the importance of finding ways to engage children and young people.

As highlighted in one of the studies providing a tertiary care centre experience for 3 years, visits to paediatric emergency departments and admission rates continue to rise, and novel strategies are needed to find solutions for the limited resources currently available (Manuel, Yen, Feng, & Patel, 2023). These strategies need to ensure that children and adolescents receive high-quality care. These strategies also need to promote engagement for children and young people, and acknowledge that time constraints can limit engagement (Ali, Wright, Curran, & Newton, 2022).

I invite you to read several studies relevant to this matter in this issue, showing how short interventions and self-help interventions can be useful strategies for some children and adolescents. Sams, Garrison, Walsh, Maeng, and Cross (2023) looked at the impact of a brief inpatient intervention on the length of stay and on readmissions in adolescents who had been admitted into the hospital. This ‘Rapid Stabilization Pathway’, where a safety planning intervention was provided, achieved a decrease in the length of stay at the hospital, and no significant differences in readmissions to the inpatient unit up to 90 days after discharge were found (Sams et al., 2023).

A pilot randomized clinical trial found that a guided paced breathing audiovisual intervention of no more than 10 min per session decreased anxiety symptoms in the intervention group compared to the control group (Shank et al., 2022). Another study evaluating a self-help, online programme showed improvements in anxiety symptoms in children and adolescents, and reductions in life interference in children (Rowe, Evans, Donovan, Spence, & March, 2023).

As highlighted by Loades and Schleider (2023), single session interventions, even provided as one-off therapeutic interventions, can be helpful to expand current mental health provisions and help young people access evidence-based interventions promptly, including underserved populations such as ethnic minorities or L.G.B.T.Q.I.A+ populations. According to the authors, reductions in depressive symptoms can be achieved at up to 9 months later.

One of the challenges is that these strategies may be helpful for some individuals and some populations, but not necessarily for others. To note, precision strategies typically depend on the characteristics of the patients (Salazar de Pablo et al., 2021). For instance, digital health interventions may be better accepted by some young people and their families than by others. Politte-Corn and colleagues evaluated age-related differences in social media use, online social support and depressive symptoms in adolescents and emerging adults (Politte-Corn, Nick, & Kujawa, 2023). As another example, in the article by Rowe et al. (2023) evaluating the use of a self-help online programme for children and adolescents, reductions in life interference were observed in children but not in adolescents. Other factors, such as the severity of symptoms, also seem to have an impact on the efficacy of the interventions. For instance, adolescents with severe obsessive-compulsive disorder seem to benefit more from face-to-face than from remotely delivered cognitive behavioural therapy, while in adolescents with mild obsessive-compulsive disorder, both strategies are equally effective (Salazar de Pablo, Pascual-Sánchez, Panchal, Clark, & Krebs, 2023).

My final invitation is to read our debate on the role of child and adolescent mental health services to provide preventive interventions for psychosis and psychotic conditions. Among other strategies, low intensity psychosocial interventions are suggested to prevent psychosis (Tiffin & Northover, 2023). Short interventions or self-help interventions providing psychoeducation strategies may also have a role in this area before there is a more significant impact on functioning and quality of life for the young people we treat. Please consider submitting a response to this debate or letting us know about your thoughts on this on social media.

In summary, we need more research on short interventions and self-help interventions to figure out which children and adolescents may benefit more from them and what we can achieve. As always, our journal is committed to advancing clinical knowledge on patient and public involvement strategies to find a way to engage children and young people and provide them with high-quality interventions, also when offering short interventions and self-help interventions. We hope this issue provides some clarity on this matter.

The author has declared that they have no competing or potential conflicts of interest.