Feasibility of telephone-delivered therapy for common mental health difficulties embedded in paediatric epilepsy clinics

TY - JOUR

T1 - Feasibility of telephone-delivered therapy for common mental health difficulties embedded in paediatric epilepsy clinics

AU - Bennett, Sophie

AU - Au, Christy

AU - Byford, Sarah

AU - Chorpita, Bruce

AU - Coughtrey, Anna E.

AU - Cross, J. Helen

AU - Dalrymple, Emma

AU - Fonagy, Peter

AU - Ford, Tamsin

AU - Heyman, Isobel

AU - Lewins, Amy

AU - Moss-Morris, Rona

AU - Reilly, Colin

AU - Xu, Laila

AU - Shafran, Roz

PY - 2020/12/21

Y1 - 2020/12/21

N2 - Background Mental and physical health treatment should be delivered together for children and young people with epilepsy. Training health care professionals (HCPs) in epilepsy services to deliver mental health interventions is an important way to facilitate integrated care. Objective To determine the feasibility of remotely delivered assessment and psychological treatment for mental health difficulties delivered by HCPs in paediatric epilepsy clinics with limited formal training in psychological interventions. We hypothesized that it would be i) feasible to train HCPs to deliver the psychological intervention and ii) that participants receiving the psychological therapy would report reductions in symptoms of mental health difficulties including anxiety, depression and behaviour difficulties and improve quality of life. Methods Thirty-four children and young people with epilepsy who had impairing symptoms of a common mental health difficulty (anxiety, depression, disruptive behaviour and/or trauma) were allocated to receive 6 months of a modular cognitive behavioural intervention delivered by a HCP with limited formal psychological therapy experience. Thirteen HCPs were trained in delivery of the intervention. HCP competence was assessed in a two-stage process. Parent-reported measures of mental health symptoms and quality of life were completed at baseline and following the intervention. Paired t-tests were used to analyse changes in symptoms over time. Results All thirteen HCPs who participated in the training were considered competent in therapeutic delivery by the end of the training period. Twenty-three patients completed pre- and post-intervention measures and were included in the analysis. There were statistically significant improvements in: symptoms of mental health problems (p=0.01; Cohen’s d = .62), total impact of mental health problems (p=0.03; Cohen’s d = .52), anxiety and depression symptoms (p<0.01; Cohen’s d = .57) and quality of life (p=0.01; Cohen’s d = .57). Conclusion A modular cognitive behavioural treatment delivered over the telephone by HCPs with limited experience of psychological therapy was feasible and effective in treating mental health problems in children and young people with epilepsy. Health related Quality of Life also improved over the duration of treatment. A randomised controlled trial is needed to demonstrate efficacy of the intervention.

AB - Background Mental and physical health treatment should be delivered together for children and young people with epilepsy. Training health care professionals (HCPs) in epilepsy services to deliver mental health interventions is an important way to facilitate integrated care. Objective To determine the feasibility of remotely delivered assessment and psychological treatment for mental health difficulties delivered by HCPs in paediatric epilepsy clinics with limited formal training in psychological interventions. We hypothesized that it would be i) feasible to train HCPs to deliver the psychological intervention and ii) that participants receiving the psychological therapy would report reductions in symptoms of mental health difficulties including anxiety, depression and behaviour difficulties and improve quality of life. Methods Thirty-four children and young people with epilepsy who had impairing symptoms of a common mental health difficulty (anxiety, depression, disruptive behaviour and/or trauma) were allocated to receive 6 months of a modular cognitive behavioural intervention delivered by a HCP with limited formal psychological therapy experience. Thirteen HCPs were trained in delivery of the intervention. HCP competence was assessed in a two-stage process. Parent-reported measures of mental health symptoms and quality of life were completed at baseline and following the intervention. Paired t-tests were used to analyse changes in symptoms over time. Results All thirteen HCPs who participated in the training were considered competent in therapeutic delivery by the end of the training period. Twenty-three patients completed pre- and post-intervention measures and were included in the analysis. There were statistically significant improvements in: symptoms of mental health problems (p=0.01; Cohen’s d = .62), total impact of mental health problems (p=0.03; Cohen’s d = .52), anxiety and depression symptoms (p<0.01; Cohen’s d = .57) and quality of life (p=0.01; Cohen’s d = .57). Conclusion A modular cognitive behavioural treatment delivered over the telephone by HCPs with limited experience of psychological therapy was feasible and effective in treating mental health problems in children and young people with epilepsy. Health related Quality of Life also improved over the duration of treatment. A randomised controlled trial is needed to demonstrate efficacy of the intervention.

KW - epilepsy

KW - mental health

KW - Children & Youth

KW - integrated care

M3 - Article

SN - 1525-5050

JO - Epilepsy & Behavior

JF - Epilepsy & Behavior

ER -