Mental healthcare in paediatric epilepsy clinics: implementation by non-mental health professionals

Anna E Coughtrey; Sophie Bennett; Cameo Stanick; Bruce Chorpita; Emma Dalrymple; Peter Fonagy; J Helen Cross; Tamsin Ford; Isobel Heyman; Rona Moss-Morris; Poonam Jetha; Pamela Myles-Hooton; Roz Shafran

doi:10.1136/bmjpo-2024-002973

Mental healthcare in paediatric epilepsy clinics: implementation by non-mental health professionals

Anna E Coughtrey, Sophie Bennett, Cameo Stanick, Bruce Chorpita, Emma Dalrymple, Peter Fonagy, J Helen Cross, Tamsin Ford, Isobel Heyman, Rona Moss-Morris, Poonam Jetha, Pamela Myles-Hooton, Roz Shafran

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVES: Research has shown that children with epilepsy often experience mental health disorders but face barriers to effective care. One solution is to train healthcare professionals within paediatric epilepsy services to deliver psychological interventions. The aim of this paper was to examine aspects of treatment integrity of the 'Mental Health Interventions for Children with Epilepsy' (MICE) treatment, a modular cognitive behavioural therapy intervention for anxiety, depression and behavioural difficulties in childhood epilepsy.

METHODS: The MICE treatment was delivered in paediatric epilepsy clinics by 21 healthcare professionals with limited mental health experience, supported by a comprehensive training and supervision package. Data from 2269 treatment sessions with 166 young people were analysed to examine adherence to the MICE protocol. Audio recordings from a randomly selected sample of 251 sessions were rated for therapist competence, of which 30 were independently rated by a second expert.

RESULTS: Therapists administered the MICE intervention with integrity and closely adhered to the established protocol. Any adaptations made were related to the sequence of delivery rather than changes to the content.

CONCLUSIONS: The overall findings indicate that professionals in paediatric epilepsy clinics can be effectively trained and supported to administer evidence-based mental health interventions. Additional research is required to explore the link between integrity and clinical outcomes, as well as to determine the most effective methods for training and supervision. This is crucial for ensuring the successful implementation of mental health interventions for children with epilepsy and concurrent mental health needs.

Original language	English
Journal	BMJ Paediatrics Open
Volume	8
Issue number	1
DOIs	https://doi.org/10.1136/bmjpo-2024-002973
Publication status	Published - 18 Nov 2024

Keywords

Humans
Epilepsy/therapy
Child
Female
Adolescent
Male
Cognitive Behavioral Therapy/methods
Health Personnel/education
Mental Health Services/organization & administration

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Mental healthcare_COUGHTREY_Publishedonline18November2024_GOLD VoR (CC_BY)Final published version, 254 KBLicence: CC BY

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title = "Mental healthcare in paediatric epilepsy clinics: implementation by non-mental health professionals",

abstract = "OBJECTIVES: Research has shown that children with epilepsy often experience mental health disorders but face barriers to effective care. One solution is to train healthcare professionals within paediatric epilepsy services to deliver psychological interventions. The aim of this paper was to examine aspects of treatment integrity of the 'Mental Health Interventions for Children with Epilepsy' (MICE) treatment, a modular cognitive behavioural therapy intervention for anxiety, depression and behavioural difficulties in childhood epilepsy.METHODS: The MICE treatment was delivered in paediatric epilepsy clinics by 21 healthcare professionals with limited mental health experience, supported by a comprehensive training and supervision package. Data from 2269 treatment sessions with 166 young people were analysed to examine adherence to the MICE protocol. Audio recordings from a randomly selected sample of 251 sessions were rated for therapist competence, of which 30 were independently rated by a second expert.RESULTS: Therapists administered the MICE intervention with integrity and closely adhered to the established protocol. Any adaptations made were related to the sequence of delivery rather than changes to the content.CONCLUSIONS: The overall findings indicate that professionals in paediatric epilepsy clinics can be effectively trained and supported to administer evidence-based mental health interventions. Additional research is required to explore the link between integrity and clinical outcomes, as well as to determine the most effective methods for training and supervision. This is crucial for ensuring the successful implementation of mental health interventions for children with epilepsy and concurrent mental health needs.",

keywords = "Humans, Epilepsy/therapy, Child, Female, Adolescent, Male, Cognitive Behavioral Therapy/methods, Health Personnel/education, Mental Health Services/organization & administration",

author = "Coughtrey, {Anna E} and Sophie Bennett and Cameo Stanick and Bruce Chorpita and Emma Dalrymple and Peter Fonagy and Cross, {J Helen} and Tamsin Ford and Isobel Heyman and Rona Moss-Morris and Poonam Jetha and Pamela Myles-Hooton and Roz Shafran",

note = "{\textcopyright} Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.",

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doi = "10.1136/bmjpo-2024-002973",

language = "English",

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T2 - implementation by non-mental health professionals

AU - Coughtrey, Anna E

AU - Bennett, Sophie

AU - Stanick, Cameo

AU - Chorpita, Bruce

AU - Dalrymple, Emma

AU - Fonagy, Peter

AU - Cross, J Helen

AU - Ford, Tamsin

AU - Heyman, Isobel

AU - Moss-Morris, Rona

AU - Jetha, Poonam

AU - Myles-Hooton, Pamela

AU - Shafran, Roz

PY - 2024/11/18

Y1 - 2024/11/18

N2 - OBJECTIVES: Research has shown that children with epilepsy often experience mental health disorders but face barriers to effective care. One solution is to train healthcare professionals within paediatric epilepsy services to deliver psychological interventions. The aim of this paper was to examine aspects of treatment integrity of the 'Mental Health Interventions for Children with Epilepsy' (MICE) treatment, a modular cognitive behavioural therapy intervention for anxiety, depression and behavioural difficulties in childhood epilepsy.METHODS: The MICE treatment was delivered in paediatric epilepsy clinics by 21 healthcare professionals with limited mental health experience, supported by a comprehensive training and supervision package. Data from 2269 treatment sessions with 166 young people were analysed to examine adherence to the MICE protocol. Audio recordings from a randomly selected sample of 251 sessions were rated for therapist competence, of which 30 were independently rated by a second expert.RESULTS: Therapists administered the MICE intervention with integrity and closely adhered to the established protocol. Any adaptations made were related to the sequence of delivery rather than changes to the content.CONCLUSIONS: The overall findings indicate that professionals in paediatric epilepsy clinics can be effectively trained and supported to administer evidence-based mental health interventions. Additional research is required to explore the link between integrity and clinical outcomes, as well as to determine the most effective methods for training and supervision. This is crucial for ensuring the successful implementation of mental health interventions for children with epilepsy and concurrent mental health needs.

AB - OBJECTIVES: Research has shown that children with epilepsy often experience mental health disorders but face barriers to effective care. One solution is to train healthcare professionals within paediatric epilepsy services to deliver psychological interventions. The aim of this paper was to examine aspects of treatment integrity of the 'Mental Health Interventions for Children with Epilepsy' (MICE) treatment, a modular cognitive behavioural therapy intervention for anxiety, depression and behavioural difficulties in childhood epilepsy.METHODS: The MICE treatment was delivered in paediatric epilepsy clinics by 21 healthcare professionals with limited mental health experience, supported by a comprehensive training and supervision package. Data from 2269 treatment sessions with 166 young people were analysed to examine adherence to the MICE protocol. Audio recordings from a randomly selected sample of 251 sessions were rated for therapist competence, of which 30 were independently rated by a second expert.RESULTS: Therapists administered the MICE intervention with integrity and closely adhered to the established protocol. Any adaptations made were related to the sequence of delivery rather than changes to the content.CONCLUSIONS: The overall findings indicate that professionals in paediatric epilepsy clinics can be effectively trained and supported to administer evidence-based mental health interventions. Additional research is required to explore the link between integrity and clinical outcomes, as well as to determine the most effective methods for training and supervision. This is crucial for ensuring the successful implementation of mental health interventions for children with epilepsy and concurrent mental health needs.

KW - Humans

KW - Epilepsy/therapy

KW - Child

KW - Female

KW - Adolescent

KW - Male

KW - Cognitive Behavioral Therapy/methods

KW - Health Personnel/education

KW - Mental Health Services/organization & administration

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DO - 10.1136/bmjpo-2024-002973

M3 - Article

C2 - 39557540

SN - 2399-9772

VL - 8

JO - BMJ Paediatrics Open

JF - BMJ Paediatrics Open

IS - 1

ER -

Mental healthcare in paediatric epilepsy clinics: implementation by non-mental health professionals

Abstract

Keywords

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