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Guided self-help interventions for mental health disorders in children with neurological conditions: study protocol

Sophie Bennett¹, Isobel Heyman^2,3, Anna Coughtrey^2,3

¹UCL Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK. Sophie.Bennett.10@ucl.ac.uk.

|November 5, 2016

Insights

This pilot study investigates guided self-help for mental health disorders in children with neurological conditions. It aims to assess the intervention

Area of Science:

Pediatric neurology
Child and adolescent psychiatry
Clinical psychology

Background:

Children with physical illnesses, particularly neurological conditions like epilepsy, exhibit higher rates of mental health disorders.
Mental health issues in children with neurological conditions are frequently under-recognized and undertreated.
Guided self-help interventions are effective for general pediatric mental health but their efficacy in this specific population is unstudied.

Purpose of the Study:

To pilot a guided self-help intervention for treating mental health disorders in children with neurological conditions.
To assess the feasibility and preliminary efficacy of this intervention in a pediatric neurology setting.

Main Methods:

A pilot randomized controlled trial involving 18 patients with neurological conditions and mental health disorders.
Participants will be randomized to either a 10-session telephone-delivered guided self-help intervention or a 12-week waiting list control.
Primary outcome is the reduction in mental health disorder symptoms; exclusion criteria focus on safety and ability to access the intervention.

Main Results:

This section is to be filled once the study is completed and results are available.

Conclusions:

This is the first study to explore guided self-help for mental health problems in children with neurological conditions.
The modular intervention is adapted from established cognitive behavioral treatments.
Broad inclusion criteria enhance generalizability, though may present challenges.

Read full analysis

Abstract

Background:

Rates of mental health disorders are significantly greater in children with physical illnesses than in physically well children. Children with neurological conditions, such as epilepsy, are known to have particularly high rates of mental health disorders. Despite this, mental health problems in children with neurological conditions have remained under-recognised and under-treated in clinical settings. Evidence-based guided self-help interventions are efficacious in reducing symptoms of mental health disorders in children, but their efficacy in reducing symptoms of common mental health disorders in children with neurological conditions has not been investigated. We aim to pilot a guided self-help intervention for the treatment of mental health disorders in children with neurological conditions.

Methods/Design:

A pilot randomised controlled trial with 18 patients with neurological conditions and mental health disorders will be conducted. Participants attending specialist neurology clinics at a National UK Children's Hospital will be randomised to receive guided self-help for common mental health disorders or to a 12-week waiting list control. Participants in the treatment group will receive 10 sessions of guided self-help delivered over the telephone. The waiting list control group will receive the intervention after a waiting period of 12 weeks. The primary outcome measure is reduction in symptoms of mental health disorders. Exclusion criteria are limited to those at significant risk of harm to self or others, the presence of primary mental health disorder other than anxiety, depression or disruptive behaviour (e.g. psychosis, eating disorder, obsessive-compulsive disorder) or intellectual disability at a level meaning potential participants would be unable to access the intervention. The study has ethical approval from the Camden and Islington NHS Research Ethics Committee, registration number 14.LO.1353. Results will be disseminated to patients, the wider public, clinicians and researchers through publication in journals and presentation at conferences.

Discussion:

This is the first study to investigate guided self-help interventions for mental health problems in children with neurological conditions, a group which is currently under-represented in mental health research. The intervention is modular and adapted from an empirically supported cognitive behavioural treatment. The generalisability and broad inclusion criteria are strengths but may also lead to some weaknesses.

Trial Registration:

Current Controlled Trials: ISRCTN21184717 . Registered on 25 September 2015.

Keywords:

Children Cognitive behaviour therapy Guided self-help Mental health disorders Neurological conditions

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