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Agenda setting with children using the 'three wishes' technique
Nikki Kiyimba1, Michelle O'Reilly2, Jessica Nina Lester3
11 Department of Social and Political Science, Westminster Building, University of Chester, Chester, UK.
Summary
Practitioners in child mental health services often redirect children
Area of Science:
- Clinical Psychology
- Conversation Analysis
- Child and Adolescent Mental Health Services
Background:
- The UK's National Health Service (NHS) uses initial screening appointments for children referred to child and adolescent mental health services (CAMHS).
- These appointments aim to determine clinical need and assess risk.
- Conversation analysis is a method for studying social interaction.
Purpose of the Study:
- To analyze agenda-setting strategies in CAMHS screening appointments.
- To examine the use of the 'three wishes' technique in goal establishment with children.
- To understand how practitioners manage assessment-relevant versus non-relevant wishes.
Main Methods:
- Conversation analysis of 28 video-recorded CAMHS screening assessments.
- Assessments involved multidisciplinary teams and lasted approximately 90 minutes.
- Focus on practitioners' discursive strategies during the 'three wishes' task.
Main Results:
- Children often articulated fewer wishes when initial wishes were assessment-relevant.
- Practitioners frequently realigned non-assessment-relevant or 'fantasy' wishes.
- Dismissal of irrelevant wishes occurred without further exploration, impacting engagement.
Conclusions:
- Practitioners' management of the 'three wishes' task can sideline child-centered contributions.
- Strategies used to ensure assessment relevance may limit the exploration of children's perspectives.
- This has implications for effective engagement and child-centered practices in mental health assessments.