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How to improve outcomes for children and young people with long term conditions – the evidence is in

Posted on June 5th 2019

Children and young people suffering with long term physical conditions can find anxiety and depression impacting on their lives and on those around them. Now a systematic review, led by the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula’s (PenCLAHRC) Evidence Synthesis Team has found that Cognitive Behavioural Therapy (CBT) might help.

Among a range of findings the team identified evidence of the benefits of CBT for children and young people with inflammatory bowel disease, chronic pain and epilepsy. The research, published in the NIHR Journals Library and funded by the National Institute for Health Research Health Technology Assessment Programme, used robust methods to draw together all the available information on the treatment of mental health in children and young people with long term conditions.

Fiona Lockhart, Co-investigator from the Biomedical Research Centre Patient & Public Involvement Group at University College London, said: “Children and young people with long-term health conditions face enormous challenges. As well as their physical illness, many of these young people suffer from mental health problems as a consequence of their condition.”

The review also found that building good relationships and delivering interventions in what felt like a safe space was important. Providing social support and accessible and engaging interventions were found to be key factors in their successful delivery and in helping participants to feel better about living with a long term condition.  

Study author Dr Liz Shaw, said: “As well as looking at whether treatments worked for these children, we also included studies that explored the experiences of people giving and receiving the treatments. These studies highlighted the benefits of building good relationships and providing treatments in what feels like a ‘safe space’.”

Additionally parenting programmes were found to be beneficial in reducing behavioural problems in children with acquired brain injury and/or cerebral palsy while further studies showed that children and young people valued treatments that considered a range of needs beyond their mental health. The opportunity to meet and build a supportive relationship with people who are managing their long term condition was seen to help some young people by producing a sense of hope for the future and the opportunity to learn skills to help manage their physical and mental health.

Gaps were identified where interventions had not been studied for specific long term physical conditions, leading the team to identify scope for future research, in line with an NHS identified priority, for the closer integration of mental and physical healthcare.


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This research was a result of collaboration from The University of Exeter, Great Ormond Street Hospital and University College London. It received funding from the National Institute for Health Research Heath Technology Assessment Programme (project 14/157/06) and the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula.