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CHOOSINGWHAT’S
BEST FORYOU
What scientists have foundhelps children and young people who are sad, worried or troubled
First Edition July 2007
ContentsHow this booklet can help you 4
What the different types of difficulty mean 6What the different types of help mean 8
How the different types of help are rated 10
What scientists have found helps children and young people with…Anxiety 13Attention Deficit Hyperactivity Disorder (ADHD) 14Autism and Asperger’s 17Conduct Disorder 18Deliberate Self-Harm 20Depression 22Eating Disorders (Anorexia and Bulimia) 24Obsessive Compulsive Disorder (OCD) 27Post Traumatic Stress Disorder (PTSD) 28Psychosis (Bipolar Disorder and Schizophrenia) 30Substance Misuse 32Tourette’s Syndrome 34
Things to bear in mind 35
Useful information and resources 36Who wrote this booklet 38
3
CHOOSINGWHAT’S
BEST FORYOU
Copies of this booklet can be obtained from:Child and Adolescent Mental Health Services (CAMHS) Evidence-Based Practice UnitUniversity College London & Anna Freud Centre21 Maresfield GardensLondonNW3 5SD
www.annafreud.org/ebpu ebpu@annafreud.org
© 2007 CAMHS PublicationsISBN 978-0-9553956-2-8
Design: www.chapmandesign.netIllustration: Clive GoodyerPrint: Captiv8 UK Ltd.
How thisbooklet canhelp you
This booklet was written tohelp you make
the best choicesfor you.
Knowing “the facts”makes it easier tomake choices, butworking out what
“the facts” are is notalways easy.
54
There are many ways oftrying to help that
haven’t been properlytested yet by scientists,
but which might helpsome individuals. Wehaven’t written about
them here.
CHOOSINGWHAT’S
BEST FORYOU
This was written in2007. Our knowledge
will grow with timeand this advice mightchange. Check out the
links on p36 for thelatest info.
This is our firstattempt to make thisinformation available
to children andyoung people in
this way.
We have includedsome quotes from
young peopleabout their
experience ofgetting help.
Remember…
This booklet describeswhat scientists have
found out so far, aftercomparing differentways of helping with
large numbers ofpeople.
How well you geton with the persontrying to help you
is likely to beimportant – let
them know whatyou find helpfuland unhelpful.
There are things forand against all typesof help and they all
mean you doingsomething new - ask
about what isinvolved
We would reallylike to know whatyou think of thisbooklet so we
can make futureversions better.
Let us know what you think: ebpu@annafreud.org
Knowledgeispower
This does notmean you haveto decide to gowith any of theways of helping
listed here.
By knowing whatscientists have found
out so far, you can havebetter conversations
with those who are trying to
help you.
Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centre
www.annafreud.org/ebpu
Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centrewww.annafreud.org/ebpu
76
What the differenttypes of difficultymean
Deliberate Self-HarmPeople who self-harm deliberately hurtthemselves.
DepressionPeople with depression are very sadover a long period of time and can seeno way forward.
Eating Disorders (Anorexia and Bulimia)People with anorexia nervosa more orless stop eating altogether. People withbulimia nervosa eat, but are then sick ortake laxatives to get rid of the food.
Obsessive-CompulsiveDisorder (OCD)People with OCD feel they have to dosomething over and over again, e.g. wash their hands.
Post Traumatic StressDisorder (PTSD)People with PTSD continue to be verydisturbed by an upsetting event.
Psychosis (Bipolar Disorder andSchizophrenia)People with psychosis have very seriousproblems that affect how they think, feeland act.
People with Bipolar Disorder feelalternately very manic (very high) andthen very depressed.
People with Schizophrenia can imaginethey are hearing things and that they arebeing controlled by others.
Substance MisusePeople with substance misuse difficultiesare addicted to, or being harmed by, theiruse of drugs or alcohol.
Tourette’s SyndromePeople with Tourette's shout out, or havemultiple repetitive behaviours (tics) thatthey cannot control.
NoteYou may have been told youhave one or more of thefollowing difficulties.You are not alone.Millions of children and youngpeople in the UK havedifficulties like these at any onetime.Often they have more than onedifficulty at the same time.For all the difficulties listedhere, there are things that youand others can do to makethings better and make lifeeasier.This booklet tells you aboutways of helping that have beentested by scientists.Different people trying to helpyou may use different names todescribe the difficulties. We have used these namesbecause they are the ones thescientists used.If you want to know more, ortalk to someone about aparticular worry or difficulty, try “useful information andresources” listed on p36.
AnxietyPeople with anxiety difficulties getextremely worried about things. Phobiasare when people are excessivelyfrightened of something, e.g. spiders.
Attention DeficitHyperactivity Disorder(ADHD)People with ADHD find it very difficult tosit still, to concentrate and/or focus onthings and/or to think before they act.
Autism and Asperger’sPeople with autism or Asperger’s havedifficulties communicating with othersand understanding the world as othersdo.
Conduct DisorderPeople with conduct disorder behave ina way that is out of control and harmfulto others.
Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centrewww.annafreud.org/ebpu
CHOOSINGWHAT’S
BEST FORYOU
9
What the different types of help mean
8
Information and SupportLearning about how to understanddifficulties, and talking things through.
Intensive Behaviour Training Parents and others provide intensivetraining to help a child develop basicskills.
Interpersonal TherapyTalking about key issues in yourrelationships and agreeing waysforward.
MedicineTaking medicine as a pill or as a liquidto help you think, feel or behavedifferently. For more information aboutparticular medicines, go towww.netdoctor.co.uk
Motivational InterviewingHaving conversations which focus onthe advantages and disadvantages ofchanging your behaviour.
Multi-systemic TherapyLots of different types of help for youand your family, all working together totry to sort out the problems.
NoteMany of the ways of helpinglisted here involve youmeeting with an adult who istrained to help children andyoung people when they aretroubled.
This sort of help maysometimes be lumpedtogether as “therapy” or“support and advice”.
In fact, there are manydifferent sorts of “therapy”and “support and advice”.
This booklet aims to let youknow which of themscientists have found to bemost helpful.
We have kept thedescriptions very short.
You can find out more aboutthe different types of helpmentioned here by asking the person who is offering to help you or by searchingthe internet.
Parent TrainingHelp and practical advice for parentsand carers on how to change their ownand their child’s behaviour.
Problem-solving TrainingLearning and practising new ways oftackling problems in a helpful way.
PsychodynamicPsychotherapyExploring unconscious processes andpast relationships to try to understandthe causes of the problems.
Social Skills TrainingLearning and practising new ways ofgetting on better with others.
Systemic Family TherapyHelping families work together to findnew solutions that work for them.
Therapeutic Foster CareLiving with foster parents who aretrained and supported in helping youwith difficulties.
Watchful Waiting Waiting and checking to see if things get better by themselves.
Behaviour Therapy Learning and practising new behaviourthat will make life easier for you andothers.
Cognitive Behaviour Therapy Learning and practising new ways ofthinking and behaving to make lifeeasier for you and others.
DebriefingTalking in detail about an upsettingevent immediately after it has happened.
DietChanging what you eat. This mightmean no longer eating some foodsand/or taking in extra amounts of others.
Eye MovementDesensitisationReprocessing (EMDR)Focussing on a particular physicalaction whilst thinking about difficultthings, in order to change your thoughtsand feelings about those things.
Group TherapyTalking about things in a group on aregular basis with other people who arehaving difficulties.
CHOOSINGWHAT’S
BEST FORYOU
Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centre
www.annafreud.org/ebpu
How differenttypes of helpare rated
•This booklet rates whatscientists have found helps,based on how sure we canbe about what they havefound out.
•All the tests by scientistsreported here have beenchecked to see how muchwe can trust the findings.
•Ways of checking scientificfindings include looking at:how scientists have testedsomething; who paid forthe research; whether otherscientists have found thatthe same things helpdifferent people in differentplaces.
10
VERY LIKELY TO HELP
WHAT IT MEANS
WHY THIS RATING?
STAR RATING
Scientists are very sure about thisway of helping.
Several different scientists havedone the most careful kind ofstudy where they split people intodifferent groups, each of whichgot a different type of help.
The groups people were put inwere decided ‘randomly’, e.g.someone might toss a coin to seewho goes in which group – so thateach group has roughly the samemix of people in it.
This is thought to be the fairesttest of whether something helpsbecause people in the groups aresimilar in every way, except forthe type of help they get.
LIKELY TO HELP
WHAT IT MEANS
WHY THIS RATING?
STAR RATING
Scientists are pretty sure aboutthis way of helping.
Scientists have done several goodstudies where they have splitpeople up into different groupsand given them different sorts ofhelp.
People got to choose – or werechosen – to be in each group.
This is not as fair a test, becausepeople in the different groupsmay be different in some waythat affects whether they getbetter or not.
MIGHT HELP
WHAT IT MEANS
WHY THIS RATING?
STAR RATING
Scientists are not so sure aboutthis way of helping.
Scientists have not yet done manygood studies, or they have onlylooked at what people are alreadydoing and compared one groupwith another.
This is thought to be the leastfair test because it is quite likelythat the people in the differentgroups are different in some waythat affects whether they getbetter or not.
For more information about how scientists decide whathelps: Testing Treatments: Better Research for BetterHealthcare Imogen Evans, Hazel Thornton and IainChalmers (2006, University of Toronto)
Whattheratingsmean
CHOOSINGWHAT’S
BEST FORYOU
Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centre
www.annafreud.org/ebpu
Learning and practising new behaviour thatwill make life easier for you and others.
Learning and practising new ways ofthinking and behaving that make lifeeasier for you and others.
Behaviour Therapy VERY LIKELY TO HELP
VERY LIKELY TO HELP
Can be done as agroup or individually.
If you are under 11years old and/or ifyour parents worry a lot, it can be helpful if they take part too.
Cognitive Behaviour Therapy
Taking medicine as a pill or as a liquid tohelp you think, feel or behave differently.
MedicineVERY LIKELY TO HELP
Anti-depressantmedicines called“SSRIs” can helppeople with socialanxiety when otherforms of help havenot worked.Any medicine may have side effects – you need to talk
this over with your doctor. For more information aboutparticular medicines go to www.netdoctor.co.uk
Information and SupportLIKELY TO HELP
Learning about how to understand thedifficulties, and talking things through.
12
May help ifyou are veryanxious about going to school.
13Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centre
www.annafreud.org/ebpu
Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centrewww.annafreud.org/ebpu
What scientists have found helps with…
AnxietyPeople with anxiety difficulties get extremely worried about things. Phobias are when people are excessivelyfrightened of something, e.g. spiders.
RememberWe are all different;
what helps others maynot help you.
RememberYou may need
to try more than one thing.
RememberNever be afraid to ask
questions or to tell peoplehow you are finding things.
RememberOur knowledge is still
growing – check the linkson p36 for the latest info.
CHOOSINGWHAT’S
BEST FORYOU
RememberThere may be other ways of
helping not yet tested byscientists that might help you.
“I HAVE BEENGIVEN ADVICEABOUT HOW TOHELP MYSELF,WHICH HAS BEENREALLY USEFUL”SOPHIE, AGED 11
What scientists have found helps with…Attention Deficit Hyperactivity Disorder (ADHD)People with ADHD find it very difficult to sit still, to concentrateand/or focus on things and/or to think before they act.
14 Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centrewww.annafreud.org/ebpu
RememberOur knowledge is stillgrowing – check thelinks on p36 for the
latest info.
RememberThere may be other
ways of helping not yettested by scientists that
might help you.
Taking medicine as a pill or as a liquid tohelp you think, feel or behave differently.
MedicineVERY LIKELY TO HELP
If you are takingstimulantmedicines itmay help tohave breaks, tomake sure youcontinue togrow properly.
Any medicine may have side effects – you need to talkthis over with your doctor. For more information aboutparticular medicines go to www.netdoctor.co.uk
Learning and practising newbehaviour that will make lifeeasier for you and others.
Behaviour TherapyLIKELY TO HELP
This can be tried first oralong with medicine andmight mean you don’thave to take so muchmedicine.
This should also happen in school to make sure it helps your behaviour there as well.
Help and practical advice for parentsand carers on how to change theirown and their children’s behaviour.
Parent TrainingLIKELY TO HELP
This can betried first oralong withmedicine.
Changing what you eat so that youno longer eat some foods.
Diet: avoiding certain foodsLIKELY TO HELP
If you have a genuinefood intolerance thenstopping eating thefoods you are intolerant to may help your behaviour.
Changing what you eat so that youtake capsules that contain fish oils.
Diet: taking Omega 3 and Omega 6 oilsMIGHT HELP
Not manystudies havebeen made sofar to find outwhether thishelps.
RememberYou may need
to try more than one thing.
RememberWe are all different;
what helps others maynot help you.
RememberNever be afraid to ask
questions or to tellpeople how you are
finding things.
Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centre
www.annafreud.org/ebpu
15
CHOOSINGWHAT’S
BEST FORYOU
What scientists have found helps with…
Autism and Asperger’sPeople with autism or Asperger’s have difficulties communicating with others and understanding the world as others do.
16 Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centrewww.annafreud.org/ebpu
Taking medicine as a pill or as aliquid to help you think, feel orbehave differently.
MedicineLIKELY TO HELP
No medicine has beenfound to help theunderlying problems ofautism itself, but thereare medicines that can helpwith some of the other difficulties that people withautism may have.
Any medicine may have side effects – youneed to talk this over with your doctor. Formore information about particular medicinesgo to www.netdoctor.co.uk
Parents and others provide intensivetraining to help a child develop basicskills.
Intensive Behavioural TrainingLIKELY TO HELP
Can be doneindividually or aspart of a group.
Can help improvegeneral abilitiesand social skills.
RememberWe are all different;
what helps others maynot help you.
RememberOur knowledge is stillgrowing – check thelinks on p36 for the
latest info.
RememberThere may be other
ways of helping not yettested by scientiststhat might help you.
17Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centre
www.annafreud.org/ebpu
RememberNever be afraid to ask
questions or to tellpeople how you are
finding things.
RememberYou may need
to try more than one thing.
CHOOSINGWHAT’S
BEST FORYOU
“THE PEOPLETRYING TO HELPME DON’T JUDGEME, THEY LET MESAY WHAT IWANT”TALV, AGED 13
19
What scientists have found helps with…
Conduct DisorderPeople with conduct disorder behave in a way that is out ofcontrol and harmful to others.
18 Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centrewww.annafreud.org/ebpu
Help and practical advice for parentsand carers on how to change theirown and their child’s behaviour.
Parent TrainingVERY LIKELY TO HELP
Most likely to helpon its own if you are under 10 years old and the difficulties are not severe.
Helping families work together to findnew solutions that work for them.
Systemic Family TherapyVERY LIKELY TO HELP
Works best if it includesadvice on andpractice inchangingbehaviour.
Learning and practising new ways of tacklingproblems in a helpful way.
Learning and practising new ways ofgetting on better with others.
Problem-solving TrainingVERY LIKELY TO HELP
VERY LIKELY TO HELP
Helpful alongsideparent training if youare 8-12 years old orif the difficulties arequite severe.
Social Skills Training
RememberWe are all different;
what helps others maynot help you.
RememberYou may need
to try more than one thing.
RememberNever be afraid to ask
questions or to tellpeople how you are
finding things.
Lots of different types of help for youand your family, all working togetherto try to sort out the problems.
Multi-Systemic TherapyVERY LIKELY TO HELP
Helpful if youhave had a lotof difficultiesfor a longtime.
Living with foster parents who aretrained and supported in workingwith difficulties.
Therapeutic Foster CareVERY LIKELY TO HELP
Only necessary ifyou have had veryserious difficultiesover a longtime.
Taking medicine as a pill or as aliquid to help you think, feel orbehave differently.
MedicineLIKELY TO HELP
Medicines for conductdisorder should only beused in specialcircumstances. Try other things first.
RememberOur knowledge is stillgrowing – check thelinks on p36 for the
latest info.
RememberThere may be other
ways of helping not yettested by scientiststhat might help you.
Any medicine may have side effects – youneed to talk this over with your doctor. Formore information about particular medicinesgo to www.netdoctor.co.uk
Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centre
www.annafreud.org/ebpu
CHOOSINGWHAT’S
BEST FORYOU
21Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centre
www.annafreud.org/ebpu
What scientists have found helps with…
Deliberate Self-HarmPeople who self-harm deliberately hurt themselves.
20
Helping families work together to findnew solutions that work for them.
Systemic Family TherapyLIKELY TO HELP
Meeting a fewtimes to focus onsolving key problems can helpafter a child or young person hasself-harmed.
Talking about things in a group on aregular basis with other people whoare having difficulties.
Group TherapyLIKELY TO HELP
Helps youngpeople who have
self-harmedseveral times.
Learning and practising newways of tackling problems in ahelpful way.
Problem-solving TrainingLIKELY TO HELP
It is likely to behelpful to includefamily members.
RememberThere may be other
ways of helping not yettested by scientiststhat might help you.
RememberNever be afraid to ask
questions or to tellpeople how you are
finding things.
RememberOur knowledge is stillgrowing – check thelinks on p36 for the
latest info.
RememberYou may need to try more
than one thing.
Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centrewww.annafreud.org/ebpu
RememberWe are all
different; whathelps others may
not help you.
“I'VE BEEN ABLE TOTALK ABOUT MYPROBLEMS AND I’VELEARNED TO OPENUP AND NOT HIDEAWAY ANY MORE”CORRINE, AGED 17
CHOOSINGWHAT’S
BEST FORYOU
22 Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centrewww.annafreud.org/ebpu
What scientists have found helps with…
DepressionPeople with depression are very sad over a long period of timeand can see no way forward.
23Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centre
www.annafreud.org/ebpu
Waiting and checking to see ifthings get better by themselves.
Watchful Waiting LIKELY TO HELP
Sometimes people get betterby themselves without anyhelp – this is only suggestedif the difficulties are not severe.
Talking about key issues in yourrelationships and agreeing ways forward.
Learning and practising new ways ofthinking and behaving that will make lifeeasier for you and others.
Interpersonal Therapy LIKELY TO HELP
LIKELY TO HELP
Cognitive Behaviour Therapy
LIKELY TO HELP
Systemic Family Therapy
Taking medicine as a pill or as aliquid to help you think, feel orbehave differently.
MedicineVERY LIKELY TO HELP
Any medicine may have side effects – youneed to talk this over with your doctor. Formore information about particular medicinesgo to www.netdoctor.co.uk
RememberWe are all
different; whathelps others may
not help you.
RememberNever be afraidto ask questionsor to tell people
how you arefinding things.
RememberYou may need
to try more than one thing.
Can be helpful wheredifficulties are not toosevere.
Because people canget depressed again, it may help to have afew meetings, evenafter you are feelingbetter, to help stop thishappening.
RememberThere may beother ways of
helping not yettested by
scientists thatmight help you.
RememberOur knowledgeis still growing –check the linkson p36 for the
latest info.
If things are very bad, orif other things are nothelping, anti-depressantmedicines called “SSRIs”can be helpful forteenagers (and possiblyfor younger children).
These should be usedalongside CognitiveBehaviour Therapy,Interpersonal Therapy orSystemic Family Therapy.
Note: antidepressantsknown as “tricyclics”have been shown NOT tohelp.
CHOOSINGWHAT’S
BEST FORYOU
Helping families work together to findnew solutions that work for them.
25Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centre
www.annafreud.org/ebpu
What scientists have found helps with…
Eating Disorders (Anorexia and Bulimia)
People with anorexia nervosa more or less stop eatingaltogether. People with bulimia nervosa eat, but are then sick ortake laxatives to get rid of the food.
24 Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centrewww.annafreud.org/ebpu
Helping families work together to findnew solutions that work for them.
Systemic Family Therapy VERY LIKELY TO HELP
Helps teenagerswith anorexia.
Learning and practising new behaviour thatwill make life easier for you and others.
Behaviour TherapyLIKELY TO HELP
Can be used inhospital, tohelp people put on weight.
Exploring unconscious processes and pastrelationships to try to understand the causesof the problems.
Psychodynamic PsychotherapyLIKELY TO HELP
May help olderteenagers andyoung adultswith anorexia.
Cognitive Behaviour Therapy May helpolderteenagerswith bulimiaLearning and practising new ways
of thinking and behaving that makelife easier for you and others.
MIGHT HELP
“BEING ABLE TOTALK TOSOMEONE HASREALLY HELPED”AMY, AGED 11
RememberWe are all different;
what helps others maynot help you.
RememberNever be afraid to ask
questions or to tellpeople how you are
finding things.
RememberOur knowledge is
still growing – checkthe links on p36 for
the latest info.
RememberThere may be other
ways of helping not yettested by scientiststhat might help you.
RememberYou may need
to try morethan one
thing.
CHOOSINGWHAT’S
BEST FORYOU
26 Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centrewww.annafreud.org/ebpu
What scientists have found helps with…
Obsessive-Compulsive Disorder (OCD)People with OCD feel they have to do something over and over again, e.g. washing their hands.
27
Learning and practising new behaviour thatwill make life easier for you and others.
Learning and practising new ways ofthinking and behaving that make lifeeasier for you and others.
Behaviour Therapy VERY LIKELY TO HELP
VERY LIKELY TO HELP
If you are under 11years old or if yourparents worry a lotabout things, it maybe helpful if they takepart too.
Cognitive Behaviour Therapy
Taking medicine as a pill or as aliquid to help you think, feel orbehave differently.
Medicine Taking anti-depressantmedicines called SSRIsor a medicine called“clomipramine” can be helpful when otherthings have not helped.Any medicine may have side effects – you
need to talk this over with your doctor. Formore information about particular medicinesgo to www.netdoctor.co.uk
VERY LIKELY TO HELP
RememberNever be
afraid to askquestions or to
tell peoplehow you are
finding things.
RememberWe are all
different; whathelps othersmay not help
you.
RememberYou may need
to try morethan one
thing.
Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centre
www.annafreud.org/ebpu
CHOOSINGWHAT’S
BEST FORYOU
“MEDICATIONHAS HELPED MEAND PEOPLEHAVE HELPED ME ACHIEVETHINGS”EDWARD, AGED 15
RememberThere may beother ways of
helping not yettested by
scientists thatmight help you.
RememberOur knowledge is
still growing – checkthe links on p36 for
the latest info.
28 Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centrewww.annafreud.org/ebpu
29Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centre
www.annafreud.org/ebpu
What scientists have found helps with…
Post Traumatic Stress Disorder(PTSD)People with PTSD continue to be very disturbed by an upsetting event.
Learning and practising new ways ofthinking and behaving that make lifeeasier for you and others.
Cognitive Behaviour TherapyLIKELY TO HELP
This should lookat your specificproblems, andshould besuitable for yourage.
Focussing on a particular physical actionwhilst thinking about difficult things in orderto change your thoughts and feelingsabout those things.
Eye Movement Desensitisation and Reprocessing (EMDR)MIGHT HELP
Not manystudies havebeen made sofar to find out ifthis helps.
RememberWe are all different;
what helps others maynot help you.
RememberThere may be other
ways of helping not yettested by scientiststhat might help you.
Note: Whilst talking can be helpful, being encouraged to talk to new people in detail about anupsetting event immediately after it has happened (debriefing) if you don’t want to may not be helpful
Medicines have NOT been found to help children and young people directly with PTSD
RememberYou may need
to try more than one thing.
RememberNever be afraid to ask
questions or to tellpeople how you are
finding things.
RememberOur knowledge is
still growing –check the links onp36 for the latest
info.
“I FEEL RESPECTED AND LISTENED TO”ADAM, AGED 12
CHOOSINGWHAT’S
BEST FORYOU
31Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centre
www.annafreud.org/ebpu
What scientists have found helps with…
Psychosis (Bipolar Disorder and Schizophrenia)
People with psychosis have very serious problems that affect how they think, feel and act.
30 Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centrewww.annafreud.org/ebpu
Taking medicine as a pill or as aliquid to help you think, feel orbehave differently.
Medicine when you are first illLIKELY TO HELP
If you become illvery quickly,medicines called“neuroleptics” or“mood stabilisers”may help.
Taking medicine to stop yougetting ill again
Taking medicine as a pill or as a liquid tohelp you think, feel or behave differently.
MedicineVERY LIKELY TO HELP
Anti-psychoticmedicinescalled “atypicalneuroleptics”may be veryhelpful.
Bipolar DisorderPeople with bipolar disorder feel alternately very manic (very high) and then very depressed.
Schizophrenia People with schizophrenia can imagine they are hearing things and that they are being controlled by others.
Any medicine may have side effects – you need to talk this over with your doctor. For more information about particular medicines go to www.netdoctor.co.uk
Taking medicine as a pill or as a liquid tohelp you think, feel or behave differently.
MAY HELP
CHOOSINGWHAT’S
BEST FORYOU
Any medicine may have side effects – you need to talkthis over with your doctor. For more information aboutparticular medicines go to www.netdoctor.co.uk
Mood stabilisers may behelpful in stopping youbecome ill again once you are well, but scientistsneed to find out more about this.
Learning and practising new ways of thinkingand behaving that to make life easier for youand others.
Helping families work together to findnew solutions that work for them
Cognitive Behaviour TherapyMAY HELP
MAY HELP
These have beenfound to help adultswith psychosis, butscientists don’t knowhow well they wil helpyounger people.
Systemic Family Therapy
RememberOur knowledge is stillgrowing – check thelinks on p36 for the
latest info.
RememberThere may be other
ways of helping not yettested by scientiststhat might help you.
RememberWe are all different;
what helps others maynot help you.
RememberYou may need
to try more than one thing.
RememberNever be afraid to ask
questions or to tell people howyou are finding
things.
33Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centre
www.annafreud.org/ebpu
What scientists have found helps with…
Substance MisusePeople with substance misuse difficulties are addicted to, orbeing harmed by, their use of drugs or alcohol.
32 Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centrewww.annafreud.org/ebpu
Helping families work together to findnew solutions that work for them.
Systemic Family TherapyVERY LIKELY TO HELP
Helps peoplewho havedifficultieswith drugsand alcohol.
Lots of different types of help for you andyour family, all working together to try tosort out the problems.
Multi-Systemic TherapyLIKELY TO HELP
Helps if thereare severalproblems.
Motivational InterviewingLIKELY TO HELP
RememberOur knowledge is stillgrowing – check thelinks on p36 for the
latest info.
RememberWe are all different;what helps othersmay not help you.
RememberYou may need
to try more than one thing.
RememberThere may be otherways of helping not
yet tested by scientiststhat might help you.
RememberNever be afraid to ask
questions or to tellpeople how you are
finding things.
“I HAVE BEENTOLD ABOUTTECHNIQUES ICAN USE TOHELP MYSELF”BRYN, AGED 16
CHOOSINGWHAT’S
BEST FORYOU
Can helppeople limit or stop theirdrug andalcohol intake.
Having conversations which focus onthe advantages and disadvantages ofchanging your behaviour.
What scientists have found helps with…
Tourette’s SyndromePeople with Tourette's shout out or have multiple repetitivebehaviours (tics) that they cannot control.
Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centrewww.annafreud.org/ebpu
Taking medicine as a pill or asa liquid to help you think, feelor behave differently.
MedicineVERY LIKELY TO HELP
Any medicine may have side effects – you need to talk this over with your doctor. For moreinformation about particular medicines go to www.netdoctor.co.uk
Medicines called“neuroleptics” and a medicine called “clonidine” can help.
35Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centre
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RememberOur knowledge is stillgrowing – check thelinks on p36 for the
latest info.
RememberThere may be other
ways of helping not yettested by scientiststhat might help you.
RememberWe are all different;
what helps others maynot help you.
RememberYou may need
to try more than one thing.
RememberNever be afraid to ask
questions or to tell people howyou are finding
things.
34
CHOOSINGWHAT’S
BEST FORYOU
Things to bearin mind
Doing scientific studies to work out whathelps most is not easy.
There is still a lot we don’t know.
Never be afraid to ask those people offeringto help you why they are suggesting
particular ways of helping, and what otheroptions there are.
Some questions you might like to ask thosewho are trying to help you.
What have scientists found out that mosthelps people like me?
Are there any reasons why I should trysomething different?
What are the advantages and disadvantagesof the different options open to me?
37Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centre
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36 Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centrewww.annafreud.org/ebpu
This booklet is based on:
Drawing on the Evidence. Advice formental health professionals workingwith children and adolescents(Second Edition, 2006, CAMHSPublications)by Miranda Wolpert, Peter Fuggle,David Cottrell, Peter Fonagy, JenettePhillips, Steven Pilling, Samuel Stein,and Mary Target.
Free copies of Drawing on theEvidence can be downloaded fromwww.annafreud.org/ebpu
For more information:What Works for Whom? A criticalreview of treatments for children andadolescents (Guilford Press, 2003)Peter Fonagy, Mary Target, DavidCottrell, Jeanette Phillips and ZarrinaKurtz.
Useful Informationand Resources
• Childline(free helpline 0800 1111)www.childline.org.uk
• Get Connected(free helpline 0808 808 4994)www.getconnected.org.uk
• Samaritans(free helpline 08457 90 90 90) email jo@samaritans.org or www.samaritans.org.uk
• YoungMinds Parent InformationService (free helpline 0800 018 2138)www.youngminds.org.uk
If you have concerns or worries you want to discuss privately
• ADDiSS (The National AttentionDeficit Disorder Information andSupport Service)www.addiss.co.uk
• Beat (Beating Eating Disorders)www.b-eat.co.uk/Home
• Frank (for info about drugs)www.talktofrank.com
• Mental Health Foundation(produce leaflets on several subjects)www.mhf.org.uk
• National Autistic Societywww.nas.org.uk
• Parentlinewww.parentlineplus.org.uk
• Royal College of Psychiatristswww.rcpsych.ac.uk/mentalhealthinformation.aspx
• RU-OK (website for young people)www.ru-ok.com
• There4Me (website aimed at 12-16year-olds)www.there4me.com
• Tourette’s Syndromewww.tsa.org.uk
• YoungMindswww.youngminds.org.uk
• Youth In Mind (for parents andteachers as well as children andyoung people)www.youthinmind.co.uk
For more information about particular problems:
For the latest advice on the ways of helping that should be available to you:
• National Institute for Health andClinical Excellence (NICE) – thisorganisation advises the NHS on thebest ways of helping people withhealth problems. Not everything has
been covered by NICE but, where ithas, they can tell you what types ofhelp should be offered to you.www.nice.org.uk
CHOOSINGWHAT’S
BEST FORYOU
38 Choosing What’s Best For You (CAMHS Publications, July 2007)CAMHS Evidence-Based Practice Unit, University College London & Anna Freud Centrewww.annafreud.org/ebpu
Who wrote this booklet
ThanksThanks to all those who offered advice and comments. In particular: the 64 young people and their helpers who attended the YoungMindsEast Midlands Children and Young People’s Conference (March 2007);members of the YoungMinds HealthyHeads and VIK children andyoung people’s panel; Sir Michael Rutter; Dr Michael Clark; Sir IainChalmers; Sir Muir Gray; Hamish Chalmers; Professor Eric Taylor;Professor Peter Fonagy; Ottilie Dugmore of QINMAC and thepsychologists of Bedfordshire and Luton.
Thanks to the National CAMHS Support Service and YoungMinds who paid for copies of this booklet to be printed.
• Miranda Wolpert, Director, CAMHSEvidence-Based Practice Unit, UniversityCollege London & Anna Freud Centre
• Robert Goodman, Professor of Brainand Behavioural Medicine, Kings CollegeLondon, Institute of Psychiatry
• Carly Raby, Young Peoples’Participation Manager, YoungMinds
• David Cottrell, Professor of Child andAdolescent Psychiatry, University of Leeds
• Paula Lavis, Knowledge and Informationlead, CAMHS Evidence-Based PracticeUnit University College London & AnnaFreud Centre and YoungMinds
• Jonathan Bureau, Team Co-ordinator,CAMHS Evidence-Based Practice Unit,University College London & Anna FreudCentre
• Steve Kingsbury, Consultant in Child,Adolescent and Family Psychiatry,Hertfordshire
• David Trickey, Consultant ChildPsychologist, Leicester Royal Infirmary
• Samuel Stein, Consultant in Child,Adolescent and Family Psychiatry,Bedfordshire and Luton Mental Health andSocial Care Partnership
• Nisha Dogra, Senior Lecturer in Childand Adolescent Psychiatry, LeicesterUniversity
• Jeanette Phillips, Consultant Child andAdolescent Psychiatrist, Kent and MedwayNHS and Social Care Partnership Trust
• Barbara Herts, Director, YoungMinds• Dinah Morley, independent child mental
health researcher• Jude Sellen, independent child mental
health consultant• Kathryn Pugh, Head of Policy and
Innovation, YoungMinds• Cathy Street, independent child mental
health researcher• Peter Fuggle, Consultant Clinical
Psychologist, Islington Primary Care Trust• David Goodban, National CAMHS
Support Service• Ann York, Consultant Child and
Adolescent Psychiatrist, Richmond andSenior Adviser of Child and AdolescentMental Health, Department of Health
• Dawn Rees, National CAMHSImplementation Lead, National CAMHSSupport Service
This booklet is designed to be given out tochildren and young people by those trying to
help them.
It aims to help people make more informedchoices about different treatment options.
It does not tell people what to do; it simplysays what scientist have found out so far for
particular emotional and behaviouraldifficulties.
We are interested in your feedback - let us know how future versions of this
booklet might be improved:ebpu@annafreud.org
For free copies and more information go to:www.annafreud.org/ebpu
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