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Background Establishing what constitutes clinically significant change is important both for reviewing the function of services and for reflecting on individual clinical practice. A range of methods for assessing change exist, but it remains unclear which are best to use and under which circumstances. Method This paper reviews four indices of change [difference scores ( DS), crossing clinical threshold ( CCT), reliable change index ( RCI) and added value scores ( AVS)] drawing on outcome data for 9764 young people from child and adolescent mental health services across England. Results Looking at DS, the t-test for time one to time two scores indicated a significant difference between baseline and follow up scores, with a standardised effect size of d = 0.40. AVS analysis resulted in a smaller effect size of 0.12. Analysis of those crossing the clinical threshold showed 21.2% of cases were classified as recovered, while 5.5% were classified as deteriorated. RCI identified 16.5% of cases as showing reliable improvement and 2.3% of cases as showing reliable deterioration. Across RCI and CCT 80.5% of the pairings were exact (i.e., identified in the same category using each method). Conclusions Findings indicate that the level of agreement across approaches is at least moderate; however, the estimated extent of change varied to some extent based on the index used. Each index may be appropriate for different contexts: CCT and RCI may be best suited to use for individual case review; whereas DS and AVS may be more appropriate for case-mix adjusted national reporting. [ABSTRACT FROM AUTHOR]

Background: There is a need for further development and evaluation of group-based parent- training interventions for parents of children with disabilities. This paper describes interventions delivered in two areas of Greater Manchester. Method: The process and content of an approach designed for parents of children with learning disabilities and autistic spectrum disorders is described. Results: Clinical outcome data for 22 parents/carers are presented. Client feedback about the course is also reported. Conclusions: The data suggest that this intervention is effective in reducing the frequency and impact of children’s challenging behaviours, and improving parental psychological well-being. More rigorous and extensive evaluation is required. [ABSTRACT FROM AUTHOR]

Background: Efficacious parenting interventions are under-utilised in mainstream services. Empowering Parents, Empowering Communities (EPEC) aims to increase community access to effective parenting support through a peer-led manualised intervention. Method: Training outcomes, clinical effectiveness and acceptability of EPEC were evaluated using a pre-post cohort design. Data were collected from trained peer facilitators ( n=31) and parenting group participants ( n=73). Results: Peer facilitators demonstrated significantly increased knowledge of and confidence in delivering parenting groups. Parents attending groups reported improvements in child behaviour and parenting stress, and high satisfaction. Conclusions: Early evidence suggests that EPEC may be an effective and acceptable service model in socially disadvantaged communities. [ABSTRACT FROM AUTHOR]

Background: Teachers have a significant role to play in identifying children with mental health problems. However, teachers’ perceptions of children’s mental health problems are relatively unexplored. Method: Primary school teachers ( N = 113) completed a questionnaire, composed of vignettes describing children with symptoms of a common emotional disorder and a common behavioural disorder, following which they were asked a number of questions regarding problem recognition and help-seeking. Results: Teachers were able to recognise the existence of a problem and rate its severity. They were significantly more concerned about a vignette of a child with symptoms of a behavioural disorder than an emotional disorder. The gender of the child was found to independently predict teachers’ accurately recognising when a child had a problem. Conclusion: Teachers are good at recognising whether a child presents with a problem. However, their problem recognition is affected by both the gender of the child and the type of symptomatology being displayed (emotional versus behavioural). [ABSTRACT FROM AUTHOR]