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Exposure to childhood adversity is a prevalent and pressing issue due to its established links with poor physical and mental health outcomes across the lifespan. High rates of adversity have been found within young people attending mental health services, and the provision of trauma-informed care and trauma-specific therapies are therefore essential within these services. Trauma-focused cognitive behaviour therapy (TF-CBT) is an evidence-based intervention with established efficacy amongst traumatised children and youth. The primary objective of this study was to evaluate the effectiveness of trauma-specific therapy (TF-CBT) when implemented in a Child and Adolescent Mental Health Service (CAMHS). Given that most youth receive care in community settings, it is important to determine whether treatments tested under controlled conditions can apply in the real world of clinical practice. Specifically, this study aimed to quantify the number and type of adversities reported by clients receiving the intervention; investigate whether the intervention is associated with improvements in participants' posttraumatic stress disorder (PTSD) symptoms, general mental health symptoms and functioning; and report contact with CAMHS at 3 months and 2 years post-treatment. Results showed that CAMHS clients were more likely to have experienced multiple traumatic events than single events, with 100% of clients experiencing suicidal thoughts. Treatment was associated with significant improvements in PTSD symptom severity and improvements in general mental health symptoms. Many clients received ongoing mental health support at the 3-month and 2-year follow-ups, reflecting the complex nature of their issues and the need for support to maintain gains achieved during treatment. Highlights: Result from the dissemination and implementation of TF-CBT in a real-world clinical setting. CAMHS clients had experienced multiple traumas, including sexual, emotional and physical abuse. Treatment with trauma-specific interventions was associated with significant improvements in PTSD, general mental health symptoms and greater functioning. A significant number of CAMHS clients required ongoing mental health support in the short and long term. [ABSTRACT FROM AUTHOR]

Recognition of the protective value of secure parent–child relationships has prompted a growing interest in parenting interventions informed by attachment theory. Circle of Security Parenting (COS-P) is one such program, specifically designed for scalability. Although widely disseminated internationally, evidence for the effectiveness of COS-P is very limited. This non-randomized controlled effectiveness study was designed to help address this gap. A sample of 256 parents of children aged 0–6 years was recruited from four community child and family health organizations. Assessments were undertaken pre- and post-intervention for the treatment group (n = 201) and at comparable times for the waitlist control group (n = 55). Analysis of data for mothers (89% of sample) revealed a significant Time x Group interaction for six of the seven outcomes examined. Compared to mothers in the control condition, treatment group mothers reported significantly: (a) improved parental mentalizing and self-efficacy regarding empathy and affection toward the child; (b) reduced caregiving helplessness and hostility toward the child; and (c) reduced depression symptoms, at the end of COS-P treatment. There was no difference between groups for change in perceived child difficultness. Within-treatment-group analyses indicated that mothers with older children reported greatest reductions in caregiving helplessness, and mothers with probable clinical depression pre-intervention reported greatest reductions in hostility and depression symptoms. Improvements in other study outcomes did not differ by depression severity or child age. Exploratory analyses indicated that treatment group fathers showed the same pattern of change as mothers. Clinical implications and directions for future research are discussed. Highlights: This is one of few studies of the popular COS-P intervention that includes a control condition. Parents receiving COS-P reported greater improvements than control group parents. Mothers with likely clinical depression pre-intervention reported greatest reductions in hostility towards the child and depression symptoms. Mothers with pre-schoolers reported greatest reductions in caregiving helplessness. [ABSTRACT FROM AUTHOR]

As evidence continues to accumulate for the association between childhood trauma and long-term adverse outcomes, Trauma-Informed Care (TIC) approaches are emerging as fundamental to contemporary mental health services. To evaluate a workshop designed to influence mental health practitioners in TIC principles and practices. Nursing, medical and allied health professionals completed pre and post measures of confidence, awareness and attitudes towards TIC practice. The workshop was rated as highly relevant and useful to clinician's practice. Participants' self-reported confidence, awareness and attitudes towards TIC significantly increased (p <.001) and the perceived number of barriers to working within a TIC framework significantly decreased (p <.05). Child and Adolescent Mental Health clinicians routinely screened for trauma and 80% had received training in a trauma specific intervention at follow-up. This brief training provides an important foundation for the development of trauma-informed, evidence-based mental health services. [ABSTRACT FROM AUTHOR]

There is evidence that psychological treatments for postnatal depression are effective in the short-term; however, whether the effects are enduring over time remains an important empirical question. The aim of this study was to investigate the depressive symptoms and interpersonal functioning of participants in a randomised controlled trial (RCT) of group interpersonal psychotherapy (IPT-G) at 2 years posttreatment. The study also examined long-term trajectories, such as whether participants maintained their recovery status, achieved later recovery, recurrence or persistent symptoms. Approximately 2 years posttreatment, all women in the original RCT ( N = 50) were invited to participate in a mailed follow-up. A repeated measures analysis of variance assessed differences between the treatment and control conditions on depression and interpersonal scores across five measurement occasions: baseline, mid-treatment, end of treatment and 3-month and 2-year follow-up. Chi-square tests were used to analyse the percentage of participants in the four recovery categories. Mothers who received IPT-G improved more rapidly in the short-term and were less likely to develop persistent depressive symptoms in the long-term. Fifty seven percent of IPT-G mothers maintained their recovery over the follow-up period. Overall, IPT-G participants were significantly less likely to require follow-up treatment. Limitations include the use of self-report questionnaires to classify recovery. The positive finding that fewer women in the group condition experienced a persistent course of depression highlights its possible enduring effects after treatment discontinuation. Further research is needed to improve our long-term management of postnatal depression for individuals who are vulnerable to a recurrent or chronic trajectory. [ABSTRACT FROM AUTHOR]

This study is a randomised controlled trial comparing outcomes from an 8-week Interpersonal Psychotherapy group (IPT-G) for postnatal depression with ‘treatment as usual’ (TAU), conducted in a routine community setting in the Australian Capital Territory (ACT). Eligible women were recruited and randomly assigned to either IPT-G or TAU conditions. This study compared outcomes on such variables as depressive symptoms, marital adjustment, social support and mother–infant bond at baseline, mid-treatment, end-of-treatment and 3 months follow-up. Participants were also independently assessed using the Hamilton Depression Rating Scale (HAM-D). 50 women completed baseline assessments and were included in the analysis. Comparisons of treatment conditions showed that by end of treatment both the TAU and IPT-G groups significantly improved in terms of mean depression scores, however, the IPT-G women improved significantly more and had continued improvements at 3 months post therapy. Furthermore, women who received IPT-G displayed significant improvement in terms of marital functioning and perceptions of the mother-infant relationship compared to TAU participants. These findings highlight the potential benefits of an interpersonally based treatment, which not only improves outcomes for the mother but also potentially for the couple and the infant when compared to usual care. [ABSTRACT FROM AUTHOR]