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Abstract Background Dramatherapy, a creative form of psychotherapy, may be a useful treatment for child and adolescent mental health. As there is a growing evidence base, this systematic review sought to identify, describe and evaluate dramatherapy with children and adolescents who were experiencing emotional distress (anxiety, depression and trauma) in order to inform future research in this area. Methods Seven databases (PsychInfo, PubMed, Scopus, Web of Science, CINAHL, EMBASE and Cochrane) were searched for peer‐reviewed articles exploring dramatherapy as a treatment for child and adolescent emotional distress. Hand searches of relevant journals were also conducted. Two reviewers coded articles for eligibility and independently appraised papers using the Joanna Briggs Institute Critical Appraisal Tools. Details relating to intervention and participant characteristics were extracted and, where data were available, effect sizes on measures relating to emotional distress were calculated. Results Fifteen papers were included. Studies showed that dramatherapy was often delivered in schools (46%) and clinical settings (20%) and was more frequently delivered to adolescents (53%) (>11 years) than children (26%) (8–11 years). Dramatherapy was used as a treatment for diagnostically heterogeneous groups (40%), for emotional and behavioural difficulties (33%) and following a shared, traumatic, experience (20%). Seven papers reported relevant quantitative data however, just three of these studies were controlled and none were blinded. Pre‐to‐post intervention effect sizes ranged from d = 0.17 to d > 2 yet samples were small and participant response to treatment was not always consistent. The largest effects were seen in dramatherapy employed following trauma and in clinical settings. Medium to large effects were also seen in early intervention school‐based dramatherapy. Conclusion Despite promising results with regards to the treatment of child and adolescent emotional distress, the evidence base for dramatherapy is small and methodologically flawed. Larger, methodologically robust trials should test the efficacy of dramatherapy in future research.

Objectives To investigate key stakeholders’ views on how to improve access to primary care in general practice settings for people with learning disabilities (or intellectual disabilities). Further to explore how inequalities and barriers in specific areas including annual health checks might be addressed.Design A qualitative study design was used with data collected during focus groups, interviews and open-response surveys; data analysis was thematic and informed by stakeholder consultation. Processes to facilitate quality included triangulation of stakeholder perspectives, triangulation of data collection methods and checking interpretation of findings with participants.Setting UK regional services including learning disability organisations, primary care general practitioner (GP) clinical practice networks and supported housing organisations.Participants Sixteen people participated in the study: four people with learning disabilities participated in a focus group; four relatives completed an interview or survey; eight GPs, practice nurses and supported housing managers participated in interviews.Results Five overarching themes describing approaches to improve primary care access for people with learning disabilities were identified including: prioritisation, proactivity, innovation and improvement, personalisation and prevention and follow-up. Definitions of themes were described and illustrated with quotes. Ten recommendations informed by the thematic analysis, stakeholder consultation, research and primary care guidance were codeveloped with people with learning disabilities.Conclusions All stakeholders identified problems, with primary care interfaces being misaligned with the needs of people with learning disabilities. The recommendations informed by all stakeholders can be used to guide development of service provision to better meet the needs of people with learning disabilities in primary care. Future research should explore professionals’ understanding of reasonable adjustments.

Abstract Background Rates of aggression in inpatient secure care are higher than in other psychiatric inpatient settings. People with intellectual disabilities in secure care require adapted psychological treatments. Interpersonal art psychotherapy incorporates the use of creative art making approaches by participants, thus reducing sole reliance upon verbal interactions during psychotherapy for people who may have communication difficulties. During interpersonal art psychotherapy, participants are individually supported by their therapist to consider how they conduct relationships. This includes the influence and impact of interpersonal issues resulting in repeated patterns of conflict. The key feasibility objectives were to assess recruitment and retention rates, follow-up rates and trial procedures such as randomisation, allocation and identifying any practical or ethical problems. In addition, a preliminary ‘signal’ for the intervention was considered and an indicative sample size calculation completed. The acceptability of a potential third trial arm attentional control condition, mindful colouring-in, was assessed using four single-case design studies and a UK trial capacity survey was conducted. Methods Adult patients with intellectual disabilities in secure care were recruited and randomised to either interpersonal art psychotherapy or delayed treatment in this multi-site study. Outcomes were assessed using weekly observations via the Modified Overt Aggression Scale and a range of self-report measures. Within study reporting processes, qualitative interviews and a survey were completed to inform trial feasibility. Results Recruitment procedures were successful. The target of recruiting 20 participants to the trial from multiple sites was achieved within 8 months of the study opening. All participants recruited to the treatment arm completed interpersonal art psychotherapy. Between-group differences of interpersonal art psychotherapy versus the delayed treatment control showed a ‘signal’ effect-size of .65 for total scores and .93 in the verbal aggression sub-scale. There were no amendments to the published protocol. The assessment of key feasibility objectives were met and the trial procedures were acceptable to all involved in the research. Conclusion This study suggested that a randomised controlled trial of interpersonal art psychotherapy is acceptable and feasible. Trial registration ISRCTN14326119 (Retrospectively Registered).

Background: Children with physical health long-term conditions (LTCs) have increased risk of mental health difficulties relative to healthy peers. However, availability of psychological support integrated into pediatric physical health settings is limited, and there are long waiting times for access to child mental health services. Arts-based therapies involve using creative media to develop a therapeutic relationship, and offer a potential alternative to talking-based therapies. The aim of this systematic review is to establish the effectiveness of arts-based therapies for improving the mental health of children with physical health LTCs.Methods: The review protocol was published on PROSPERO. Four electronic databases were searched (Medline, Embase, Cinahl, and PsycINFO), plus hand searches of two key journals and relevant reviews, and forward/back citations searches of selected articles were conducted. The Effective Public Health Practice Project (EPHPP) Quality Assessment Tool was used to assess bias in selected articles. Second reviewers completed 10% of article screening and 20% of bias assessments. The findings were synthesized narratively.Results: Sixteen studies met inclusion criteria and demonstrated some improvements on indicators of mental health and well-being including quality of life, coping behaviors, anxiety, self-concept, and mood. However, replication across interventions and outcomes was absent. Overall, the quality of evidence of effectiveness in the studies reviewed was moderate/weak. This was due to bias in study design; other limitations included a lack of detail on intervention components, e.g., use of a manual, and single recruitment sites.Conclusions: The heterogeneity of existing research evaluating arts-based therapies for children with physical health LTCs limits conclusions about effectiveness. Suggestions are made to inform the design of future research studies to help build a robust evidence base.

An amendment to this paper has been published and can be accessed via the original article.

Play as a learning practice increasingly is under challenge as a valued component of early childhood education. Views held in parallel include confirmation of the place of play in early childhood education and, at the same time, a denigration of the role of play in favor for more teacher-structured and formal activities. As a consequence, pedagogical approaches towards play, the curriculum activities that constitute play, and the appropriateness of play in educational settings, have come under scrutiny in recent years. In this context, this study investigates children’s perspectives of play and how they understand the role of play and learning in their everyday activities. This article reports on an Australian study where teacher-researchers investigated child-led insights into what counts as play in their everyday classroom activities. Children (aged 3–4 years) described play as an activity that involved their active participation in “doing” something, being with peers, and having agency and ownership of ideas. Children did not always characterize their activities as “play”, and not all activities in the preschool program were described as play. The article highlights that play and learning are complex concepts that may be easily dismissed as separate, when rather they are deeply intertwined. The findings of this study generate opportunities for educators and academics to consider what counts as “play” for children, and to prompt further consideration of the role of play as an antidote to adult centric views of play.

Background: Rates of mental health conditions are high among adults with learning disabilities relative to the general population, however research suggests mental health conditions may be missed or under-identified in this population group. This review considers factors associated with the identification of mental health conditions among adults with learning disabilities in primary care. Methods: A scoping review was conducted and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance extension for scoping reviews (PRISMA-ScR) We searched electronic databases (Cinahl, PsychINfo and Medline) for articles published between the years 2000 and 2022. Data were extracted, tabulated and themes were identified. Findings: The searches identified 3262 articles and 34 met inclusion criteria and were included in the review. Six broad themes were identified including (i) mental health screening in primary care, (ii) education, training and awareness raising for primary care staff, (iii) increasing access to psychological therapies (IAPT) through improved mental health condition case recognition in primary care and IAPT practitioner confidence, (iv) health checks and continuity of care, (v) specialist support for primary care providers, and (vi) awareness raising among adults with learning disabilities. Conclusions: There should be efforts to increase availability in primary care of mental health screening measures suitable for people with learning disabilities. Training opportunities for providers across different sectors of health and social care pathways, on the mental health needs of people with a learning disability are also required. The findings can be used to guide the development of services, for adults with learning disabilities and symptoms of mental health conditions in primary care.