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Telephone-guided self-help for mental health difficulties in neurological conditions: a randomised pilot trial
  1. Sophie D Bennett1,
  2. Isobel Heyman1,2,
  3. Anna E Coughtrey1,2,
  4. Sophia Varadkar1,2,
  5. Terence Stephenson1,
  6. Epilepsy and Mental Health Programme Development Grant Research Group,
  7. Roz Shafran1
    1. 1 UCL Great Ormond Street Institute of Child Health, UCL, London, UK
    2. 2 Great Ormond Street Hospital For Children NHS Foundation Trust, London, UK
    1. Correspondence to Dr Sophie D Bennett, UCL Great Ormond Street Institute of Child Health, UCL, London WC1N 1EH, UK; Sophie.Bennett.10{at}ucl.ac.uk

    Abstract

    Objective This study aimed to conduct a randomised pilot trial to assess the feasibility of a randomised controlled trial (RCT) to investigate the effect of telephone-guided self-help for the treatment of mental health difficulties in children with neurological conditions.

    Design Preliminary RCT. The primary outcome measure was the Strengths and Difficulties Questionnaire.

    Setting Neurology clinics in a national tertiary paediatric hospital.

    Patients Young people attending neurology clinics who met criteria for mental health difficulties according to the Development and Wellbeing Assessment.

    Interventions 12 weeks of telephone-guided self-help based on a modular approach to psychological therapy for children delivered to children and/or their parents (n=17; eight males; mean age 12.04 years, SD=3.34) or a waiting list for telephone-guided self-help with no additional intervention over 12 weeks (n=17; nine males; mean age 10.53 years, SD=3.14).

    Results 124 participants completed the DAWBA, and 34 children and young people were entered into the trial. 65% of those randomised to the intervention arm completed the full intervention, and the intervention was acceptable to those completing it. However, there were significant problems related to lack of data completion (38% data loss for primary outcome measure), choice of control comparator and outcome measures. Due to significant loss of data at follow-up, the effect size findings are considered unreliable.

    Conclusions Further feasibility work should be conducted to improve data completeness before progression to a definitive trial of guided self-help for mental health problems in children with neurological conditions can be recommended.

    Trial registration number ISRCTN21184717.

    • neurology
    • autism
    • psychology
    • child psychiatry
    • general paediatrics

    Data availability statement

    Data are available from the corresponding author on reasonable request.

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    Data availability statement

    Data are available from the corresponding author on reasonable request.

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    Footnotes

    • Collaborators Epilepsy and Mental Health Programme Development Grant Research Group: Marta Buszewicz; Sarah Byford; Caroline Dore; Peter Fonagy; Tamsin Ford; Rona Moss-Morris; Susan Tebbs; and Erin Walker.

    • Contributors SB was a study coinvestigator, the project management lead, was the therapist for majority of patients and wrote the first draft of the manuscript for publication. IH was the joint lead coapplicant and Great Ormond Street Hospital psychiatric and clinical lead, designed the study and supervised DAWBA ratings. AEC was a study coinvestigator, contributed to the overall design of the study and rated all DAWBAs. SV was a study coinvestigator, was the neurology lead and supported study management in the neurology clinics. TS was a study coinvestigator, paediatric consultant and contributed to study design. RS was the joint lead coapplicant, designed the study, was therapist for some patients and supervisor of therapy for all and supervised the management of the study. The Mental Health in Children with Epilepsy study team provided advice regarding data interpretation and publication. SB and RS had complete access to the study data that support the publication.

    • Funding This work was funded by the Great Ormond Street Hospital Children’s Charity (Grant Number 17663). The research was supported by the National Institute for Health Research Biomedical Research Centre at Great Ormond Street Hospital for Children NHS Foundation Trust and University College London.

    • Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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