Background: Despite the ubiquitous use of Subjective Units of Distress scales (SUDs) in mental health settings to establish levels of distressing emotion, there has been little empirical research in this area. SUDs are commonly used in therapy and assessments, and are a particularly useful tool for establishing current and previous levels of distress in children and young people. Aims: To explore the use of the SUD analogue rating scale in initial child mental health assessments to better understand its application in this context. Method: The data corpus consisted of 28 naturally-occurring video recordings of children and young people attending their first assessment appointment at Child and Adolescent Mental Health Services (CAMHS). A thematic analysis was utilised to explore the specific interactional use of SUDs. Results: Four themes were identified; recency, longevity, context and miscommunication. The first three themes were found to supplement the child’s emotional score on the scale and were important in establishing the necessity for further therapeutic support. Miscommunication as a theme highlighted the need for clarity when using SUDs with children and young people. Conclusions: Recommendations were suggested for practitioners working with children and young people relating to the extended use of rating scales in clinical assessments.
O’Reilly, Michelle; Karim, Khalid; Kiyimba, Nikki (The Royal College of Psychiatrists, 2015-10-07)
Background: The mental health assessment is a fundamental aspect of clinical practice and central to this is the use of questions. Aims: To investigate the frequency and type of questions utilised within a child mental health assessment. Method: The data consisted of 28 naturally occurring assessments from a UK child and adolescent mental health service. Data were analysed using quantitative and qualitative content analysis to determine frequencies and question type. Results: Results indicated a total of 9086 questions in 41 h across the 28 clinical encounters. This equated to a mean of 3.7 questions per minute. Four types of questions were identified; yes–no interrogatives, wh-prefaced questions, declarative questions and tag questions. Conclusions: The current format of questioning may impede the opportunity for families to fully express their particular concerns and this has implications for service delivery and training.
The book provides an account of the issues faced by counseling and psychotherapy practitioners when working with clients who present at risk. Such risks include suicide and self-injury, safeguarding, violence to others, as well as broader areas of personal and situational risks. Positive risk-taking is further discussed.
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