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This case study describes how Prof Cecilia Essau's research into emotional and behavioural problems in children and adolescents has been of benefit to children and has helped parents and schools to provide them with better support. Essau has worked with a children's charity to use her externally funded research to contribute to public understanding through providing presentations and skills training and to underpin the development and implementation of an anxiety prevention programme, Super Skills for Life (SSL), which has had a demonstrable benefit on children's wellbeing. In addition, Essau's research has been of value in informing the development of DSM-5, in introducing a specifier to the diagnosis of conduct disorder using callous-unemotional traits, and in refining the diagnosis of somatic symptom disorder. It has also contributed to policies and interventions internationally.
A research programme of randomised controlled trials undertaken at the University of Southampton demonstrating the efficacy of the New Forest Parenting Programme (NFPP) played a crucial role in: (i) influencing the developers of clinical guidelines to recommend parent training in general as a core part of the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) and (ii) establishing the NFPP, in particular, as a widely employed evidence-based treatment for ADHD, a condition estimated to affect up to 400,000 children in the UK alone. As a direct result of the trials, the programme, a novel therapeutic intervention that teaches parents of preschool children with ADHD how to modify their children's behaviour and improve their self-regulation, has been included in the National Institute for Health and Clinical Excellence (NICE) and other clinical guidelines and recommended internationally as an effective alternative to medication, which often brings only short-term benefits and is associated with a range of potentially debilitating side-effects.
While in Oxford, David M. Clark and colleagues developed psychological models of panic disorder and social anxiety disorder, tested the models in experiments, and devised novel psychological treatments (forms of cognitive therapy [CT]) that target the processes in the models. Randomised controlled trials (RCTs) showed that CT was more effective than existing psychological and drug treatments, with 70-80% of people recovering. The therapies are recommended first-line interventions in current NICE guidelines, and are widely available in the NHS through the Improving Access to Psychological Therapies (IAPT) programme, which Clark helped establish and is now evaluating. The treatments are also being used and recommended in many other countries.
Professor Dieter Wolke has led several research programmes that delineate the long-term health effects of prenatal exposure to stress and moderate/late preterm, very preterm, and extremely preterm birth. His research has had a direct impact on international medical guidelines and educational recommendations for babies born preterm. The research has also informed European political debate (via a White Paper for the European parliament) on healthcare policy related to after care for preterm or sick children; has influenced UK policy regarding the education of children born preterm; and has contributed to public and practitioner understanding through media items issued, for example, by the NHS and the Royal College of Obstetricians and Gynaecologists.
Some 480,000 UK children show persistent antisocial behaviour (Conduct Disorder), a major mental health problem in childhood with strong continuity to adult substance misuse, violence and criminality. Research at King's College London (KCL) showed that these children cost the public ten times more than individuals without Conduct Disorder by age 28. To tackle the problem, KCL researchers were the first to demonstrate that a rigorous parenting programme is a highly effective treatment, even for severe cases. KCL leads the National Academy for Parenting Research which has trained 3,192 practitioners in these approaches, who are estimated to have treated 192,000 troubled children. This success has contributed to the programmes being recommended in NICE guidance and incorporated in a new nation-wide Department of Health-funded rollout reaching 54% of 0-19 year olds in England. The training has also been disseminated internationally.
Since 1994, a team from the University of Reading, led by Peter Cooper, Professor (1993-) and Lynne Murray, Professor (1996-), have published extensively on postnatal depression (PND), revealing important information on the prevalence, detection rates, prediction and assessment of this disorder. Furthermore, their studies examined the impact of PND on the mother-infant relationship and child development, and the effectiveness of interventions for PND. This work has been key to clarifying the nature of PND and its clinical significance and has had a major impact on clinical care for women with PND and their babies. Specifically, the research has provided support for an increased number of health visitors in the UK, influenced UK practice guidelines, and informed training delivered directly to healthcare professionals by Cooper and Murray. Cooper and Murray have extended their UK research to work in an impoverished community in South Africa, which has given rise to community-based parenting interventions that are now being disseminated both in South Africa and beyond.
Cancer treatment for children is one of the success stories of medical care in the twentieth century. Survival increased from almost zero in the 1950s to today, when treatment for some child cancers results in over 90% survival. These improved survival rates have, however, been achieved through use of highly aggressive treatment protocols, with adverse implications for the child's cognitive, emotional and social development and the burden of care on families. Nationally, researchers at Sheffield were among the first to identify the extent to which children continued to show psychological and behavioural problems, even long after the end of treatment. As such, they contributed significantly to discussions about how to balance medical treatment to control the cancer while taking into account the immediate and longer-term impacts on child quality of life and parents' psychological well-being. The work has had direct implications for both national and international clinical guidelines, and assessment of quality of life in national clinical trials. It has also resulted in user-friendly information for schools and families.
EPPSE is a Government-funded, high profile, longitudinal study with a multi-disciplinary design and numerous outputs, almost unprecedented in the UK in terms of its scale and scope. It has become a seminal study of the influence of early education on children's later development. Findings have been used in the UK and internationally for:
The two Principal Investigators at the IOE have taken lead roles in all of the above.
The Greenwood Institute of Child Health is a unique collaboration between the University and public service providers such as the NHS, which aims to improve psychological outcomes for children in high-risk settings. From 1993 to 2013, Greenwood's research has highlighted the increased risk of mental health, drug dependence and criminal activity among children who suffer trauma — through abuse, living in care, homelessness or war. Greenwood's programme of research has identified the complex and persistent needs of vulnerable children and contributed to changes in policy guidelines and service provision across social care in the UK (foster care / adoption, juvenile detention and homelessness) and abroad (war). Collaboration between researchers at the Greenwood Institute, service providers and practitioners has been instrumental in the establishment of clinically relevant and cost-effective care pathways, while community engagement has led to improved service provision and outcomes for vulnerable children and their families / carers in the UK and further afield.
The pioneering work undertaken at UCL has had a major impact on clinical practice for the treatment of self-harming, suicidal patients with a diagnosis of borderline personality disorder and the techniques have been drawn on in extensions to other common mental disorders including eating disorder, substance misuse, and antisocial personality disorder. This treatment, known as mentalisation based therapy or MBT, has since been applied in a range of clinical settings including inpatient and outpatient work in the UK and internationally. This case study presents two areas in particular where our research has been applied: the treatment of personality disorders, and in work with troubled adolescents.