Lockdown and adolescent mental health: reflections from a child and adolescent psychotherapist.

The author, a child and adolescent psychoanalytic psychotherapist working in the UK NHS, discusses the varied impacts of 'lockdown' on adolescents, their parents and the psychotherapists who work with them, during the COVID-19 pandemic, in this short observational paper that contributes to the Wellcome Collection in response to COVID-19. She asks, particularly, how psychological therapies are positioned during such a crisis, and whether the pressures of triage and emergency can leave time and space for sustained emotional and psychological care. She wonders how psychoanalytic time with its containing rhythm can be held onto in the face of the need for triage on the one hand and the flight to online and telephone delivery on the other.

A systematic review of qualitative studies of adults' experiences of being assessed for psychological therapies.

Objective: To synthesize the qualitative literature on adults' experiences of psychological therapy assessments. The review was led by people with experience of undergoing assessments, with high levels of client involvement throughout.

Search Strategy: A comprehensive search of electronic databases was undertaken, with additional search strategies employed to locate further literature.

Defining continuity of care from the perspectives of mental health service users and professionals: an exploratory, comparative study.

Background: Continuity of care (COC) is central to the organization and delivery of mental health services. Traditional definitions have excluded service users, and this lack of involvement has been linked to poor conceptual clarity surrounding the term. Consequently, very little is known about the differences and similarities in the conceptualization of COC by mental health service users and professionals.

Implementing an aim-based outcome measure in a psychoanalytic child psychotherapy service: insights, experiences and evidence.

In this paper, we describe the use of an aim-based outcome measure used in routine outcome monitoring of child and adolescent psychotherapy within a child and adolescent mental health service. We aim to explore the clinical feasibility and implications of the routine use of this measure. We argue that use of the measure provides a simple and useful way of clarifying the focus of the clinical work and reflecting its progress, while also having the potential to illuminate the clinical picture by contributing an additional source of clinical information from a collaborative process with the patient, parents or both.

Supported employment: cost-effectiveness across six European sites.

A high proportion of people with severe mental health problems are unemployed but would like to work. Individual Placement and Support (IPS) offers a promising approach to establishing people in paid employment. In a randomized controlled trial across six European countries, we investigated the economic case for IPS for people with severe mental health problems compared to standard vocational rehabilitation.

Continuity of care for carers of people with severe mental illness: results of a longitudinal study.

Introduction: Continuity of care has been demonstrated to be important for service users and carer groups have voiced major concerns over disruptions of care. We aimed to assess the experienced continuity of care in carers of patients with both psychotic and non-psychotic disorders and explore its association with carer characteristics and psychological well-being.

Methods: Friends and relatives caring for two groups of service users in the care of community mental health teams (CMHTs), 69 with psychotic and 38 with non-psychotic disorders, were assessed annually at three and two time points, respectively.

Attachment to the clinical team and its association with therapeutic relationships, social networks, and clinical well-being.

Objectives: To determine (1) inter-relationships between social network size and quality and therapeutic relationship ratings and (2) inter-relationships between attachment style, team attachment, therapeutic relationships, social networks, and clinical and social functioning.

Design: A cross-sectional survey.

Method: A sample of 93 people using community mental health teams were assessed on their attachment status, social networks, relationship to the keyworker, attachment to the team, characteristics, and clinical and social functioning.

Understanding service user-defined continuity of care and its relationship to health and social measures: a cross-sectional study.

Background: Despite the importance of continuity of care [COC] in contemporary mental health service provision, COC lacks a clearly agreed definition. Furthermore, whilst there is broad agreement that definitions should include service users' experiences, little is known about this. This paper aims to explore a new construct of service user-defined COC and its relationship to a range of health and social outcomes.

The relationships between employment, clinical status, and psychiatric hospitalisation in patients with schizophrenia receiving either IPS or a conventional vocational rehabilitation programme.

Purpose: Positive relationships between employment and clinical status have been found in several studies. However, an unequivocal interpretation of these relationships is difficult on the basis of common statistical methods.

Methods: In this analysis, a structural equation model approach for longitudinal data was applied to identify the direction of statistical relationships between hours worked, clinical status and days in psychiatric hospital in 312 persons with schizophrenia who participated in a multi-centre randomised controlled trial comparing the effectiveness of Individual Placement and Support (IPS) with conventional vocational services in six study settings across Europe.

Continuity of care for people with psychotic illness: its relationship to clinical and social functioning.

Background: The relationship between continuity of care and user characteristics or outcomes has rarely been explored. The ECHO study operationalized and tested a multi-axial definition of continuity of care, producing a seven-factor model used here.

Aims: To assess the relationship between user characteristics and established components of continuity of care, and the impact of continuity on clinical and social functioning.

Continuity of care for people with non-psychotic disorders.

Background: Service users with non-psychotic disorders are rarely studied. How continuity of care functions for this group is unknown.

Aims: To compare users of community mental health teams with non-psychotic disorders to those with psychotic disorders in terms of demographic and illness characteristics, continuity of care and clinical and social functioning.

Achieving continuity of care: facilitators and barriers in community mental health teams.

Background: The integration of mental health and social services for people diagnosed with severe mental illness (SMI) has been a key aspect of attempts to reform mental health services in the UK and aims to minimise user and carer distress and confusion arising from service discontinuities. Community mental health teams (CMHTs) are a key component of UK policy for integrated service delivery, but implementing this policy has raised considerable organisational challenges. The aim of this study was to identify and explore facilitators and barriers perceived to influence continuity of care by health and social care professionals working in and closely associated with CMHTs.

Therapeutic relationships in vocational rehabilitation: predicting good relationships for people with psychosis.

Therapeutic relationships between clients and vocational rehabilitation workers have been shown to predict entering competitive employment. We aimed to determine predictors of good relationships, using data from an international randomized controlled trial of supported employment (n=312). Baseline predictors of early therapeutic relationships with vocational workers were assessed, along with the impact of vocational status and changing clinical and social functioning variables on relationship ratings over time.

Therapeutic relationships: their specificity in predicting outcomes for people with psychosis using clinical and vocational services.

Objective: To determine the distinctions between the client-keyworker relationship and the client-vocational worker relationship by assessing their impact on clinical outcomes and exploring the associations between the two.

Methods: As part of an international randomised controlled trial of supported employment (n = 312), client-keyworker relationship and client-vocational worker relationship were each tested against clinical and social functioning 6 months later. Associations between the two relationships over time were explored.

Illness careers and continuity of care in mental health services: a qualitative study of service users and carers.

Continuity of care is considered by patients and clinicians as an essential feature of good quality care in long-term disorders, yet there is general agreement that it is a complex concept and the lack of clarity in its conceptualisation and operationalisation has been linked to a deficit of user involvement. In this paper we utilise the concept of the 'patient career' to frame patient accounts of their experiences of the mental health care system. We aimed to capture the experiences and views of users and carers focusing on the meanings associated with particular (dis)continuities and transitional episodes that occurred over their illness career.

Working with mental health problems: clients' experiences of IPS, vocational rehabilitation and employment.

Background: Although the effectiveness of individual placement and support (IPS) has been well established, little is known about clients' perceptions of the model compared to usual vocational rehabilitation, nor about their experiences of searching for and returning to work with this kind of support. This qualitative study aimed to explore clients' views of the difficulties of obtaining and maintaining employment, their experiences of the support received from their IPS or Vocational Service workers and the perceived impact of work on clients' lives.

Method: Semi-structured interviews were conducted with 48 people with psychotic disorders participating in a six-centre international randomised controlled trial of IPS compared to usual vocational rehabilitation.

Individual Placement and Support in Europe: the EQOLISE trial.

Background: Individual Placement and Support (IPS) has been demonstrated to increase return to open employment significantly in individuals with mental health problems in the USA. Previous experience (e.g.

IPS in Europe: the EQOLISE trial.

Background: IPS has been demonstrated to increase return to open employment significantly in individuals with mental health problems in the US. Previous experience (e.g.

The impact of supported employment and working on clinical and social functioning: results of an international study of individual placement and support.

Background: Concerns are frequently expressed that working might worsen the mental health of people with severe mental illness (SMI). Several studies of Individual Placement and Support (IPS), however, have found associations between working and better nonvocational outcomes. IPS has been found to double the return to work of people with SMI in 6 European countries.

Predictors of employment for people with severe mental illness: results of an international six-centre randomised controlled trial.

Background: An international six-centre randomised controlled trial comparing individual placement and support (IPS) with usual vocational rehabilitation for people with serious mental illness found IPS to be more effective for all vocational outcomes.

Aims: To determine which patients with severe mental illness do well in vocational services and which process and service factors are associated with better outcomes.

Method: Patient characteristics and early process variables were tested as predictors of employment outcomes.

The effectiveness of supported employment for people with severe mental illness: a randomised controlled trial.

Background: The value of the individual placement and support (IPS) programme in helping people with severe mental illness gain open employment is unknown in Europe. Our aim was to assess the effectiveness of IPS, and to examine whether its effect is modified by local labour markets and welfare systems.

Methods: 312 patients with severe mental illness were randomly assigned in six European centres to receive IPS (n=156) or vocational services (n=156).