Publications by authors named "Roz Shafran"

Objective: To conduct a proof-of-concept pilot study of a CBT guided self-help intervention for children and young people with eating disorders.

Method: Children and young people were recruited from two outpatient eating disorder services in England. They received a CBT guided self-help intervention consisting of eight modules and weekly support sessions.

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Background: We examined the feasibility and outcomes of Artificial Intelligence (AI) as a virtual coach in guided self-help (GSH-AI) compared to pure self-help (PSH).

Method: Participants ( = 85 undergraduate university students; M age = 20.65 years [ = 2.

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Loneliness is an adaptive experience evolved to create motivation to engage in social relationships. However, for some young people, loneliness can become chronic which can have serious negative health consequences. Despite this, there is a relative lack of evidence for interventions.

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Objective: Children with epilepsy may have significant mental health needs with detrimental impact on quality of life, and families often request support and intervention. This paper explores the change experienced by parents of young people with epilepsy and mental health difficulties receiving an integrated mental health intervention.

Methods: A qualitative study was conducted within a randomised controlled trial evaluating the Mental Health Intervention for Children with Epilepsy (MICE) psychological therapy in addition to usual care.

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Article Synopsis
  • - The study explores the long-term effects of SARS-CoV-2 in children and young people (CYP), identifying a condition called post-COVID-19 condition (PCC) and examining symptoms and impacts up to 24 months post-infection.
  • - Out of 31,012 eligible CYP, 12,632 participated, revealing that 7.2% consistently met the PCC criteria over two years, with around 20-25% reporting three or more symptoms, and symptom severity was found to be higher in older and more deprived groups.
  • - The findings emphasize the necessity of longitudinal research to better understand both the prevalence and severity of PCC symptoms in CYP, as well as the importance of monitoring clinical impairment over
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Objectives: Research has shown that children with epilepsy often experience mental health disorders but face barriers to effective care. One solution is to train healthcare professionals within paediatric epilepsy services to deliver psychological interventions. The aim of this paper was to examine aspects of treatment integrity of the 'Mental Health Interventions for Children with Epilepsy' (MICE) treatment, a modular cognitive behavioural therapy intervention for anxiety, depression and behavioural difficulties in childhood epilepsy.

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Background: Predicting which children and young people (CYP) are at the highest risk of developing post-COVID-19 condition (PCC) could improve care pathways. We aim to develop and validate prediction models for persistent PCC up to 24 months post-infection in CYP.

Methods: CYP who were PCR-positive between September 2020 and March 2021, with follow-up data up to 24-months post-infection, were analysed.

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Background And Aims: Low-intensity psychological interventions are effective for children and young people (CYP) with mental health difficulties and can help bridge the demand-capacity gap. Despite increasing awareness, training and use of low-intensity psychological interventions, it is not yet understood what is being implemented in clinical practice in the UK and the associated evidence base.

Method: This paper presents two studies; first, a national survey (=102) of practitioners to identify low-intensity psychological interventions currently delivered in practice and second, an exploration of the availability and the strength of empirical support (characterised as 'gold', 'silver' and 'bronze') of low-intensity CBT interventions for CYP.

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Background: There is a significant unmet treatment need for children and young people (CYP) with eating disorders. Guided self-help interventions have the potential to expand access to evidence-based treatments. Guided self-help is a type of low intensity psychological intervention where individuals engage with a workbook or online programme, with the support of a health professional.

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Article Synopsis
  • Perfectionism is linked to mental health issues, with two main dimensions: perfectionistic strivings (high standards) and perfectionistic concerns (fear of failure), impacting self-esteem in different ways.
  • A systematic review analyzed 83 studies involving over 32,000 adults, finding a moderate negative correlation between self-esteem and perfectionistic concerns, while the link with perfectionistic strivings was negligible.
  • The findings support a cognitive-behavioral understanding of clinical perfectionism and suggest that future studies should explore different treatments for perfectionism and low self-esteem.
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  • CBT (Cognitive Behavioral Therapy) is effective for treating depression, and the INTERACT platform enhances access through online resources and messaging support between therapists and patients.
  • The INTERACT trial involved interviews with patients, therapists, and supervisors to evaluate how this integrated delivery approach worked for managing depression.
  • Results showed that online resources improved patient engagement and allowed for reflection, but highlighted challenges in goal-setting and the typing process, indicating a need for clear expectations in therapy.
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Objective: Evaluate the cognitive, behavioural and affective processes involved in therapeutic change for young people with epilepsy and mental health difficulties receiving an integrated mental health intervention.

Methods: As part of a mixed methods convergent design, qualitative data were gathered in parallel to quantitative data at two timepoints in a randomised controlled trial testing the Mental Health Intervention for Children with Epilepsy in addition to usual care. Twenty-five young people and/or their families were interviewed before and after the intervention about the young person's mental and physical health, and their experience of therapy.

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Background: Post-COVID Condition (PCC), also known as 'Long COVID,' refers to persistent symptoms following a coronavirus 2 (SARS-CoV-2) infection. The prevalence of PCC in children and adolescents varies, impacting multiple body systems and affecting daily functioning. Specialised paediatric hubs were established in England to address the needs of young individuals with PCC.

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Higher Education Institutes (HEIs) have been met with an unprecedented demand on their student counselling and wellbeing services in recent years with the impacts of COVID-19 and high rates of mental health concerns amongst student populations. Online mental health programs offer one solution by providing students with quick and easy access to effective therapeutic content. The Focused Minds Program is an evidence-based eight-module online self-guided cognitive behavioural intervention that targets the transdiagnostic risk factor of perfectionism and has been shown to decrease depression, anxiety, and disordered eating.

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Rationale: Clinical pathways (CPWs) are structured care plans that set out essential steps in the care of patients with a specific clinical problem. Amidst calls for the prioritisation of integrated mental and physical health care for young people, multidisciplinary CPWs have been proposed as a step towards closer integration. There is very limited evidence around CPWs for young people with mental and physical health needs, necessitating a review of the literature.

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Background: Children and young people with epilepsy are more likely to experience multiple mental health problems than those without chronic physical health conditions, yet they often do not receive evidence-based (or indeed any) psychological interventions. Integrated healthcare is recommended as a solution to address these inequalities, but remains limited in the United Kingdom. This is partly due to the lack of training and availability of ongoing supervision for clinicians to ensure the safe and effective delivery of treatments.

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Article Synopsis
  • - The study examines the methodological challenges in assessing Long Covid in children and young people (CYP), particularly regarding issues like non-response and attrition that could lead to biased findings.
  • - It aims to create survey weights for the CLoCk study to better understand the prevalence of symptoms (like shortness of breath and tiredness) over time in both SARS-CoV-2 positive and negative CYP.
  • - The successful development and application of flexible survey weights allow for the adjustment of findings, making them more generalizable to the overall CYP population in England and emphasizing the need to account for selection biases when analyzing such studies.
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  • Guided self-help is an evidence-based mental health intervention that relies on a facilitator, referred to as the guide, who supports clients in using self-help materials effectively.
  • The article highlights the essential competencies and responsibilities of guides, such as fostering client engagement, personalizing support, and structuring sessions appropriately.
  • It emphasizes the need for better recognition of guides' roles in mental health services and discusses challenges like "self-help drift" that guides must manage while identifying mental health issues and adhering to supervision protocols.
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Article Synopsis
  • Cognitive impairment, referred to as "brain fog," was reported in 7.0% of first-time PCR-positive children and young people (CYP) and 7.5% of reinfected CYP 12 months after SARS-CoV-2 infection, indicating no significant difference by infection status.
  • Most cases of cognitive impairment either appeared at the time of testing or within three months post-test, with similar prevalence observed across both groups.
  • A majority of those with cognitive issues were aged 15 to 17, suggesting a potential age-related trend in the manifestation of cognitive impairments related to the infection.
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Background: Despite the high prevalence of mental health difficulties in children and young people with long-term health conditions (LTCs), these difficulties and experiences are often overlooked and untreated. Previous research demonstrated the effectiveness of psychological support provided via a drop-in mental health centre located in a paediatric hospital. The aim of this prospective non-randomised single-arm multi-centre interventional study is to determine the clinical effectiveness of drop-in mental health services when implemented at paediatric hospitals in England.

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Young people living with Long COVID are learning to navigate life with a constellation of poorly understood symptoms. Most qualitative studies on experiences living with Long COVID focus on adult populations. This study aimed to understand the experiences of young people living with Long COVID.

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Background: Prompt access to evidence-based treatment for children and young people with eating disorders is important for outcomes, yet the gap in service provision remains pervasive. Record levels of young people are waiting for eating disorder treatment and access to care is limited. Guided self-help interventions that are brief and require minimal clinician support have the potential to meet the unprecedented demand for treatment quickly and effectively.

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Background: Pediatric rheumatology is a term that encompasses over 80 conditions affecting different organs and systems. Children and young people with rheumatological chronic conditions are known to have high levels of mental health problems and therefore are at risk of poor health outcomes. Clinical psychologists can help children and young people manage the daily difficulties of living with one of these conditions; however, there are insufficient pediatric psychologists in the United Kingdom.

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