UCL Great Ormond Street Institute of Child Health, London, UK
Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
BMJ Paediatr Open. 2024 Nov 18;8(1):e002973. doi: 10.1136/bmjpo-2024-002973.
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.
The MICE treatment was delivered in paediatric epilepsy clinics by 21 healthcare professionals with limited mental health experience, supported by a comprehensive training and supervision package. Data from 2269 treatment sessions with 166 young people were analysed to examine adherence to the MICE protocol. Audio recordings from a randomly selected sample of 251 sessions were rated for therapist competence, of which 30 were independently rated by a second expert.
Therapists administered the MICE intervention with integrity and closely adhered to the established protocol. Any adaptations made were related to the sequence of delivery rather than changes to the content.
The overall findings indicate that professionals in paediatric epilepsy clinics can be effectively trained and supported to administer evidence-based mental health interventions. Additional research is required to explore the link between integrity and clinical outcomes, as well as to determine the most effective methods for training and supervision. This is crucial for ensuring the successful implementation of mental health interventions for children with epilepsy and concurrent mental health needs.
研究表明，癫痫患儿常患有心理健康障碍，但他们在获得有效治疗方面存在障碍。一种解决方案是培训儿科癫痫服务中的医疗保健专业人员，以提供心理干预。本文旨在研究“癫痫儿童心理干预（MICE）”治疗的治疗完整性方面，该治疗是一种针对儿童癫痫中焦虑、抑郁和行为困难的模块化认知行为疗法干预。
21 名医疗保健专业人员在有限的心理健康经验的基础上，在全面的培训和监督方案的支持下，在儿科癫痫诊所中提供 MICE 治疗。对 166 名年轻人的 2269 次治疗会议的数据进行分析，以检查对 MICE 方案的依从性。从随机选择的 251 次会议中抽取音频记录，对治疗师的能力进行评分，其中 30 次由第二位专家进行独立评分。
治疗师完整地实施了 MICE 干预，并严格遵循既定方案。任何进行的调整都与交付顺序有关，而不是内容的改变。
总体研究结果表明，儿科癫痫诊所的专业人员可以通过有效培训和支持来管理基于证据的心理健康干预措施。需要进一步研究来探索完整性与临床结果之间的联系，以及确定培训和监督的最有效方法。这对于确保成功实施癫痫儿童和并发心理健康需求的心理健康干预措施至关重要。
