Brain development and impact of trauma and stress on children

Objectives: 1. Understanding human brain development and the importance of positive brain development in early years 2. Impact of trauma and stress on children and the developing brain 3. Contextualising trauma and neglect 4. Focusing on the role of the relationship in recover

Evaluation of the Solihull Approach in Kent: drawing conclusions from the data

• The Solihull Approach is both a theoretical framework and a comprehensive resource pack developed by practitioners for practitioners. It is designed to be used as a brief intervention and is supported by a comprehensive resource pack which contains evidence based information for practitioner, carers and young people. This framework has been rolled out across Kent county. Data from various sources has been collected over several years and has been summarised to offer some comment on the efficacy of the training. • Using a training evaluation framework developed by Kirkpatrick (1998) various levels of impact were assessed including participant views of the training, perceptions of change in their behaviour and impact on outcomes for children and families. • The course feedback shows a high level of satisfaction with the training in terms of content, framework and delivery. A survey of participants 1 year after the courses revealed that over 90% were using the skills, making use of the resources and felt more confident. However 40% were experiencing difficulties in accessing the practice development sessions. • An evaluation of outcomes for children and families was undertaken using pre- and post work assessment measures. Despite the challenges encountered using measures in a frontline setting the data does suggest that there were positive outcomes for those children and their families who worked with a Solihull Approach trained practitioner. The Strengths and Difficulties Questionnaire both Parent and Child versions indicated that there were significant differences. The BAI also indicated that parent’s anxiety levels had improved. It is important to bear in mind that these are only indicative as the number of participants was small. • Parent interviews also indicate that based on their descriptions of what was helpful practitioners were making use of the model. • Data from 2 qualitative research studies indicates the positive impact of the training. A mix methods study exploring and evaluating frontline education practitioners’ experiences of The School Years Solihull Approach training within a multi-agency context revealed that the training has the potential to facilitate multi-agency working and enhance training practices within universal children’s service more generally. The second study looked at the experiences of Solihull Approach trained school and community nurses, in use the Solihull Approach in their school drop-in sessions. The study also explored the experiences of pupils who have attended drop-ins with Solihull Approach trained nurses. This study revealed that participants were using the framework and that young people found these drop-ins useful. • Taking the data as a whole it would appear that the Solihull Approach training is having both a positive impact on the practitioners being trained as well as on the young people and families they are working with

CAMHS Information Project: a resource kit for outcomes measurement in Kent Child and Adolescent Mental Health Services

The CAMHS Information Project (CIP) was commissioned as a county-wide response to the call for implementation of routine outcomes measurement (ROM), as indicated in both national and local level policies (Every Child Matters, 2004; National Standards Framework: Standard 9, 2004; CAMHS Commissioning Strategy for Kent, 2007; Kent Children and Young People’s Plan, 2008-2011). The aims of the CIP were to implement systems of ROM across Tier 2 and 3 CAMH services in Kent; and in doing so, promote a culture of learning and advancement through the proactive use of outcomes tools, and monitor, evaluate and ensure continual high-quality service provision to children, young people and families living in the county. Furthermore, as ROM is considered an essential aspect of commissioning arrangements needed for service improvement, its implementation indicates a further example of good practice across the county’s CAMH services. The CIP was therefore intended as more than a performance management measure, and instead was to make a strategic contribution to CAMH service development with improved outcomes for service users

Brauer groups and quotient stacks

A natural question is to determine which algebraic stacks are qoutient stacks. In this paper we give some partial answers and relate it to the old question of whether, for a scheme X, the natural map from the Brauer goup (equivalence classes of Azumaya algebras) to the cohomological Brauer group (the torsion subgroup of $H^2(X,{\mathbb G}_m)$ is surjective.Comment: American J. Math, to appear. (Latex2e, 17pp

Domains pilot: Kent County Council HeadStart Project. Case studies in promoting resilience in vulnerable children

This pilot exercise was undertaken as part of the Big Lottery funded HeadStart programme. HeadStart aims to improve the mental well-being of at-risk* 10 to 16 year-olds by investing up to £75m in up to 12 local partnerships to facilitate and support: 1. the implementation of a locally developed, cross-disciplinary, multi-layered and integrated prevention strategy, with the young person and their needs at its core 2. the development of the necessary local conditions to enable that strategy to become sustainable in time 3. the development of a more robust evidence-base around ‘what works’ in the area of mental well-being to be pro-actively shared beyond HeadStart with the aim of contributing to the national and local policy debate. Previous stages of HeadStart Kent involved knowledge transfer exercises in the form of seminars. KCC staff and the HeadStart programme partners were introduced to the theory of resilience and its application with vulnerable children. A key aim of the seminars was to ensure projects focused on promoting the protective factors associated with resilience when designing and delivering their services. The HeadStart seminars provided the knowledge transfer to partners delivering commissioned services specific to the programme. This pilot exercise will further contribute to the evidence gathering by working with KCC practitioners at the earlier stage of assessment using a resilience approach. Increasing the chance of children and young people demonstrating resilience when faced with adversity requires the enhancement of protective factors (those factors which shield the young person from potential blows to their resilience) and the reduction of risk (the removal or re-framing of potentially threatening events or issues). Therefore, it is useful to focus on resilience in terms of the areas or ‘domains’ of a person’s life that can be manipulated or changed. The introduction of a domains approach to resilience at the assessment stage, will better inform intervention and support strategies based on a child or young person’s individual need

Optimal Long-Run Fiscal Policy: Constraints, Preferences and the Resolution of Uncertainty

We construct a computational dynamic stochastic overlapping generations general equilibrium model with uncertain lifetimes and explore the impact of policy stickiness (specifically, a major reform will preclude future reforms for a generation) on optimal long-run fiscal policy. Under such circumstances, entitlement reforms exhaust a valuable option to move in the future. We explore the conditions under which the gain to waiting is large enough to induce optimizing policymakers to delay reforming a suboptimal system. We also allow for the uncertainty to have ARCH characteristics and explore the impact of time-varying uncertainty on the optimality of delayed policy action.

Service user involvement in cognitive behavioural therapy training; an interpretive phenomenological analysis

Purpose: The last two decades have seen an increase in service user involvement (SUI) in the training of Mental Health Professionals (MHP). There is developing empirical support for SUI in MHP training, however, there is no published research into SUI in the training of Cognitive Behavioural Therapists. This study explores Cognitive Behavioural Therapy (CBT) trainees’ experience of SUI in their training. The study focuses on how an individual service user (SU) led training session is experienced and how this differs to routine CBT training. Approach: Semi-structured interviews were conducted with six participants. Transcripts of the interviews were analysed using Interpretative Phenomenological Analysis (IPA). Findings: Data revealed three superordinate themes: 1; predisposing influences on learning, 2; factors associated with emotional processing of experience and 3; impact upon learning outcomes. The results suggest that participants’ appraisal of their learning from SUI maybe influenced by how they accommodate the emotional impact of the experience. Value: The paper makes recommendations for educators on courses involving service users, acknowledges the study’s methodological limitations and suggests areas for future research

Youth offending teams: a grounded theory of the barriers and facilitators to young people seeking help from mental health services

Young people within the youth justice system experience three times higher rates of mental health problems than the general youth population yet are one of the least likely groups to seek help. Very little theory or research is available within this population to explain these high rates of unmet need. The study aimed to develop a theory about the barriers and facilitators that Youth Offending Team workers experience when supporting young people to access mental health services. Eleven semi-structured interviews were conducted with participants; eight Youth Offending Team workers, two young people and a mental health worker. Interviews were audio-recorded and transcribed verbatim before being analyzed using “grounded theory”. This method was chosen to allow the in-depth exploration of participants experiences and the development of theory within an under-researched area. Youth Offending Team workers appeared to play a crucial role in supporting a young person’s help-seeking from mental health services. A preliminary model was developed which demonstrated the complex relationships between six identified factors which influenced this role. Youth Offending Team workers would benefit from more support, training and recognition of the key role they play in supporting young people to become ready for a referral to mental health services. Mental health services could be well placed to provide this. Clinical implications are discussed. Further research is needed to develop our understanding of what influenced the help-seeking of this vulnerable population