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Recent changes to the law in England require all primary schools to teach Relationships Education and all secondary schools to teach Relationships and Sex Education (RSE). Our focus in this article is on the voices of teachers and other educational professionals in relation to this change. Discussion in three focus groups held with 16 educational professionals, indicated concerns regarding some of the challenges associated with the implementation of the new legal requirements, as well as recognising fresh opportunities afforded to teachers for engaging with children and young people. Through analysis, it was noted that participants considered how lessons on relationships and sex should cover LGBTQ+ (lesbian, gay, bisexual, transgender, queer/questioning, others) issues, with strategies advanced for building bridges between schools and parents/communities. Our research indicates a difference between the importance of Relationships Education/RSE and the perceptions of those charged with teaching it, as well as the view that the laudable aims underpinning the new provisions in England will only be realised if appropriate support and training is given to teachers. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your understanding of young people's use of digital technology • To learn how digital technology can be used to provide mental health services for young people • To recognise the importance of considering young people's abilities and preferences when implementing digital interventions Background: Digital technology affords opportunities to expand mental healthcare beyond the clinic setting, supporting sustainable delivery. A pilot qualitative study was undertaken with a view to using the experience gained from it to develop a substantive project in this area. Aim: To identify and better understand the perceived barriers and benefits to using digital technologies when delivering mental healthcare to young people. Method: In-depth semi-structured interviews were conducted with three young people under the care of a child and adolescent mental health service (CAMHS) team. The interview data were analysed thematically. Findings: Three main themes were identified from the interviews: digital identity and digital literacy; trusting and accessing digital health resources; and therapeutic relationships, choice and convenience. Conclusion: The findings of this pilot study reinforce the importance of avoiding a 'one-size-fits-all' approach to integrating digital technology in CAMHS. It was also identified that it is important to carefully consider the involvement of parents when conducting mental health research with children and young people. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To gain insight into the concept of free association and its role in clinical psychoanalysis and psychoanalytically oriented psychotherapy • To consider the application of free association in the context of qualitative research interviewing • To critically assess differences and similarities between qualitative research interviewing and psychoanalytic therapy Background: Free association is a core concept of the free association narrative interview method, an approach that is well-known among researchers in the UK who are interested in using psychoanalytic ideas in qualitative psycho-social research. Aim: To examine the relationship between the framing of the psychoanalytic concept of free association in the contexts of qualitative research interviewing, clinical psychoanalysis and psychoanalytically oriented psychotherapy. Discussion: This article considers the definition of free association in psychology and psychoanalysis. It then explores free association's role in the free association narrative method, in terms of interview technique and the analysis of interview material. Conclusion: Researchers should carefully consider differences in the contexts of research, clinical psychoanalysis and psychotherapy to avoid makeshift integrations of clinical concepts. Implications for practice: The free association narrative interview method is an attractive approach for researchers interested in applying psychoanalytic ideas in their studies. However, researchers should carefully reflect on the meanings of the clinical ideas and terminology they use. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to report findings from a service evaluation undertaken within a single specialist child and adolescent mental health service (CAMHS) team. The team works closely with local authority children's services to serve specific populations recognised as experiencing higher levels of mental health need, including children living in alternative care and with adoptive families. The evaluation sought to better understand the experience of this provision during the COVID-19 pandemic and concomitant increase in remote and digitally mediated care delivery. Design/methodology/approach: Analysis of the accounts of 38 parents, carers and professionals involved with the team gathered via telephone interviews and email and postal questionnaires. Findings: Similar views were expressed from participants involved with the team before and following the onset of the pandemic. Overall, satisfaction was high; however, changes in care appeared more challenging for those already involved with the team before the pandemic. Differences in experience between groups were also evident. Whereas foster carers' accounts were generally appreciative of the involvement of clinicians, particularly regarding clinician–patient relationships, amongst adoptive parents and members of children's birth families there were more mixed and negative impressions. Originality/value: Locally based service evaluations can help inform care pathway planning in specialist CAMHS provision as part of wider quality improvement initiatives. This is especially relevant considering the repercussions of the COVID-19 pandemic and as the longer-term acceptability of remote working practices is appraised. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To critically assess parallels between research interviewing and psychotherapeutic practice • To understand how research interviews can be conceptualised and practised in a way that is informed by principles derived from psychoanalytic therapy • To recognise some of the limits and possibilities in using interpretive comments and feeding back analyses with a psychoanalytically informed research approach Background: This article focuses on approaches to qualitative research interviewing that draw direct inspiration from psychoanalytic therapy. The reflective discussion piece provides a critical spotlight on this method to promote reflection and ethical application. Aim: To provide clarity regarding the meaning of psychoanalytically informed, psycho-social research and the interpretive nature of qualitative interviews and of therapy, and to reflect on nurse researchers' partiality for using quasi-dynamic interpretative comments and the sharing of formulations in interviews. Discussion: The authors review relevant literature, and comment on the apprehension and uncertainty researchers may experience with this type of research approach. Conclusion: Researchers should consider how they conduct themselves as interviewers and what to share of the analysis of participants' accounts based on the specifics of the research, including their or their team's experience of conducting psychotherapy and their and participants' expectations about what may be therapeutic about interviews. Implications for practice: Psychoanalytically informed research interviewing should be used in a reflective way by nurse researchers with attention paid to the limitations and possibilities of parallels between psychotherapeutic and research interview dialogue. [ABSTRACT FROM AUTHOR]

Digital technology offers opportunities for child mental health capacity building, which is a priority for Majority World Countries (MWC). The aim of this study was to explore the experiences and perspectives of professionals from different disciplines in Turkey (n =12) and Pakistan (n =15), who had completed a two-module digital trauma-informed programme on enhancing practice skills and instigating systemic changes. Interview data were analysed through a coding thematic approach. Participants especially valued the interdisciplinary and holistic approach of the training, and its proposed scaled service model. Digital training, particularly in blended format, can enhance reach and capacity in MWC low-resource settings. [ABSTRACT FROM AUTHOR]

Background: Approaching qualitative interviews using principles drawn from psychoanalytic therapy can assist nurse researchers in developing nuanced accounts of participants' and their own subjectivity. Yet, doing so means confronting questions about the use of psychoanalytic concepts and techniques outside the traditional clinical context of the consulting room. Aim: To consider the researcher's interpretive involvement when a psychoanalytically informed interview approach is used with specific reference to email correspondence as a form of interpretive intervention. Discussion: The authors describe the experience of completing a study involving a psychoanalytically informed interview approach. The interpretive quality of email correspondence is illustrated via reference to the case of one study participant for whom this correspondence appeared to help in the level of insight afforded overall. Conclusion: When using a psychoanalytically informed interview approach, researchers should consider emails delineating topics for discussion in follow-up interviews as a form of interpretive intervention. Implications for practice Nurse researchers interested in this type of method should reflect on the interpretive function of email correspondence. Pre-participation and pre-interview dialogue with participants may be used to explore participants' views on the potentially therapeutic aspects of participation and what might be related to them of the researcher's understanding. [ABSTRACT FROM AUTHOR]

In England schools are increasingly responsible for supporting children with Social, Emotional and Mental Health (SEMH) difficulties yet their voices are rarely represented. Through semi-structured interviews, the views of 11 children aged 6–11 years with SEMH difficulties were sought. Using thematic analysis two themes were identified – (1) social relationships and interactions, and (2) emotional and behavioural reactions. The children demonstrated that they were articulate and reflective about the impact their difficulties have in the learning environment. For some, they reported building and maintaining close reciprocal friendships which they felt enriched their time at school. It was concluded that children with SEMH difficulties need to feel safe and supported by adults to flourish in school. This work demonstrates the importance of taking a child-centred approach, allowing children to feel heard, understood and valued. [ABSTRACT FROM AUTHOR]

The implementation of child protection training programmes can be influenced by a range of societal, policy, service and practice-related factors. The aim of this study was to establish the experiences of implementation barriers among 26 professionals from different disciplines in Saudi Arabia, 18 months after they had completed such training. The three identified themes related to customs and traditions; organizational, administrative and staff-related barriers; and challenges in contact with families. It is important that these inter-linked levels of barriers are tackled in co-ordination through policy, legislation, awareness campaigns and service development, and that they are anticipated holistically by educational programmes. [ABSTRACT FROM AUTHOR]

Background: Unaccompanied refugee minors present with disproportionately high prevalence of emotional and psychological morbidities. However, their utilization of mental health services has been shown to be significantly poorer than the indigenous population of the country they seek asylum in. Despite this, there is limited research exploring their perspectives on the barriers they face. Aims: This research aims to understand unaccompanied refugee minors' and their carers' perceptions of the barriers to utilize mental health services and to explore issues perceived to be related to poor engagement with services. Methods: Semi-structured interviews with 15 unaccompanied refugee minors and their carers were conducted. This was to elicit their views, perceptions and beliefs based on their experience of receiving treatment from a specialist mental health service in the UK. Results: Thematic analysis was used and the findings were categorised into two broad themes; the participants' perceptions of the intervention and perceptions of the professionals. Salient aspects of these are discussed. Conclusions: The findings have potential to stimulate further research into gaining a better understanding of the barriers these young people face in accessing help, and may contribute to developing services that are more efficient in engaging this vulnerable group and meeting their specific needs. [ABSTRACT FROM AUTHOR]

Children exposed to multiple adversities are at high risk of developing complex mental health and related problems, which are more likely to be met through integrated interprofessional working. Combining the expertise of different practitioners for interprofessional care is especially pertinent in low- and middle-income countries (LMIC) in the absence of specialist resources. The aim of this study was to work with practitioners who deliver care to vulnerable children in six LMIC (Turkey, Pakistan, Indonesia, Kenya, Rwanda, and Brazil) to understand their perspectives on the content of an interprofessional training programme in building resilience for these children. Seventeen participants from different professional backgrounds, who were in contact with vulnerable children were interviewed. A thematic analytic framework was used. Four themes were identified, which were the benefits of a tiered approach to training, challenges and limitations, perceived impact, and recommendations for future training. The findings indicate the importance of co-ordinated policy, service, and training development in an interprofessional context to maximize resources; the need for cultural adaptation of skilled-based training and interventions; and the usefulness of new technologies to enhance accessibility and reduce costs in LMIC. [ABSTRACT FROM AUTHOR]

Low‐ and middle‐income countries (LMIC) are faced with disproportionately high levels of unmet child mental health needs. This study explored through interviews the perspectives of 17 inter‐agency service stakeholders from Brazil, Indonesia, Kenya, Pakistan, Rwanda and Turkey on existing supports and challenges. Four themes emerged on the holistic nature of children's mental health needs linked with disadvantage; limited resources and skilled workforce; stigma; and strategies for future implementation, including awareness, parental engagement, skills‐based programmes and cultural adaptation. Stakeholder input is essential in conceptualising, developing and evaluating culturally appropriate interventions for vulnerable children in LMIC. [ABSTRACT FROM AUTHOR]

Background: Supporting the education of children and young people with complex emotional mental health difficulties requires schools to have knowledge of their needs. Exchanging information about less visible mental health difficulties is, however, known to be complex. Exploring the perceptions of young people experiencing problems can explicate some of this complexity and identify solutions. Yet their views are rarely given credence in this context. Methods: The findings were derived from a broader qualitative study exploring the school experiences of young people, aged 14–16 years, identified by CAMHS as having severe emotional difficulties. Their parents’ and teachers’ perceptions were also explored. Data were collected via semistructured interviews and analysed using thematic analysis. Results: Findings demonstrated that young people experiencing emotional difficulties need to feel safe about exchanging private information pertaining to their mental health. Teachers having a basic knowledge of mental health promoted their safety as this ensured confidentiality. Participants reported that CAMHS practitioners needed to be more proactive regarding the practicalities of exchanging information. Conclusions: Arguably, teachers need to have basic knowledge of mental health and schools need clearer mental health confidentiality guidance. CAMHS also have responsibility in identifying more information exchange mechanisms and young service users and parents can play a part in this. [ABSTRACT FROM AUTHOR]

Adopted children tend to have high levels of emotional, behavioural and developmental need and are more likely to present to a range of services, including Child and Adolescent Mental Health Services (CAMHS). Although research exploring adopted children's perspectives is growing, it remains limited. Furthermore, there has been little work to engage adopted children in research. Our project aimed to examine adopted children's viewpoints of mental health and services alongside those of their adoptive carers. Results indicated that although there were some similarities between carer and child perspectives, they also frequently differed. They provided different constructions of the problem but agreed that family relationships were strained. Some acknowledgement of the role of the school was offered and other external sources of support cited. Coping was considered to be complex and while some issues were analogous to ‘normal’ family life, much was inherent to the adoption status. [ABSTRACT FROM AUTHOR]

The assessment of interprofessional competence or capability following interprofessional education (IPE) remains essential if we are to ensure future practitioners who are able to work in teams and collaborate for improved health outcomes. Any IPE curriculum must design and describe its theoretical stance and this also applies to how learning will be assessed. This article reports on a study of the use of an IPE portfolio by students across 10 professions as a flexible framework for students to demonstrate their learning. Using a qualitative approach, the completed portfolios of a proportion of students from medicine, social work, and speech and language therapy were read, and a sub-set of students were interviewed to gain their perceptions of this assessment process. The findings are discussed in the light of the value of reflection for learning to consolidate interprofessional understanding. The study highlights how emotional and cognitive learning triggers lead to new understandings for collaborative practice reached only because students were able to reflect on their experiences. The portfolio is now summative and includes other assessment components. [ABSTRACT FROM AUTHOR]

Self-harm in young people is a common presentation to mental health services. There is little literature, however, on how professionals view their role and the role of others within the assessment of these young people, and the relative accountability. This study explored Child and Adolescent Mental Health Services (CAMHS) professionals’ views of these roles utilising a qualitative framework. The interviews of 18 CAMHS professionals from different disciplines were analysed using a thematic approach. Findings showed participants to be clear regarding the remit of their own role and the purpose of the assessment process, but were less confident in the abilities of those outside their service. They commented on the ongoing problems of stigma in this area and the difficulties with multi-agency working. Findings suggested possible ways to ameliorate these problems; however, the current economic climate may not be conducive to this. [ABSTRACT FROM PUBLISHER]

Background: Unaccompanied refugee adolescents are a small but clinically significant group. This group is vulnerable with physical and psychiatric needs which are often not met. There are several barriers to providing care for this group, originating with the refugees but also due to service provision. Aims: The aim of this research is to appreciate the views and perceptions that unaccompanied minors hold about mental health and services. Method: Fifteen unaccompanied adolescents engaged with mental health services were interviewed, and thematic analysis was employed to explore relevant issues. Discussion: Their views reflected a range of opinions on mental health and the treatments they received, but many held negative attitudes toward mental health and had a lack of trust in services. This could be explained by their descriptions of their experiences within their home country of psychiatric care, their experiences of being a refugee/asylum-seeker or cultural differences. Conclusion: We argue it is important to engage this group in the development of policy and practice in child mental health, and in developing services. [ABSTRACT FROM AUTHOR]

Background Recent policies recommend effective joint working between health and education; however, the views of service users are underrepresented, particularly opinions of young children. Method The project was operational from 2005-2008 when interviews were conducted with parents and children. The children were attending CAMHS for mental health and educational difficulties. Results Results indicated that they had a positive view of multiagency working. They consider that joint working is limited by a number of problems and make recommendations for improvement. Conclusions Findings indicate that more effective communication between agencies is needed and this should be provided for parents in an accessible language. This has implications for training professionals together. [ABSTRACT FROM AUTHOR]

Historically, the safety of research participants has taken precedence in health research. More recently, however, in response to anecdotal reports, there is growing concern for researcher safety, which has resulted in policy development. Also, there is a small body of empirical discussion emerging. In this article, we present a case study example of a particular incident that happened to one of the authors during the course of data collection. We present this as a case study using two sources of data to support the narrative. We utilise extracts from the original interview in which the threat to safety occurred, and this is supplemented by an interview with the transcriptionist who transcribed the threatening interview. Using thematic analysis, we found three key themes from the data: physical threat, emotional responses, and managing risk. Our findings suggest that despite reflectively considering and adhering to valuable protocols relating to risk assessment, unprecedented events may still occur. We recommend, therefore, that research teams develop strategies to manage the implications and impact of research involvement to maintain a healthy research team. [ABSTRACT FROM PUBLISHER]

The use of complementary and alternative interventions is growing and gaining popularity, both in the UK and internationally, with significant financial and emotional implications. Complementary and alternative interventions are often utilised by parents of children with Autistic Spectrum Disorders and research has investigated parental beliefs. There is, however, limited understanding regarding what professionals believe about the use of alternative treatments. In this paper we explore the opinions of a range of different professionals about alternative treatments and found that while some have an open-minded opinion, there was a tendency to hold beliefs that these treatments are ineffective, that they give false hope and have potential to harm the child. We discuss the implications for this in terms of the importance of an open dialogue between professionals and families and consider the importance of this in relation to the popularity of these interventions. [ABSTRACT FROM PUBLISHER]

The importance of joint working between educational and child mental health professionals is well documented but there are numerous challenges and only limited training models. While the evidence base and training programmes for educationalists regarding child mental health is growing, training mental health professionals about education is more limited. This study presents the views of 36 child mental health and education professionals from four service localities in England regarding their experiences of joint working and perceptions of training, including a preliminary evaluation of a training programme designed to bridge this gap. The findings indicate that participants perceived that a degree of knowledge in education matters is important, and reported that this could be acquired through the development of relationships with educational professionals, setting up link posts and joint training; they also described challenges related to building experience and to resource constraints. Participants were generally positive about the training package and reported that there was a clear training need in this area. [ABSTRACT FROM AUTHOR]