The journal Clinical Child Psychology and Psychiatry was established to provide a forum for articles relevant to clinicians who work with children and families. Published four times a year, it is intended to balance a perceived overemphasis on quantitative measurement. This peer-reviewed journal prefers qualitative research over quantitative research. The editor, the book review editor, and all associate editors are from London. Assessors on the panel are from the United States, Canada, the Netherlands, Japan, and Italy. These assessors represent the disciplines of child psychiatry, child psychology, pediatrics, social work, education, psychotherapy, nursing, ethics, sociology, and anthropology. No professional society sponsors this journal. Topics covered in the first three issues of the journal are timely and important, including child abuse, suicide, HIV and AIDS in children, and eating disorders.

Clinical Child Psychology and Psychiatry

Initial RCT of a distress tolerance treatment for individuals with substance use disorders.

Background Suicide is the second leading cause of death among adolescents. The purpose of this study was to test a family-focused outpatient cognitive behavioral treatment (F-CBT) protocol for depressed adolescents following psychiatric hospitalization for a suicide attempt or suicidal ideation, and who had a co-occurring risk factor (suicidal behavior prior to the index admission, nonsuicidal self-injury, and/or a substance use disorder), in a randomized Phase 2 efficacy trial. Method One hundred forty-seven adolescents (mean age = 14.91 years; 76.2% female, 85.5% White) and their families, recruited primarily from an inpatient psychiatric hospitalization program, were randomly assigned to F-CBT or enhanced treatment-as-usual (E-TAU). A suicide attempt was the primary outcome variable. Depression, suicidal ideation, and nonsuicidal self-injury are also reported here. Assessments were completed at pretreatment as well as 6, 12, and 18-months postrandomization (Trial Registration ClinicalTrials.gov Identifier: NCT01732601). Results In the sample as a whole, rates of attempts decreased from 20% at 6 months to 9% at 12 months to 7% at 18 months. There was no evidence of a significant difference between treatment arms in rates of suicide attempts, major depressive disorder, suicidal ideation, or nonsuicidal self-injury at any of the postrandomization assessment points. Conclusions Though F-CBT was associated with reductions in suicidality, depression, and nonsuicidal self-injury, E-TAU showed an equally strong effect. Greater frequency of F-CBT treatment sessions, particularly at the start of care, and alternative approaches to transitioning to care at 12 months, may be necessary when using F-CBT with this population.

Family‐focused cognitive behavioral treatment for depressed adolescents in suicidal crisis with co‐occurring risk factors: a randomized trial

Suicide is the tenth leading cause of death in the United States (US), with nearly 100 suicides occurring each day and over 36,000 dying by suicide each year. Among Veterans and current military, suicide is a national public health concern. Recent estimates suggest current or former military represent 20 percent of all known suicides in the US and the rate of suicides among Veterans utilizing Veterans Health Administration (VHA) services is estimated to be higher than the general population. The enormity of the problem has led to several major public health initiatives and a growth in research funding for suicide prevention.Despite recent suicide prevention efforts, the suicide rate in the US has changed relatively little over the past 100 years. The body of research on suicide prevention approaches has been reviewed previously by Gaynes and colleagues, and Mann and colleagues, and recent, similar work exists in the form of draft self-harm guidelines from the National Institute for Health and Clinical Excellence (NICE) in 2011. As requested by the Veterans Affairs (VA)/Department of Defense (DoD) Evidence Based Practice Working Group (EBPWG) on suicide prevention, we examined recent research on suicidal self-directed violence as defined by Crosby et al. 2011. We update the work of Gaynes et al. and Mann et al. by systematically reviewing relevant literature that was not included in either report, and was published in 2005 through November 18, 2011. Though the focus of the report is on suicide prevention, we include as outcomes any type of suicidal self-directed violence, defined as “Behavior that is self-directed and deliberately results in injury or the potential for injury to oneself. There is evidence, whether implicit or explicit, of suicidal intent.”

Suicide Prevention Interventions and Referral/Follow-Up Services: A Systematic Review

In this study, the author researched his clinical practice in a community mental health center with six parental couples whose latency-aged children suffered from prevalent separation anxiety disorder symptoms. Through thematic analysis of the anamnestic process recordings of 53 parent sessions, the author's speculation on the effectiveness of the supportive psychodynamic psychotherapy techniques to psychodynamic clinical social work practice with parents was confirmed. Nine of thirteen supportive psychodynamically grounded therapy techniques were highlighted, whereas the clinical practice produced three more. The techniques permeated and shaped the author's clinical social work intervention, and a follow-up confirmed the reduction in mental health symptoms for the children and also increased parental satisfaction in response to the interventions.

Psychodynamic supportive psychotherapy techniques in clinical social work practice with patients

Outpatient treatment is standard care for adolescents discharged following a psychiatric hospitalization. There is little research, however, on the amount and types of psychotherapy these clients receive in the community. We examined therapy attendance and therapist report of outpatient therapy practice with adolescents discharged from psychiatric hospitalization following either a suicide attempt or severe suicidal ideation in the Northeastern USA. Therapists (n = 84) completed a packet of self-report questionnaires regarding treatment of these adolescents in the first six months after discharge from the hospital. Information on number of sessions attended, primary presenting problem, therapist orientation, therapy techniques, and therapeutic relationship was collected. The findings indicated that therapists met their clients in both private and community outpatient settings. The most common modality of treatment was individual therapy, but almost all types of therapeutic techniques were endorsed. Adolescents attended an average of 8.1 therapy sessions (SD = 4.7), with 18% terminating treatment against therapist advice within the first three months. Psychologists, psychiatrists, and social workers used cognitive-behavioral, psychodynamic, and family system techniques about equally. Social workers used humanistic techniques more than their counterparts. The variability in number of therapy sessions attended suggests that many adolescents discharged after a psychiatric hospitalization will not receive adequate care. Short-term therapy protocols designed for community practice emphasizing cognitive techniques may be useful to test in future community-based research trials based on the high percentage of adolescents attending relatively few sessions.

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Outpatient psychotherapy practice with adolescents following psychiatric hospitalization for suicide ideation or a suicide attempt

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Outpatient psychotherapy practice with adolescents following psychiatric hospitalization for suicide ideation or a suicide attempt