To what degree do the limitations of the evidence base for ‘common’ psychiatric disorders have an impact upon ‘popular’ treatment approaches?

Abstract

Introduction: As we enter a period of economic downturn, the question of further demonstrating meaningful child and adolescent mental health services (CAMHS) outcomes becomes more salient (Department of Health, 2010). Early research had been stymied by a need to develop age‐appropriate measures (Roth & Fonagy, 2005), as well as childhood being a culturally specific and historically changing construct (Buchanan, 1996). However, Weisz et al (1995; 2005) argued that the current literature provides a basis for understanding what practices are effective.Method: A range of search terms, including ‘child mental health’, ‘CAMHS’ and ‘evidence base’ were entered into ASSIA, EBSCOhost, IngentaConnect, PsychINFO and Web of Knowledge. This revealed 197 hits. Only 19 papers focused upon the ‘implications of the evidence base’. Due to conceptual overlap, three papers were reviewed in greater depth. Additionally, due to the nature of the question, I reviewed two seminal texts to better understand the theoretical framework that constructed the area.Findings: Any conclusions drawn from the evidence base are largely influenced by three main tensions and limitations. These are: 1) the need to demonstrate the efficacy and cost effectiveness of CAMHS; 2) the impact of the theoretical allegiances of researchers (Kuhn, 1970); 3) the need to meet and better integrate a range of theoretical perspectives (particularly social approaches) into the evidence base (Department of Health, 2001; World Health Organization, 2000).Conclusions: The current evidence base is well placed to direct clinicians upon treating conditions that commonly present to CAMHS. However, there are significant tensions and limitations within the literature, which future research may be well placed to reconcile. Once these have been addressed training, supervision and consultancy, to inform the future direction of CAMHS.

Citation

Coote, D. (2011), "To what degree do the limitations of the evidence base for ‘common’ psychiatric disorders have an impact upon ‘popular’ treatment approaches?", Mental Health Review Journal, Vol. 16 No. 1, pp. 15-24. https://doi.org/10.5042/mhrj.2011.0176