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Emotional and Behavioural Problems in Children and Adolescents

Emotional and Behavioural Problems in Children and Adolescents by Lyn Littlefield
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To reduce the prevalence and impact of mental disorders, it is essential to identify children at an early stage within the developmental pathway of the disorder and provide prompt and effective treatment. Early intervention can make a significant difference to reducing children’s mental health difficulties and can result in dramatic, practical benefits that are sustained over time.

Based on theoretical knowledge and research evidence of effective interventions, in 1986 the Exploring Together Program (ETP), an early intervention program for primary school-aged children with early signs of, or established, mental health problems, was developed. ETP was designed to treat both children with externalizing problems and those with internalizing problems. Evaluations of ETP have shown it to be very successful and demonstrations of its effectiveness as an early intervention program have led to further evolution of the program and its adaptation for other target groups, such as preschool aged children, adolescents and Indigenous children.

Reid and colleagues describe the development and evaluation of the Exploring Together Preschool Program (ETPP), an early intervention program designed for the very early identification of preschool children with behavioural, emotional or social problems and their families. ETPP was found to be effective in reducing preschool children’s behavior problems, enhancing their relationships with peers and parents, and improving parenting practices and parents’ satisfaction.

The Parents and Adults Communicating Together (PACT) program is based on a similar ETP model of training a group of young adolescents in communication, problem-solving and conflict resolution skills. Soltys and Littlefield report on an evaluation of PACT which found the program was successful in increasing mothers’ and adolescents’ abilities to resolve conflict through using the model to find ‘win-win’ solutions to problems.

Two preliminary studies of the effectiveness of separate components of the multi-group ETP for primary school-aged children are presented in this issue. Trinder et al. report on an evaluation of the effectiveness of the stand alone Confident Kids program, which comprises the child group component of ETP. An analysis by Burke and collaborators of the effectiveness of the parent group component of ETP, Parenting Together, found significant reported improvements in children’s emotional and behavioral difficulties, parents’ style of parenting and level of parenting satisfaction.

Ngaripirliga’ajirri is an Indigenous version of ETP based on the concept of Indigenous social and emotional wellbeing and taking into account the importance of the culture and the roles of the extended family and community in the rearing of Indigenous children. Robinson and Tyler provide details of the ETP Tiwi adaptation in their paper.

While there is considerable evidence to support the effectiveness of early intervention per se, very few children with mental health difficulties actually receive any professional support. This means that the chances of receiving effective help are quite low, even for children who are identified, resulting in many children going on to develop serious mental health difficulties. Concern for action to address children’s mental health issues has been growing in response to the population trends indicating troubling rates of vulnerability to mental health problems. Given the prevalence of children experiencing mental health difficulties and the low level of access to mental health treatments and interventions, there is a need for population-based models for addressing mental health. The various iterations of the effective Exploring Together Program have helped to inform this exciting new mental health initiative which is facilitating access to early intervention for an even larger number of children with mental health difficulties.

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Title: Emotional and Behavioural Problems in Children and Adolescents
Author: Lyn Littlefield; Jennie Parham

As part of my clinical duties with Brisbane North Child and Adolescent Mental Health Services (and like other psychiatrists in my service), I do a regular fortnightly videoconference (eCYMHS) to a rural area of Queensland. We have a very small full tim

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