Improving the mental health and mental health support available to adolescents in out-of-home care via Adolescent-Focused Low-Intensity Life Story Work: A realist review

Hammond, Simon P. ORCID:, Mickleburgh, Ella, Duddy, Claire, Hiller, Rachel, Neil, Elsbeth ORCID:, Blackett, Rosie, Williams, Kevin, Wilson, Jon and Wong, Geoff (2023) Improving the mental health and mental health support available to adolescents in out-of-home care via Adolescent-Focused Low-Intensity Life Story Work: A realist review. BMJ Open, 13 (10). ISSN 2044-6055

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Objectives Life Story Work (LSW) is used to promote the mental health and well-being of children and adolescents living in out-of-home care. LSW should be offered to all but is conventionally delivered in high-intensity ways. Low-intensity approaches are more accessible but there is significant variation and little guidance for supporting adolescents. We aimed to create guidance for Adolescent-Focused Low-Intensity LSW. Design Realist review. Data sources MEDLINE, Embase, PsycINFO, Sociology Collection (ProQuest), CINAHL, CDAS, Web of Science (SCIE, SSCI), Social Care Online and grey literature sources. Searches were performed between December 2021 and March 2022. Eligibility criteria Documents on children and adolescents in care, LSW and/or low-intensity interventions to improve mental health were included. Documents focusing on parenting style and contact with birth family were excluded. Analysis Documents were analysed using a realist logic of analysis. In consultation with Content Expert Groups (comprising professionals and care leavers), we developed an initial programme theory. Data relating to and challenging the initial programme theory were extracted and context-mechanism-outcome-configurations developed, critiqued and refined in an iterative fashion. Interpretations were drawn from context-mechanism-outcome-configurations to enhance the programme theory. Results 75 documents contributed to the analysis. Generally, studies were small-scale and lacked in-depth methods and evaluation descriptions. Findings indicated important factors contribute to the development of high-quality Adolescent-Focused Low-Intensity LSW. Adolescent-Focused Low-Intensity LSW should be person-centred, begin in the now, involve co-construction, record everyday positive life events and be supported by trained carer(s). Context-mechanism-outcome-configurations relating to these themes are reported. Conclusions Using this knowledge we developed initial practice guidance to support social care to deliver better quality Adolescent-Focused Low-Intensity LSW more consistently. To address gaps in our knowledge about the impact of Adolescent-Focused Low-Intensity LSW, further primary research is needed to strengthen understandings of how this intervention works (or not) in different contexts. PROSPERO registration number CRD42021279816.

Item Type: Article
Additional Information: Data availability statement: All data relevant to the study are included in the article or uploaded as supplementary information. Funding information: This project is funded by the National Institute for Health Research (NIHR) for Patient Benefit Programme (Grant Reference Number NIHR 201963).
Uncontrolled Keywords: adolescent,mental health,systematic review,medicine(all),sdg 10 - reduced inequalities,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700
Faculty \ School: Faculty of Social Sciences > School of Education and Lifelong Learning
Faculty of Social Sciences > School of Social Work
UEA Research Groups: Faculty of Social Sciences > Research Centres > Centre for Research on Children and Families
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Depositing User: LivePure Connector
Date Deposited: 25 Aug 2023 15:30
Last Modified: 13 Nov 2023 17:58
DOI: 10.1136/bmjopen-2023-075093


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