Children with emotional and behavioural disorders (EBD)

 

Behavioral and emotional problems of children and adolescents

Behavioral and emotional problems of children and adolescents  are highly prevalent (Jaspers, 2012) and also may seriously affect the success in the education system, in the labor market, but also the functioning of social relations, which may be closely associated with life satisfaction and quality of life (Kessler, 2001). To the extent to which management is to manage these clients also affects the family environment, clients and the wider extent, on the whole society (Jaspers, 2012). Only a minority of the children and adolescents with psychosocial problems actually receive professional care. Furthermore, it is unclear whether the care offered is adequate for their problems (Reijneveld 2004). Currently, the prevention, diagnosis and treatment in youth health and social care is not optimal due to a number of factors. First, children and adolescents with behavioural and emotional problems frequently do not receive support or treatment because of inadequate identification and treatment of problems (Reijneveld 2004).

Second, if identified and referred, deterioration of the problems may occur because waiting lists delay the start of the professional care or the intervention offered is second best. Finally, the clients who repeatedly come into the care system is difficult to achieve the necessary level of cooperation, respectively, these clients tend to display inadequate treatment adherence, treatment, or prematurely terminate cooperation in solving their problems and treatment (Knorth 2008). The communication between professionals and their clients and the coordination of multidisciplinary and interorganizational arrangements seems to be critical for the quality of care (Wissow 2008; van Eijk et al. 2013). Care is often described as a ‘black box’ (Libby 2005) suggesting that less is known about the specific content of care as offered and even less about its short-and long-term results. Moreover, various types of youth health and social care seem to have partially overlapping therapeutic arsenals, which is at the very least not very efficient. In addition and partially related, multiple interventions are frequently applied by different youth health and social care providers simultaneously or in succession (Farmer 2003; Lambert 1998; Schofield 2007; Wulczyn 2003). Longitudinal study of quality of life and life satisfaction of children and adolescents with emotional and behavioral problems in their social context and in the context of care has the ambition to fill the gap in knowledge. Moreover the aim is to deepen understanding of the issues and supports the development of a comprehensive integrated system of social and health care for children and adolescents with behavioral and emotional problems.

 

Scientific level of the project

The main aim of Care4Youth is to contribute to the understanding of the process and quality of care for children and adolescents with emotional and behavioural problems, aiming at the enhancement of better social functioning and quality of life. Longitudinal cohort study design is compared to the commonly implemented cross-sectional study by several benefits. It allows us to separate the effect of aging (changes over time at the individual level) from cohort effects (differences between respondents at baseline). This study covers the area of preventive care for children and adolescents as well as the area of social and health care. Health care has traditionally focused on psychopathology; social care focuses on behavioural problems and the (social) environment. Health care has traditionally focused on psychopathology; social care focuses on behavioural problems and the (social) environment. However, over time types of care have gradually adapted parts of each other’s approach. Therefore Care4Youth was designed to cover the entire spectrum of care for children and adolescents with emotional and behavioural problems. The added value of this study its focus on long term outcomes and on the full range of types of care and professionals that aim to help children and adolescents with emotional and behavioural problems and their parents/guardians. One of the unique products of the collaboration will be a data collection infrastructure that provides excellent facilities for obtaining the evidence in this field and for developing the knowledge base on which can be built by practitioners as well as creators of measures and policies in relevant areas.

 

Project aims and objectives and their feasibility

The aim of this project is a longitudinal follow the trajectory of children and adolescents with behavioural and emotional problems in the preventive, social and health care in close cooperation with experts from the field of psychiatry, psychology and social work. We would be interested in the extent to which clients enter and exit to and from the care or transition from one type of care to another within the system and what impact have different trajectories on life satisfaction and quality of life of clients with regard to their social context. Lessons learned will allow us to evaluate the effectiveness of our system and the impact on life satisfaction and quality of life of clients. Capitalizing on the experience in the implementation of a number of studies as well as the know-how acquired in cooperation with foreign partners, we are structured in different stages so that the time-feasible and targets at different stages are therefore clearly defined.

 

Originality of the project

EBP have been shown to be major drivers of adverse outcomes and inequalities. Increasing the responsiveness of health and care systems to the needs of children and adolescents with EBP may contribute largely to a reduction of these disadvantages, e.g. by impinging on a pattern of antisocial behaviour leading to adversity that in turn again increases the likelihood of this behaviour.

The uniqueness of our project is in the fact that it tries to look at the health care system as a whole in all its complexity and using a longitudinal design to bring in comparison with cross-sectional studies and a better understanding of the results of recent interventions and individual levels.

 

Importance of preliminary results, relation of the suggested solution and own published results

Research activities of principal investigator as well as co-workers focus on psycho-social determinants of health and health-related behaviour of adolescents and the proposed project is only natural continuation of scientific interest to explore and understand the determinants of health in a broader context.