Children and young people (CYP) living with long-term physical health conditions (LTCs) have a higher prevalence of mental health conditions but report barriers in accessing mental health interventions. One way to increase access to such interventions is through Children and Young Person Wellbeing Practitioners (CWPs) who deliver low-intensity cognitive behavioural therapy (LI CBT). This non-randomised study evaluates the effectiveness of LI CBT delivered by CWPs integrated in a specialist paediatric psychology service. Thirty-six CYP aged 3‒23 years receiving LI CBT interventions were included in the evaluation. Outcome measures included the Revised Children’s Anxiety and Depression Scale (RCADS) and goal based outcomes (GBOs), which were administered at the beginning and end of the intervention. Feedback from participants was also gathered to complement quantitative data. Analysis of pre- and post-intervention data highlighted a reduction in symptoms across all RCADS subscales with notably large effect sizes observed when comparing total RCADS scores (d = 0.86) and low mood scores (d = 0.99). GBO data similarly reflected progress towards personal goals with a large effect size reported (d = 1.44). Participants provided positive feedback, emphasising improvements in symptom control and emotional understanding. The integration of CWPs into paediatric hospitals demonstrated preliminary effectiveness in reducing anxiety and depression symptoms among CYP with LTCs and significant progress towards their personal goals. These findings suggest that LI CBT delivered by CWPs could fill a critical gap within paediatric settings, although further research with a larger sample size is warranted.

Key learning aims

1. (1) To understand the mental health needs of children and young people with long-term physical health conditions.

2. (2) To learn how low-intensity cognitive behavioural therapy (LI CBT) delivered by Children and Young People’s Wellbeing Practitioners (CWPs) can be integrated into paediatric healthcare settings to improve mental health outcomes.

3. (3) To explore the preliminary effectiveness of CWP-delivered interventions through clinical outcome measures and participant feedback, and consider implications for future service development and research.

This paper highlights the many complex psychological needs of paediatric patients in intensive care. The literature on the experience of children in intensive care and their relatives is reviewed and related to the work of a paediatric psychologist. Case examples are given of direct work with children and suggestions are made of ways in which the psychologist can work in a consultation/liaison capacity. The personal impact of this work is addressed, as is the need to disseminate information to other health professionals. Further research is called for, both on the child's experience and on the development of appropriate psychological interventions.