Care-experienced young people have limited access to best evidenced PTSD treatments
Submitted by Rosie McGuire
Rates of Post-Traumatic Stress Disorder (PTSD) are up to 12 times higher in care-experienced young people compared to their peers. Trauma-focused cognitive behavioural therapies (tf-CBTs) are the best-evidenced treatment for young people with PTSD. Yet, in practice, care-experienced young people often struggle to access this treatment. We worked alongside 28 mental health services in England to understand why, by exploring factors that can be barriers or facilitators to carrying out tf-CBTs with care-experienced young people.
We found that 46% of teams were using the tf-CBT treatment we had trained them in, but only 25% of teams were using the treatment with care-experienced young people. When asked about this, all teams discussed the challenges of delivering psychotherapies, especially trauma-focused ones, when young people often had competing or complex needs - but this was not a unique barrier. Unique factors that differentiated teams who did and did not use the treatment included:
Service structure and commissioning practices
The culture of the team and buy-in to evidence-based practice
Leadership engagement and style
The development of supervision structures
Findings offer key considerations for mental health teams, service leads, commissioners and policymakers to enhance the delivery of best-evidenced mental health treatments like tf-CBTs, particularly for care-experienced young people.
I’m a clinician – what does this mean for me?
This research highlights the importance of considering the structure and culture of your service, to understand whether this is affecting the team's ability to deliver best-evidenced treatments. This includes trauma-focused treatments, and treatments for more marginalised groups like care-experienced young people. Service leads and supervisors in particular should consider how they can create an environment that supports and encourages clinicians to deliver trauma-focused psychotherapies for (care-experienced) young people with PTSD.