What interventions can CAMHS provide for young people involved with Oranga Tamariki? A review of the literature

Authors

  • Joanna Appleby University of Auckland, Aotearoa New Zealand
  • Barbara Staniforth University of Auckland, Aotearoa New Zealand
  • Susan P. Kemp University of Auckland, Aotearoa New Zealand
  • Helene Connor Te Atiawa and Ngāti Ruanui, Ngāti Rahiri and Ngāti Te Whiti; University of Auckland, Aotearoa New Zealand

Keywords:

Mental health, child welfare, therapy, adolescents, care-experienced

Abstract

INTRODUCTION: Many care-experienced young people face significant mental health challenges. However, this group is not well served by child and adolescent mental health services. In this first of a two-part series, we present the evidence for effective mental health interventions for care-experienced young people to inform clinical decision-making and improve mental health service delivery. This precedes a second review of principles for working effectively with care-experienced young people.

METHODS: This is a narrative review of the literature regarding mental health interventions for young people involved with child welfare. It is based on international reviews of mental health interventions with the addition of relevant research from Aotearoa New Zealand, especially with Māori young people.

FINDINGS: Appropriate mental health interventions include Trauma-Focused Cognitive Behavioural Therapy, Dialectical Behavioural Therapy, Wraparound, and assertive outreach approaches, as well as systemic interventions that work with the whole care system around a young person. Application of each of these interventions to meet the specific needs of care- experienced youth in Aotearoa New Zealand is discussed. The findings are also relevant to other jurisdictions with overrepresentation of Indigenous young people involved with child welfare services.

CONCLUSION: Individual and systemic interventions are recommended that can support holistic mental health care. There is little integration of cultural considerations and anti- discriminatory practice within the existing literature, despite many of these young people coming from marginalised communities. The authors argue that mental health interventions must be culturally appropriate to meet the needs of care-experienced young people.

References

Allen, B., & Kronenberg, M. (Eds.). (2014). Treating traumatized children: A casebook of evidence-based therapies. Guilford Press.

Appleby, J., Staniforth, B., Kemp, S. P., & Connor, H. (2024). How should CAMHS work with young people who are involved with Oranga Tamariki? A literature review of principles for working with care-experienced young people. Aotearoa New Zealand Social Work, 36(2) forthcoming.

Andrew, E., Williams, J., & Waters, C. (2014). Dialectical behaviour therapy and attachment: Vehicles for the development of resilience in young people leaving the care system. Clinical Child Psychology and Psychiatry, 19(4), 503–515. https://doi. org/10.1177/1359104513508964 ccp.sagepub.com

Assan, B., Burchell, P., Chia, A., Coffey, C., Floreani, S., Weir, J., Wingenfeld Hammond, S., & Woods, B. (2008). The adolescent intensive management team: An intensive outreach mental health service for high-risk adolescents. Australasian Psychiatry, 16(1), 423–427. https://doi.org/10.1080/1039856080188602

Bennett, S. T., Flett, R. A., & Babbage, D. R. (2016). Considerations for culturally responsive cognitive- behavioural therapy for Māori with depression. Journal of Pacific Rim Psychology, 10(8), 1–11. https://doi. org/10.1017/prp.2016.5

Bergström, M., Cederblad, M., Håkansson, K., Jonsson, A. K., Munthe, C., Vinnerljung, B., Wirtberg, I., Ostlund, P., & Sundell, K. (2020). Interventions in foster family care: A systematic review. Research on Social Work Practice, 30(1), 3–18. https://doi. org/10.1177/1049731519832101

Bernard, D. L., Calhoun, C. D., Banks, D. E., Halliday, C. A., Hughes-Halbert, C., & Danielson, C. K. (2021). Making the “C-ACE” for a culturally-informed adverse childhood experiences framework to understand the pervasive mental health impact of racism on black youth. Journal of Child and Adolescent Trauma, 14(2), 233–247. https:// doi.org/10.1007/s40653-020-00319-9.

Bruns, E., & Walker, J. (2008). Resource guide to wraparound. https://nwi.pdx.edu/NWI-book/Chapters/ COMPLETE-RG-BOOK.pdf

Bush, A., Chapman, F., Drummond, M., & Fagaloa, T. (2009). Development of a child, adolescent and family mental health service for Pacific young people in Aotearoa/New Zealand. Pacific Health Dialog, 15(1), 138–146.

Callaghan, J., Young, B., Pace, F. & Vostanis, P. (2004). Evaluation of a new mental health service for looked after children. Clinical Child Psychology and Psychiatry, 9(1), 1359–1045. https://doi.org/10.1177/1359104504039177

Cargo, T. (2008). Hoea a mai tōu waka: Claiming spaces for Māori tamariki and rangatahi in cognitive behaviour therapy. In M. Levy, L. W. Nikora, B. Masters-Awatere, M. Rua, & W. Waitoki (Eds.), Claiming spaces: Proceedings of the 2007 National Māori and Pacific psychologies symposium (pp. 97–102). Māori and Psychology Research Unit, University of Waikato.

Cohen, J. A., Mannarino, A. P., & Murray, L. K. (2011). Trauma-focused CBT for youth who experience ongoing traumas. Child Abuse and Neglect, 35, 637–646. https:// doi.org/10.1016/j.chiabu.2011.05.002

Commons Treloar, A., & Lewis, A. J. (2008). Professional attitudes towards deliberate self-harm in patients with borderline personality disorder. Australian and New Zealand Journal of Psychiatry, 42(7), 578–584.

Craven, P. A., & Lee, R. E. (2006). Therapeutic interventions for foster children: A systematic research synthesis. Research on Social Work Practice, 16(3), 287–304. https://doi.org/10.1177/1049731505284863

Dittmann, I., & Jensen, T. K. (2014). Giving a voice to traumatized youth: Experiences with trauma-focused cognitive behavioural therapy. Child Abuse and Neglect, 38, 1221–1230. https://doi.org/10.1016/j. chiabu.2013.11.008

Durie, M. (1994). Whaiora Māori health development. Oxford University Press.

Eketone, A. (2021). Dual relationships and crossing boundaries in Māori social work practice. Journal of Indigenous Social Development, 10(1), 29–49.

Elder, H., & Tapsell, R. (2013). Māori and the Mental Health Act. In J. Dawson & K. Gledhill (Eds.), New Zealand’s Mental Health Act in practice (pp. 249–167). Victoria University Press.

Evans, R., MacDonald, S., Trubey, R., Noyes, J., Robling, M., Willis, S., Boffey, M., Wooders, C., Vinnicombe, S., & Melendez-Torres, G. J. (2023). Interventions targeting the mental health and wellbeing of care-experienced children and young people in higher-income countries: Evidence map and systematic review. Systematic Reviews, 12(1), 1–33. https://doi.org/10.1186/s13643- 023-02260-y

Every-Palmer, S., Grant, M. L. & Thabrew, H. (2022). Young people don’t tend to ask for help more than once: Child and adolescent psychiatrists’ views on ailing mental health services for young New Zealanders. Australasian Psychiatry, 30(6), 684–688. https://doi. org/10.1177/1039856222111562

Fleming, T., Archer, D., King-Finau, T., Ormerod, F., & Clark, T. C. (2021). Health and wellbeing of young people who have been involved with Oranga Tamariki: Home and housing. https://www.orangatamariki.govt.nz/assets/ Uploads/About-us/Research/Latest-research/Youth19- Rangatahi-Smart-Survey/Youth19_young-people- involved-with-Oranga-Tamaki_mental-physical-health-and-healthcare-access.pdf

Fonagy, P., Luyten, P., Allison, E., & Campbell, C. (2017). What we have changed our minds about: Borderline personality disorder as a limitation of resilience. Borderline Personality Disorder and Emotional Dysregulation, 4(11).

https://doi.org/10.1186/s40479-017-0061-9

Fuchs, C, Lee, J. K., Roemer, L., & Orsillo, S. M. (2013). Clinical considerations in using acceptance- and mindfulness-based treatments with diverse populations. Cognitive and Behavioural Practice, 20(1), 1–12. https://doi.org/10.1016/j.cbpra.2011.12.004

Garcia, A. R., Circo, E., DeNard, C. & Hernandez, N. (2015). Barriers and facilitators to delivering effective mental health practice strategies for youth and families served by the child welfare system. Children and Youth Services Review, 52, 110–122. https://doi.org/10.1016/j.childyouth.2015.03.008

Hambrick, E. P., Oppenheim-Weller, S., N’zi, A. M., & Taussig, H. N. (2016). Mental health interventions for children in foster care: A systematic review. Children and Youth Services Review, 70, 65–77. https://doi. org/10.1016/j.childyouth.2016.09.002

Hamley, L., Le Grice, J., Greaves, L., Groot, S., Latimer, C. L., Renfrew, L., Parkison, H., Gillon, A., & Clark, T.C. (2023). Te Tapatoru: A model of whanaungatanga to support rangatahi wellbeing. Kōtuitui: New Zealand Journal of Social Sciences Online, 18(2), 171–194. https://doi.org/10.1080/1177083X.2022.2109492

Hirini, P. (1997). Counselling Maori clients: He whakawhiti nga whakaaro i te tangata whaiora Maori. New Zealand Journal of Psychology, 26(2), 13–17.

Human Rights Commission. (2022). Maranga Mai! https:// tikatangata.org.nz/our-work/maranga-mai

James, A. C., Winmill, L., Anderson, C., & Alfoadari, K. (2011). A preliminary study of an extension of a community dialectical behaviour therapy (DBT) programme to adolescents in the looked after care system. Child and Adolescent Mental Health, 16(1), 9–13. https://doi.org/10.1111/j.1475-3588.2010.00571.x

Johnstone, M., Brown, C., & Ross, N. (2022). The Mcdonaldization of social work: A critical analysis of mental health care services using the Choice and Partnership Approach (CAPA) in Canada. Journal of Progressive Human Services, 33(3), 223–243. https://doi.org/10.1080/10428232.2022.2050117

Kirkwood, T. (2014). The engagement phase of wraparound systems of care. Aotearoa New Zealand Social Work, 26(1), 3–9. https://doi.org/10.11157/anzswj-vol26iss1id49.

Landsverk, J. A., Burns, B. J., Stambaugh, L. F., & Reutz, J. A. R. (2009). Psychosocial interventions for children and adolescents in foster care: Review of research literature. Child Welfare, 88(1), 49–69.

Latimer, C. L., Le Grice, J., Hamley, L., Greaves, L., Gillon, A., Groot, S., Manchi, M., Renfrew, L., & Clark, T. C. (2022). “Why would you give your children to something you don’t trust?”: Rangatahi health and social services and the pursuit of tino rangatiratanga. Ko ̄tuitui: New Zealand Journal of Social Sciences Online, 17(3), 298–312. https://doi.org/10.1080/117708 3X.2021.1993938

Lee, T., Fouras, G., & Brown, R. (2015). Practice parameter for the assessment and management of youth involved with the child welfare system. Journal of the American Academy of Child and Adolescent Psychiatry, 54(6), 502–517. https://doi.org/10.1016/j.jaac.2015.03.005

Leve, L. D., Harold, G. T., Chamberlain, P., Landsverk, J. A., Fisher, P. A., & Vostanis, P. (2012). Practitioner review: Children in foster care: Vulnerabilities and evidence-based interventions that promote resilience processes. Journal of Child Psychology and Psychiatry, 53(12), 1197–1211. https://doi.org/10.1111/ j.1469-7610.2012.02594.x

Lidchi, V., & Wiener, A. (2020). How can services be improved to effectively address the mental health of vulnerable children and young people? Child Abuse & Neglect, 104648. https://doi.org/10.1016/j.chiabu.2020.104648

Linehan, M. M. (1993). Diagnosis and treatment of mental disorders: Cognitive-behavioural treatment of borderline personality disorder. Guilford Press.

Linehan, M. M., Korslund, K. E., Harned, M. S., Gallop, R. J., Lungu, A., Neacsiu, A. D., McDavid, J., Comtois, K. A., & Murray-Gregory, A. M. (2015). Dialectical behaviour therapy for high suicide risk in individuals with borderline personality disorder: A randomized clinical trial and component analysis. JAMA Psychiatry, 72(5), 475–482. https://doi.org/10.1001/jamapsychiatry.2014.303

Lobatto, W. (2021) Using systemic principles in the design of mental health and wellbeing services for looked after children and young people: Bringing together research, theory and practice. Journal of Family Therapy, 43(3), 469–488. https://doi.org/10.1111/1467-6427.12351

Mathieson, F., Bennett, S., Cargo, T., & Froggatt, W. (2022). Cognitive behavioral therapy in Aotearoa/New Zealand. In M. D. Terjesen & K. A. Doyle (Eds.), Cognitive behavioral therapy in a global context. https://doi. org/10.1007/978-3-030-82555-3_2

McClintock, K., & McClintock, R. (2018). Tuku iho, tuku iho, culture in Māori health service provision. https://terauora. com/wp-content/uploads/2019/05/Tuku-Iho-Tuku-Iho.pdf

McClintock, K., Tauroa, R., Mellsop, G., & Frampton, C. (2016). Pilot of Te Tomo Mai, a child and adolescent mental health service evaluation tool for an indigenous rangatahi (youth) population. International Journal of Adolescence and Youth, 21(1), 96–103, https://doi.org/1 0.1080/02673843.2013.813861

McNatty, G. E. D. (2017). “Becoming the spoke in the wheel”: Wraparound and the theory of change: An investigation into what promotes changes within wraparound [Unpublished doctoral dissertation] Massey University.

Ministry of Health. (2017). Infant, child, adolescent and youth mental health tier two service specification. https://www.tewhatuora.govt.nz/our-health-system/ nationwide-service-framework-library/about-nationwide- service-specifications/mental-health-and-addiction- service-specifications/infant-child-adolescent-and-youth- mental-health/

Ministry of Health. (2020). Whakamaua: Māori Health Action Plan. https://www.health.govt.nz/publication/ whakamaua-maori-health-action-plan-2020-2025

Morton, L. A. (2019). Piloting a dialectical behavioural therapy-based skills with New Zealand youth in care using three case studies [Unpublished master’s thesis]. Massey University.

Neelakantan, L., Hetrick, S., & Michelson, D. (2019). Users’ experiences of trauma-focused cognitive behavioural therapy for children and adolescents: a systematic review and metasynthesis of qualitative research. European Child and Adolescent Psychiatry, 28, 877–897. https://doi.org/10.1007/s00787-018-1150-z

Oranga Tamariki. (2022). Oranga Tamariki Action Plan. https://orangatamarikiactionplan.govt.nz/assets/Action- Plan/Uploads/Resources/Publications/Oranga-Tamariki-Action-Plan.pdf

Oranga Tamariki. (2023). Mental health and wellbeing needs of children and young people involved with Oranga Tamariki. https://www.orangatamarikiactionplan.govt.nz/ assets/Action-Plan/Uploads/Understanding-need/Mental- health-and-wellbeing/OT-MW-Needs-Assessment_final- for-publication_Redacted.pdf

Payne, M. (2014). Modern social work theory (4th ed). Oxford University Press.

Pitama, S. G., Bennett, S. T., Waitoki, W., Haitana, T. N., Valentine, H., Pahina, J., Taylor, J. E., Tassell-Matamua, N., Rowe, L., Beckert, L., Palmer, S. C., Huria, T. M., Lacey, C. J., & McLachlan, A. (2017). A proposed hauora Māori clinical guide for psychologists using the hui process and meihana model in clinical assessment and formulation. New Zealand Journal of Psychology, 46(3), 7–19.

Racusin, R., Maerlender, A. C., Sengupta, A., Isquith, P. K., & Straus, M. B. (2005). Psychosocial treatment of children in foster care: A review. Community Mental Health Journal, 41(2), 199–221. https://doi.org/10.1007/ s10597-005-2656-7

Rathus, J. H., & Miller, A. L. (2013). DBT skills manual for adolescents. Guilford Press.

Rayment, P., Young, C., & Guidolin, M. (2014). Therapeutic interventions for traumatised children in the child protection system in South Australia: Matching the therapy to the child. Developing Practice: The Child Youth and Family Work Journal, (38), 34–48.

Ryall, V., Radovini, S., Crothers, L., Schley, C., Fletcher, K., Nudds, S., & Groufsky, C. (2008). Intensive youth outreach in mental health: An integrated framework for understanding and intervention. Social Work in Mental Health, 1(3), 153–175. https://doi. org/10.1080/15332980802072512

Schley, C., Ryall, V., Crothers, L., Radovini, S., Fletcher, K., Marriage, K., Nudds, S., Groufsky, C., & Pan Yuen, H. (2008). Early intervention with difficult to engage, “high-risk” youth: Evaluating an intensive outreach approach in youth mental health. Early Intervention in Psychiatry, 2, 195–200 https://doi.org/10.1111/j.1751- 7893.2008.00079.x

Shailer, J. L., Gammon, R. A., & de Terte, I. (2017). An investigation of the fidelity to a wraparound process in New Zealand. New Zealand Journal of Psychology, 46(2), 87–98.

Slayter, E. (2016). Youth with disabilities in the United States child welfare system. Children and Youth Services Review, 64, 155–165. https://doi.org/10.1016/j. childyouth.2016.03.012

Tamihere, K. (2015). “Kōkiritia i roto i te kotahitanga” A process evaluation of a wraparound programme at Te Whānau o Waipareira Trust [Unpublished doctoral dissertation]. University of Auckland.

Tarren-Sweeney, M., & Vetere, A. (2014). Mental health services for vulnerable children and young people: Supporting children who are, or have been, in foster care. Routledge.

Tarren-Sweeney, M. (2021). A narrative review of mental and relational health interventions for children in family-based out-of-home care. Journal of Family Therapy, 1–23. https://doi.org/10.1111/1467-6427.12341

Taylor, O. (2019). Evaluation and update of trauma-focused cognitive behavioural therapy with sensory approaches for the treatment of post-traumatic stress disorder in maltreated children [Unpublished doctoral dissertation]. Auckland University of Technology.

Te Hiringa Mahara – Mental Health and Wellbeing Commission, (2023). Young people speak out about wellbeing. https://www.mhwc.govt.nz/assets/Youth- wellbeing-/Youth-Wellbeing-Insights-Report-Full.pdf

Thabrew, H., Henderson, S., Hazell, P., Moor, S., Kowalenko, N., & Kenn, F. (2017). Is it time for child psychiatry to grow up? Australian & New Zealand Journal of Psychiatry, 51(10), 971–973. https://doi. org/10.1177/0004867417718946

Veysey, S. (2014). People with a borderline personality disorder diagnosis describe discriminatory experiences. Ko ̄tuitui: New Zealand Journal of Social Sciences Online, 9(1), 20–35. https://doi.org/10.1080/117708 3X.2013.871303

Vijverberg, R., Ferdinand, R., Beekman, A., & van Meijel, B. (2017). The effect of youth assertive community treatment: A systematic PRISMA review. BMC Psychiatry, 17, 284. https://doi.org/10.1186/s12888-017-1446-4

Vreeland, A., Ebert, J. S., Khun, T. M., Gracey, K. A., Shaffer, A. M., Watson, K. H,. & Compas, B. E. (2020). Predictors of placement disruptions in foster care. Child Abuse and Neglect, 99. https://doi.org/10.1016/j.chiabu.2019.104283

Walter, U. M., & Petr, C. G. (2011). Best practices in Wraparound: A multidimensional view of the evidence. Social Work, 56, 73–80. https://doi.org/10.1093/sw/56.1.73

Weenink, M. M. M. (2019). He waka eke noa at Korowai Manaaki: A process evaluation of a dialectical behaviour therapy-informed skills programme for young people in a secure youth justice residence [Unpublished master’s thesis]. Victoria University of Wellington.

Whāraurau. (2021). 2020 Stocktake of Infant, Child and Adolescent Mental Health and Alcohol and Other Drug Services in New Zealand. https://www.wharaurau.org.nz/ all-workstreams/stocktake

Wilson, D., Moloney, E., Parr, J. M. Aspinall, C. & Slark, J. (2021). Creating an Indigenous Māori-centred model of relational health: A literature review of Māori models of health. Journal of Clinical Nursing, 30(23), 3539–3555. https://doi.org/10.1111/jocn.15859

Wolpert, M., Harris, R., Hodges, S., Fuggle, P., James, R., Wiener, A., & Munk, S. (2019). THRIVE-Framework for system change. www.implementingthrive.org.

Wolpert, M., Harris, R., Jones, M., Hodges, S., Fuggle, P., James, R., Wiener, A., Mckenna, C., Law, D., & Fonagy, P. (2014). THRIVE: The AFC-Tavistock model for CAMHS. http://implementingthrive.org/wp-content/ uploads/2016/03/Thrive.pdf

York, A., & Kingsbury, S. (2009). The choice and partnership approach: A guide to CAPA. CAMHS Network.

Downloads

Published

2024-06-15

How to Cite

Appleby, J., Staniforth, B., Kemp, S., & Connor, H. (2024). What interventions can CAMHS provide for young people involved with Oranga Tamariki? A review of the literature. Aotearoa New Zealand Social Work, 36(2), 68–83. Retrieved from https://anzswjournal.nz/anzsw/article/view/1069

Issue

Section

Original Articles