Intended for healthcare professionals

Student Education

Community intensive therapy

BMJ 2007; 335 doi: https://doi.org/10.1136/sbmj.0710368 (Published 01 October 2007) Cite this as: BMJ 2007;335:0710368
  1. Kimberley Kendall, intercalating medical student1,
  2. Ahmed Darwish, consultant child and adolescent psychiatrist2
  1. 1Wales College of Medicine, Biology, Life and Health Sciences, Cardiff University, Cardiff CF14 4XN
  2. 2Child and Family Centre, Tonteg, Pontypridd CF38 1HE

Community based treatment for psychiatric illness is available in many countries. Kimberly Kendall and Ahmed Darwish consider the options for children and adolescents

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Being admitted as an inpatient to a psychiatric unit either voluntarily or involuntarily can be a terrifying experience for an adult. Imagine how it feels for a child.

Historically, the provision of mental health care for children and adolescents in most rich countries has been patchy at best. In fact, the number of beds provided at a local level is tiny. In 2004, 9.6% of children in Great Britain aged 5-15 years were estimated to have a mental disorder.1 Of course, not all of these children need admission to hospital, which can be an isolating experience. Admission to hospital can be disruptive for the child and his or her family. Also, parents can often feel unable to help and worry that their child will be negatively affected by other patients.2

In the past decade or so, the treatment of children and adolescents with psychiatric disorders in the community has become more common. More professionals have questioned the usefulness of inpatient treatment, and the use of inpatient beds for these patients has decreased.3

Defining the term

Community intensive therapy is an often vaguely defined term that describes a model of service delivery. However, its principles are given away in its name. The approach allows patients to stay at home for most if not all of their treatment, and treatment takes place at home, at school, and anywhere else that is considered the patient's normal environment.

Examples of the types of treatment are cognitive behaviour therapy and family therapy. Usually the same therapist or therapists will visit each time, allowing a relationship of trust to develop. The programme of …

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