Helping Children Access and Use Services: A Review

High rates of dropping out from mental health services are documented for children and their families. These high rates exist at different treatment stages, in different service settings, and for different populations of children and families. Some researchers have developed and tested engagement interventions to address barriers to service access and use and increase participation in services by children and their families. Studies of engagement interventions for children and their families are critically reviewed in this paper. Overall, the engagement interventions were effective in increasing attendance at first appointments. Only those with an ecological and total service delivery approach reduced the drop-out rate. However, even then, the drop-out rate was 26% to 29%. Suggestions for future research are made, including ascertaining from children and families their reasons for quitting or staying in treatment, comparing the outcomes of drop-outs with the outcomes of those who remain in treatment, developing and testing conceptual models of engagement for subgroups of at-risk children and their families, and examining the cost-effectiveness of engagement interventions.     

The chance project: Complex interventions with adolescent school drop-outs in Naples

Abstract

In this paper the authors describe their long experience, as psychoanalytically oriented psychotherapists, with an experimental school project with adolescent school drop-outs, a project that has been running in three deprived contexts of Naples. In the paper the structure of the psychological project supporting workers involved with these disruptive adolescents is analysed in detail along with the theoretical framework that lies behind it. The authors also give some illustrations that show the intense dynamics present in this field of work and some meaningful developments observed in the relationships and communications between adolescents and adults and in the group of peers.