‘Clinicians’ use of and attitudes towards technology to provide and support interventions in child and adolescent mental health services’

Matt Kempen
Marketing Manager for ACAMH

Posted on

. Video abstract from Bethany Cliffe from her paper in the Child and Adolescent Mental Health journal.

Other authors; Abigail Croker, Megan Denne, Paul Stallard

First published: 11 December 2019


Technology can increase child and adolescent mental health service (CAMHS) capacity by supporting and delivering interventions, yet it has not been widely adopted by CAMHS child mental health professionals. Uptake can either be facilitated or obstructed by child mental health professionals’ attitudes, which remain largely unknown.

Research digest also available

Child mental health professionals need more technology training

Bethany Cliffe
Bethany Cliffe

First-year PhD student at the University of Bath, researching a smartphone app for self-harm in university students.


Hello.  My name is Bethany Cliffe and I’m a PhD student in the Department for Health at the University of Bath.  Today, I’m going to be talking through a paper that was recently published in the Journal Childhood and Adolescent Mental Health and the paper is called Clinicians’ Use of and Attitudes towards Technology to Provide and Support Interventions in Child and Adolescent Mental Health Services.  The paper is by myself, Abby Croker, Megan Dan and Professor Paul Stallard.  Just to give you a bit of a background, technology-based talks can be good, as they can help services to increase their capacity, as well as overcoming some of the barriers that individuals with mixed experience with face-to-face support.  These talks can range from things such as telecommunications to computerised CBT, smart phone apps or YouTube videos, things like that, and they can help to support face-to-face interventions through things like mood monitoring or psycho education.  Or they can actually work as standalone interventions in themselves.

They can be particularly helpful in CAMHS, with the majority of children and adolescents in the UK now having access to the internet and research has also shown that some young people are indeed open to the idea of receiving support in this way.  So, it seems like technology could offer solutions to some of the problems that young people experience when seeking support.  However, research suggests that it isn’t necessarily being used still in mental health services.  So, the attitudes towards technology held by mental health professionals have been identified as a key factor in whether they’re implemented or not and, yet despite this, their attitudes towards technology were still largely unknown.

So that leads me to the aims of our study.  We wanted to firstly understand if mental health professionals are using these technology tools in their services.  We wanted to understand what their attitudes towards technology were and, lastly, we wanted to understand what factors may be influencing their attitudes.  So, to find this out, we developed an online questionnaire and we invited all 320 clinical members of staff in Oxford Health NHS Trust CAMHS to participate.  We had 154 people beginning the survey, so roughly a 50 per cent response rate and, of those, 120 went on to actually compute it.  We have assistance from a range of professions, including social workers, support workers, psychiatrists, nurses, psychologists et cetera, and we found out that they were using technology to a limited extent.  So, they were using things most commonly, such as websites, helplines, smart phone apps and online support services, all of which are more older technologies.  We also asked them to rate their competence at using technology on a scale of 1 to 10 and the mean response was 6.2 out of 10.  Similarly, we asked them to rate how helpful they perceived technology to be in their practice on a scale of 1 to 10 and the mean response was 6.7.

So roughly quite helpful and quite competent.  In terms of attitudes towards technology, the majority indicated that they did not know what is available to use and just under half said that they do not feel skilled or confident using technology.  This last point was sort of demonstrated when participants were rating whether technology is private and secure, safe and reliable with around half indicating that they neither agreed nor disagreed with this statement, suggesting an amount of uncertainty there.  Positive attitudes towards technology were also endorsed.  For example, they widely acknowledged that technology can be appealing to young people.  It can be helpful to engage those struggling with face-to-face interventions and it can be convenient, accessible and able to offer earlier access to support.  Participants perceived the role of technology to be for providing psycho education, providing access to a wide range of resources and helping to enable peer support, but there is not a solution to a lack of available trained therapists.

In terms of any factors influencing attitudes, there were no differences relative to gender or profession.  However, age and level of technology use did make a difference.  So, for example, the younger participants rated themselves as more competent at using technology and they rated it to be more helpful compared to older participants who more strongly endorsed not feeling skilled or confident.  The people who were using technology more so, they rated it to be more helpful and they rated themselves as more competent using it compared to people who used it less so, who instead indicated that they did not feel skilled or confident using it.  They didn’t know what was available and they perceived technology to be unsafe.  So, overall, attitudes towards technology were somewhat mixed and they were influenced by age and level of technology use.  There were some positive attitudes towards technology that were widely endorsed, but also, there was a lot of uncertainty around what’s available, whether it’s safe, reliable and secure.

Technology was perceived as helpful by clinical staff, but older technologies were most commonly used with newer technologies, such as VR therapy or Avatar therapy rarely being used.  So, from this, we did take an overall interest and a positive attitude towards technology, whether this was particularly reflected in practice, so moving forward, it can be helpful to offer training and workshops around technology-based tools and mental health support.  And research suggests that being shown demonstrations of how to use certain technologies can increase interest in their use and increase acceptability ratings, so this could be one avenue worth exploring.

It’s worth noting some limitations of this study.  So, firstly, participants were only recruited through one NHS Trust and Oxford Health has been identified as a digitally advanced Mental Health Trust, so it could be that attitudes towards technology and its use would be very different in different Trusts.  Also, we had about a 50 per cent response rate and those people may be individuals who are perhaps more favourably disposed to using technology.  And, finally, this was an online questionnaire so there wasn’t much scope for follow-up questions or in-depth responses and this may have limited our results.

So, to sum up, in order to move forward and incorporate technology more widely into services, concerns need to be addressed so the staff can feel confident using technology and this may open up sales capacity and hopefully reach more young people, who are in need of support for their mental health.

Thank you so much for listening to this video abstract.  If you would like to find out more about this study, please feel free to read the full paper on the Journal of Childhood Adolescent Mental Health website.  Thank you.

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