Professor Eva Serlachius
Lund University, Sweden
Professor Serlachius spoke to Professor Charlotte Ulrikka Rask, member of the 2023 ESCAP Congress Programme Committee, about her work on internet based psychological treatment in child and adolescent psychiatry and how this can address the issue of shortage of specialist treatment. Read her interview below to learn more about the opportunities and her studies in this area.
We look forward to hearing more from Professor Serlachius at our next ESCAP congress which takes place from 29th June to 1st July 2023 in beautiful Copenhagen.
For more information visit our congress website!
What is your main research interest in relation to the use of internet based psychological treatment in child and adolescent psychiatry?
My main interest and ambition is to increase the availability to effective psychological treatments for mental health disorders in children and adolescents by developing, evaluating and disseminating treatment in the form of digital interventions.
Why do you think is it important to present this topic at a congress like ESCAP 2023?
The problem we are trying to solve is the shortage of specialist treatment for children and adolescents with psychiatric disorders. Cognitive-behavioral therapy (CBT) is the first line treatment for children and adolescents with common mental health disorders, but the demand is larger than the availability and specialist treatment is rarely available outside big cities. Research by our group and others has shown that it is possible to deliver CBT via the internet in the form of a self-help programme with minimal support from a clinician. I consider digital interventions a cornerstone of the next generation of mental health treatment for youth and research is important to help identify what works, and when and where it works.
What opportunities does this offer?
Internet-based CBT has the potential to greatly increase access to specialized treatment for children and adolescents with psychiatric disorders. The mental health professional can be located anywhere and provide asynchronous support via a built-in messaging system, and the treatment can be conducted from home at times suitable for the family. Online interventions require less therapist time, which means that the more intensive treatment such as face-to-face therapy can be reserved for more complex patients or those who do not benefit sufficiently from online interventions.
What is your most important study up to date - if you can pick one?
Our first study was probably the bravest one since digital treatment in CAMHS was a new concept. That study was published in 2013 and reported results from our pilot study on Internet-based CBT for children with specific phobia. One of our largest studies was published 2021 in JAMA, where we found that Internet-based CBT for children and adolescents with OCD (followed by traditional face-to-face therapy for those in need) was equally effective as providing face-to-face therapy to all patients. This study is important as it shows how effective treatment can reach all youth with OCD within available resources.
What disorders have you developed treatments for?
We have developed digital CBT interventions for children and adolescents with anxiety disorders, major depressive disorder, OCD, excessive/dysfunctional worry, social anxiety disorder, functional gastrointestinal disorders and tic disorders.
What studies are you currently involved in?
In a current RCT, we are evaluating therapist-guided and self-guided Internet-based CBT for adolescents with depression. If self-guided ICBT is efficacious, we can increase availability and free up resources for CAMHS.
Further, much more research is needed on how to integrate ICBT into the broader care pathway for young people with mental health problems and psychiatric disorder. We have recently been awarded funding to compare two models of service delivery for children and adolescents with anxiety disorders: stepped care, where all patients start with Internet-based CBT and stratified care, where patients are matched to ICBT or individualized in-person CBT based on their severity and complexity. We aim to include over 600 families and results will have wide implications for how to best organize care for common psychiatric disorders in youth.
What do you think are the most exciting developments in your research area of internet based treatments?
Our results indicate that both patients and their families express high levels of satisfaction with this novel form of treatment and that Internet-based CBT is efficacious and cost-effective for a range of disorders. I am very excited that that our digital treatment programs are being implemented in regular health care across Sweden so that our work can benefit youth and families in need. Our research has also been instrumental for the development of a specialized Internet-based CBT unit in CAMHS Stockholm, as well as a digital unit in CAMHS Skåne.
What collaborations do you have with other countries?
We are collaborating with Professor Chris Hollis, Charlotte Hall and others at the University of Nottingham regarding therapist-supported online remote behavioral interventions for tic disorders in children and adolescents.
We would like to thank Eva for taking the time to give us an insight into her work and upcoming State of the Art lecture!