Examining change in the mental health of young people with epilepsy following a successful psychological intervention

Abstract

Objective

Evaluate the cognitive, behavioural and affective processes involved in therapeutic change for young people with epilepsy and mental health difficulties receiving an integrated mental health intervention.

Methods

As part of a mixed methods convergent design, qualitative data were gathered in parallel to quantitative data at two timepoints in a randomised controlled trial testing the Mental Health Intervention for Children with Epilepsy in addition to usual care. Twenty-five young people and/or their families were interviewed before and after the intervention about the young person’s mental and physical health, and their experience of therapy. Interview data were analysed inductively, idiographically and longitudinally using Interpretative Phenomenological Analysis combined with Framework Analysis.

Results

The young people’s emotional and behaviour problems improved, mirroring the trial’s quantitative outcomes. Their anxiety decreased and behaviour improved as they acquired tools and understanding through therapy. Problems, like aggressive behaviours and emotional outbursts, were also reduced, with young people gaining increased awareness and ability to self-regulate and parents learning to contain their child’s impulsive behaviours.

Conclusions

The qualitative findings complement the MICE trial’s significant positive quantitative results by providing insight and context to the therapeutic change, providing vivid insight into the mechanisms of therapy for individual families.

Plain language summary

This study involves young people with epilepsy and mental health difficulties who received an integrated mental health intervention called the Mental Health Intervention for Children with Epilepsy (MICE). The effectiveness of the MICE intervention (in addition to usual care) was assessed by comparing it to only usual care. This article reports on the changes in the behaviour, thinking, feeling of the young people after they received therapy. The research data was qualitative, using transcripts from interviews with 25 young people and/or their families. There was also some quantitative data, in the form of questionnaires. Both types of data were gathered at two different time points and compared over time. Then the results from the two types of data were considered together in a so-called mixed methods approach. During the qualitative interviews, participants were asked about the young person’s mental and physical health, as well as their therapy experiences. The interview data were analysed using an in-depth approach to the analysis. This article describes improvements in emotional and behavioural problems among the young participants, which align with the positive mental health outcomes observed in the trial’s quantitative data. Participant quotes before and after the intervention reveal reduced anxiety and improved behaviour as the therapy gave the young people new tools and understanding. Parents of young people with intellectual disabilities also felt more confident in managing their children’s fears. Aggressive behaviours and emotional outbursts decreased, and young people developed greater self-awareness and self-control. The qualitative findings provide context and insight into the therapeutic change observed in the MICE trial. Understanding the mechanisms of therapy is crucial. In summary, this study sheds light on how therapy positively impacts young people’s mental health and behaviour, with benefits for both the young people and their families.