Adolescents' experience of receiving internet-delivered cognitive therapy for social anxiety disorder.

Background: Social anxiety disorder (SAD) is a debilitating condition that usually begins in adolescence. We recently demonstrated preliminary efficacy of an internet-delivered therapist-assisted version of Cognitive Therapy for Social Anxiety Disorder (SAD) for adolescents called Online Social anxiety Cognitive therapy for Adolescents (OSCA). Here we report on the helpfulness, support, and overall acceptability of OSCA from the perspective of trial participants. Methods: Participants were 17 young people aged 15-18 years who had participated in a trial of OSCA. Post-treatment, participants completed an online treatment acceptability questionnaire and took part in a semi-structured interview to gain an understanding of their experience of OSCA. Results: Overall, there was a very high rate of treatment satisfaction. Core aspects of the treatment were viewed as most helpful, including behavioural experiments even though participants found them challenging. Participants found the online nature of the treatment helpful, allowing for easier communication with the therapist, regular encouragement from the therapist, and the ability to go back to their treatment and view their progress. Challenges were, for some, the quantity of content and practical issues around scheduling the short weekly calls with their therapist. Conclusions: This study suggests that young people felt helped and supported by OSCA.

The influence of postnatal psychiatric disorder on child development. Is maternal preoccupation one of the key underlying processes?

There is considerable evidence that maternal postnatal psychiatric disorder has an adverse influence on infant development. In attempting to examine the pathways of intergenerational transmission, most research has concentrated on genetic factors or on maternal behaviours during mother-child interaction and attachment. However, researchers have largely ignored the possible role of maternal cognition underlying behaviour, especially the thought and attentional processes involved in psychiatric disorders. This paper argues that a particular form of maternal cognition, namely 'preoccupation', is one key, but under-recognised, mechanism in the transmission of psychiatric disturbance. We propose that preoccupation interferes with specific aspects of mental functioning, especially attention and responsivity to the environment. This impairs the mother's parenting capacities and adversely affects mother-child interaction and child development.