Miranda Wolpert

Miranda Wolpert
University College London | UCL

Doctor of Philosophy

About

148
Publications
58,390
Reads
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3,276
Citations
Additional affiliations
January 2015 - present
University College London
Position
  • Reader in Evidence Based Research and Practice
June 2004 - present
Anna Freud Centre
Position
  • Director of Service Improvement and Evaluation, Director of Evidence Based Practice Unit
June 2004 - present
Child Outcomes Research Consortium (CORC)
Position
  • Managing Director
Education
September 1996 - August 1998
University of Surrey
Field of study
  • Clinical Psychology
September 1984 - August 1985
University of Sussex
Field of study
  • History
September 1981 - August 1984
University of Cambridge
Field of study
  • History

Publications

Publications (148)
Article
Mental health research grapples with research waste and stunted field progression caused by inconsistent outcome measurement across studies and clinical settings, which means there is no common language for considering findings. Although recognising that no gold standard measures exist and that all existing measures are flawed in one way or another...
Article
Full-text available
Parents play a critical role in child and adolescent mental health care and treatment. With the increasing implementation of shared decision-making (SDM) across health settings, there is a growing need to understand the decision support interventions used to promote SDM in child and adolescent mental health services (CAMHS). The overall aim of this...
Article
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Interest in youth perspectives on what constitutes an important outcome in the treatment of depression has been growing, but limited attention has been given to heterogeneity in outcome priorities, and minority viewpoints. These are important to consider for person-centred outcome tracking in clinical practice, or when conducting clinical trials ta...
Article
Background: Routine outcome monitoring (ROM) is a valuable tool for monitoring client progress and pre-empting deterioration, however, there is considerable variation in how data are collected and recorded and uptake in clinical practice remains low. The aim of this study was to develop a self-report measure of practitioner attitudes to ROM in ord...
Article
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Background: Many young people with anxiety or depression drop out of treatment early, and/or leave treatment without showing measurably improved symptom levels. To enhance treatment engagement and effectiveness, it is critical to better understand how young people's perceptions of the symptoms, causes, consequences, treatability, and course of the...
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Background: Approximately half of those who access child and adolescent mental health services do not show measurable improvement in symptoms. This study aimed to provide practice recommendations for managing treatment endings, particularly when outcomes have not improved. Method: Semi-structured interviews were carried out with 26 young people wit...
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Reviews around interventions to improve shared decision making (SDM) for child and youth mental health have produced inconclusive findings on what approaches increase participation. Importantly, the previous reviews did not explore the use of theory, as well as mechanisms of change (intervention functions) and active units of change (behaviour chan...
Article
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Strategies for comparing routinely collected outcome data across services or systems include focusing on a common indicator (e.g., symptom change) or aggregating results from different measures or outcomes into a comparable core metric. The implications of either approach for judging treatment success are not fully understood. This study drew on na...
Article
A major barrier to improving care effectiveness for mental health is a lack of consensus on outcomes measurement. The International Consortium for Health Outcomes Measurement (ICHOM) has already developed a consensus-based standard set of outcomes for anxiety and depression in adults (including the Patient Health Questionnaire-9, the Generalised An...
Preprint
Full-text available
Background: Previous studies have focused on individual stressors in adolescents' lives, and less on the subjective experience of how stressors interact. There is a gap in the literature exploring English adolescents' subjective experiences of stressors. Objectives: The present study aimed to explore the types of stressors identified by a sample of...
Article
Objective Enduring mental health (EMH) is a relatively new concept, which refers to a long-term state of not experiencing a mental illness (ie, enduring mental wellness). No analysis using this concept has been undertaken on UK data nor specifically in the childhood years. The present study seeks to consider the extent and predictors of EMH in chil...
Article
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Psychosocial functioning is considered an important and valued outcome in relation to young people’s mental health as a construct distinct from psychiatric symptomology, especially in the light of an increasing focus on transdiagnostic approaches. Yet, the level of psychosocial functioning is rarely directly asked of young people themselves, despit...
Article
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Objective: Decision-tree methods are machine-learning methods which provide results that are relatively easy to interpret and apply by human decision makers. The resulting decision trees show how baseline patient characteristics can be combined to predict treatment outcomes for individual patients, for example. This paper introduces GLMM trees, a d...
Article
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Of children with mental health problems who access specialist help, 50% show reliable improvement on self-report measures at case closure and 10% reliable deterioration. To contextualise these figures it is necessary to consider rates of improvement for those in the general population. This study examined rates of reliable improvement/deterioration...
Article
Appropriate measurement of emotional health by all those working with children and young people is an increasing focus for professional practice. Most of the tools used for assessment or self-assessment of emotional health were designed in the mid-20th century using language and technology derived from pen and paper written texts. However, are they...
Article
Authors’ reply - Volume 216 Issue 1 - Jessica Deighton, Suzet Tanya Lereya, Praveetha Patalay, Neil Humphrey, Miranda Wolpert
Article
Objective: Depression and anxiety are the most prevalent mental health problems in youth, yet almost nothing is known about what outcomes are to be expected at the individual level following routine treatment. This paper sets out to address this gap by undertaking a systematic review of outcomes following treatment as usual (TAU) with a particular...
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Depression is one of the main reasons for youth accessing mental health services, yet we know little about how symptoms change once youth are in routine care. This study used multilevel modeling to examine the average trajectory of change and the factors associated with change in depressive symptoms in a large sample of youth seen in routine mental...
Article
Young people and parents want to be more active in treatment decisions. Using the Theoretical Domains Framework (TDF), which segments behaviour change into barriers and facilitators across fourteen domains, the aim of this study is to explore the barriers and facilitators to shared decision‐making (SDM) from young people and their parents’ perspect...
Article
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Background: Digital tools have the potential to support patient activation and shared decision making in the face of increasing levels of mental health problems in young people. There is a need for feasibility trials of digital interventions to determine the usage and acceptability of interventions. In addition, there is a need to determine the ab...
Article
There is increasing focus on the need for schools to work more effectively with specialist mental health providers, but there have been historic challenges in embedding closer interagency working. This article reports the results of a service evaluation of a 2-day workshop designed to facilitate improved working between schools and children and you...
Preprint
BACKGROUND Shared decision-making (SDM) is recognised as a person-centred approach to improving health care quality and outcomes. Few digital interventions to improve SDM have been tested in child and adolescent mental health (CAMH) settings. One such intervention is Power Up, a mobile phone application for young people, which has shown some eviden...
Article
Full-text available
Background: Shared decision making (SDM) is recognized as a person-centered approach to improving health care quality and outcomes. Few digital interventions to improve SDM have been tested in child and adolescent mental health (CAMH) settings. One such intervention is Power Up, a mobile phone app for young people (YP), which has shown some eviden...
Article
Full-text available
Objectives To analyse the language and conversation used in huddles to gain a deeper understanding of exactly how huddles proceed in practice and to examine the methods by which staff members identify at-risk patients. Setting Paediatric wards in four English hospitals, which were part of a 12-hospital cohort participating in the Situation Awarene...
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Background Mental health difficulties in young people are increasing, and there is a need for evidence on the effectiveness of digital interventions to increase opportunities for supporting mental health in young people. Such studies are complicated due to issues of implementation and adoption, outcome measurement, and appropriate study designs. O...
Preprint
BACKGROUND Mental health difficulties in young people are increasing, and there is a need for evidence on the effectiveness of digital interventions to increase opportunities for supporting mental health in young people. Such studies are complicated due to issues of implementation and adoption, outcome measurement, and appropriate study designs. O...
Article
Full-text available
Background There are suggestions that denser network connectivity (i.e., the strength of associations between individual symptoms) may be a prognostic indicator of poor treatment response in depression. We sought to examine this aspect of depressive symptom networks in the context of early responses to treatment in adolescents. Methods Routine psy...
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Current mental health provision for children is based on estimates of one in ten children experiencing mental health problems. This study analyses a large-scale community-based dataset of 28 160 adolescents to explore school-based prevalence of mental health problems and characteristics that predict increased odds of experiencing them. Findings ind...
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Purpose The purpose of this paper is to determine the efficacy of the Peer Education Project (PEP), a school-based, peer-led intervention designed to support secondary school students to develop the skills and knowledge they need to safeguard their mental health and that of their peers. Design/methodology/approach Six schools from across England a...
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The use of routinely collected data that are flawed and limited to inform service development in healthcare systems needs to be considered, both theoretically and practically, given the reality in many areas of healthcare that only poor-quality data are available for use in complex adaptive systems. Data may be compromised in a range of ways. They...
Article
This Review reports on a scoping review followed by a systematic review to consider interventions designed to address or manage depression or anxiety in children and young people up to the age of 25 years without the need to involve mental health professionals. The scoping review identified 132 approaches, 103 of which referred to children or young...
Article
Background Recent policy in England has called on services for children and young people's mental health and well‐being to develop and deliver local transformation plans to increase the provision of evidence‐based, outcomes‐informed and service user‐informed treatments. The role of local leadership in service transformation is poorly understood, de...
Article
Objective: Measurement of treatment outcomes in childhood depression has traditionally focused on assessing symptoms from the clinician's perspective, without exploring other outcome domains or considering young people's perspectives. This systematic review explored the extent to which multidimensional and multi-informant outcome measurements have...
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Background There is a growing concern about the mental health of children and young people (CYP) in the UK, with increasing demand for counselling services, admissions for self-harm and referrals to mental health services. We investigated whether there have been similar recent trends in selected mental health outcomes among CYP in national health s...
Preprint
BACKGROUND Digital tools have the potential to support patient activation and shared decision making in the face of increasing levels of mental health problems in young people. There is a need for feasibility trials of digital interventions to determine the usage and acceptability of interventions. In addition, there is a need to determine the abil...
Article
Full-text available
Background Literature has focused on effect sizes rather than individual-level improvement rates to determine how effectively services address burgeoning numbers of adolescents with anxiety and depression. Aims To consider how many adolescents report reliable improvement in anxiety, depression and comorbid depression and anxiety by end of treatmen...
Article
Background The importance of patient and public involvement (PPI) in designing interventions to support young people’s mental health is becoming a central tenet of the research process. Existing research has indicated that co-design with service users may help to engender multiple improvements in research projects, from design through to applicatio...
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The Strengths and Difficulties Questionnaire (SDQ) is one of the most widely used measures in child and adolescent mental health in clinical practice, community-based screening and research. Assessing the readability of such questionnaires is important as young people may not comprehend items above their reading ability when self-reporting. Analyse...
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Background Patient-reported outcome measures (PROMs) are recommended by healthcare systems internationally, but there are a number of barriers to implementation. The aim of this research was to examine the impact of training supervisors in using PROMs on clinical practice, given the importance of leadership when changing behaviour. Method Data inc...
Chapter
The goals of this chapter are to: ◆ identify and review different goal-based measures for children and adults; ◆ outline the considerations around psychometric properties of goal measures; ◆ explain the benefits and challenges of goal-setting and tracking.
Chapter
Goal-based outcome measures are increasingly seen as important tools when working with counselling and psychotherapy clients. The aim of this chapter is to identify and review different measures used with children and adults, outline the considerations around their psychometric properties, and explore the benefits and challenges of goal setting and...
Article
Objectives: To explore paediatric hospital staff members' perceptions of the emerging benefits and challenges of the huddle, a new safety improvement initiative, as well as the barriers and facilitators to its implementation. Design: A qualitative study was conducted using semi-structured interviews to explore staff perspectives and experiences....
Article
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Background: The association between behavioral difficulties and academic attainment is well established. Recent policy advising schools on managing behavior has promoted the early identification of behavioral difficulties. There is also increasing research into mHealth interventions to provide support for emotional and behavioral difficulties for...
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Background: Evidence suggests that young people want to be active participants in their care and involved in decisions about their treatment. However, there is a lack of digital shared decision-making tools available to support young people in child and adolescent mental health services (CAMHS). Objective: The primary aim of this paper is to pre...
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Background: Case-mix classification is a focus of international attention in considering how best to manage and fund services, by providing a basis for fairer comparison of resource utilization. Yet there is little evidence of the best ways to establish case mix for child and adolescent mental health services (CAMHS). Aim: To develop a case mix...
Article
Jensen and Corralejo highlight that most mental health intervention research focuses on the group level rather than individual level. They looked at parent-reported outcomes for up to 24 children and found that individual-level findings appear to tell a less positive story than the more traditional group-level finding. They call for more reporting...
Article
Objective: Whilst the benefits of shared decision-making (SDM) have been promoted across different health settings, its implementation is complex, particularly for children and young people with mental health difficulties. The aim of this scoping review was to identify and describe SDM approaches (tools, techniques, and technologies) used in child...
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Goal formulation and tracking may support preference-based care. Little is known about the likelihood of goal formulation and tracking and associations with care satisfaction. Logistic and Poisson stepwise regressions were performed on clinical data for N = 3757 children from 32 services in the UK (Mage = 11; SDage = 3.75; most common clinician-rep...
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Service comparison is a policy priority but is not without controversy. This paper aims to investigate the amount of service-level variation in outcomes in child mental health, whether it differed when examining outcomes unadjusted vs. adjusted for expected change over time, and which patient-level characteristics were associated with the differenc...
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A great deal of bullying behavior takes place at school, however, existing literature has predominantly focused on individual characteristics of children associated with bullying with less attention on school-level factors. The current study, comprising 23,215 children (51% boys) recruited from Year 4 or Year 5 (M = 9.06 years, SD = .56 years) from...
Chapter
This chapter considers attempts to implement routine outcome monitoring both at the level of the individual and at the level of the system. It draws on learning from the Child Outcomes Research Consortium (CORC), the United Kingdom's (UK's) leading membership organization of mental health providers that supports members to collect and use evidence...
Chapter
Children’s and young people’s well-being is a central aspect in many welfare states. Chapter 21 by Edbrooke-Childs et al. explores the many and varied methodological issues related to the ability to analyse interventions and support for this population. Besides methodological reflections, there is a discussion of what has been learnt, and how this...
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Mental health booklets may provide a low-cost means of promoting mental health self-management and help seeking in schools. The aim of the study was to assess the (a) use, (b) acceptability and (c) impact of booklets for students in primary (10–11 years) and secondary school (12–13 years) alone and in conjunction with funding for targeted mental he...
Chapter
Within the context of child mental health across the UK, a practice research network, Child Outcomes Research Consortium (CORC), has been formed and is committed to collating and using outcome data to inform clinical and service decision making . CORC began with 4 subscribing organizations in 2004 and has grown to approximately 65 in 2015. Based on...
Article
Key practitioners messages: As research shows, children and young people are rarely actively involved in their treatment within mental health services. This is despite a strong recent emphasis on providing care within child and young people mental health services according to person-centred principles. Still, there is little known about factors af...
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Background Policies, designed to promote resilience, and research, to understand the determinants and correlates of resilience, require reliable and valid measures to ensure data quality. The student resilience survey (SRS) covers a range of external supports and internal characteristics which can potentially be viewed as protective factors and can...
Article
Background Policy recommends using patient reported outcome measures (PROMs), yet their use is persistently low. Our aim was to examine the association between PROM use and clinician demographic characteristics, attitudes and efficacy. Method A sample of N = 109 clinicians completed an online survey. Results Clinicians who reported higher levels...
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Full-text available
Objectives Explore how patient-reported experience measures (PREMs) are collected, communicated and used to inform quality improvement (QI) across healthcare settings. Design Systematic review. Setting Various primary and secondary care settings, including general practice, and acute and chronic care hospitals. Participants A full range of patie...