Govind Krishnamoorthy

PsychiatryOnline.org is the platform for all American Psychiatric Association Publishing journals, DSM, and bestselling textbooks, as well as APA Practice Guidelines, and continuing medical education.

This study examined the effectiveness of psychological interventions in reducing interpersonal problems and enhancing interpersonal competence among adolescents with posttraumatic stress symptoms. A systematic search of PsycInfo, PubMed, Scopus, CINAHL and Google Scholar identified 17 studies that met the inclusion criteria, with 12 effect sizes reported for interpersonal competence and 24 for interpersonal problems. Results showed similar small but statistically significant aggregated post-intervention effect for both interpersonal competence (g = 0.37, p < 0.001, 95% CI [0.20, 0.55]) and interpersonal problems (g = 0.40, p < 0.001, 95% CI [0.25, 0.54]), with intervention type and mode significantly moderating effects only for interpersonal problems. Trauma-focused Cognitive Behavioural Therapy (TF-CBT) had the largest effect on interpersonal problems, whereas skill-based interventions had the smallest. Mixed-mode interventions also showed a significantly larger effect on interpersonal problems compared to group interventions. In contrast, neither intervention type nor mode significantly moderated effects on interpersonal competence. Furthermore, insufficient follow-up data precluded evaluation of the long-term effects of interventions. This meta-analysis indicates that current interventions have small but significant aggregated post-intervention effects on both interpersonal competence and interpersonal problems, with effectiveness influenced by intervention type and mode. However, this meta-analysis is limited by small inclusion number, inclusion of heterogenous assessments, and insufficient data to examine moderating effects of gender and age. This study identified gaps in existing evidence-based interventions simultaneously targeting both interpersonal competence and interpersonal problems. Moreover, a lack of sufficient follow-up assessments raises concerns about the long-term effectiveness of existing interventions. These findings underscore the need for integrative, evidence-based interventions that target both competence and maladaptive aspects of interpersonal functioning, as well as for further high-quality studies to rigorously evaluate their long-term effectiveness across diverse adolescent populations.

This chapter examines how cumulative harm influences learning through the intertwined pathways of threat, deprivation, and disrupted relational expectations. It outlines how classroom environments can unintentionally reproduce these conditions through curricular omissions, instructional habits, and unexamined assumptions. Drawing on trauma-informed, culturally responsive, and neurodevelopmental research, the chapter presents a three-phase implementation framework encompassing preparation, monitoring, and evaluation. The framework emphasises predictable routines, cultural alignment, differentiated instruction, and reflective practice as core components of safe and effective learning environments. Practical examples illustrate how educators can interpret behaviour through a developmental lens, avoid reenacting harmful relational patterns, and strengthen conditions for engagement. The chapter positions schooling as a context for repair, regulation, and identity affirmation when instructional decisions intentionally counter the effects of cumulative harm.

While there are many approaches in the use of narratives for children and young people as symbolic forms of real-life education, this article specifically investigates the use of narratives as a public health communication and intervention strategy for young people. This strategy foregrounds imaginative stories based on health education messaging that are told from patient perspectives. Through a thematic analysis of 57 research articles, the article explores the themes and discursive strategies of narrative-based health communication, including digital storytelling, in supporting young people to develop coping and resilience skills. The article identifies five interrelated themes, revealing that narratives are not only effective tools for conveying health information but also foster psychosocial support, patient empowerment, and social connection. Such narratives serve as tools for facilitating change and informing decision-making across various stages of health engagement, including prevention, promotion, and management of chronic conditions. These narratives are socially transformative: in assisting young people; they also educate clinical professionals and organizations and thereby inform public health practice at large. In this way the article both consolidates and clarifies the field of literature concerned with the use of story as a health communication strategy for children and young people.

This study evaluates the feasibility and impact of the Open Online Course (OOC) aimed at enhancing teachers’ trauma-informed care practices during the onset of the COVID-19 pandemic. Educators from two public primary schools in Queensland, Australia, completed the course. Twenty-six educators were interviewed about their experience of the OOC. Thematic analysis revealed the feasibility of the OOC was influenced by participants’ ability to navigate the digital divide and allocate time for learning. The impact of the OOC was reflected in reports of the adoption of trauma-sensitive classroom management techniques amongst participants. The findings highlight that sustaining OOC-based teacher education on trauma-informed practice requires long-term access, integration of trauma-informed strategies, and ongoing support for hyflex and blended learning models. Findings are mapped onto a trauma-informed education framework and inform recommendations for future OOC design and delivery in post-pandemic educational settings.

Introduction: Universal digital mental health interventions (DMHIs) are emerging as a viable approach to promoting mental health among children and adolescents in general population. However, there is a scarcity of meta-analyses that examined their short- and long-term effects or potential moderators in individuals aged 19 or younger. Methods: A systematic search was conducted to identify randomised controlled trials that delivered universal DMHIs for promoting mental health, targeting children and adolescents aged 19 or younger in general population. Meta-analysis was performed to identify studies using Comprehensive Meta-Analysis. Results: The meta-analysis of 29 included studies identified significant overall effects ( g = 0.16) as well as significant effects for anxiety ( g = 0.09), depression ( g = 0.06), psychological distress ( g = 0.28), externalising problem ( g = 0.21), psychological well-being ( g = 0.19), interpersonal functioning ( g = 0.21) and social-emotional skills ( g = 0.19) at post-intervention. The analysis of 7 studies that followed up 6 months or longer revealed a significant overall effect ( g = 0.09) as well as significant effects for anxiety ( g = 0.11) and depression ( g = 0.05) at follow-up. Age and intervention duration moderated the overall effects. Gamification moderated the effect on depression. Attrition rate moderated the effect on social-emotional skills. Conclusions: Providing universal DMHIs with longer durations to younger children may be critical for effectively improving a range of mental health outcomes among children and adolescents. To promote engagement and effectiveness, future studies may explore how gamification and other features for reducing attrition could be effectively incorporated into DMHIs.

Background/Objectives: Mental disorders that emerge during adolescence frequently extend into adulthood, predicting poor academic and employment outcomes and heavy societal burdens. Novel efforts to improve youth mental health have transitioned from clinical recovery, typically focused on a cure, to a strength-based approach to wellbeing in supporting youth within mental health services. Mental health scholars have appealed for interventions to adopt an ecological system of care approach that integrates the principal caregivers in a young person’s life. Despite preliminary literature indicating the importance of caregivers, little research has focused on the caregiver’s role in supporting personal recovery in youth. Methods: This study sought to understand the role of caregivers in youth recovery by employing a qualitative design to inductively analyze the narratives from nine semi-structured interviews with caregivers. Additionally, deductive analysis explored the core five underpinnings of personal recovery connectedness, hope, identity, meaning, and empowerment (CHIME). Results: A thematic analysis of the literature identified five themes: providing unconditional love and positive regard; encouraging connection with peers; co-creating a sense of purpose, meaning, and hope; supporting assertiveness and advocacy; and promoting strength and opportunity for mastery aligning with the CHIME framework. The findings will allow health services to understand caregivers’ roles better, thus providing information to guide recovery-oriented and family-centered care.