Social Psychiatry and Psychiatric Epidemiology

, Volume 48, Issue 4, pp 583–593

Can standardized diagnostic assessment be a useful adjunct to clinical assessment in child mental health services? A randomized controlled trial of disclosure of the Development and Well-Being Assessment to practitioners

Authors

    • Peninsula Medical SchoolUniversity of Exeter
  • Anna Last
    • Peninsula Medical SchoolUniversity of Exeter
  • William Henley
    • Peninsula Medical SchoolUniversity of Exeter
  • Shelley Norman
    • Peninsula Medical SchoolUniversity of Exeter
  • Sacha Guglani
    • South London and Maudsley NHS TrustCroydon CAMHS
  • Katerina Kelesidi
    • Department of Child and Adolescent PsychiatryKings College London, Institute of Psychiatry
  • Anne-Marie Martin
    • Department of Child and Adolescent PsychiatryKings College London, Institute of Psychiatry
  • Pippa Moran
    • Department of Child and Adolescent PsychiatryKings College London, Institute of Psychiatry
  • Harriett Latham-Cork
    • Peninsula Medical SchoolUniversity of Exeter
  • Robert Goodman
    • Department of Child and Adolescent PsychiatryKings College London, Institute of Psychiatry
Original Paper

DOI: 10.1007/s00127-012-0564-z

Cite this article as:
Ford, T., Last, A., Henley, W. et al. Soc Psychiatry Psychiatr Epidemiol (2013) 48: 583. doi:10.1007/s00127-012-0564-z

Abstract

Purpose

While research demands standardized diagnostic assessments as an indication of sufficient methodological rigour, there is debate about their application to clinical practice. The Development and Well-Being Assessment (DAWBA) provides a structured assessment of psychiatric disorder. Since it can be completed on-line, it could be used by Child and Adolescent Mental Health Services with few additional demands on staff. Access to the standardized diagnostic information as an adjunct to clinical assessment could reduce the number of appointments spent on assessment, free up practitioner time to work on engagement and improve clinical outcomes by increasing the accuracy of assessment and thus access to the appropriate evidence-based treatment.

Method

Randomized controlled trial of the disclosure of the DAWBA to the assessing practitioner (n = 117) versus assessment at normal (n = 118) and analysed by “intention to disclose”.

Results

Exposure to the DAWBA may increase agreement between the DAWBA and practitioners about some anxiety disorders, but detected no other statistically significant increased agreement for other disorders, nor a reduced need for further assessment, the number of difficulties recognised or influence on outcomes.

Conclusions

The results may be explained by the inadequacy of the DAWBA, lack of statistical power to detect any effects that were present or a reluctance of some practitioners to use the DAWBA in their assessment. Future research might benefit from exploring the use of the DAWBA or similar assessments as a referral rather than an assessment tool, and exploring how practitioners and parents experience and use the DAWBA and what training might optimise the utility of the DAWBA to clinical practice.

Keywords

DAWBA Standardized Assessments Diagnosis RCT

Copyright information

© Springer-Verlag 2012