Mentalization-based therapy for children and adolescents referred for aggressive or violent behaviour

The Mentalization Intervention for Children and Adolescents (MICA) Study: A Randomised Controlled Trial of Support for Aggressive and Violent Behaviour Via Forensic Child and Adolescent Mental Health Services (FCAMHS)

This trial will test whether mentalization-based therapy helps young people aged 10–17 referred to specialist services for aggressive or violent behaviour reduce those behaviours and improve how they understand themselves and others.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 632 (estimated)
• Ages: 10 Years to 17 Years
• Sex: All
• Sponsor: Anna Freud (Academic / other)
• Locations: 8 sites (Southampton, Calmore and 7 other locations)
• Trial ID: NCT07091721 on ClinicalTrials.gov

What this trial studies

The trial randomises young people referred to Forensic Child and Adolescent Mental Health Services (FCAMHS) in England to receive either mentalization-based therapy (MBT) alongside usual support or usual support alone. MBT involves regular sessions with a trained mental health practitioner and may include parents or carers for younger adolescents, with a focus on understanding thoughts, feelings, and behaviours. Participants are community-dwelling youth aged 10–17 who show aggression or violence at referral and whose involvement will not interfere with statutory orders. Outcomes will compare changes in aggressive/violent behaviour and related mental health measures over the follow-up period.

Who should consider this trial

Good fit: Ideal candidates are community-based young people aged 10–17 referred to FCAMHS for aggressive or violent behaviour who can consent or assent (with parent/carer involvement where required) and whose participation will not conflict with statutory orders.

Not a fit: Young people under 10 or 18 and older, those with imminent plans to move to hospital, residential or secure settings, or whose legal/orders would be disrupted by participation may not receive benefit or be eligible.

Why it matters

Potential benefit: If successful, this could reduce aggressive and violent behaviour and improve emotional understanding and relationships for vulnerable young people in FCAMHS.

How similar studies have performed: MBT has shown benefits in adolescents for emotion regulation and self-harm in prior research, but using it specifically for aggressive or violent behaviour in FCAMHS populations is relatively novel and less well established.

Eligibility criteria

Inclusion Criteria:

* Age 10-17 years at the time of referral;
* Aggression and/or violence are indicated at referral or assessment;
* Participation in the evaluation would not interfere with statutory orders;
* Child and parent/carer (for children 10-15 years) are able to consent and engage with the study materials;
* Living in the community at time of referral and no imminent plans to move to hospital, residential, or secure settings.

Additional inclusion criteria for participants recruited from a clinician's existing caseload:

* There has been no direct contact between child and FCAMHS clinicians, including assessments.
* There has been no indirect therapeutic support provided by FCAMHS e.g. advising non-FCAMHS professionals on therapeutic support.
* It is permissible for the clinician to have previously engaged in consultation activities where these did not involve contact with the child.

Exclusion Criteria:

* Age under 10 or age 18 or older at the time of referral;
* No evidence of aggression and/or violence indicated at referral or assessment;
* FCAMHS are only offering a one-off consultation or assessment (e.g., the network around the child requires support to manage risk but additional input is not required);
* Child's level of English is not sufficient to engage in the intervention;
* Child and/or parents/carers refuse to engage with FCAMHS;
* No statutory service is involved in supporting the child;
* No statutory service will agree to hold the child's case open for a minimum of six months.
* Currently involved in another psychological intervention research study.

Where this trial is running

Southampton, Calmore and 7 other locations

• Hampshire and Isle of Wight Healthcare NHS Foundation Trust — Southampton, Calmore, United Kingdom (Not_yet_recruiting)
• Yorkshire and Humber FCAMHS, South West Yorkshire Partnership NHS Foundation Trust — Wakefield, Ouchthorpe Lane, United Kingdom (Recruiting)
• South Central Community Forensic CAMHS Team, Oxford Health NHS Foundation Trust — Headington, Oxford, United Kingdom (Recruiting)
• South West (North) Community Forensic CAMHS Team, Oxford Health NHS Foundation Trust — Headington, Oxford, United Kingdom (Recruiting)
• The North East and North Cumbria Community Forensic Child & Adolescent Mental Health Service, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust — Newcastle upon Tyne, Upon Tyne and Wear, United Kingdom (Recruiting)
• East of England Community FCAMHS Team, Cambridgeshire and Peterborough NHS Foundation Trust — Cambridge, United Kingdom (Not_yet_recruiting)
• North London Forensic CAMHS, North London NHS Foundation Trust — London, United Kingdom (Not_yet_recruiting)
• South West FCAMHS, Somerset NHS Foundation Trust — Taunton, United Kingdom (Recruiting)

Conditions Conduct Disorder; Mentalization Based Therapy; Violent Behavior; Aggressive Behaviour; Adolescent Behavior; Children Behavior; The Mentalization Intervention for Children and Adolescents study.; Forensic Child and Adolescent Mental Health Services.