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Abstract
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Objectives: Over the last decade, clinical practice guidelines for diagnosing and treating severe behavioural problems (SBPs) in children have been developed around Europe as an important tool. First, they would help coordination of care across the multiple agencies that need to be involved in the management of children with SBPs. Second, they would assist health and non-specialist health, social care, and educational services in choosing interventions supported as efficacious. This study provides an overview of experts’ perspectives on the current prevalence and implementation of clinical guidelines for SBPs in children across Europe. Additionally, it discusses the pros and cons for further developing national and/or European clinical guidelines for this group. Methods: An online semi-structured interview was completed by 28 academic experts from 23 countries. Results: One third of the European countries included have developed official clinical guidelines for SBPs, and just over a half have at least some unofficial documents. Although the content of guidelines was perceived as beneficial for daily practice, experts called for more specific recommendations, including severe aggression management, legal and forensic aspects, to better cater for real-life practice demands. Additionally, their implementation was described as one of the most salient challenges at present. Similarly, unofficial documents were considered useful for clinicians, but experts stressed the need for change towards more comprehensive evidence-based clinical practices, by means of developing national and particularly European clinical guidelines for SBPs. Such guidelines were believed to increase accessibility to evidence-based and early intervention, harmonise practices and provide a shared understanding of SBPs. Conclusions: Based on the consensus on the need for developing official guidelines reached by experts, this study creates an appropriate momentum for a transition towards European clinical practice guidelines for this population. Such guidelines would facilitate cross-disciplinary collaboration both within and between countries. Increasing global exchange may further stress the prioritization of SBPs and reinforce implementation of guidelines in practice. Moreover, joining efforts could also reduce costs, time, and resources required for the creation of national guidelines, all of these tackling the current barriers encountered by professionals when treating these children.
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