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Wow, this is quite a long paper, I hope I manage to get through it all with a sound understanding of the content.

Found it quite strange that they hadn't managed to do any Type 1 studies of children, only of adolescents.

I found that this paper increased my knowledge of the different interventions available, this is not something I have previously studied in depth as I am not on the clinical course.

Emotions
Little bit irritable in general and slightly distracted at times.
As I was reading it I felt quite relieved that the interventions mentioned in the paper had been found to reduce symptoms of depression in the experimental groups.

Physical sensations
I am calm in general although I am suffering from a bit of a headache.
Feeling quite tired.

Behaviours
Taking notes from the paper in order to make sure that I have understood what I have read and to have something to refer to again so I do not have to re read the paper.

I was unable to read this in one sitting, when I found my concentration wavering I was taking breaks and then coming back to it.

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Concrete experience:
Reading this paper opened my eyes to the lack of research that has been conducted on the effectiveness of treatments for children and adolescents suffering from depression, and other disorders.

Observing and reflecting:
The paper was very interesting, however I do find reviews a bit less engaging than other research papers, and during the middle of the paper I did start to lose focus. It made me realise that the findings from the research that has been conducted tends to vary, and this seems to be due to the great variation in methodologies applied.

Conceptualisation:
I think I felt this way, as I am very interested in child and adolescent CBT and wanted to know what the research says about the effectiveness of this intervention. Because I do not know much about this area, I think I was even more interested, as I wanted to expand my knowledge on the subject and be able to apply it to other areas of my study.

Doing:
I feel that I have a better idea of the research surrounding the effectiveness of certain child and adolescent interventions and the need for further, thorough research in this area. I think it has encouraged me to find out more about it, to start to understand why there are some discrepancies in the research findings.

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Thoughts: My dominant thought whilst reading the paper was that it did not feel like reading a paper based around CBT in adulthood. Phrases such as "probably" made me very aware of the fact that the paper did not have the capacity to make any conclusions that was based on overwhelming evidence. I am aware that a piece of scientific research cannot prove anything but even with that in mind this research struggled to assess CBT in children compared with research that assesses CBT in adults.

Emotions: I feel frustrated whilst reading the paper. It has the right idea to assess effectiveness of CBT in young people but does not have the capacity to do it. This reminds me of a statistic highlighted in one of the seminars that children and young person services get 6% of the money invested in mental heath.

Physical Sensations: annoyance; heart began beating a little faster; heavily focussed on flaws of the research and potentially overlooked key conclusions or discussion points.

Behaviours: re-read sections to make sure I was allowing myself to take in all information. Looked for other research into CBT in young people to see if there was a trend.

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Thoughts: As I began reading the paper, phrases in the abstract such as 'probably efficacious' made me question the evidence that was going to be presented as I read on and what the paper's conclusions about the effectiveness of CBT for children and adolescents were going to be.
Emotions: Pleased that the overall conclusions were supportive of the use of CBT, encouraging my faith in the therapy, but also disappointed with the lack of more firm findings.
Physical sensations: Alert, sitting upright as concentrating, tired eyes towards the end of the paper.
Behaviours: Highlighting key points, taking particular note of the recommendations section at the closure of the paper.

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Concrete experience: As I was reading the paper I skimmed for the most part, I was picking out what I wanted to read. I noticed before how long the paper was. I noticed I took more interest in the parts regarding CBT and IPT. Throughout reading the article I was primarily thinking about CBT and why I was rooting against it (versus IPT, not the placebo-like interventions).
Observing and reflecting:
I think I took such an interest in these areas because CBT bothers me. Coming to a point where I am using it as a framework to work with patients with, I have become disappointing with it. Not as far as it is efficacious, but because it is too narrow to deal with certain problems. I do not feel as though it offers any depth of psychological insight to the patient. It's explanations for psychopathology are largely intuitive. As a result, I was particularly interested in whether or not IPT was more effective than CBT, I know that this has been the case in some adult studies. I noticed that another reason I have a problem with CBT is that it is overhyped, in general it works, but it has just become a standard - any new intervention will re-brand the ideas of CBT and make them specific to a purpose. I don't see this as progress. There is no market place of ideas around psychological therapy. There is nothing new to add, if anything researchers start with CBT and try to take things away from it to see if it still works. I think this bias of mine took my mind away from the purpose of the article, I did not engage much with the parts that did not meet my own interests.
Conceptualisation:
I have a bias against CBT and this takes away my capacity to engage in tasks where therapeutic efficacy are out for scrutiny.
Action:
I plan to read more of the earlier parts of articles to ensure that I understand what their point is before I read them in full

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Thoughts:
CBT is everywhere and all-pervasive. I know it's effective but NHS / NICE seem to be over-enthusiastic about it. I wonder how effective it will be for a child or teenager given that they are probably at school and pretty busy even if depressed so  how would BA work for them ...?

Emotions:
A bit stressed that of course this is far more complicated than I imagined so will be hard to understand; there are so many variables / ages / co-morbidity. I am reading this with a lot of noise / distraction in the room and from the computer - maybe I should print this off and highlight parts?

Physical:
Once I have printed it off ... relaxed as it's easier to read and understand, settling into comfy chair, slower breathing and relaxed body posture (shoulders / neck); eyes feel more comfortable

Behaviour:
Humming to myself as I read; smiling at the people around me; Googling other papers on efficacy of CBT in CYP; getting the Padlet done quickly so I can go and do other things

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Thoughts: 'There seems to be an abundance of issues with CBT, but it remains supposedly effective. Is there an agenda that the paper is attempting to push?'

'Perhaps common factors within a therapeutic experience are more important than the therapy that is being delivered'

'Perhaps the methodological issues described are due to the lack of variance in method for different age groups. A teenager will certainly have a different response to the therapy than an 8 year old child'

Physical Symptoms: Slowed breathing, concentration, feeling of relaxation.

Behaviours: Adjusting sitting position. Taking breaks from reading occasionally. Highlighting areas of interest for review later.

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Thoughts: I was surprised to read that some of the papers use participants from an age range of 8-15 in the same study. Surely, someone who is 8 would not benefit from the same intervention as someone in their teens? There life perspective and goals must be so different. Considering the emotional and biological differences in these age groups, I believe they should be in separate studied and not all be classified as 'children'. 

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Thoughts: I was surprised to read that some of the papers use participants from an age range of 8-15 in the same study. Surely, someone who is 8 would not benefit from the same intervention as someone in their teens? There life perspective and goals must be so different. Considering the emotional and biological differences in these age groups, I believe they should be in separate studied and not all be classified as 'children'. 

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Physical feelings:
Increased concentration, hot face

Behaviours:
Spoke to house mate to see whether my disbelief was shared.

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ThoughtsBegan thinking about how the paper is likely to be similar to papers that I have read about the efficacy of CBT for adults. Wondering how the researchers would go about examining the question and concerns over whether there would be a definitive answer at the end.Emotions	Disappointed at the moderate effect sizes found, despite this being in the direction of showing improvements. It made me think of the do-do bird effect and whether this may account for the treatment improvements, as opposed to certain factors or mechanisms of CBT. Physical Symptoms	Tense in my shoulders when reading from my laptop screen, as the paper was quite long. Also noticed that my eyes became strained.Behaviour 	Saving the document and highlighting relevant parts to the padlet and to what could come up in the exam. 

# data[].attributes.subject
ThoughtsBegan thinking about how the paper is likely to be similar to papers that I have read about the efficacy of CBT for adults. Wondering how the researchers would go about examining the question and concerns over whether there would be a definitive answer at the end.Emotions	Disappointed at the moderate effect sizes found, despite this being in the direction of showing improvements. It made me think of the do-do bird effect and whether this may account for the treatment improvements, as opposed to certain factors or mechanisms of CBT. Physical Symptoms	Tense in my shoulders when reading from my laptop screen, as the paper was quite long. Also noticed that my eyes became strained.Behaviour 	Saving the document and highlighting relevant parts to the padlet and to what could come up in the exam. 

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Concrete Experience

Reading the paper and the information provided on this padlet, allowed me to transfer the knowledge I have around CBT and its evidence base from adults to children and young adults.

Observing and reflecting

I found reading the paper, at the start I was interested and felt I was alert in what I was reading, highlighting the important parts. However, I found as the paper progressed I found my concentration began to lag and found myself looking around the room. I began to read the content quicker, and started to miss pages if I thought they were repeating what was already stated. This lead me to have thoughts such as how much longer is this paper and will it teach me anything new.

Conceptualisation

I feel I felt interest at the start of the paper as I am interested in the evidence base around CBT in children and wanted to learn if there were any differences between the adult and children CBT evidence base. The interest may have been me trying to improve my knowledge base for future practice and academic work. However, I feel I may have become bored of the paper, as the paper was long in length and I was reading it at a time when I was tired and had a lot of other things on my mind. This may have swayed my concentration, making me not as focused as I should have been.

Doing

Overall, I feel I have a basic understanding around the evidence base of CBT for depression in children and young adults. I will increase my understanding by reading around the subject and will additionally research further evidence supporting and reviewing the use of CBT for depression in young people.

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Thoughts:
'Is CBT really effective if there are so many methodological issues?'
'Is it specific or common factor skills driving it's effectiveness?'

Emotions:
Happy- that there is support for using CBT to treat childhood depression, and that it is found to be effective
Frustrated- that there are no studies with 'perfect' methodology providing a definitive answer

Physical sensations:
Heightened concentration, dilated pupils as I got into reading the paper. Quite relaxed as I feel confident in my understanding of this area of research.

Behaviours:
I found myself automatically picking out the methodological issues, and then doing further research to find studies that might not have these issues

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Hopefully of interest for those that have time

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This session is aimed at a universal audience and examines key concepts associated with evidence-based practice in Child and Adolescent Mental Health Services (CAMHS) and some of the tensions within the approach. It outlines how clinicians bring together different sources of information in order to inform their practice, the outcome of which may go on to build the evidence base support future practice.

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Alternatively mirroring the CBT model, consider formulating your responses to the information

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Now there's a surprise!

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Using either a Kolb cycle or a CBT generic formulation model, post your reflections on material onto this padlet.