Warm and consistent parenting can lead to meaningful changes in brain function and learning style in children with behaviour problems

by Jigyasha Sharma | Sep 15, 2025 | Research

Warm and consistent parenting can lead to meaningful changes in brain function and learning style in children with behaviour problems

The research, published in Biological Psychiatry, is the first proof that evidence-based parenting programmes are accompanied by specific changes in children’s brain activity and decision‑making processes, and underscores the value of offering such programmes early in life.

78 boys with conduct problems (CPs) aged 5 to 10, and 35 matched controls, completed a reward‑learning task while undergoing functional MRI scanning. Families in the CP group then took part in a 10 -12‑week group parenting programme designed to encourage positive behaviour with warmth and praise.

At the end of the program, the participants were then sub-classified as either “improvers” or “persistent” based on whether they displayed an improvement in antisocial behaviour. All children then repeated the task and scan at a follow‑up session.

In the initial scans, researchers found that the insula, an important brain region that helps to anticipate whether something good (a reward) or bad (a punishment) might happen when we do something, was not activating or “lighting up” as much as it should when expecting a reward. However, after having taken part in the parenting programme, researchers found that the insula in the improvers group responded more like that of typically developing children, especially when they expected a reward.

Other brain areas also changed, including the ventromedial prefrontal cortex and the hippocampus, both of which are involved in making decisions and learning from outcomes. Again, these areas also showed more normal activity in the second scan after the intervention in children who improved.

“Parenting programmes are highly effective for many families. What’s been missing is a biological account of how children’s behaviour improves. We show that when behaviour gets better, so does the functioning of brain systems that evaluate rewards and punishments – particularly in the ventromedial prefrontal cortex and insula.”

Professor Michael Craig

Professor in Forensic & Neurodevelopmental Sciences at King’s IoPPN and the study’s senior author

The study also found changes in how these children learn from their experiences. After the parenting programme, the improved boys became slower to change their expectations after just one good or bad outcome, which may help them make more balanced decisions over time. They were also less likely to act impulsively and became more sensitive to the difference between reward and punishment.

Dr Arjun Sethi, the study’s lead author from King’s IoPPN said, “Using computational modelling, we found that responders learned more gradually and were less driven by a reflex to act. That combination – slower learning and reduced action bias – appears to support more thoughtful choices and fewer antisocial behaviours.”

Professor Stephen Scott, Professor and Consultant Child and Adolescent Psychiatrist at King’s IoPPN and one of the study’s authors said, “Evidence based parenting programmes like the ones explored in this study promote what I consider to be “love and limits”. They focus on developing closer relationships between parent and child, but also providing clear boundaries and expectations that reinforce good behaviour.

“This study, which is a world first, demonstrates not only that these programmes can impact the inner working of a developing child’s brain, but also provides valuable evidence of the value of programmes like these.”

Dr Bruce Clark, Medical Director of the King’s Maudsley Partnership said, “Issues relating to young people’s behaviour are amongst the most common we see being referred into our clinical services. This study highlights the importance of intervening early with evidence-based treatments, so that brain and behavioural changes are mitigated early. Within the King’s Maudsley Partnership we are testing and piloting interventions to provide support in the most timely and cost effective way.”

This study was funded by the Medical Research Council (MRC).

Successful Evidence-Based Parenting Programs are Associated With Brain Changes and Improved Reward Processing in Boys With Conduct Problems (DOI10.1016/j.biopsych.2025.06.008) (Sethi, Craig et al) was published in Biological Psychiatry.

For more information, please contact Patrick O’Brien (Media Manager)

You can also find this press release on King’s College, London website

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Digital health and CAMHS: Unpacking the Government’s 10-year Health Plan – Part 2

by Jigyasha Sharma | Sep 12, 2025 | News

Digital health and CAMHS: The role of digital innovation in improving children’s mental health

Unpacking the Government’s 10-year Health Plan – Part 2

– By Prof. Johnny Downs and Zoë Firth, on behalf of the CAMHS Digital Lab

In Part 1 of this blog series, we explored how the work underway in the CAMHS Digital Lab aligns with the Government’s ambitions for digital innovation in transforming mental health care. In Part 2, we turn our attention to the NHS Long Term Plan—highlighting the areas where key questions remain. How can we ensure that the shift to digital delivers meaningful improvements for children and young people’s mental health? And what needs to happen to make that vision a reality?

Digital inclusion

We welcome the recognition that increasing the use of digital solutions relies both on the digital inclusion of service users and digital upskilling for staff. It is important to acknowledge that the ‘digital divide’ for service users is not only caused by unequal access to digital devices, but also factors like gender and ethnicity. This complex picture of intersecting inequalities needs to be addressed when creating and implementing integrated, equitable digital services.

The roles and risks of AI

We are highly interested in the use of AI-assisted diagnostics, which the plan suggests could offer 24/7 virtual support for people with mild to moderate mental health needs, and remote monitoring for those with more severe conditions to enable faster crisis response. However, a word of caution here. It is not entirely clear how the benefits of AI-enabled diagnostics – which have shown success in areas like dermatology – will translate into mental healthcare. The Plan mentions using digital tools like online therapies and real-time digital suicide surveillance as ways to reduce suicide rates. Unsupervised AI-assisted mental health therapies are associated with a number of dangers, from failure to recognise suicidal forms of thinking to actively encouraging dangerous behaviours. Even if AI is not involved, the crisis management of acute mental health symptoms, including suicidality, is a complex clinical issue. In some cases remote tools like suicide helplines can be useful, e.g., suicide helplines, but they must be backed by robust systems that ensure people at high risk of harm are identified and referred to appropriate support. Additionally, the evidence base for suicide helplines indicates further work is required to understand what types of crisis management work, when, and for whom.

Areas of caution

A few areas where we would have liked to see more focus in the plan are:

Signposting to well curated resources. While the launch of ‘a new AI-powered digital tool to provide more personalised health advice’ sounds promising, service users deserve expert-written, evidence-based resources. We have signposted mental health resources to families waiting to be seen by CAMHS through the ‘Virtual Waiting Room’ on myHealthE. AI-driven technology may be able to collate useful information for service users, but this does not replace effective curation of, and signposting to, resources designed by experts. Service users also deserve the opportunity to discuss this health information with clinicians to interpret what it means for them. In the age of widespread access to unmoderated information about mental health, especially through social media, access to health information which is evidence-based, accessible, and culturally-sensitive is essential.
Using outcome measures to personalise treatment. The focus on collecting outcome measures in the Plan was primarily about making this data public to allow patients to decide which services they want to receive care from. However, the primary purpose of these outcome measures in mental healthcare is to support individual clinical care: they give service users and clinicians more data to use when making clinical decisions. Without proper context and management, the Government proposing to use data in this unintended way risks it being misinterpreted; think of Goodhart’s law: ‘when a measure becomes a target, it ceases to be a good measure’. We need to consider the best way of providing patients and clinicians with the data they need in a way that values their choice and decision-making while not introducing these risks.
Children’s mental health needs. We welcome the level of focus given to children’s mental health within the Plan. However, there was little mention of how the mental health needs of children and young people differ from that of adults, and how this should be reflected in differences in service models and patient care.
Supporting caregivers. Parents and caregivers are key participants in their child’s journey through CAMHS. There was not enough acknowledgement of caregivers’ role in children’s mental healthcare.

Overall, the plan’s focus on improving, streamlining, and expanding forms of digital and remote data collection, and using this health intelligence to improve services, is encouraging. As researchers and clinicians with a strong interest in digital health, we’re excited by the potential of sophisticated data monitoring systems. However, we also recognise that for these tools to be effective, they must be simple, robust, and user-led. Technology should simplify service delivery, not complicate it. At the same time, digital innovation cannot be a substitute for addressing long-standing challenges in mental healthcare. Reducing treatment wait times and delivering long-promised service improvements—such as integrated care and expanded community-based services—remain critical. While the plan highlights a shift toward integrated community care, what this means in practice for mental health services is still unclear. Building effective partnerships across diverse clinical structures and communities with varying needs will require meaningful input from clinicians, families, and service users, alongside better data. Improvements in data collection can translate into improved outcomes for young people and their families – but not always. We hope to be able to contribute what we have learned about the barriers and facilitators affecting the translation of health informatics into patient outcomes to the implementation of this plan: ultimately improving mental health for children, young people, and their families.

For more information please email us at camhsdlab@kcl.ac.uk.

This blog is also posted on the CAMHS Digital Lab website.

Acknowledgements

Special thanks to Dr. Shuo Zhang and Jessica Penhallow for their support in preparing these blogs.

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Digital health and CAMHS: Unpacking the Government’s 10-year Health Plan – Part 1

by Jigyasha Sharma | Sep 4, 2025 | Blog Post

Digital health and CAMHS: Unpacking the Government’s 10-year Health Plan – Part 1

– By Prof. Johnny Downs and Zoë Firth, on behalf of the CAMHS Digital Lab

The Government recently released its 10-year Plan for the NHS. After an initial reaction, we have spent the past few weeks reading the plan and discussing it with colleagues in clinical services. We are encouraged to see a shift to digital named as a key operational driver of change across the NHS. At the CAMHS Digital Lab, we create digital innovations and health informatics to support children and young people’s mental health services. Our work aligns with the plan in many ways – placing prevention, community care, and digital innovation at the heart of clinical services. Read on to find out more about how the CAMHS Digital Lab is already delivering on key ambitions in the 10-year Plan.

Digital innovations that provide clinicians with more data to support decision-making. We were pleased to see encouragement for NHS providers to make better use of IT systems, supporting activities like collecting outcome measures from patients as well as using dashboards designed for clinicians to visualise data. With the support of our NHS colleagues, we have successfully developed and implemented these technologies across our local CAMHS teams in Southwark, Lambeth, Lewisham and Croydon. We were interested in the emphasis on the use of ambient voice technology (AVT) to support clinicians by, for example, streamlining note taking. We agree that there is a lot of the potential for these technologies to reduce the administrative burden on clinicians, improve their job satisfaction, and provide more time for patients. There are still questions to be answered to ensure these tools are accurate across different clinical specialties and the needs of different patient groups. We hope to address some of these questions as we prepare for a trial we are conducting of AVT in Croydon and Lambeth CAMHS in partnership with Anathem.

Early intervention and prevention. These were named as critical to supporting children and young people’s mental health, with schools identified as key to implementing this ambition. Our work within the Maudsley Education Consultation Service has supported schools to understand and improve their students’ mental health. Together, we implemented our co-designed myJournE app, developed for students, caregivers, and teachers to monitor mental health risk factors and outcomes, and provide school leaders with a comprehensive, whole school mental health needs assessment. We are also supporting a pioneering pilot of digitally delivered Single Session Interventions for adolescents with anxiety and depression who are on the waiting list for community CAMHS. The goal is to provide short and accessible support to teens who may otherwise be at risk of deteriorating mental health while waiting to access CAMHS.

In line with the early intervention and prevention aim, the plan highlighted how increasing the collection of information on children’s mental health – i.e., remote monitoring – can support earlier intervention and improve clinical decision-making. This starts in early childhood, with the plan outlining plans to move to the use of a digital ‘e-red book’. In our work within Gen2020, we’re developing a digital platform to track early developmental milestones, aiming to help parents and early childhood services accurately track development and access support more efficiently. We appreciated the Plan’s support for further expansion of data collection across different health services, including patient-reported outcome measures like those we have collected from children and young people through the myHealthE platform. Likewise, wearables – wearable devices like watches that monitor health data such as movement and heartrate – are valuable sources of information. Through our PACES+ project, we have brought wearables into mental health, piloting a device to track activity levels in children and young people trying to find the right dose of ADHD medication. To support this ambition, we could also monitor mood through apps such as myJournE, currently in use in the international AIMS 2 Trials study capturing the daily experiences of autistic young people. The Plan also highlighted the need for improved ways of assessing the implementation of digital technologies in clinical services, as we are doing through our Digital Therapeutics Assessment Group.

We’re sharing this work not just to highlight achievements, but to celebrate the parts of the plan that are grounded in strong evidence and are already making a difference in clinical settings. These uses of digital innovation and focus on early detection and prevention also aligns with other NHS priorities like the UK clinical research system transformation. Across our services, we’ve seen how digital innovation can transform the way we support children and young people’s mental health. This innovation is helping families feel more informed and empowered, while giving clinicians more time to focus on what matters most: working closely with families to deliver personalised, effective, and joined-up care.

For more information please email us at camhsdlab@kcl.ac.uk.

Acknowledgements

Special thanks to Dr. Shuo Zhang and Jessica Penhallow for their support in preparing these blogs.

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Reflections from the Neurodevelopmental Conditions Community of Practice

by Jigyasha Sharma | Jul 24, 2025 | Blog Post, Events, News

Reflections from the Neurodevelopmental Conditions Community of Practice

On Friday 18th July, members of the Neurodevelopmental Conditions Community of Practice (CoP) gathered to share learning, test new ideas, and explore what the NHS 10-Year Plan could mean for children and young people with neurodevelopmental conditions.

AI and Sleep Testing New Ideas in Real Time

A highlight of the session was Dr Laurence Telesia’s presentation on “Developing an AI chatbot to elicit clinically meaningful narratives from parents”.

“The Neurodevelopmental Conditions Community of Practice was an excellent forum to discuss my research ideas and get feedback from a diverse range of professionals from clinical, academic and other backgrounds.

My research interest is in sleep and ADHD, which we know from the existing literature is an important topic. Sleep problems impact the lives of many children and their wider families. But there has been very little qualitative research looking at the bedtime routine in this group, or identifying the sort of things that tend to go wrong. I’m looking to address this gap in the literature and explore whether AI can be used as a novel approach to get rich qualitative information from a much wider range of people than traditional qualitative methods can.

I think that we, as researchers and clinicians, could learn from the principles of User Centred Design. In this approach, input is sought very early, and prototypes are repeatedly iterated. I was therefore grateful for the opportunity to present an early prototype of an AI chatbot to the Community of Practice. Having so many people test the technology at the same time, and then thoughtfully discuss the experience of using it and its future potential, has been really valuable.

The group highlighted several improvements that could be made for the next iteration. There is no doubt that the Community of Practice has had a meaningful impact on the design of my research; within minutes of the meeting, I had updated the chatbot based on our discussions. I don’t think there would be another way to get such valuable feedback so quickly. “

What Could the NHS 10-Year Plan Mean for Neurodevelopmental Services?

The session also included a discussion on the NHS 10-Year Plan for England, led by Ashish Jain, exploring its potential impact on children and young people with neurodevelopmental conditions.

The Plan sets out three headline shifts: from hospital to community, from analogue to digital, and from sickness to prevention. These ambitions align closely with the ethos of the King’s Maudsley Partnership, but the group also surfaced important reflections:

Hope and Curiosity – There was clear appreciation for the ambition of the Plan. Members were interested to understand more about how the Government would ensure that the funding, staffing, and infrastructure would match its ambitions.

Equity and Access- Concerns were raised about regional disparities and whether children and young people with neurodevelopmental conditions will benefit equitably from reforms. Who will get access first? Will digital tools reach the digitally excluded?

The Role of Lived Experience- Members emphasised the need to embed lived experience in service design — particularly when developing community-based and digital solutions for children, young people and families navigating complex neurodevelopmental journeys.

Research Gaps and Opportunities- The Plan’s shift toward prevention and digital care opens doors for new research — but also raises questions. How do we measure impact for neurodiverse populations? What models are most effective for early intervention?

Joined-Up Working- A consistent theme was the need for genuine cross-sector collaboration. Education, health, and social care must be aligned if the vision of early, community-based, preventative support is to be realised.

Get Involved

Interested in contributing to the conversation or shaping what comes next?
📩 Contact us at pmcyp@slam.nhs.uk

Let’s keep building this community—together.

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Our reaction: 10 Year Health Plan

by Jigyasha Sharma | Jul 3, 2025 | News

Our reaction: 10 Year Health Plan

The King’s Maudsley Partnership welcomes the commitments to prioritising children’s mental health set out in the 10 Health Plan. The plan calls for a ‘joined up’ approach to children and young people’s mental health.  It’s an urgent challenge that we all have to respond to: schools, communities, the workplace, the third sector and the NHS. It is vital that the Government has a strong evidence base for the policies and interventions implemented to deliver the plan.

We agree that there are many opportunities for reaching more children and families than ever through effective use of public services data, better mobilisation of knowledge through digital platforms, and evidence based digital interventions.

To achieve this the Government must bridge the gap between these technological advancements and sustaining their adoption in clinical practice, especially within the proposed integrated neighbourhood teams and Young Futures Hubs. At King’s Maudsley Partnership, our CAMHS Digital Lab have been pioneering the use of digital technology, showing how it can streamline care, in part by allowing many assessments to be done safely and securely at home. The Digital Lab is leading studies into the digital delivery of care, showing what works and what doesn’t work. Innovations such as those happening within the CAMHS Digital Lab will be crucial to the Government being able to successfully achieve its aims.

We are pleased that the Government has reconfirmed its commitment today to expand Mental Health Support Teams (MHSTs) in schools with an ambition of 100% coverage by 2029/30. Investing in MHSTs is a powerful tool in improving children’s mental health. King’s Maudsley Partnership is home to a leading provider of MHSTs across South London, and to those delivering its national training programme.  Our academic teams have developed and rigorously tested classroom-based workshops for young people to help them build skills to tackle stress and symptoms of depression. Such evidence-based programs are key to success.  We are keen to see a long-term plan for investing in MHSTs and the workforce delivering it to enable the Government to achieve its ambitions.

The King’s Maudsley Partnership for Children and Young People will transform our understanding and treatment of young people’s mental health through a unique collaboration between specialist clinicians from the South London and Maudsley NHS Foundation Trust and leading academics at King’s College London. Learn more about us.