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Mobile team in child and adolescent psychiatry: Contributions from research Volume 95, issue 6, Juin-Juillet 2019

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Authors
1 Pôle hospitalo-universitaire de psychiatrie de l’enfant et de l’adolescent (PHUPEA), 154 rue de Châtillon, 35000 Rennes, Université de Rennes 1 et Centre hospitalier Guillaume-Régnier
2 Laboratoire psychologie de la perception, Université Paris-Descartes et CNRS UMR 8242
3 Professeur en pédopsychiatrie, chef de pôle PHUPEA, Rennes
4 Praticien hospitalier en psychiatrie, PHUPEA
* Correspondance

This article presents research based on clinical practice of a child psychiatry mobile team for preadolescents and adolescents in difficulty who do not have a direct request for care. This multidisciplinary mobile team is characterized by changing locations of meeting points chosen by the youth and his or her family and changing caregiver dyads. A telephone follow-up (from initial meeting to 10 months after the last one) allowed symptom severity, therapeutic alliance and sustainability of relay to be evaluated. The results indicate the importance of the therapeutic alliance (as a predictive factor of a favorable clinical evolution) and changes in physical environment (changes of meeting locations) and relational environment (changes of family configuration and caregiver dyads). Changes in meeting locations are significantly associated with therapeutic engagement whereas when all the meetings take place in a single location (home, mobile bureau, or care center), a greater frequency of rupture in follow-up is observed. In most cases, the progression is home to mobile bureau (transitional space) to the care center. The results highlight the positive role of physical movement for psychic mobilization, openness toward the outside world reducing social isolation, and a plurality of representations associated with the diversity of meeting locations. Finally, the benefits of research and evaluation of mobile team practices contribute to the evolution of this clinical approach, the mobility of the project participating also to life skills.

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