Assessment of digital risks in child and adolescent mental health services: A mixed-method, theory-driven study of clinicians’ experiences and perspectives
Open accessAbstract
Children and adolescents in the UK spend increasingly more time in the digital world, raising societal fears about digital risks in this age group. Professionals are not always aware of the ever-developing research or guidance available around digital safety. This gap underscores the need to understand current experiences and determinants of digital risk assessment, including clinicians' views on barriers and facilitators. A mixed-method design was used. Fifty-three clinicians working in child and adolescent mental health services (CAMHS) in South England took part in a survey; of these 12 took part in semi-structured interviews. A psychological model of behavioural change (COM-B: capabilities, opportunities, motivation and behaviour) guided the analyses. Survey data revealed that clinicians showed awareness and concerns for several digital risk issues but there appeared to be gaps in their knowledge and practice. Interview data revealed different factors influencing staff enquiry about digital risks in CAMHS. These included aspects of capabilities (knowledge and skills), opportunities (resources, organisational context and empowerment of youth), and motivations (habit change, emotional experiences, and professional identity/role). Targeting both staff-level and organisation-level barriers to digital risk assessments in CAMHS is crucial. This study informs service improvement to ensure that children and young people safely navigate the digital world.
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Clinicians in the UK expressed challenges around knowing how to encourage incident reporting and felt unable to appropriately advise young people.
“Yet clinicians in the UK expressed challenges around knowing how to encourage incident reporting and felt unable to appropriately advise to young people (52).”
From A thematic analysis of adolescents’ perceptions of cyberbullying and cyberaggression: definitional distinctions and educational gaps (2026) · cites this paper as [52]
In Results > Study 2 (page not provided), clinicians discuss difficulty enabling young people to share their experiences and say they often felt unable to provide adequate advice. The paper supports those general challenges, but the passage concerns disclosure during digital-risk assessments, not specifically encouraging incident reporting. (LLM, conf=0.84)
Experimental — accuracy not yet measuredConceptual issues substantially impact clinical practice, as UK clinicians require accurate prevalence rates to support adolescent mental health services associated with digital risks.
“All the aforementioned conceptual issues substantially impact the field, including clinical practice as UK clinicians require accurate prevalence’s rates to support adolescent mental health services associated with digital risks (52).”
From A thematic analysis of adolescents’ perceptions of cyberbullying and cyberaggression: definitional distinctions and educational gaps (2026) · cites this paper as [52]
In Results (Study 2; page not provided), clinicians describe ambiguities in the term “digital risks” and say they would like to know more about its general prevalence and normative risk-taking. The paper links knowledge gaps to clinical assessment, but it does not say that accurate prevalence rates are required to support services or establish that conceptual issues substantially affect the field as a whole. (LLM, conf=0.83)
Experimental — accuracy not yet measuredTo maximize effectiveness of interventions, having young people involved in educating clinicians about online harms was emphasized.
“To maximize the effectiveness of interventions, having young people involved in educating clinicians about online harms was emphasized (52).”
From A thematic analysis of adolescents’ perceptions of cyberbullying and cyberaggression: definitional distinctions and educational gaps (2026) · cites this paper as [52]
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- Authors
- Lau-Zhu, A., Anderson, C., & Lister, M.
- Affiliations
- Medical Sciences Division, Oxford Institute for Clinical Psychology Training and Research, University of Oxford, UK
- University of Oxford (GB)
- Oxford Health NHS Foundation Trust (GB)
- ORCID
- Lau-Zhu, Alex
- Venue
- Clinical Child Psychology and Psychiatry
- Publisher
- SAGE Publications
- Published
- 2022-05-06
- Volume
- 28
- Issue
- 1
- Pages
- 255-269
- ISSN
- 1359-1045 (ISSN-L)
- 1461-7021
- PMC
- PMC9893305
- OpenAlex
- W4229040992
- Cited by
- 16
- References
- 25
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 8 · 2023: 3
- FWCI
- 4.68
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Clinical Child Psychology and Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Oxford Health NHS Foundation Trust
- Topics
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Social Sciences › Education › Child Development and Digital Technology
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- digital risks, child and adolescent mental health services, online safety, clinicians' perspectives, risk assessment, COM-B model, barriers and facilitators, professional knowledge and skills, organizational context, youth empowerment, professional identity, children's digital use
- MeSH terms
- Adolescent, Child, England, Fear, Humans, Mental Health Services, Motivation, Adolescent Health Services
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