An interventional study of Mentalization based therapy (MBT) and Support as usual in Conduct Disorder, Mentalization Based Therapy and Violent Behavior, sponsored by Anna Freud. Recruiting at 8 sites in United Kingdom. Open to participants aged 10 Years to 17 Years. Per ClinicalTrials.gov, last updated 2026-05-08.
Sponsored by Anna Freud · Not applicable, Interventional, and Treatment
The MICA Study is a research project that has been designed to work out how helpful mentalisation based therapy is. This is a new type of support that helps young people make sense of their own behaviours and feelings, and those of others. It involves meeting regularly with a mental health practitioner and parents/carers can be involved in some meetings too. It is hoped that this new type of support will help young people stop acting aggressively/violently.
This project will be delivered in Forensic Child and Adolescent Mental Health Services (FCAMHS) in England. This service supports some of the most vulnerable young people in the country, who may also have involvement from other professionals including the Youth Justice System.
The aim of the research is to make the support better for young people who use these services. This research involves doing a randomised controlled trial. This means half the young people will get the usual support from FCAMHS, and half will get the usual support plus the new support. The results will be used to compare mentalisation based therapy to the support FCAMHS usually provides. This will show the best way to support young people with their aggressive/violent behaviours.
To start with, young people will answer a questionnaire. Following this, young people will receive either usual support or usual support plus MBT for six months. After this, young people will answer a questionnaire again. Some young people will be asked to take part in an optional interview to share their thoughts on this research. All young people aged 10-17 years who have been referred to a FCAMHS in England will be asked to take part, as long as they can speak and understand English. Some young people might not want to take part in this research and that will not change the support they receive.
101 studies on the registry are indexed under Conduct Disorder; 15 are open to participants now.
This study's planned enrollment of 632 is above the median of 124 across 80 interventional studies indexed under Conduct Disorder.
Browse Conduct Disorder studies →This is the only study on the registry with Anna Freud as lead sponsor.
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Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Additional inclusion criteria for participants recruited from a clinician's existing caseload:
Exclusion Criteria:
Behavioral: Mentalization based therapy (MBT)
Other: Support as usual
Mentalization based therapy for conduct disorder
Support usually provided by FCAMHS which may include advice/guidance to the professional network around the child/adolescent, psychoeducation, other mental health treatment e.g. CBT
Reactive and Proactive Aggression Questionnaire (child reported)
The primary outcome is aggression and violent behaviour measured by the self-reported Reactive and Proactive Aggression Questionnaire. The RPQ combines two subscales, one measuring reactive aggression (12 items), the other proactive aggression (11 items). Each item is scored on a three-point scale from 0 (never) to 2 (often). Item scores from each subscale are added together to produce sub-scale scores (range 0-24 for reactive aggression, and 0-22 for proactive aggression). The total score can range from 0-46.
Time frame: Completed at baseline and six months post-baseline (primary endpoint).
Strengths and Difficulties Questionnaire (child reported)
Five outcomes will be measured using the 30-item Strengths and Difficulties Questionnaire including impact supplement: conduct problems using the conduct problem subscale (5 items); inattention difficulties using the hyperactivity/inattention subscale (5 items); emotional difficulties using the emotional symptoms subscale (5 items); difficulties with peers using the peer relationship problems scale (5 items). Each item is rated on a 3-point scale: Not True = 0, Somewhat True = 1, and Certainly True = 2. For each subscale, scores range from 0 to 10, with higher scores reflecting more difficulties. The impact supplement asks participants whether they experience difficulties in emotions, behaviour, concentration, or relationships rated from 'no' to 'severe difficulties'. Further questions ask about interference of these difficulties in areas of life including home, friendships, learning and leisure, rated from 'not at all' to 'a great deal'.
Time frame: Completed at baseline and six months post-baseline.
Emotion Awareness Questionnaire (child reported)
Two outcomes will be measured to assess mentalizing using two subscales (10 items) of the Emotion Awareness Questionnaire: 1. Analyses of emotions (5 items, score 5-15) (sample item: "When I am angry or upset, I try to understand why"). 2. Attending to others' emotions (5 items, score 5-15) (sample item: "It is important to know how my friends are feeling"). For items in both subscales, responses are scored on a three-point scale from 1 (not true) to 3 (often true).
Time frame: Completed at baseline and six months post-baseline.
Systemic Clinical Outcome and Routine Evaluation (SCORE-15) (child reported)
One family outcome will be measured using the total score of the SCORE-15, a 15-item self-report measure designed to assess perceived family functioning across emotional, behavioral, and communication areas. Participants are asked to indicate how well each statement describes their family using a 5-point scale between the range: 1 (Describes us: Very well) to 5 (Describes us: Not at all). In addition to the 15-item quantitative scale, the SCORE-15 includes two open-ended, qualitative questions i.e. "What words would best describe your family?" and "What is the problem/challenge that brought you to therapy?". Lastly, the SCORE-15 includes three single-item visual analogue scales designed to capture subjective ratings of severity of difficulties (scale of 0 \[No problem at all\] to 10 \[Really bad\]), family managing (scale of 0 \[very well\] to 10 \[very badly\]), and perceived helpfulness of therapy (scale of 0 \[very helpful\] to 10 \[unhelpful\]).
Time frame: Completed at baseline and six months post-baseline.
Reactive and Proactive Aggression Questionnaire (parent/carer reported)
One outcome, aggression and violent behaviour, will be measured using a parent/carer version of the RPQ. The RPQ is a 23-item self-report questionnaire designed to assess two subtypes of aggressive behaviour: reactive aggression (12 items) and proactive aggression (11 items). Each item is rated on a 3-point scale indicating frequency of behaviour (0 = Never, 1 = Sometimes, 2 = Often). Subscales range from 0-24 (reactive) and 0-22 (proactive). The total aggression score ranges from 0-46.
Time frame: Completed at baseline and six months post-baseline.
Strengths and Difficulties Questionnaire (parent/carer reported)
Five outcomes will be measured using the 30-item parent version of the Strengths and Difficulties Questionnaire including impact supplement: conduct problems using the conduct problem subscale (5 items); inattention difficulties using the hyperactivity/inattention subscale (5 items); emotional difficulties using the emotional symptoms subscale (5 items); difficulties with peers using the peer relationship problems scale (5 items). Each item is rated on a 3-point scale: Not True = 0, Somewhat True = 1, and Certainly True = 2. For each subscale, scores range from 0 to 10, with higher scores reflecting more difficulties. The impact supplement asks participants whether their child experiences difficulties in emotions, behaviour, concentration, or relationships rated from 'no' to 'severe difficulties'. Further questions ask about interference of these difficulties in areas of life including home, friendships, learning and leisure, rated from 'not at all' to 'a great deal'.
Time frame: Completed at baseline and six months post-baseline.
Systemic Clinical Outcome and Routine Evaluation (SCORE-15) (parent/carer reported)
One family outcome will be measured using the total score of the SCORE-15 as reported by parents/carers. SCORE-15 is a 15-item self-report measure designed to assess perceived family functioning across emotional, behavioural, and communication areas. Participants are asked to indicate how well each statement describes their family using a 5-point scale between the range: 1 (Describes us: Very well) to 5 (Describes us: Not at all). In addition to the 15-item quantitative scale, the SCORE-15 includes two open-ended, qualitative questions i.e. "What words would best describe your family?" and "What is the problem/challenge that brought you to therapy?". Lastly, the SCORE-15 includes three single-item visual analogue scales designed to capture subjective ratings of severity of difficulties (scale of 0 \[No problem at all\] to 10 \[Really bad\]), family managing (scale of 0 \[very well\] to 10 \[very badly\]), and perceived helpfulness of therapy (scale of 0 \[very helpful\] to 10 \[unhelpful\]).
Time frame: Completed at baseline and six months post-baseline.
Health of the Nation Outcome Scales for Children and Adolescents (clinician reported)
Six child outcomes will be measured using six items of the Health of the Nation Outcomes Scales for Children and Adolescents (HoNOSCA) reported by a clinician: Disruptive, antisocial or aggressive behaviour; Non accidental self-injury; Substance misuse; Peer relationships; Family life and relationships; School attendance. Each item is scored from 0 (no problem) to 4 (severe to very severe problem), with higher scores indicating greater severity. A score of 3 or above on any item indicates a moderate to severe problem.
Time frame: Completed at baseline and six months post-baseline.
Therapeutic alliance (child reported)
Therapeutic alliance, as a potential mediator or mechanism of change, will be assessed in the intervention arm at three timepoints (early therapy e.g. session 1-3, mid-therapy e.g. session 10-13, and late therapy e.g. session 20-24) using the Session Rating Scale (SRS). The SRS assesses the young person's perceptions of: respect and understanding from the clinician, how much they talk about the topics that matter to them, the clinicians approach or method, and overall acceptability of the session. A visual line is presented with contrasting statements at each e.g. "I did not feel heard, understood and respected", versus "I felt heard, understood and respected", (on the SRS version for 6-12 year olds, the statements are supplemented with a sad face or smiley face, respectively). Participants indicate their experience by placing a mark somewhere along the line. Reponses marked closest to the positive version of the statement (the smiley face) indicate a better therapeutic alliance.
Time frame: Will be assessed at three time points during 6 month reporting period: early therapy (defined as sessions/weeks 1-3), mid-therapy (defined as sessions/weeks 10-13), and late therapy (defined as sessions/weeks 20-24)
Goal based outcomes (child reported)
Progress towards goals, as a potential mediator or mechanism of change, will be assessed in the intervention arm at three timepoints (early therapy e.g. session 1-3, mid-therapy e.g. session 10-13, and late therapy e.g. session 20-24) using the goal based outcome (GBO) tool. The GBO enables young people to set up to three goals and rate the extent to which they feel that they have reached their goals on a scale of 0 (no progress) to 10 (fully reached).
Time frame: Will be assessed at three time points during 6 month reporting period: early therapy (defined as sessions/weeks 1-3), mid-therapy (defined as sessions/weeks 10-13), and late therapy (defined as sessions/weeks 20-24)
Plan to share: Yes — All anonymous study data (and name, date of birth and postcode) will be securely transferred to the Department for Education (DfE). The DfE will replace all identifying information about the young people who have taken part in the study (their name, date of birth, and postcode) with the young person's unique Pupil Matching Reference number in the DfE's National Pupil Database. The DfE will transfer this data to the YEF archive, which is stored in the Office for National Statistics' Secure Research Service. Access to the anonymised data may be granted to other researchers through controlled procedures governed by the YEF Data Archive. Anonymised data will also be retained by the University of Hertfordshire and Anna Freud Centre for up to 10 years to support secondary analysis and related research outputs. This may or may not involve sharing data with other researchers, contributing to a larger data set.
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