{
  "abstract": "Background: The quality of healthcare delivery relies heavily on building strong relationships between healthcare providers (HCPs) and clients. This study presents the results of a process evaluation for a Randomised Controlled Trial (RCT) examining the effectiveness of Intensive Community Care Service (ICCS) vs Treatment as Usual (TAU; inpatient or core community CAMHS). Methods: Thirty-four semi-structured interviews were conducted with staff across various services, including 20 from ICCS and 14 other TAU services. A thematic decomposition analysis was conducted on the data, and specific themes relevant to staff experiences of young people’s engagement with services and overall recovery. Results: Three main themes were observed in the HCP data (1. Relational Ecologies: barriers and enablers to engagement, 2. flexibility of approach amidst systemic pressures and 3. the web of trust in the relationship-building process). HCPs highlighted the necessity of developing trust and rapport through non-clinical engagement strategies, such as informal visits and personalised interactions. HCPs emphasised that without trust, treatment effectiveness diminishes, necessitating a tailored approach rather than a one-size-fits-all model. The flexibility in duration of treatment and methods of engagement was noted as crucial in accommodating individual client needs and fostering an open, trusting environment necessary for long-term recovery. Conclusion: The findings highlight the vital importance of relational care models, especially ICCS, in addressing the complex needs of Children and Young People (CYP). Flexible, family-centred approaches improve trust, engagement, and long-term recovery outcomes. Recommendations include tackling systemic barriers and expanding relational care models within CAMHS to meet increasing mental health demands effectively. Further research should investigate scalable strategies for integrating these insights into wider mental health service frameworks.",
  "abstract_shown": true,
  "affiliations": [
    "London South Bank University, London, United Kingdom",
    "East London NHS Foundation Trust, London, United Kingdom",
    "Queen Mary University of London, London, United Kingdom",
    "Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom",
    "South London and Maudsley NHS Foundation Trust, London, United Kingdom",
    "Oxford University Hospitals NHS Trust, Oxford, United Kingdom",
    "Central and Northwest London NHS Foundation Trust, London, United Kingdom",
    "Kings College London, London, United Kingdom",
    "Northeast London NHS Foundation Trust, London, United Kingdom",
    "Royal Berkshire NHS Foundation Trust, Reading, United Kingdom",
    "Cwm Taf Morgannwg University Health Board, Abercynon, United Kingdom"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 16,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Opeyemi Atanda"
    },
    {
      "affs": [
        1
      ],
      "name": "Paula Reavey"
    },
    {
      "affs": [
        2
      ],
      "name": "Ben Wong"
    },
    {
      "affs": [
        3
      ],
      "name": "Ebony Baker"
    },
    {
      "affs": [
        4
      ],
      "name": "Jessica Collier"
    },
    {
      "affs": [
        5
      ],
      "name": "Thilipan Thaventhiran"
    },
    {
      "affs": [
        6
      ],
      "name": "Veronika Dobler"
    },
    {
      "affs": [
        7
      ],
      "name": "Ruth Woolhouse"
    },
    {
      "affs": [
        8
      ],
      "name": "Toby Zundel"
    },
    {
      "affs": [
        9
      ],
      "name": "Joe Clacey"
    },
    {
      "affs": [
        10
      ],
      "name": "Jovanka Tolmac"
    },
    {
      "name": "Izabela Pilecka"
    },
    {
      "name": "Leon Wehncke"
    },
    {
      "name": "Tauseef Mehdi"
    },
    {
      "name": "Rhys Bevan-Jones"
    },
    {
      "name": "Dennis Ougrin"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/96kwbaqwz710v.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0356608",
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  "id": "96kwbaqwz710v",
  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0356608",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "3203|Psychiatric care and mental health services"
    ],
    [
      "plos",
      "/Biology and life sciences/Psychology/Emotions"
    ],
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      "plos",
      "/Medicine and health sciences/Health care/Health care providers/Nurses"
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      "/Medicine and health sciences/Mental health and psychiatry"
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      "/Medicine and health sciences/Mental health and psychiatry/Child psychiatry"
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      "/Medicine and health sciences/Mental health and psychiatry/Mental health therapies"
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      "/People and places/Population groupings/Professions/Medical personnel"
    ],
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      "/People and places/Population groupings/Professions/Medical personnel/Nurses"
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  "openalex": "W7212043207",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-09",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/96kwbaqwz710v.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:56Z",
      "native_id": "10.1371/journal.pone.0356608",
      "source": "plos",
      "url": "https://doi.org/10.1371/journal.pone.0356608"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "plos:mental health and psychiatry",
      "subfield": "psychiatry"
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  ],
  "title": "Relational care in community mental health: Evaluating staff experiences in Intensive Community Care Services (ICCS) vs treatment as usual",
  "title_text": "Relational care in community mental health: Evaluating staff experiences in Intensive Community Care Services (ICCS) vs treatment as usual",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:56Z",
  "url": "https://research.draconitic.com/paper/96kwbaqwz710v",
  "venue": "PLOS One",
  "versions": []
}