Awareness and perceptions of clinical guidelines for the diagnostics and treatment of severe behavioural problems in children across Europe: A qualitative survey with academic experts

Severe behavioural problems (SBPs11Severe behavioural problems (SBPs) were defined in this study as persistent and frequent oppositional, aggressive, and destructive behaviours (ie. severe aggression, hostility, disobedience or fighting) occurring in more than one life area, and interfering with functioning in the major life domains, such as home, school and peer relationships. This definition was formulated by the authors (A.L., A.R.G, L.vD., and R.V.) based on descriptions of ODD, CD, disruptive behaviour disorders, and aggressive behaviours in childhood in the literature. SBPs is an umbrella dimensional term for such diagnostic categories and is virtually equivalent to other known umbrella terms such as‘disruptive behaviour disorders’.) in childhood are highly prevalent, impair functioning, and predict negative outcomes later in life. Over the last decade, clinical practice guidelines for SBPs have been developed across Europe to facilitate the translation of scientific evidence into clinical practice. This study outlines the results of an investigation into academic experts’ perspectives on the current prevalence, implementation, and utility of clinical guidelines for SBPs in children aged 6–12 across Europe. An online semi-structured questionnaire was completed by 28 psychiatry and psychology experts from 23 countries. Experts indicated that approximately two thirds of the included European countries use at least an unofficial clinical document such as textbooks, while nearly half possess official guidelines for SBPs. Experts believed that, although useful for practice, guidelines’ benefits would be maximised if they included more specific recommendations and were implemented more conscientiously. Similarly, experts suggested that unofficial clinical documents offer a wide range of treatment options to individualise treatment from. However, they stressed the need for more consistent, evidence-based clinical practices, by means of developing national and European clinical guidelines for SBPs. This study offers a preliminary insight into the current successes and challenges perceived by experts around Europe associated with guidelines and documents for SBPs, acting as a stepping stone for future systematic, in-depth investigations of guidelines. Additionally, it establishes experts’ consensus for the need to develop official guidelines better tailored to clinical practice, creating a momentum for a transition towards European clinical guidelines for thi