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Joint NIHR Maudsley BRC CMHND-DCAP PhD Studentship

Start date

1st October 2024


One fully funded three-year studentship jointly funded by the NIHR Maudsley Biomedical Research Centre's Theme in Child Mental Health and Neurodevelopmental Disorders and the Department of Child & Adolescent  


We have three projects for a potential student to choose from. Please refer to individual projects for full information about each project, including the supervisory team, contact email addresses and references.



Project 1 - Identifying the Key Factors Associated with Non-response to Psychological Interventions for Autistic Youth



Matthew Hollocks, Department of Child & Adolescent Psychiatry (

Johnny Downs, Department of Child & Adolescent Psychiatry (



This primary aim of this project is to identify the key individual characteristics and environmental factors associated with response (or non-response) to psychological therapies in autistic young people. There will be a particular focus on treatment for anxiety and depression as two of the most prevalent co-occurring conditions experienced by autistic individuals. A secondary aim is to explore what treatments are being offered within local services and what components of these are associated with successful outcomes.



Autistic youth have extremely high levels of co-occurring mental health difficulties (Hollocks et al., 2022), including rates of depression and anxiety which are between two and four times more common compered to non-autistic people. Existing psychological therapies (for example, Cognitive Behavioural Therapy) for these co-occurring conditions are helpful for some, but not all, autistic youth. There are likely certain individual or environmental characteristics which may indicate that an alternative treatment is needed. In current clinical practice this tends to be discovered only after a significant time investment for both young people and clinicians. The predictors of treatment response for autistic youth have to date been underexplored. Gaining insight into which factor may indicate someone may or may not benefit from a treatment is a key step in moving towards a personalised approach to mental health treatments.


There are several candidate predictors which have been associated with anxiety and depression in autism and have been identified clinically as significant barriers to treatment. These include cognitive inflexibility (Hollocks et al., 2022; Lei et al., 2022), emotional dysregulation, and the presence of social camouflaging/ masking behaviours (Lei et al., 2023). Relevant family and environmental factors which may impact on an individual’s ability to benefit from treatment will also be explored.


Methods and project plan

This study will recruit approximately 100 autistic young people (aged between 12-18 years) from Child and Adolescent Mental Health Services (CAMHS) across South London, who are initiating / have recently initiated psychological therapy for either anxiety or depression.


Participants will be enrolled on an online system for the remote collection of routine self-, parent- and teacher-reported outcome measures (including symptoms of anxiety and depression) which will be completed for the duration of their intervention. Data will be collected on the duration, type and content of the intervention (specific adaptations etc.) as well as the nature and number co-occurring conditions (other than autism and anxiety/depression).


At treatment initiation young people and parents will complete a series of online questionnaires to assess key processes thought to be associated with poor treatment response (as described above). There will also be a period of engagement and co-design with autistic young people to ensure the variables included meet the need of the clinical population. A subsample of participants can then be invited for a more detailed in person assessment which could include the collection of neuropsychological measures and biological samples.


Expected outputs

The outputs from this project will result in a series of publications in peer reviewed journals and will be presented by the student at both national and international conferences. This work will have clinical impact by building the evidence necessary to support decision making about which psychological treatments are best used with whom, and when. The indicators could be integrated into routine clinical practice to support the delivery of treatments in clinical teams. By quantifying for the first time the relative impact of these factors on treatment outcomes, it will open the way for the development of mechanistically informed treatments and treatment-adaptations, to improve outcomes. 


Key references

Hollocks MJ, Charman T, Baird G, Lord C, Pickles A, Simonoff E. Exploring the impact of adolescent cognitive inflexibility on emotional and behavioural problems experienced by autistic adults. Autism. 2022 Jul;26(5):1229-1241. doi: 10.1177/13623613211046160.


Hollocks MJ, Leno VC, Chandler S, White P, Yorke I, Charman T, Pickles A, Baird G, Simonoff E. Psychiatric conditions in autistic adolescents: longitudinal stability from childhood and associated risk factors. Eur Child Adolesc Psychiatry. 2023 Nov;32(11):2197-2208. doi: 10.1007/s00787-022-02065-9.


Lei J, Charman T, Leigh E, Russell A, Mohamed Z, Hollocks MJ. Examining the relationship between cognitive inflexibility and internalizing and externalizing symptoms in autistic children and adolescents: A systematic review and meta-analysis. Autism Res. 2022 Dec;15(12):2265-2295. doi: 10.1002/aur.2826.



Lei J, Charman T, Leigh E, Russell A, Mohamed Z, Hollocks MJ. Examining the relationship between cognitive inflexibility and internalizing and externalizing symptoms in autistic children and adolescents: A systematic review and meta-analysis. Autism Res. 2022 Dec;15(12):2265-2295. doi: 10.1002/aur.2826.


Project 2 - Prediction modelling for depression and bipolar (onset/relapse): Development, Translation and Implementation



Dr Andrea Danese, Department of Child & Adolescent Psychiatry (

Dr Gonzalo Salazar de Pablo, Department of Child & Adolescent Psychiatry (

Dr Josefien Breedvelt, Department of Child & Adolescent Psychiatry (



This project aims to advance precision psychiatry for patients at risk of relapse for bipolar disorder and depressive disorders. Specifically, it aims to improve the identification of individuals at high-risk of relapse in clinical practice and translate these results to inform improved treatment prioritisation and stratification of care.


Objectives are to:

1) Identify unique and overlapping predictors for bipolar and depressive disorder which will be used to inform a transdiagnostic prediction model for depressive disorders and bipolar disorder relapse.

2) Develop a transdiagnostic mood disorders’ digital phenotype informed clinical risk prediction model which will be externally validated using the Clinical Records Information Service (CRIS).

3) Conduct in-depth exploration of the barriers and facilitators to implementing prediction modelling, including ethical concerns regarding the implementation of prediction models in clinical practice.



Depressive disorders and bipolar disorders share high levels of comorbidity, temporal interdependence, and are often recurrent. Both conditions significantly affect psychosocial functioning and quality of life.


Still, current models to identify patients at high risk for relapse are very limited and even more rarely transdiagnostic (Meehan et al., 2022). Furthermore, exploration of unique and common phenotypes for depressive and bipolar relapse risk are lagging (Salazar de Pablo et al., 2021).


This is in the context of limited quality and predictive performance of models to predict depressive disorders’ and bipolar disorders’ relapse (Meehan et al., 2022; Böttcher et al., 2023) and a lack of external validation and clinical update of clinical prediction models (Meehan et al., 2022). Furthermore, clinical prediction models have rarely successfully reached clinical practice and models for successful implementation are yet to be fully defined (Salazar de Pablo et al., 2021; Böttcher et al., 2023).


Methods and project plan

WP1: Improving the relative predictive performance of clinical risk prediction models for depression and bipolar disorder relapse.

This project will involve using a deeply phenotyped existing dataset of young people and identify unique and overlapping contributors to relapse risk for depressive and bipolar disorder (Salazar de Pablo et al., 2020). The student will conduct decision tree modelling and logistic regression to identify a potential set of putative predictors (Böttcher et al., 2023). After this, the student will develop an internally validated prediction model to identify patients at high risk of relapse which will be externally validated in WP2.


WP2: Developing clinical risk prediction model using clinical practice data.

The dataset described in WP1 or an alternative database will be used to develop and inform an initial risk prediction model (WP1) which we will seek to validate in CRIS. Risk prediction model will be developed according to the TRIPOD statement guidelines ( and using best-practice guidance. Additional prediction modelling expertise will be sought from BRC collaborators where required.


WP3: Barriers and facilitators to transdiagnostic implementation of prediction models

A qualitative research study exploring views of 1) clinicians 2) lived experience experts and 3) service managers will be set up to explore barriers, facilitators, and ethical considerations towards implementing prediction modelling in clinical practice. Data will be synthesized using narrative synthesis and thematic analyses.


Expected outputs

This programme of work will result in at least three scientific publications:


Manuscript 1: Exploring common and unique phenotype for depressive and bipolar relapse risk.

An additional MSc thesis project to support WP1 wherein a systematic review aiming to identify putative risk factors for depression and bipolar relapse will be conducted may be considered.

WP1 & 2:

Manuscript 2: Developing clinical risk prediction model using clinical practice datasets.

Additional manuscripts for a second external validation of the model may be considered.


Manuscript 3: Barriers and facilitators to transdiagnostic implementation of prediction models.

An additional manuscript exploring the ethical considerations regarding implementing precision medicine in clinical practice may be considered.


This research will inform future funding applications such as an MRC Developmental Pathway. Funding Scheme to further develop translational tools for treatment stratification in clinical practice. Furthermore, we will be developing a policy and practice briefing detailing current state of the art for prediction models and recommendations for clinical practice and explore a range of innovative outputs to disseminate our results.


Key references

Beshai S, Dobson KS, Bockting CL, Quigley L. Relapse and recurrence prevention in depression: current research and future prospects. Clin Psychol Rev. 2011 Dec;31(8):1349-60. doi: 10.1016/j.cpr.2011.09.003.


Bockting CL, Breedvelt JJF, Brouwer ME. Relapse Prevention. In: Asmundson G, editor. Comprehensive Clinical Psychology, vol. 6. 2nd ed. Amsterdam: Elsevier; 2022. p. 177–93. doi: 10.1016/B978-0-12-818697-8.00224-7


Böttcher L, Breedvelt JJF, Warren FC, Segal Z, Kuyken W, Bockting CLH. Identifying relapse predictors in individual participant data with decision trees. BMC Psychiatry. 2023 Nov 13;23(1):835. doi: 10.1186/s12888-023-05214-9.


Meehan AJ, Lewis SJ, Fazel S, Fusar-Poli P, Steyerberg EW, Stahl D, Danese A. Clinical prediction models in psychiatry: a systematic review of two decades of progress and challenges. Mol Psychiatry. 2022 Jun;27(6):2700-2708. doi: 10.1038/s41380-022-01528-4.


Salazar de Pablo, G., Studerus, E., Vaquerizo-Serrano, J., Irving, J., Catalan, A., Oliver, D., Baldwin, H., Danese, A., Fazel, S., Steyerberg, E. W., Stahl, D., & Fusar-Poli, P. Implementing Precision Psychiatry: A Systematic Review of Individualized Prediction Models for Clinical Practice. Schizophrenia Bulletin. 2021 Mar;47(2):284-297. doi: 10.1093/schbul/sbaa120.


Project 3 - Proof-of-Concept & Assessing the Feasibility Eating Disorder Intensive Outpatient Programmes (IOPs) for Children and Young People across England



Dr Maria Livanou, School of Mental Health and Psychological Sciences (

Dr Erica Cini, Department of Child & Adolescent Psychiatry (

Prof Ulrike Schmidt, Department of Psychological Medicine (

Prof Hubertus Himmerich, Department of Psychological Medicine (



       1.            To conduct a systematic review on service user and carer’s experiences of IOPs.

       2.            To undertake a national mapping audit to explore the heterogenous characteristics of different IOPs.

       3.            To conduct a qualitative study with clinicians, patients, and carers to identify risks/pressure points/solutions of IOPs.

       4.            To assess the feasibility by assessing willingness to participate and study protocol fidelity and adherence, and if feasible, developing a proof of concept that will be evaluated at a later stage.



Intensive home treatment offers, as alternatives to acute admission, have been introduced throughout England as mandated by the NHS Plan (Department of Health, 2000). The range of theoretical models and styles of intensive interventions is extensive, but there is substantial consensus supports on the core organisational characteristics and interventions which supports intensive community offers, including crisis resolution and home treatment options. This is summarised in Johnson’s (2013) paper as a multidisciplinary team (including senior psychiatry members alongside other professionals) that offer a range of community interventions. The aim is to support those high-risk patients that would otherwise require inpatient care or to maintain contact if admission is needed to facilitate early discharge from hospital. Such a team would require low patient:staff ratios and regular interventions, if needed even multiple times/day and that this offer would be a short-term intervention.


Whilst these service models are established in other mental health conditions, these were more recently brought to the forefront of children and young people’s eating disorder services since the pandemic due to the surge in eating disorder presentations. The prevalence of any eating disorder increased by 2.1% in 11-16y olds and by 11.7% in 17-19y from 2017 to 2023 (Newlove-Delgado et al., 2023). This, together with the increased demand for admissions to acute medical settings for physical stabilisation or to mental health inpatient units, in combination with the national shortage of beds (because of the pandemic) drove staff to think creatively and flexibly as to how to best manage children and young people with eating disorders in the community setting.


Child and Adolescent Mental Health Service (CAMHS) provider collaboratives encouraged services to reduce the use of inpatient admissions out of their local area and to reduce lengths of inpatient stay (O’Shea, 2020). Beat’s report (2019) also highlighted that IOPs are less disruptive to the young person’s life, as they allow children and young people to pursue other interests (i.e., outside of the eating disorder) and stay in touch with their support networks whilst still engaging in an intensive community treatment offer. These are all benefits that the children and young people will experience because of IOPs, as they will be offered a more integrated, holistic, patient-centred care offer closer to their family/friends. 


Methods and project plan

Year 1:

                     Co-design of project with Patient and Public Involvement (PPI) group comprised of children and young people with lived experience and their carers who will support all phases of the project.

                     Systematic review on service user and carer perspectives on their experience of intensive outpatient treatment offer (Aim 1).

                     Obtaining HRA ethical approval, advertising, recruiting sites and participants, setting up the sites’ database to allow collation of the quantitative data over the first two years.

                     Undertake a mapping audit of the various IOPs in England (Aim 2) aiming to understand the:

§  Service design (in person (e.g., home-treatment, outreach, clinic-based), online or hybrid offer and whether this is a standalone treatment or an enhancement of the core therapeutic offer),

§  Care offer (e.g., key-work sessions, meal support, dietetic reviews, psychiatric assessments),

§  Staffing levels/mix including patient:staff ratio,

§  Training provided.


Year 2:

Semi-structured interviews to explore experiences of IOPs as well as risks/pressure points of these services and potential solutions (Aim 3). The interviews will be conducted with young people, carers and clinicians.


Year 3:

Feasibility of generating evidence about outcomes by assessing willingness to participate in and adhere to the study protocol (Aim 4). This part of the study will involve quantitative analysis of the data collated across the previous two years to evaluate clinical effectiveness (pre- and post-IOPs) and estimation of overall costing to run an IOP. Additional collated data will include patient demographics, diagnosis (incl. comorbidities) and family composition.


Creation of a proof-of-concept, specifying the key components of IOPs, that are likely to make this service design a successful care alternative for eating disorder treatment in children and young people. 


Skills learnt:

                     Setting up of a PPI group and co-designing parts of the project.

                     Designing service mapping.

                     Evaluation of literature using systematic review methodology.

                     Good clinical practice when working with vulnerable groups.

                     Conducting interviews, reflective skills, thematic analysis and use of NVivo.

                     Undertaking a feasibility study which will involve quantitative data analysis.

                     Organisational skills as the project involves collaborating with multiple sites.

                     Project management, leadership, presentation and teamwork skills.


Expected outputs

                     A systematic review on service user and carer’s experiences of IOPs.

                     A mapping audit to explore the heterogenous characteristics different IOPs in England, as described above.

                     An understanding of young people’s, carers,’ and clinicians’ views on IOPs on the risks/pressure points/solutions of IOPs.

                     Recommendations to improve/amend IOPs.

                     The feasibility of generating evidence about outcomes by assessing willingness to participate and adhere to the study protocol.

                     If feasible, the establishment of a proof-of-concept.


Key references

Beat. (2019) Intensive day- and home-based treatment for eating disorders: an effective and less expensive alternative to inpatient care. Accessed at:

Blake, E.*, Rajendran, A.*, Austin, A., Cini, E. (2023) Intensive Outpatient Programmes for Children and Adolescents with Eating Disorders: A Rapid Scoping Review of Services and Treatment Models. [Poster presentation]. European Society of Child & Adolescent Psychiatry Congress, Copenhagen, Denmark. 

Cini E.*, Salucci K.*. (2023) Learning from Existing Intensive Outpatient Programmes for Children and Adolescents with Eating Disorders. [Poster presentation]. European Society of Child & Adolescent Psychiatry Congress, Copenhagen, Denmark. 

Department of Health. (2000) The NHS Plan: A Plan for Investment, A Plan for Reform. TSO (The Stationery Office).

Johnson S. Crisis resolution and home treatment teams: an evolving model. Advances in Psychiatric Treatment. 2013;19(2):115-123. doi:10.1192/apt.bp.107.004192

Newlove-Delgado, T., Marcheselli, F., Williams, T., Mandalia, D., Dennes, M., McManus, S., Savic, M., Treloar, W., Croft, K., Ford, T. (2023) Mental Health of Children and Young People in England, 2023. NHS England, Leeds.

O’Shea, N. (2020) Bringing care back home: Evaluating the new care models for children and young people’s mental health. Centre for Mental Health. Accessed at:

*Joint first authorship 



Entry requirements

Applicants should have (or be expected to obtain) a bachelor’s degree with 2:1 honours (or Overseas equivalent). A 2:2 degree may be considered only where applicants also offer a master’s with Merit.

Award types and eligibility

Students will be fully funded for three years full time, to include home tuition fees, annual stipend and some research and travel costs.

To be treated as a Home student, candidates must meet one of the following criteria:

•            A UK national (meeting residency requirements)

•            Settled status

•            Pre-settled status (meeting residency requirements)

•            Indefinite leave to remain or enter


Applications from overseas students will be accepted on condition they can pay the difference in fees.

Further information

About the IoPPN (

Studying at the IoPPN (

Research degrees at the IoPPN (link to

 Other relevant links and information:



How to apply

Applicants must complete and submit an online admissions application, via the admissions portal by midnight (23:59 GMT) on 11th February 2024. 

On the ‘Choosing a programme’ page, please select Child and Adolescent Psychiatry MPhil/PhD (Full Time). 

In your application, you will be asked to include:

  • Academic Transcripts – where applicable, academic transcripts must be submitted with the online admissions application
  • Details of your qualifications (you will need to attach copies)
  • A personal statement describing your interests and why you wish to apply for this project. Please include this as an attachment rather than using the text box.
  • Academic References – all admissions applications require one supporting reference. If the applicant is relying on thier referees to submit a reference directly to the College after they have submitted thier admissions application, then the applicant must ensure that (1) their chosen referee is made aware of the funding deadline (i.e. 7 days from application deadline) and (2) that the reference needs to be sent from an institutional email address.
  • Please also attach an A4 document listing, in order of preference, a minimum of 1 project and maximum of 3 projects from those listed with this advert. For each project choice please use a maximum of 200 words to tell us why you are interested in your chosen project/s.

In the Funding section, please tick box 5 and include the following reference: IoPPN-SLaMBRC-DCAP-24. 

Please note there is no need to complete the Research Proposal section in your application as the project has already been set. 

You are welcome to email Dr Amanda Bye ( for more information regarding the studentship, or the project supervisors for more information regarding the projects.

If you have any queries regarding the application process, please contact the Education support team at

References must be received by the deadline for the applicant to be eligible. Only shortlisted applicants will be contacted.

Closing date

11th February 2024


From the week beginning 4th March 2024 


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