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From the 1960s to the 1980s, in parallel with societal changes from welfarism to the counterculture, the legacy of the child guidance and psychodynamic approaches gave way to more active, transparent and fast-moving therapies. Family/systemic therapy involved the whole family, training practitioners from all disciplines. Cognitive behavioural therapy (CBT) was developed as an alternative effective psychological treatment. A variety of longitudinal and epidemiological research approaches developed, providing a variety of ways of measuring the presence and impact of mental health problems. Conditions such as anorexia of childhood, self-harming and neurodevelopmental disorders – autism and attention deficit hyperactivity disorder (ADHD) – have been identified. Despite attempts to ‘shrink the state’ in the 1980s, a continuing theme has been the recognition of the hidden yet pervasive traumatic impact of maltreatment many children suffer. There is a lifespan impact of adversity on mental and physical health and the need for a trauma-informed care approach.
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