Every week I receive a call or email from a troubled parent, colleague or friend asking me the same questions:
Do you work with children?
Do you know anyone that does? I’m really struggling to find support…
Sadly this seems to be the case for many people when they try to access wellbeing support for a person under 18. Few private therapists work with young people exclusively and the NHS provision is almost impossible to access unless the need is deemed extreme or severe.
I’ve become so used to signposting and referring people on that I thought it might be helpful for some of you if I shared what I know…So here it is.
THE BEHAVIOURAL PYRAMID
The first thing you may want to think about is:
What kind of support do we actually need?
Not all needs are the same and there are lots of ways we can support a child/young person without accessing therapy. A young person with exam stress for example may need very different support to someone who has just lost a parent to cancer. That said, support is absolutely available at all levels but it helps if we know how to find it!
This is not a complete list but I have tried my best to give a good pathway overview without it becoming overly complicated. The main thing to remember is that no one thing will ‘fix’ your child. The best support for anyone (young or old) is consistent care that is multi-layered and multi-directional…I’ll show you what I mean:
The above pyramid is my idea of matching how a child is feeling (and acting) with what type of support is available.
So what does this pyramid mean in practice? Let’s look at each layer separately and see what kind of support is available…
A change in behaviour of this type is very common in children aged between 5-10 years. Very often parents will comment that the behaviour is isolated to one place i.e. ‘only at home’ or ‘whenever they are with a childminder’.
It’s a very challenging stage to parent as it is often impossible to understand exactly what is going on. What I will say however is that changes like this are very normal as children grow and develop. What may seem like awful, terrible behaviour to an adult is actually just a child’s way of testing the rules and boundaries. We all did this at some stage and the very best response a caregiver can offer is consistent, unconditional care coupled with firm boundaries and consequences.
Level 1 support therefore is centred entirely around the child’s family and caregivers. Creating a safe space for the child to talk is a great start and ‘side-by-side’ chat is always preferable. This means talking to your child whilst walking together, playing a game or driving in the car. Face-to-face talking can be very confrontational to children (and many adults) so finding space to engage them gently can be a great place to start.
Just talking and being heard can make a dramatic change to a child who is bottling up emotion. Encourage them to express what they’re feeling and tell them it’s normal and okay. Anything that gets the body moving can really help the body to uncork pent-up emotions: Sport, exercise, dancing, walking outdoors, swimming, playing, climbing, singing, shouting. All of these are a great way to release energy, particularly if you share in this activity with them. Use them to spend time with your child and really connect with them. It really will mean the world to them.
Finding support as a parent during difficult times is also really important – what are you bottling up? How do you vent and what kind of role model are you emotionally? If you’re lucky enough to have friends and family supporting you then be sure to lean on them.
If however you feel isolated or maybe need a little more support, then maybe look at accessing the following in North Somerset.
For parenting support locally try contacting your local Homestart for free, practical advice.
Or websites such as Portishead Parent
There are also peer supported ‘Mum’ groups such as Mum’s the Word, which are open to all mum’s who just need a bit of support:
And Bluebell who provide support services during and after pregnancy
For local parenting courses and some fantastic parenting podcasts, there are national websites such as:
If a change in behaviour (level 1 style) has become long term or has progressed to all areas of their life, it may be a sign that something significant is affecting the wellbeing of your child. It might also be that your child’s behaviour is different or extreme compared to their peers or you have a feeling of ‘not knowing them’ any more. This can be extremely difficult to manage, especially if there are other children in the family who also require your support and attention. So what can you do?
As above, assessing their home life/support is a good place to start and anything you can do to help the child feel safe, heard and listened to will be really helpful here. Beyond that however I would really recommend involving your child’s school in their ongoing care. During the average week, most children will spend more time in the company of teachers than their own family, so it is vital that school are notified and informed of any change in behaviour (vice versa if the problem is more prolific at school).
Start with their own teacher (primary) or their tutor if they’re at secondary school and be honest with them about what’s worrying you about their behaviour. Sharing information is really important at this point and many schools have specific resources to provide support. If you don’t know how they can help then you have a right to ask:
What is the pastoral care provision at this school?
All schools will have additional support available including teaching assistants, learning mentors, play leaders, counsellors, play therapists and even group-based mindfulness!
If you feel your child is old enough it may also help to highlight online, anonymous support. There are a number of general helplines and online support charities that provide unbelievable resources and advice to young people, in a language and method that suits them:
Relate (for children and young people)
Finally, it may be prudent to keep the child’s GP informed of what’s happening, even if you have decided on helping your child at home. Mental Health like any other condition is best supported when we have a long term history of what has been happening and touching base with a GP at this stage may be wise.
When a child (or anyone) becomes overwhelmed emotionally, you may start to see this ‘leaking out’ in a manner of ways. Self-harm, depression, anxiety, eating disorders are just some of physical signs that a young person is just not coping.
If not already I would strongly advise involving your child’s school at this stage, as well as your GP. If you or your GP feel the change is particularly concerning it may warrant a referral to the Child and Adolescent Mental Health Service (CAMHS) or your community mental health team. In theory a referral such as this should provide more immediate, elevated mental health support for your child, however in practice few children meet the threshold to receive support this way. If this happens then seeking alternative support while you wait may help.
I can’t stress enough how unbelievable some local and national charities are when it comes to bridging the gap between an underfunded NHS and very high patient demand. Whilst not exhaustive I can recommend the following specialised charities:
SELF INJURY SUPPORT
OFF THE RECORD
If you find yourself waiting on an NHS referral then the above charities are immediate sources of advice and support. As well as specialising in the given condition many of them provide suggestions for both the parent and the child, which is something I would strongly recommend. Taking the time to understand your child’s situation, whilst simultaneously seeking support yourself provides a well-rounded, multi-directional support system which is key.
At the final level, we are thinking about less common, yet more serious factors that have contributed to a decline in your child’s wellbeing. Examples would be: abuse (all), addiction, LGBT+, bereavement, divorce, sexuality, homelessness, neglect, long term illness, terminal illness, medical trauma, estrangement, adoption, addiction, severe anxiety or depression, psychosis.
Whilst there are private charities and support groups to offer support and guidance, I would strongly suggest therapy at this stage. The NHS does provide a good basic service in these cases and as before I would strongly recommend keeping your GP informed, however long waiting lists guarantee that your child won’t be seen immediately which is why many turn to private therapy at this stage.
The decision to engage with a therapist is often a bittersweet experience. On the one hand it may be a relief to engage a professional in the ongoing care of your child and yet trusting someone else to provide that support may be challenging. There is also a financial implication to going this route, with most therapists charging between £40-100 per session.
Furthermore, how do you know what type of therapist you should be looking for? Where do you even start? Perhaps start by answering the following:
Who needs therapy?
Or the whole family?
If you think the whole family could benefit then you may want to consider family therapy.
Relate (www.relate.org.uk 0300 100 1234) offer support, guidance and counselling services (webcam and telephone) for families and young people going through a tough time.
In Bristol, you may also want to contact the Bridge Foundation (www.bridgefoundation.org.uk), a charity that employs specialist clinicians who are trained in family psychology and therapy.
Alternatively if you are looking at a private therapist for either you or your child, I would suggest consulting the following directories to find someone local to you:
British Association for Counselling and Psychotherapy (BACP)
UK Council for Psychotherapy
Association of Child Psychotherapists
Where possible, it really helps if your child is on board when it comes to seeking therapy, so if you are able to involve them in the search process I would really recommend it. Don’t be disheartened if they are reluctant however, as any qualified child therapist will be very experienced with this and will have strategies to help engage your child.
If you’ve read through all of this then my guess is you and your family are struggling through something right now. I hope some of the above highlights that you are not as alone as you think. I know it’s by no means a complete guide, but maybe it helps some of you find some light in the dark. Good luck on your search for support and if anyone has any other suggestions, please feel free to add them to the comments below.
'Understanding Anxiety and Managing your own Self Care'
Saturday 30th June, 9am-midday
The aim of this workshop is to provide good basic information on what anxiety is, how it feels and offer ideas on how to manage it. Whether you suffer with anxiety personally or you support someone who does, learning more about it can empower you to manage your own self care and provide ongoing support and strategies to help you move forward.
Places are limited so that the workshop remains intimate and discrete. Refreshments will be provided on the day. For more information and to reserve your place, please email me directly or contact me through the below link.
Every now and again psychological theory seeps into our everyday life, formerly through the medium of self-help books/seminars and now more commonly through TED Talks, blogs and even memes!
I like that we live in a world where we can use terms such as ’inner child’ within the common language, even if sometimes the true psychological meaning of a term becomes diluted or changed through misinterpretation (narcissism is a great example of this!) . As a whole, mental health and psychology in general is becoming more acceptable as a topic, thereby allowing greater empathy and understanding for your own behaviours and that of your fellow man.
In my work I will often share certain theories and concepts for just this reason, as by understanding ourselves in a wider concept can often give us a sense of belonging and acceptance that we might not have considered before. One such theory was one of favourites during training, as it offered a very simplistic but meaningful understanding of my own behaviour and how I related to others: The Drama Triangle.
The basic idea is that during our life we may find ourselves in a position where we have inadvertently adopted one (or more) of the above roles; Rescuer, Victim or Persecutor. I’ll explain them briefly here…
A Rescuer for example is ‘someone you can rely upon’. They are the Mr and Mrs fix-it’s of the world, who will consistently put the needs of others before themselves. They manage anxiety and stress by smoothing things over and are most likely known as ‘positive’ people,
A Victim on the other hand is someone who feels absolutely powerless in their everyday life. This is a person who can be heard saying ‘why does this always happen to me?’ They may find themselves feeling powerless and incapable of doing things alone and may expect/wait for others to come to their rescue.
Finally we have a persecutor. These are people who feel the need to present a ‘strong’ outer image, rejecting help from anyone and only feeling comfortable when they have power over another. They may appear to need nobody but themselves and will insist that they’re fine going it alone.
Do they remind you of anyone? Is this familiar in the way your relationships work? For us to exist in these roles, we will find ourselevs involved with people who often occupy an opposing position eg/ A rescuer will unknowingly have lots of victims in their lives. The quality of the relationship between these two people is therefore familiar but also inevitable. This is comforting on the one hand but will ultimately lead to feelings of being misunderstood and disconnected.
I’m pretty sure the majority of us can admit to possessing some, if not all of the above traits and yet for many we will find ourselves repeatedly adopting one of these positions regularly within a high number of relationships. When we first adopt one of these roles they are often borne out of a reaction to an uncomfortable situation (a child with divorcing parents trying to keep the peace for example) and the act of becoming a Rescuer, Victim or Persecutor serves as a great distraction from what we are actually feeling at the time. This makes sense at the time, but over time and with regular occurrences, adopting this position without thinking can be hurtful.
In all of these above examples, what you are actually doing is pushing people away and denying yourself the right to be heard. It becomes a barrier to relationships and leaves us feeling misunderstood and alone.
So what can we do about it?
Having empathy and compassion for yourself is a really good start. Figuring out why you adopted this position in the first place can be a great indicator of who you believe you are and what you have to offer. Be curious about your relationships and see whether you can identify the roles you take with your partner/your family/your boss. If you can relate to one of these more than another, ask yourself what you’re really achieving by blindly following this routine.
As I said, this was one of my favourite theories during training and it has personally offered me a great insight to who I am and how I work. Having awareness means we have a choice in who we are moving forward, which ultimately brings greater peace and satisfaction.
So I ran today. I ran outdoors for the first time in about 20 years. I ran slowly but surely...and I survived! I have to admit I'm not a natural runner and any onlookers could be forgiven for assuming that the tears running down my cheeks were from pain as opposed to the pollen count. And yet I managed just over 4k on my first ever go and I feel pretty chuffed with myself right now.
My target is a 10k run in Bristol on 21st October called 'She Runs the Night'. If you haven't already heard of it it's worth checking out the link. As the name suggests it is run at night and is a global event offering 'to help women all over the planet become stronger together'. Putting the physical struggle aside, I am genuinely looking forward to completing this with some of my oldest and closest firends. Whether I actually manage to run the whole way or not isn't really the point for me. I already use excercise to maintain my own self care both mentally and physically, so completing something like this is more about the experience and feeling of accomplishment than anything else.
Add to that we have collectively chosen to fundraise for 'Mind', an amazing charity who are committed to providing mental health support to anyone and everyone. Any extra support or advertising for such an amazing charity has to be worthwhile and may even come some way to destigmatising mental health issues in a wider snese.
I understand that most of you reading this will have dontaed to many friends and family and you may be forgiven for not wanting to shell out for 'another charity run'. However, if you or someone you know has experienced mental ill-health, I'm asking that you consider supporting such worthwhile cause and just find that little extra cash.
You can find our fundraising page at ** (see below note)
**sadly a week after writing this we found out that the event 'she runs the night' was in fact fraudulent! I won't give up though and will continue training for another 10k next Spring. Watch this space!
Whether you've made the decision yourself to find a therapist or perhaps your GP has recommended it, the sheer weight of choice can be pretty daunting to many people. On the one hand you want to make an informed choice and on the other you may not even be capable of working things out right now...how exactly are you meant to pick someone - a stranger - to talk to week on week, without knowing a single thing about them? Where do you even start?
During a portion of my core training I too had to find and select a therapist to work with, so I can share in the bewilderment some of you may be feeling. It is a difficult task and unless you are recommended to somebody, the choice is quite unbelievable. Whilst the below tips are by no means a complete list, I hope some of the ideas may offer some food for thought and help some of you in your search.
1. HOW TO LOOK
If your GP can't recommend a private practitioner I can recommend the following links as a great place to start (click for direct link):
- Counselling Directory
- British Association of Counsellors and Psychotherapists (BACP)
- United Kingdom Council for Psychotherapy (UKCP)
It still frustrates me that in the UK there is no formal legal qualification base for a practicing therapist/counsellor/psychotherapist. Quite frankly, anyone can pick any one of these labels and begin seeing clients, which means from a client's point of view that you have little to go on. Using any of the above organisations ensures that you are working with a fully registered, competent therapist. It guarantees that they meet minimum guidelines in training, that they are insured and that they are working to an ethically sound level.
2. WHAT TO LOOK FOR!
You will have noticed that I often use the terms therapist or counsellor or psychotherapist interchangeably. I'm not trying to confuse you (honestly), but the point is that whilst the profession remains unregulated there are a number of umbrella terms that people use when they are referring to talking therapy.
There are in fact differences between all of the above terms (more than I can cover in one blog), so I will try and make this simple: THEY ALL DO BASICALLY THE SAME THING...they might just work a little differently and have slightly different training to each other. That means that you can search for any of the above terms on google and will probably end up with the same people.
The important part however is whether you feel you can work with them. You will make a lot of this decision unconsciously i.e. "I could only work with a woman" but the rest will fall into place once you start searching. Take your time to read through a therapist's profile and try and get a feel for who they are. If you're not sure and need to know more, why not email them to ask some questions first? Think about what is important to you (age/ gender/experience) and look for that in their description.
3. WHERE? WHEN?
You may not have considered this already but where you will meet with your chosen therapist may affect your choice. I'm not just talking location here either. Are you expecting an office? Someone's home? Where would you feel most comfortable? Don't forget geography either - if you want to see someone 'privately' then maybe consider seeing someone in the City as opposed to your home town. All of this information should be available on the therapist's profile, but if not just ask!
The second point is to think about when you will be able to make a regular commitment. Although some therapists can move appointments week to week, others will want you to agree to a specific time and day each week.
4. MEETING FOR THE FIRST TIME
So you've selected a therapist(s) and you've arranged to meet for an initial session. Quite often a new client may feel that they are obligated to work with someone following a first meeting, or maybe they feel obligated to make a decision there and then. In therapy terms this is absolutely not the case. The first meeting is so important, not just for you the client but for the therapist also. Essentially you are both trying to gauge whether you will be able to work together moving forward and I would really encourage anyone to take their time over making such an important decision. I know for my clients I always encourage them to think about things for a few days after our meeting to process how they're feeling and what they want to happen next. You could even use this opportunity to see a number of different therapists to see if there is anyone else you prefer.
5. WHAT TO EXPECT FROM THERAPY
It can be difficult to explain therapy to someone who hasn't tried it, not just because each therapist is different but moreover because each client is. By nature, the therapy relationship will be unique to each duo and will often change and move throughout the work. You may find therapy to be much harder than you anticipated. You may find doesn't quite 'do' what you thought it would. The truth is that a productive therapy will often be less about a therapists' tricks or training and more about mutual trust and honesty.
That said each therapist will have a unique way of working which will depend on their training and their orientation. There is often a strong assumption for first-time clients that the therapist will take the lead, or will have tips/cures for them to overcome whatever they are struggling with. This may happen of course - a CBT-based therapist would work to give you focus for example and may even give you homework, however for a more 'client-led' therapist therapy can often feel like you're doing all the work!
If you are concerned about choosing the wrong type of therapist or if you just want to know more then click here for more detailed information.
6. WHAT IF THINGS GO WRONG?
If you have tried meeting with a therapist and just don't feel things are 'right', stay true to that feeling. If you are comfortable, I would suggest that you discuss this directly with them (if you feel safe enough to do so), but if you have simply changed your mind then that's okay! It may be that the time isn't right for you and I would expect most therapists to honour and respect your autonomy in this.
If on the other hand you feel that the therapist is not working ethically, then you have every right to contact their regulating body (BACP or UKCP for example) who will offer further advice on what to do next.
As I said from the outset this is by no means an exhaustive list, however I do hope it addressed some queries or concerns.
Please free to add your own tips in the comments if I've missed anything, or if you have any questions please contact me directly!
I found the following poem online and I hope the author doesn't mind me sharing!
People often balk at the term 'co-dependent' and can sometimes associate it only in addiction terms. In a wider sense co-dependent behaviour simply describes a person who satisfies their own needs through relationships that deny the self. This poem is a wonderful description of how some of us live our lives through others. On the surface this can feel right and is no doubt viewed by many as kind and selfless. And yet where we find ourselves consistently putting others before our own needs, this behaviour can leave us feeling unfulfilled, empty and alone.
Read on and see whether you can identify with this poem - I know I can.
The following blog is a very personal account of a mother's experience of post-natal depression. It may never have happened to you, or on the contrary this may read as very familiar, either way the account shows that we are all fallible.
Read on - maybe this will touch something in you.....
So it's pretty much the same thing for me this time of year. The night's draw in, the heating comes on and I can feel myself start to cocoon. This is a familiar feeling and one that brings me a sense of comfort and safety...that is until the guilt kicks in and I'm back to 7 years ago when the darkness felt very different.
My gorgeous, wonderful first-born son arrived in the crisp, dark cold of November in 2009. He was overdue and very stubborn and so we waited and waited until on the day of my induction day when he promptly made his presence known. Following a relatively smooth labour, he arrived early hours of the following morning and thus followed our first few hours together.....
I'd like to say I cried when he was born.
I'd like to say I had a rush of love for him when I first held him.
I'd like to say I didn't panic when he started crying in the night and I was all alone wondering what the hell I was meant to be doing.
I'd like to tell you all those things because even now as I remember, I can't ignore the stab of guilt and shame that envelops me. What kind of a mother was I?! Well I'll tell you. I was the type of mother who felt a complete panic and fear every time he cried. I was someone who watched other people cuddle him and would wonder if my own 'instinct' would ever kick in. I was a mother who would dread feeding my baby. I was absolutely and completely lost.
This continued for the first few months and despite my inner turmoil and detachment from my baby, I somehow managed to keep up the appearance of 'aren't I lucky to have such a gorgeous baby boy?'. I told myself this every day and even the health visitors were convinced! Therein lies the problem actually - my sole idea of post-natal depression was of a mother crying and rocking in a corner, unable to hold or care for her baby. That's not to say that doesn't happen but the point is that I had created a very small box for PND and I simply couldn't recognise myself within it.
It wasn't until my husband challenged me one day that something changed. As I chatted away about how I was 'simply a cow. A milking cow', I saw the confusion on his face. With zero emotion and utter conviction I stated that the only reason my son wanted me was for milk and that he didn't love or need me for anything else. It was obvious to me at least that I was there for food and everyone else was there for love. And so he gently questioned me. I don't know why his challenge shifted things for me that day, I just know that hearing those words reflected back to me made me appreciate just how detached I had become. It wasn't a magic wand of course and my feelings didn't change overnight, however the realisation that I was normal and not some kind of unfeeling monster was just the balm I'd been unknowingly searching for. It took time and support but I gradually got to know my little man and he finally got to know me.
Seven years have gone by and I have heard many stories of PND since. Some are similar to mine and some are entirely different, yet the consistent thread of familiarity I share with others is the guilt. I haven't completely forgiven myself for delaying our connection together and I will wonder forever if it caused him invisible damage or pain. And yet, in knowing I am not alone in this is a small, soothing comfort. I am not a monster, I am a human being and I am learning to forgive myself when I 'get things wrong'. Maybe writing this is part of that.
If you are reading this then I was brave enough to make it public. And if it rings a bell for you then just try and remember: you're not alone either.
We live in stressful times. If we're not worrying about our jobs, our families, our health, our wealth, our lives; then quite simply we're not breathing!