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.