9th February 2017

Supporting young people with psychotherapy

Supporting young people with psychotherapy Cover Photo

Child and Adolescent Psychotherapist Todd Hinds tells us how psychotherapy supports young people at I CAN's Dawn House School...

Dawn House School is a residential special school for children and young people (5-19) with speech, language and communication needs. All pupils have a speech and language disorder or Asperger’s syndrome and associated difficulties which impact on their educational, social and emotional development.

I work at I CAN’s Dawn House School as a Child and Adolescent Psychotherapist one day a week as part of the multi-disciplinary therapy team which includes Speech and Language Therapists and Occupational Therapists. I have been working at Dawn House School for four years, prior to this I worked in Child and Adolescent Mental Health Services. As a Child and Adolescent Psychotherapist I am trained to work with children who may present with different communication needs. Some of the children I work with may communicate mostly through non-verbal communication or with the support of play based therapy.

Students with speech, language and communication needs (SLCN) often find it difficult to put into words what they are thinking or how they are feeling. This can be further complicated if the students are also experiencing mental health difficulties. The added dimension of a speech, language or communication difficulty means it’s even more crucial that the student’s mental health and emotional wellbeing is actively supported by the entire school community. I work closely with teaching staff, care staff and parents and families of pupils in order to continuously monitor the student’s mental health and provide advice as to how best to support students with their wellbeing. I run a combination of individual sessions for students, which includes counselling and psychotherapy, along with a range of staff sessions which covers general support, guidance and formal training. As a part of the team at Dawn House, I understand the language needs of the pupils and so can make sure the approach is accessible and relevant e.g. making sure my explanations avoid complex words and concepts, and using visual approaches.

Why a focus on mental health is important for children with SLCN

A focus on mental health support is particularly important for students with SLCN as there are particular challenges they can face during child and adolescent development. An increased desire for greater levels of independence can clash with the anxiety that stems from the desire to interact independently within peer groups and in the wider society. During adolescence, a desire for greater self-determination may also clash with an increased awareness of the levels of support they may still require, which in turn can lead to feelings of over dependence, isolation, loneliness and frustration. Typically, adolescents rely heavily on close peer relationships to navigate this process, but many students with SLCN may have either a very small peer group or none at all and so are limited by who to reach out to for support. This level of isolation can lead to depression and low self-esteem.

Often students with special educational needs have encountered difficulties in previous educational settings. During times of acute stress students can develop depression, mood swings and exhibit high levels of anxiety similar to that seen in post-traumatic stress. Students who move to Dawn House School often arrive with a history that they are still trying to make sense of, and this can trigger social anxiety, prolonged school absence, social isolation and withdrawal. All of this can impact upon adolescent development and complicate their access to opportunities in later life.

The national landscape

In May 2016, the government’s Children’s Commissioner produced a report that examined access to Mental Health Services in England across 2015. The report highlighted major barriers in terms of access and inconsistent provision of services across England. Figures for the number of referrals made to CAMHS were provided, and highlighted that of all the referrals received in 2015, only 15% were seen immediately, 57% were seen once and then placed on a waiting list, whilst 28% were not seen at all. The picture for the East Midlands, where Dawn House School is situated, is very similar; 14% of referrals were seen immediately, 62% were seen once but then placed on a waiting list and 24% were not seen at all. The report highlights an increase in referrals at a time when services are already under pressure and as a result children are failing to receive the support they need. The implications of this report are that students with complex mental health needs continue to attend school whilst waiting for mental health services. As a consequence there is a need to develop in-house programmes of support for students with these needs.

Dawn House School has a wellbeing team led by full-time staff which means that mental health awareness and support is integrated into the rest of the curriculum*.* The aim of the team is to promote wellbeing in school, to facilitate access to appropriate external services and provide support to aid emotional literacy, support transitions and manage anxiety. The team monitors the mental health of students and provide in-house support where appropriate. We are looking to develop an in-house referral system, which will allow all staff and parents to raise concerns about a student when concerns arise. Given the pressures facing students with SLCN it is important that we are looking to develop this support in school.

Psychotherapy is a means of better understanding ourselves, which in turn may help us to make the most of the opportunities around us. I generally find that the students I work with become empowered to make some of their own life choices and begin to take notice of the opportunities that are available to them. Supporting students with SLCN with their mental health difficulties is particularly important and can make a huge difference when someone takes the time to listen, understand and provide tools that may help them to communicate how they are feeling. It is particularly inspiring to watch students progress in a short space of time with the support from the entire school.

To find out more about I CAN's Dawn House School please see their profile on www.specialneedsguide.co.uk.