If you missed this BBC documentary, here is the link to catch up with Dr Chris van Tulleken as he investigates whether there are alternative treatments to drugs (in particular Calpol) to treat our children. He focuses on a small group of children who are medicated for Attention Deficit and Hyperactivity Disorder, otherwise known as ADHD. https://www.bbc.co.uk/iplayer/episode/b0b4jjq3/the-doctor-who-gave-up-drugs-series-2-episode-1
Art therapy techniques combined with play is effective in children’s counselling.
Art therapy is a form of psychotherapy and it uses art and media as a tool for expression. Its use of visual media makes it successful form of expression and communication with adults and children, especially with people who experience verbal communication difficulties and disabilities. It is also used as a medium with people with neurological problems, mental health, emotional and behavioural issues, neurological conditions and physical illness. It uses creative methods to improve a person’s emotional wellbeing, enhance cognitive abilities, manage stress and promote self-development. Art therapy does not require a client to have any artistic training, rather its techniques rely on the exploration of the properties of a wide variety of materials such as paint, clay, chalks and markers and the use of symbolism and imagery. The image can provide a safe boundary to enable the process of exploration without necessarily involving talking therapies or language, but in so doing can enhance and promote talking.
Art therapists are required to undergo training in psychological theories, clinical practice and human development. The profession has developed from a psychoanalytical and psychodynamic model to embrace cognitive therapies, neuroscience, mindfulness and mentalisation-based techniques. The training is postgraduate and the profession is state regulated by the Health and Care Professions Council (HCPC). Art Therapy is promoted in the UK by the British Association of Art Therapists (BAAT) which provides support, advice and an Art Therapy Practice Research Network for members.
Mindfulness has definitely been the trend for a while and has become mainstream over the course of the past decade. This new age concept has transformed into a multi-million pound business and the number of books on mindfulness has mushroomed, bringing a range of meditation methods that are now easily accessible to all and practiced by many. Millennials aspire to Scandinavian notions of ‘Hygge’ and ‘lykke’, words of Danish origin that have been adopted into the English language expressing notions of comfort, happiness and well-being. As high tech, high speed, frenetic lifestyles and increasing reliance upon social media and technology can prevent people from being deeply aware of themselves, let alone of each another. Humans are in danger of becoming deprived of giving face to face contact, of a sense of deeper awareness and sense of being human, of feeling healthy in mind and body. Stress, anxiety, depression, pain, illness and addiction pursue, especially amongst young people where the anxieties and stresses can easily commence early in life. Mindfulness can deal with many issues including teenage depression, addiction, pain and anxieties.
The roots of mindfulness originally lie in the heart of Buddhist meditation in which awareness is cultivated and the mind is calibrated and stabilised. The idea is to help one find a state of being in which the person may reclaim the present moment, anchoring oneself in the here and now, free from distortion and interpretation so they may reframe their narrative. It can be practiced by anyone, virtually anywhere and I use it in my practice.
Jon Kabat-Zinn, Professor of Medicine Emeritus, developed the Mindfulness-Based Stress Reduction program (MBSR) at Massachusetts Medical Centre Stress Reduction Clinic and his methods have been adopted by a host of notable cognitive psychologists and developed into the practice of Mindfulness Based Cognitive Therapy (MBCT). These include Dr Zindel Segal at University of Toronto, Oxford based John Teasdale and, Prof. Mark Williams, founding Director at the Oxford Mindfulness Centre. Dr Patrizia Collard at University of East London has written ‘The little book of mindfulness’ and Christina Feldman at The Insight Meditation Society offers meditation retreats.
So, teachers in secondary schools are to receive mental health training! £200,000 has been pledged by a Government funded scheme known as Mental Health First Aid and the scheme will also be rolled out into primary schools by 2022. It is fair to say that teachers are on the front line, not just for safeguarding, but additionally for helping to build resilience in children and young people.
Evidence given in a recent report on Social media and children’s mental health by the Education Policy Institute, demonstrates that 37.3% of UK 15 year olds are classed as extreme internet users (6+ hours daily). Evidence of the correlation between extreme internet use and the harmful effects on young people’s well-being makes teachers uniquely well placed to educate about the strong links between periods spent on social media and mental health and well-being problems. Especially to raise their concerns about vulnerable pupils or pupils who are exposed to problems relating to their mental and emotional well-being.
It is also fair to say that the government should ‘get real’ about the mental health problems facing children and young people. Talking therapies are in desperately short supply and underfunded, specialist services, like CAMHS, have long waiting lists. Dumping the problem onto teachers is a pitifully inadequate way to tackle serious mental health issues affecting our young and which require much more specialist input than schools-based first aid. Teachers already have overwhelming workloads and schedules and are driven to attain high targets. Target crunching is not the mind set required to understand and deal with mental health problems. To expect teachers to be able to recognise and cope with mental health issues as well, is not only naïve but it undermines the skill and experience of a properly trained mental health professional. How would a teacher be expected to have the time or skills to successfully deal with a child or young person with a full blown psychosis or offer counselling support to a suicidal teenager?
Funding needs to be pumped into specialist mental health services for children and young people so that trained and skilled mental health professionals can meet the needs of children and young people with emotional and mental health problems. Meanwhile, let the teachers get on with what they are trained to do, and do best, which is to educate.
In a climate of deepening NHS crisis, it is heartening news that the PM is talking about making an investment in mental health services and even addressing the issue of ‘parity’. Whether or not it is a question of ‘hard’ or ‘soft’ parity, one certainty is the fact that there needs to be new Treasury money for these investment plans. Professor Sir Simon Wessely, Regis Professor of Psychiatry at the Royal College Of Psychiatrists states that there is a need for more specialist mental health workers, Child and Adolescent Psychiatrists, nurses etc. “We have a long way to go before mental health services are on an equal footing with those for physical disorders.”
The reality is that almost 250,000 children and young people and children aged 18 and under receive treatment by specialist NHS support services each month and this is probably just the tip of the iceberg. Child and Adolescent Mental Health Services (CAMHS) account for just 0.7% of NHS spending and approximately 6.4% of mental health spending, therefore Clinical Commissioning Groups (CCG’s) will be using some of the 1.4 billion that has been allocated by ministers to improve mental health services for young people. Some mental health charities argue that just how much of this funding actually reaches frontline services is debatable. It is a great pledge, but the capacity for CAMHS to provide support is limited because their services are already overstretched with long waiting lists and high threshold levels for treatment which means that many children are being turned away from services.
Jeremy Hunt, Health Secretary has said that care for children and young people is a “black spot” needing urgent attention as the pressures of social media, cyber bullying and a big increase in self-harming is a “massive worry for parents”. He pledges that he will improve diagnosis and treatment of mental health conditions and put specialists in schools with a proposal that CAMHS and schools work closely together and for more schools to have a CAMHS specialist.
The Mental health charity Sane states that these plans need to “be matched by substantially increased funds to mental health trusts”. Mind said it is “important to see the prime minister talking about mental health” but the difference it made to patients’ day-to-day experiences would be proof.
Teresa May has pledged to help CAMHS by investing £250 million more and by offering mental health first aid training to teachers to recognise symptoms of distress. This puts teachers on the frontline when they already have heavy workloads and are driven by a target led culture that is judged by rigorous observations and inspections. The prospect of Ofsted monitored mental health support provided by schools adds further pressure. An outcome of outstanding, good or requiring improvement is not an appropriate approach to dealing with young people’s mental health issues. The focus needs to be entirely on recognition and sensitive understanding of the needs of the individual child and young person and how they are rapidly going to get the vital support required before self-harm occurs.
Recognition of mental health disorders can require a trained eye and skilled personnel are able to recognise and deal with mental health issues to ensure clear and rapid signposting to the relevant service.
In the UK, approximately 300,000 children and young people are known to experience a form of anxiety. There are notable increases in adolescent self-harm, reported cyberbullying and a significant rise in the number of young women with emotional difficulties. Overall, there has been a marked increase in the severity and complexity young people’s problems while children and adolescent mental health services have experienced a 25% cut in expenditure.
The Anna Freud National Centre For Children and Families (NCCF) have released an informative series of podcasts called “Child in Mind” which is suitable for both parents and professionals alike to listen to and covers problems such as ADHD, anxiety and more issues concerning children and young people.
Raising public awareness of children and young people’s mental wellbeing is critical and equally important is signposting services and where to get help. Contact me if you require help or further information.
To hear the podcasts, visit:- https://soundcloud.com/anna-freud-centre
The use of alcohol and drugs as well as gambling are often regarded as a normal part of family life but inevitably can lead to addiction which may pass from generation to generation. We tend to associate with people from similar backgrounds, so drinkers will associate with other drinkers, gamblers with gamblers and so on. The support and influence of family and friends, on the one hand, can enable a person to escape from addiction, break the cycle of dependence and seek help. In this BBC podcast however, partners also talk of how they deal with imposing ultimatums on their addicted partners. It demonstrates how dealing with addiction requires developing coping skills and strategies, not only by the addicted individual themselves, but also crucially by their families and partners. Successful recovery requires the support of family and friends, however beware the dangers of co-dependency. The importance of sharing experiences with other people in a similar situation is emphasised. The advice given:-
“Take a deep breath and ask that first question …. learn to ask the really uncomfortable questions”
“Think of your role as the enabler…. You find out that you are not actually the supporter, you find out that you are the enabler and that you are actually part of the problem and because you love that person, you have helped them maintain their habit.
For further insight, follow the link:-
2% of mainly females will develop anorexia nervosa between the ages of 15 and 20, of whom approximately 25% will develop an entrenched anorexia. The signs to look out for, whether you are male or female, are that you spend hours exercising excessively, you are taking in few calories, you are feverishly trying to maintain control of your body, and you experience intense, obsessional thoughts about food and weight. If this matches you, then it is very likely that you are becoming entrenched in an eating disorder. Anorexia nervosa is largely about control and it can be life-threatening. The more you focus on food and weight, the less rational your thoughts are.
Severe and enduring anorexia nervosa can become a challenging condition and treatment, including the talking therapies, are not always very effective. As a psychiatric condition, it is most successfully treated during the first few years of its course before patterns become entrenched, fixed and habitual. Ultimately if left untreated, hospitalisation may be necessary. In-patient treatment of this nature sometimes results in painfully slow weight gain, agonising hours spent in the dining room, desperately trying to cope with compulsive anorexic thoughts and emotions, (including suicidal ones), and frequently deeply-rooted ambivalence towards treatment.
The potential effects of starvation on the brain may be key in new innovative treatment methods. Recent research using neuro-imaging reveals clues that parts of the brain may be stimulated to bring about recovery, such as the limbic system, which is linked with reward processing and other areas of the brain dealing with body image perception and also which determine the way that we sense internal body states, like hunger or pain. Transcranial Magnetic Stimulation (TMS), using an electrical stimulation technique is in use experimentally and is undergoing trial in the UK. This may be helpful in resetting the brain areas that control eating patterns and decision making processes, resulting in a greater chance of being able to access a psychological therapy. This treatment could potentially be lifesaving and prevent early deaths.
If you are suffering from anorexia or a similar eating disorder such as bulimia, or are worried that you, a friend or relative may have an irregular eating pattern or may be developing an eating disorder, don’t hesitate to seek some professional help and advice before the problem progresses further. You can hear women share their experiences about binge eating problems by clicking here.
For further information follow the links or contact me.
Bethany Hughes discusses Narcissism with Psychotherapist Phillipa Perry
There is a need for heightened vigilance around coronavirus. A call for increased support for healthcare workers on the frontline.
This LBC radio recording with Dr Jack, Consultant in Intensive Care, highlights the need for containment of infection. He …