
Children and Young People
“Deep inside us we know what every family therapist knows: the problems between the parents become the problems within the children.”
Behaviour and development - behaviour is a communication in itself
Behaviour and emotional distress
Challenging behaviour, expressions of anxiety or signs of depression are all indicators that something might be going wrong in your child’s life. The onset of such symptoms tends to alert parents and carers that there is a problem. I work with children and young people who are showing outward signs of emotional distress. This may take the form of increased worry; changes in sleep pattern; loss of interest in activities; compulsive behaviours and social withdrawal.
Anxiety, Depression, Self-harm
Anxiety
I find that anxiety responds best to an integrated approach as an anxious young person does not exist in isolation of their family. My aim is to weave together a combination of different therapeutic approaches such as, cognitive behavioural therapy, psychodynamic and systemic therapies in order to deconstruct the anxiety and remove any sense of blame or individual failure.
Depression
I draw upon an Interpersonal Psychotherapy Approach (IPT). This works equally well with adolescents and adults who are experiencing an episode of depression. The therapy tends to be short term with treatment sessions lasting between 12 – 16 weeks. It has been shown to be extremely effective as a treatment for depression and has a low relapse rate compared to other approaches.
Self-harm
It can be really hard for parents to understand the meaning of their child’s self-harming behaviour. It is distressing and upsetting and it can be hard for parents to accept that it is their child’s way of managing and communicating a range of feelings around their inner distress. There are different theories about why people self-harm, but as a parent your main concern will be to minimize the harm to your child, keep them as safe as you can and reduce the cause so that the behaviour will stop.
Suicide
Suicide
It will be additionally worrying if they express suicidal thoughts and you might not know how to respond. My immediate thought is that you are doing well as a parent if they are able to tell you how they are feeling. A suicidal expression is most likely an expression of their inner turmoil rather than a real expression of suicidal intent, but as their parent you will want to seek support and advice on how to manage this.
What you can do if you think your child is feeling suicidal - It is very distressing for you as the parent to know what to do when you fear that your child might be at risk of significantly harming themselves. While this is something that can be explored in therapy your first step will be to follow one or all of the steps below.
Stay with them and do something nice together – have a drink, dog walk, go for a drive, play music or watch a favourite soap etc…
Talk with them if they are up for that.
Take your child to the GP as they can advise on the best course of action.
Take them straight to A&E if you are really worried about them, as this will show them that you really care and that you are taking their distress seriously.
Ensure all medication in the house is securely locked away.
Ensure as far as possible to keep all sharps out of range of your child
When the crisis has passed you can then resume or engage with therapy, but immediate action needs to be taken when a young person is at risk.
Eating Disorders
Eating Disorders
It is probably one of the most distressing situations, for any parent, to discover that their child has developed an eating disorder, and that they had not noticed the signs or realised the significance of what was happening. Once the eating disorder is established it can be a very long and painful process to help your child detach themselves from the demands that the eating disorder will continue to place on them.
The parent and family role
An eating disorder impacts on the whole family and not just the young person and can set the young person at odds with the whole household as the usual rules around food consumption, mealtimes, shopping, cooking and spending time together can become points of high tension that create upset, emotional distance and distress all round. It is likely that despite your best efforts your child will do their best to try and deviate from any existing eating plans that have been put in place. In the early days of the condition, it can be really hard to stop them from continuing to lose weight and maintain a tight control over what they eat. The tension created in any family by an eating disorder can be tremendous and leave all family members feeling frayed, fractious, disillusioned, highly anxious and distressed.
Treatment
The Maudsley Method to eating disorders, promotes a family approach to treatment for a range of reasons apart from the obvious one that most families eat and most parents are interested in what their child is eating. Additional factors include one or more of the following: emotional attachment in the family; if the child feels criticised or undervalued within the family; jealousy of a sibling; over or under involved parenting style; feeling unheard or overlooked and feeling under pressure to do well. There may also be intergenerational family factors that influence how feelings are expressed and emotional attachment is practised within the family.
First steps
If you think your child might have developed an eating disorder, contact your GP to undertake a full physical check. Alongside family therapy, it can be helpful to obtain nutritional advice and support as well as individual psychological support for your young person.
Professional teams
I am always keen to join other professionals who may be supporting you and your child as this aids communication, maintains momentum, demonstrates care and the commitment of others to help them recover.
Supervision
I currently offer individual and group supervision to systemic therapists, trainees and therapists from other disciplines. I trained at the Tavistock Clinic in supervision and consultancy.