|
1.
Early intervention
therapeutic work for children and young people with emotional/
behavioural difficulties that are not in need of a Child and
Adolescent Mental Health service (CAMHS). This includes
children with attachment difficulties. There is a need for
psychologically informed interventions to be co-constructed with
families to take into account that while the child’s
difficulties may be early emerging, frequently parents have had
long standing difficulties with their own mental health, often
related to adverse early experiences and trauma in their own
childhood and early adulthood. This means that parents can
experience difficulties helping their child regulate emotionally,
as they, themselves struggle to regulate their own emotions.
Therefore services need to be tailored to fit whole families
so that parents can receive emotional support as well as
individualised parenting support based on an understanding of
emotional regulation and child development fitted to the family
rather than the family needing to fit to a service. Parental
emotional support should offer a range of services including
individual therapy and access to a family therapy clinic. In
order to engage families, home and community visiting should be
offered.
2.
An
understanding of the needs of a child based on a psychological
formulation rather than a diagnosis of mental disorder.
A psychological
formulation gives an explanation of the possible reasons for a
difficulty, along with current maintaining factors. It also
focuses on the child, family and wider network strengths and
resilience in order to motivate change or understanding.
Increasingly we are seeing children who have received diagnoses
such as Attention Deficit Hyperactivity disorder (ADHD) or
Oppositional Defiance Disorder (ODD) or Autistic Spectrum disorder
from a professional working in the private sector.
Occasionally this can also be from a Paediatrician within the
health board. Parents can sometimes find themselves in the
situation where professionals disagree and therefore a number of
diagnoses are considered, or given and taken away. This is very
confusing and often frustrating for parents who can
then spend time trying to get the “right” diagnosis
which can divert focus from the interventions aimed at meeting the
child’s needs. This needs a societal approach to emotional
wellbeing rather than early diagnosis of developmental disorder
(for the majority of children.) This would also mean less strain on
the limited resource for assessment of neurodevelopmental disorders
as the right children would be referred into these
services)
3.
Schools need
support in understanding children’s behaviour within the
context of their emotional development, particularly a
child’s attachment needs. This could
be in closer working between health and education e.g. clinical and
educational psychologists working together and offering training on
Attachment to schools. Ongoing supervision is needed to embed
new understanding and skills. (There is a project led by Newport
Educational psychology Service that has begun this way of working).
Some schools have Family liaison/links officers who support
parents in their communication with school and developing parental
understanding of their child’s emotional and behavioural
development. These staff are ideally placed to make links between
Education, Health, Social Services and the third sector in order to
support the child in their main contexts of home and school.
Robin Banerjee’s work on wellbeing in schools is very
important.
4.
Post diagnosis
support for children with neuro-developmental
difficulties such as Autistic
Spectrum disorders. Currently, following diagnosis local CAMHS are
not able to offer any support to families.
5.
A range of
universal/ less stigmatising support for children and young people
including clubs and activities which help to
develop skills, a sense of pride and self-esteem in achievements as
well as social skills and developing attention. These groups
need less qualifying criteria so more children and young people can
attend. Their qualifying criteria should be strengths based
(e.g. enhancing social skills and self-esteem) rather than being
based on needing to have a problem to join.
6.
Quicker responses
for children not attending school that are based on understanding
of the family’s dynamics that have led to
or maintained an absence (or repeated absences) from school (before
a court/fine based response).
7.
Parent support
groups, initiated by a
co-ordinator (e.g. the Monmouthshire Parent Network) which parents
can then take on and run themselves.
8.
It
should be noted that Third sector funding for projects is
frequently very short term and that for the stability of staff and
service users, the minimum funding period of services for children
and families should be 3 years.
|