5 Reasons why having a Therapist in school is harder than it seems

5 Reasons why having a Therapist in school is harder than it seems

While we all continue to raise our voices and advocate for better provision for the mental health of children and young people, we need to talk about what is already happening. It may be that we can make what is there even better, even more effective. Many organisations are suggesting we need a play therapist in every school – and don’t get me wrong, it would be a great step in the right direction – but there are certain things we need to talk about when it comes to therapy provided in school. Many schools around the country have taken the courageous decision to employ a qualified play therapist at least 1 day a week. Many schools know it is important and have fought to retain that provision through the crazy current budget situations. Many schools don’t realize what they have really done by doing that! What do I mean? Well beyond the obvious ‘we have employed a qualified mental health professional to work with a few of our children’ is hidden something else. It is this:

‘We have brought into our school, a mental health professional who works in a different way, with different priorities, different processes and a whole different way of thinking.’

Many schools and therapists actively say they value diversity, however, it is a common phenomenon across the country, that when therapists start working in schools, these differences, between their culture and school culture, if not handled proactively, can bring confusion, frustration and quiet animosity on both sides. Understanding the main points where these two cultures clash can bring real insight and when openly addressed actually improve the quality of the mental health provision for each child.

  1. Closed doors.

In a school a closed door is frequently hardly noticed (apart from the door to the Head’s office?) and is opened and often walked through without acknowledging it even existed. Any message it may be giving is unheard, un-acknowledged and not respected. Closed doors have little-to-no meaning, and whatever a person needs on the other side of the door, whatever activity is happening there that they will interrupt, they are allowed to proceed to their agenda. That is common door culture in schools. In the world of therapists a closed door is imbued with profound meaning. It is a sacred way of protecting a client. Helping them know they are safe here; there will be no interruption, intrusion or any distraction.  It lets them know that this room, this space is for them. It lets them know that they are important, they are valuable. It reassures them that the often hideous things they have experienced that may have them feeling worthless and vulnerable, will not happen here. A respected closed door communicates to the hurting child that they, and the things they may need to concentrate on in this session, are IMPORTANT, will be HONOURED and are worth PROTECTING.

  1. Making changes

In schools change is the one constant. Room changes, timetable changes, lesson changes (curriculum changes and government focus changes!). One of the qualities of a proficient teacher is to be able to ‘go with the flow‘ be spontaneous and keep the learning agenda high whilst juggling, being flexible and creating ‘on the hoof’. In the therapy world consistency is another sacred way of showing respect for the client and the journey they need to make. Therapists will resist change and it is important that they do. Sessions need to be at the same time, on the same day, in the same place each week. Children learn very quickly when their session is, and that time and day becomes an anchor for them in their often turbulent weeks. Keeping things looking the same, and in the same place in the room (without items suddenly missing or being added) helps children develop relationship with the room as well as the therapist. It is a big part of helping a child feel safe and trusting this space. I will never forget the child who made a card to stick on the cupboard before he left his last play therapy session before the Christmas holidays. What did he write on it? ‘Bye room. See you next year.’

  1. Accessing sessions

In school playing with toys, or doing anything that is not timetabled or sitting in the classroom with the rest of the class can be seen as a ‘treat’. If a child isn’t in school then they don’t get to go swimming, they don’t get to see the pantomime, they don’t go to Lego club, and they don’t get Golden Time; they don’t get their ‘treats’. Therapy is a mental health provision. It is there to support a child as they try to survive and heal from the challenges that life has thrown them. Therapy is often very hard work. It may seem like fun to an outsider, because a client gets to choose what they ‘play with’ but really a child is just choosing their safest way to express what has happened to them in the past, what they are dealing with in the present or what the are scared about in the future. Going there, thinking about that stuff, is rarely fun. Therapy is not a treat. Even though it may happen on the school premises it is not ‘school’ ie education, it is a mental health provision. If a child is unwell they will obviously miss a session. If a child is excluded however, they will still need to attend their session (and they now have even more to process) and then go home again.

  1. Assessing progress

In school any educational process is governed by the progress and outcomes that are provable. Each lesson, intervention group, and module of work is assessed and evidence is gathered that progress is being made in lines with already pre-determined markers. Progress in these terms is more-or-less a straight upward trajectory. If there is evidence that things are getting better then ‘it’ is working. In therapy assessing ‘progress’ is an altogether different scenario. General tick box-assessments (SDQs etc) are made regularly (probably termly). However, in between these tools, which are only 1 element to a wider review process, ‘progress’ may look different to the therapist than it does to school staff. A child who has been shut down, possibly in freeze following earlier life trauma will always hit into the massive survival energies of the fight/flight physiology as they start to feel safe enough to ‘heal’. As I explain in detail in GROUNDED, this is a particular area where staff can easily mistake behaviour that is more challenging for no-progress or things getting worse.

 5. Endings

In school extra educational provision can stop on a whim. Heads are under intense scrutiny from higher powers to line up budgets, to justify spending, to use the little money they have for the greatest return. They think big picture. What’s best for everyone, and make most of their decisions of success inline with section 4 above. If something isn’t seeming to them to be ‘working’ they are used to having the power and autonomy and (internal sense of responsibility) to make a decision and stop it swiftly. In therapy endings are INCREDIBLY important. The child is likely to have already had a collection of losses in their life – possibly leaving them with self-beliefs like ‘people always leave me’, ‘don’t trust people- they will go’, ‘people don’t want to be with me’, ‘people don’t like me and go away’. If a child has been through a deep healing journey with a therapist they will need a long run of sessions to process all their thoughts and feelings as their relationship and their access to their safe space comes to an end. 6 weeks of counting down with the child enables them to do what they need to, say what they want to and have a positive ending experience that leaves a good deposit in their life. They are part of the process and empowered by it. Ending a child’s therapy should be a joint decision made by the therapist, school, parents AND the CHILD. Any deviation to this procedure and the therapist will likely challenge the decision. They will advocate for their client. It is their job. It is important for that child’s mental health that they do. Of course, emergencies happen, and will be managed as best as possible by the therapist, however as a rule they should be the rare exception. Suddenly imposed endings cause damage to a child’s mental health. No one wants to be responsible for that.

Common Ground

Schools and therapists both long for happy children. Schools and therapists agree that there are oceans of unhappy children currently swirling through schools. Therapy can absolutely be a life raft for them, but only when the school and therapist work hard to communicate. Communicate needs. Communicate expectations. Communicate about communication! Communicate with curiosity, respect and with a desire to understand each other. We only manage to build bridges and work together with those from other cultures when we can first acknowledge we are not the same. Supporting our children’s mental health and supporting effective therapeutic provision in schools is going to challenge, test and grow us all! Are these children worth it? I believe we already know the answer to that… Claire Wilson is the Clinical Director of CHEW Initiatives and has many years experience as a teacher and subsequently an accredited play therapist. She is now a therapeutic adviser to schools, and is the author of GROUNDED: Discovering the Missing Piece in the Puzzle of Children’s Behaviour written for parents and all professionals working with and around children (www.groundedbook.net)

From Grenfell to GROUNDED – A story behind the book

From Grenfell to GROUNDED – A story behind the book

More than CPD
In June last year (2017) I was in London for a few days. I was there to be part of a specialist training for further enhancing my skills and credentials of working with trauma and the body – with children. I was excited about the training – in fact I heard from the organiser I was the first one booked on it. However, as I look back, those days mean even more to me now.

I arrived the afternoon before and met some of the other participants (from all over the world) for a meal. When walking back from that meal, we passed this march… You may/may not remember that that was a few days after the horrific fire at Grenfell Tower – just down the road from where we were staying.
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I will never forget the energy of that moment… we stopped still and honoured those that marched past – the survivors… their anger, their grief, their fight, their trauma and I felt I became part of that moment, honouring them all, and those who were impacted by the trauma of the fire.
Over the years I have learnt so much about trauma. About how it can change people, the elements needed to heal from it, that it can change the course of your life, but doesn’t have to be a life sentence. About how brains and bodies change. About the hope there is.

At the end of the training days, when we sat in a big circle in a closing activity, I remember talking about Grenfell and committing myself to do my part to contribute to changing society views around trauma, and those who have experienced it.

What you wont know, is that just before that course, a few hours before that meal, and a few hours before witnessing that march I had pulled out my iPad in my hotel room in London and started writing… my book.

Catalyst for Good

Grenfell had had an impact on me – as my car crash had years before – that same ‘you never really know when your time is up’.
I didn’t want my time to be up without passing on some of the things I have learnt over 25 years working with and around children and families. Things I have learnt and researched and seen in action about what it really takes to bring the best out in children  –  trauma or not. Things that are not common knowledge…yet. That would be a waste. Grenfell was my catalyst to stop procrastinating and start using my voice. It was time to start getting what was in me out.

The Book

GROUNDED is a book that has come from over 25 years of working with and around children. Insight from years as a teacher, an accredited play therapist, a clinical supervisor, a therapeutic adviser to schools and families – and a trauma specialist still helping people of all ages heal from the impact of their experiences.

It is a book that is relatable to teachers, parents, TAs, grandparents, aunts and uncles, football coaches and Scout leaders. It is packed with current neuroscience and everyday stories that make it all so easy to read and understand. It is a book that advocates for children – and has a message they often can’t speak for themselves. It is a book for all adults who want to be the best they can be for the kids they know. It is a book with a message and a mission. It is a book of hope.

GROUNDED is a book that is endorsed by teachers, Heads, parents, grandparents, play therapists, psychotherapists, international trauma specialists and world leading neuro-scientists.

It is done. GROUNDED is out.

There is a lot more I could say about the book, but I wanted to let you know some of the story of where it came from.
Now I want to share it with you all, with gratitude,  as you have felt like part of the team that has helped bring it to birth.

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What it’s like for Children When Adults Shout

What it’s like for Children When Adults Shout

I was standing on the dock of a bay… Waiting for a boat to come and take my friends and me to another island. The sea was emerald, the sky was blue, the sun was warm and the air was dry. This idyllic corner of the world was colourful and vibrant with people and life and bustle…
…and I felt scared. My heart was racing, I felt tight and small, and vulnerable.
Why?
I was in a different country, experiencing a different culture, and a few feet away from where I was standing waiting for the boat, were a group of men.
Tall men.
Big men.
Loud men.
Men who were deep in ‘discussion’… although I didn’t realise it was discussion. I thought they were having a full blown argument.
I couldn’t understand what they were saying, but it didn’t matter as I was getting quite enough from all the other ways they were ‘communicating’, and all I knew was what was happening with them made me feel unsafe.
They were shouting. Shouting loud and so very fast. They were gesturing aggressively with hands slapping, fists hitting palms and arms waving. They were getting in each other’s space. They were really, really animated… And I had never seen anything like this before… in real life. I had also never seen this kind of thing (even on TV) end well.
Our sense of safety is largely driven by subconscious processes. We take in information through our senses and use the information of what is happening around us to help us decide whether we are safe or not… and then what to do next.
Adults shouting, jumping, gesticulating, making passionate, emotional faces that look angry, and generally behaving aggressively can be scary. I was an adult – I even knew a couple of the men – and I was really unnerved by it.
I was reminded of this moment in my life recently and the implications of hearing people shouting – for a child.

  • Being around adults who are shouting, whether they understand why or not, can be scary for children.
  • Being around adults while they watch a football match on TV can be scary for children.
  • Being around adults who are loud and drunk and ‘just having a good time’ can be scary for children.
  • Being around adults who use shouting as their means of control in a house, sports field, gym or classroom can be scary for children.

When children are scared they can’t be their best selves.
When children are scared they can feel totally alone and vulnerable.
When everyone else thinks they are having a great time ‘enjoying’ the sport / the party / keeping control, a scared child can feel confused, ashamed and misunderstood as well as unsafe.

It’s worth a chat

If you want to have a chat with the children you know about their experiences of being around adults who are shouting, get ready to listen, respect and honour the things they will tell you.

Whether it was a ‘fun’ thing that was happening, a neutral thing, or a recognizably horrible thing, children often react in their body when they hear adults shouting. That’s not wrong, that’s how they were made. Shouting is generally interpreted as a sign of danger. Until the child is totally comfortable with the shouting, it will likely be setting off alarms in their subconscious and their body in a way that doesn’t feel nice.
If you have that chat with the children you know, be wary of dismissing their body-felt experiences and making them feel embarrassed for feeling the way they do when ‘it’s only a sports match’ ‘they were just having a disagreement’ ‘I’m just getting their attention’.
The world is different through the eyes of a child, and their body is programmed to know that when adults are shouting, they are not safe.
Let’s be honest, it’s easy for adults to get caught up in the moment and overlook the things that can impact children. That’s why I am writing this. I’ve had enough of these conversations with children of all ages myself over the years to know this ‘shouting thing’ is a ‘thing’ and is important for adults to consider. And it is not just hard for the kids who are known to have sensory issues – or those who have experienced domestic abuse (although they will be even more sensitive to it) it is how we are all wired.

What can be done?

So what can we do, because clearly shouting is not going anywhere?

  • We can warn children ahead of time that there will be shouting (during a sports match, even in the classroom) – and help them make a plan for what to do if they don’t feel OK with it.
  • We can be curious and find out from them what it was like hearing adults shouting after the event – and really listen and empathise without needing to explain the shouting away.
  • And, if appropriate, we can take our shouting elsewhere – or better still find ways to communicate with someone else that don’t include shouting when children are around…

Children don’t like it when adults shout. It makes them feel horrible. Why not ask them and see what you find out?

What Dr Chatterjee Said About Getting People to Change

What Dr Chatterjee Said About Getting People to Change

CW speakingI got an incredible opportunity to speak to a packed room of health-interested adults last week. They were healers, helpers, educators and ‘advocates for health’ in professional roles as well as everyday life-role-models.  I was sharing a bit of my story – my experience of Integrative or Functional Medicine, and encouraging others to listen to the story their body was telling.

It was one of those days I will never forget… and particularly because next on the stage after me was one of my modern-day heros; Dr Rangan Chatterjee. You may have seen him on the TV, he is the Doctor in BBC’s Doctor in the House series. He is also a familiar face on newsy chat shows on both TV and Radio. He has a brilliant book out – The 4 Pillar Plan and he is trying to shake things up from the inside of the NHS – why?
Because he cares about his clients.
He actually wants to help people get better, live better and live in greater health… not just ‘managing symptoms with another pill’.

He is risking sticking his head above the parapet, committing his time to the demands of TV series (I was shocked how much time these series take!), because he is committed to getting the message of true health out with the platform he has been given. I resonate. Not the TV thing, obviously – just feeling the challenge of choosing to be different and challenge the status quo – because I care.
 
DrCh CW
 
ONE thing he said REALLY struck me – because it is relevant to the people I spend my time with.

Dr Chatterjee told a story of how one of his medical colleagues asked him (with incredulity) how he gets people (his regular patients in his GP practice – not the TV ones) to actually listen and do the things he suggests. Giving people recommendations for how they can bring their blood sugar levels down, increase their energy, decrease the vast array of symptoms from elevated cortisol levels etc. are easy to suggest, and for the patient easy to do and easy NOT to do. How is it that Dr Chatterjee’s patients are creating book-fulls of stories of incredible drug-free life improvements from doing the simple things he suggests?

Dr Chatterjee’s response was this: ‘In my opinion, as health professionals, the biggest tool we need to have is an ability to communicate. The question is really can you communicate and really connect with the person in front of you?’  

I loved that answer. It is so totally true. It is true in the classroom, it is true in the playground and it is true in a family home.  If we care about people and have ways to help them grow and develop and flourish, then we have to prioritise making sure we CONNECT with them, before we try and share any of the good stuff.
 

How do you know if you really connect with your clients, your patients, your pupils, your children?

And here’s the kicker. In a school, home or office getting people to just do what you say does not mean you have connected. Ask anyone who feels like they work for or live with a mini-dictator!!’ One of the survival responses closely related to the well-known ‘freeze’ is submit – appeasement. It is in operation so much in schools – and some homes. Dr Chatterjee does not have a power relationship with his patients. They are totally at liberty to walk out of his surgery and ignore everything he says, and maybe some do. But the majority don’t.
 
If you really connect then you will have people actually wanting to do the thing you suggest for them, because they know it comes from you genuinely respecting them, wanting the best for them, because they like you and because they trust you.
 
It is an important reminder for us all. Whatever our sphere of influence, are we connecting with those in our care? Are we growing relationships of trust and mutual respect? Do we honour those we work with, whatever their age?
 

TRUTH

The level to which we develop our communication skills and find ways to effectively, authentically connect with those we work with, will be the level of our professional influence. If we have any ambition to make a difference to others, or maybe even want to change the world, one star-fish at a time, we need to start with genuine, authentic connection.
 
 
 

Doctor Nye, Head of Integrative General Practice in S.A. explains QEC

Doctor Nye, Head of Integrative General Practice in S.A. explains QEC

This article was recently written for a newsletter going to all medical Doctors (GPs) in South Africa. More and more people in the UK, Europe and across the world, understand the future of HEALTH care is in Integrative medical approaches. His words are interesting for anyone interested in health, healing, potential and thriving in life.
This article is reproduced with permission.

NEWSLETTER TO GPs in South Africa

from Dr David Nye, Head of Integrative General Practice SASIM (South African Society for Integrative Medicine)

QEC

“Earlier this month, I was fortunate enough to attend a life-changing presentation by Dr Melanie Salmon at the monthly SASIM meeting in South Africa. As many of you may know, Melanie introduced TRE [Trauma Releasing Exercise] to South Africa over the past 10 years. Previously she practiced as a GP and Counsellor (Gestalt Psychotherapist) in the UK for 40 years.

On this occasion she presented her unique treatment called Quantum Energy Coaching [QEC]. This concept is so exciting I felt compelled to share it with all of you, who did not have the opportunity to hear it first-hand. QEC is based in neuroscience and is a distillation of: Gestalt Coaching, Focused Intention, Brain Gym, Cardiac Coherence, Neuroplasticity, Neurogenesis and Kinesiology. Basically, it is a quick and efficient means of imprinting positive affirmations on the subconscious mind.

Melanie was greatly impressed by the ground-breaking work of Dr. Bruce Lipton, published in his book “The Biology of Belief”. He showed scientifically, that the foundation of most ailments lies in negative, limiting thinking. As we now know, we are not controlled by our genes, but by epigenetic influences of toxicity, lifestyle, nutrition, stress, etc. The most powerful of these epigenetic influences are our thoughts.

Lipton was the first to show that if we want to make permanent changes in our lives, we need to find methods able to change thinking at the subconscious level of the mind. He demonstrated that humans operate 5% of the time in the conscious mind and 95% of the time in the subconscious. It is our negative subconscious thought patterns that hold us back from achieving our best, and it is those same thought patterns that underpin so much suffering in chronic diseases. How often do we find ourselves exhorting our patients to ‘think positively’, or to engage in years of therapy, only to be disappointed by the outcomes?

QEC provides a quick, permanent way of replacing the ‘negatives’ with ‘positives’, thus allowing the individual to move forward, freed of the baggage holding him/her back. Successful outcomes can often be achieved in one session of 90 minutes, but up to 6 sessions may be required in some individuals.

QEC combines well with TRE and other forms of counselling, and anyone can learn to do it. The scope of QEC is infinite and it can help everyone from those who are healthy, but wish to succeed in business, to those with allergies, phobias, addictions, mental and physical illnesses, to those coping with cancer. In this broken, traumatised and stressed country of ours, it is something that can change the present and future of every single one of us!”
Dr David Nye, Head of Integrative General Practice, South African Society for Integrative Medicine. 

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QEC comes to Birmingham, UK ~  May 2018

A unique 4-day training to become a QEC certified practitioner is being held for the first time in Europe in May 2018. Open to anyone who is a professional healer or mind or body. Many places already booked.

Further details, videos of participants, flyer and booking information is available here.

Improving mental health, marking schemes and saving money in schools

Improving mental health, marking schemes and saving money in schools

I have an idea.

It’s a way to help improve children’s mental health…

It is something that could happen in schools, especially primary schools…

It would cost, …. ummm …  £0.
Yup. Zero. Nothing.

I can just imagine all the cash-starved Head teachers out there, sitting up and starting to pay attention 😉
free-stuff
If you were to survey 100 children between the ages of 5-10 it would be really interesting to see what they think about themselves. If anyone has already done this please let me know. I have a theory.

The thing is that mental health is often related to body health (which is why so much can be improved through optimal nutrition, movement and sleep). It is also shaped by life experiences and rooted in subconscious beliefs.

In my experience of working therapeutically with children, coaching parents and supporting adult clients for many years, there is 1 belief that seems to be present for so many:-

“I’m not good enough”

The seed of the belief that we are not ok, we are not enough, we are not good enough and what we do is not good enough, can be sown in us in so many different ways. That seed will be nurtured, fed and watered by future experiences.

I was speaking with a lovely mum recently. She told me how her daughter, a bright, sunny girl, started to develop a shadow over her a few years ago in school. She had a tricky time in Year 2. Don’t get me wrong, she was a perfect student, great behaviour, trying her best, lots of friends so it was not ‘that’ kind of tricky. Nothing was ‘really’ wrong – yet she started to feel the weight of self-doubt. She started really questioning her self, her abilities and whether she was good enough.
depressed girl
The reason? The school changed their marking system and were now using the ‘developmental marking / feedback marking’ (Assessment For Learning or AFL to some).
What that meant in plain English was her work got marked by the teacher and beside the smiley face, and maybe a positive comment, she always got a suggestion of what she could do to improve her work next time:-

“Next time try…. ”
“When you do your next …. Can you…”
“Have a go at ….”
“You could make this even better by….”

Many teachers love this marking. It gets results. I can understand why. Children pay attention to their personalised comments (don’t you remember devouring every word personally written to you by your teachers as a child?). The majority of pupils try their best. They want to get better. They want to make their teacher / head teacher / parent happy. Most of them will do whatever it takes to work harder and do better. It’s all looking good. Work gets better, marks go up, levels go up, Ofsted is happy, SLT is happy, everyone’s happy…
And yet this system held within it the power to erode a child’s self confidence and self esteem one tiny bit of work at a time.

IMAGINE

Can you imagine someone, who’s opinions of you matters, constantly telling you to improve?
Can you imagine how it might feel if your success is never really celebrated but always pushed into second place by a suggestion for ‘better’?
Can you imagine how the seed of not being good enough gets sown and/or nurtured faithfully, diligently by those guiding your development?
Can you remember the last time you did something out of your comfort zone (presentation, speech, blog etc) and you got feedback – some good, some not. Which are the comments you heard the loudest? Can you imagine that feeling for a child?

PERSPECTIVE

I am obviously not saying that this is the only factor in a child’s mental health. I’ve worked therapeutically with children for so many years now, and I know very well that it’s not. However, in a time when so many of our young people ARE struggling with mental health issues, and schools ARE struggling with budgets shrinking – isn’t it a good time to look at everything we are doing (however, well established) that might not be helping?
I wonder how many schools could help support / improve the mental health of these children by changing how they use this marking scheme?
I wonder what might happen to how children feel about their work – and themselves, if more of the time the comments coming back were just highlighting the positives?
“I loved your adjectives. I wanted to keep reading.”
“You have got full stops and capital letters nailed! Well done.”
“I can tell how hard you worked to get these words down today. Well done on not letting yourself get totally distracted. That’s a great skill to have.”
“You come up with such great creative ideas. I love reading your work.”

Please hear me on this. I am not suggesting we stop this feedback / developmental marking altogether – clearly we ALL need to have help to see how we can grow and what our next step could be. I am just talking about using it more sporadically. I wonder how much more effort you would put into noticing and implementing a suggestion for improvement if it came once in a while rather than every piece of work?
I also wonder how often teachers let pupils know what they are currently working on improving themselves – so children see it as a life skill, not something they have to do (directed by a perfect teacher) just because they are children and not good enough…yet?

I really don’t think that tweaking this approach to marking would cost any money… and yet could have a significant impact on the children trying their best to be good enough… before they grow up bringing those beliefs into their tweens, teens and adulthood.

I’d be curious to know what you think… Is this idea good enough to be considered?