Children, Young People and Family Services
Children and young people are as equally vulnerable as adults to experiencing distressing emotions. Often such distressing feelings can be easily managed with the support of family and friends. There are other times when a child or young person may find it too difficult to cope with stressful life situations without professional help. It may not be clear to the adults around them what is the best way to help and whether therapeutic support is needed, but we can help you decide.
We have strong professional links within health, education and social care and can access consultation when required. This means we work to ensure that there is a community of expertise available to support a child or young person.
Consultation and first steps:
We offer a one-off consultation as a first step to discuss any concerns you may have about the needs of a child, young person or your family. This may lead to further assessment, but if we are unable to help, we can help to facilitate a referral to other services.
Assessment and plan going forward:
A carefully considered and thorough assessment is fundamental to successful therapeutic intervention. We follow professional practice guidelines to ensure that our assessments are comprehensive, informative and help parents/carers make sense of a young person’s difficulties. This helps us identify the young person’s level of need and guide those around them in how best to support them. We can also help in facilitating a referral to other services where necessary.
The assessment helps us:
- Carefully consider key areas of concern as well as the hopes and wishes of each child/young person and family.
- Develop a shared understanding of how particular difficulties may have evolved over time. This may also involve consultation with other professionals.
- Identify whether there is a need for psychiatric assessment or other assessments.
- Inform a therapeutic plan finely tuned to the specific needs of a child or young person.
Assessment may also involve:
- Meeting with parents/carer and possibly other professionals involved with the child or young person.
- Joint meeting with parents/carer and child/young person.
- Home visit and observation in school or other settings.
- Meeting with child (depending on age) or young person.
- More formal psychological tests to assess intellectual functioning/developmental skills, mood and behaviour.
- Feedback meeting with parents/carer and possibly other professionals.
Sometimes more specialised assessments are needed, particularly if a child or young person is struggling to cope with school and relationships or has experienced trauma. These may include:
- Attachment and separation difficulties
- Cognitive abilities
- Developmental concerns
- Educational problems
- Neurodevelopmental difficulties related to Autistic Spectrum Conditions
- The unfolding impacts of trauma on psychological health and emotional well-being
We work with children, young people and their families who may be experiencing a range of common and more complex difficulties. These may include:
- Anxiety including phobias
- Anger and aggression
- Attachment or relationship difficulties
- Adaptation to life events including the arrival of siblings
- Attention deficit and hyperactivity disorder
- Chronic illness
- Developmental trauma
- Loss and bereavement
- Low mood and low self-esteem
- Obsessive Compulsive Disorder
- Post-Traumatic Stress Disorder
- Parental separation and divorce
- Problems associated with neurodevelopmental such as Autism and Asperger Syndrome
- Problems managing anger and other strong emotions
- Problems at school with teachers, peers or bullying
- Separation anxiety
- Self-harming and thoughts of suicide
Therapies for children and families
Our child psychologists, psychotherapists and family therapists are highly experienced and creative practitioners. Their differing but complementary knowledge and skills enable us to develop a holistic package of care that is based on a carefully considered assessment of therapeutic need.
We can draw from a range of intervention techniques and therapeutic approaches to find a psychological care plan tailored to the needs, hopes and wishes of each child and their family. Some of the therapies we offer include:
Child and Adolescent Psychotherapy
Child and Adolescent Psychotherapy offers an effective treatment for emotional and psychological difficulties from infancy through to late adolescence. Child and Adolescent Psychotherapists are dedicated to understanding the complex emotional lives of infants, children, young people, families and carers in great depth. This approach seeks to look below the surface of problematic behaviours helping children, young people and their families/carers understand and make sense of what is driving such difficulties. One of the key aims is to understand what a child or young person is attempting to communicate through difficult emotions, behaviours and play. Their distinctive training enables them to develop and sustain relationships with children and young people whose difficulties may be rooted in early trauma, attachment disruptions and neglect, which often renders them vulnerable to blocking opportunities for the care and nurturing needed for healing and recovery.
Child and Adolescent Psychotherapy works with children and young people individually or with other family members as well the professional network around them to actively encourage a deeper understanding from the child’s perspective. During a therapeutic session, younger children may be encouraged to play, while older children may be asked to draw or paint and teenagers to talk about their feelings. Through the relationship with the therapist in a safe setting, the child or adolescent may begin to know and to feel able to express their most troubling thoughts and feelings. Gradually as these feelings are understood and put into words, there is less need in acting out through behaviour or unhelpful ways to self and other. Part of this process involves helping a child or young person build the internal resources that support their readiness for learning and their ability to form and sustain relationships with friends, family and other significant people in a child’s world.
What to expect from Child and Adolescent Psychotherapy:
- An exploration of a child or young person’s internal anxieties reflected through problematic behaviours and intense emotions
- Supporting a child or young person develop a better understanding of their troubling thoughts and hurt feelings so they can learn healthier ways of relating
- Supporting parents and carers better understand and make sense of their child’s communication attempts and to think with parents from the child’s perspective
- Supporting parents/carers to develop a more reflective stance as well as strengthen their resources for the task of parenting
Cognitive Behavioural Therapy
Cognitive-behavioural therapy (CBT) focuses specifically on helping children and young people develop an understanding of the relationship between thoughts, feelings and behaviour. CBT can help to improve a child’s moods, anxiety and behaviour by helping them explore confused and distorted patterns of thinking. In particular, CBT focuses on teaching children that thoughts have a direct influence on feelings and moods, which often then impacts on behaviour. In CBT therapy, a child or young person will learn to identify harmful and self-defeating thought patterns and develop the skills required to challenge and change the negative beliefs that often underpin such thinking styles. Parents or carers play a key part in co-facilitating therapeutic work outside of sessions and in supporting a child to meet the goals that are set and agreed.
CBT has a strong evidence base and is perhaps one of the most popular therapeutic approaches. CBT is an effective intervention for treating a wide range of psychological difficulties. Some of these include depression, anxiety, separation anxiety, panic, sleep problems, obsessional difficulties, phobic fear of sickness and various other phobias, self-esteem issues and body-image problems. It is also often particularly helpful for a range of physical symptoms without any specified medical diagnosis such as chronic pain. CBT is an extremely pragmatic and highly structured approach that focuses specifically on present difficulties.
What to expect from CBT:
- Working to break down difficulties into distinct parts: thoughts, feelings, actions as well as corresponding body sensations
- Homework is a key part of CBT and daily observation records help in understanding how thoughts influence feelings and behaviours in real-time
- Agreed treatment goals at the end of each session along with possible practice experiments between sessions supported by parents where appropriate
- The practice work will help to identify the pacing interventions so that a child or young person is working within your own window of emotional tolerance while challenging it at the same time
Drama therapy is an extremely powerful and creative therapeutic intervention that focuses on the healing aspects of drama and theatre as an exploratory tool in therapy. The transformative power of theatre and storytelling captures the imagination in playful and magical ways. Drama and play are an integral part of children’s everyday lives as well as being a vital part of their emotional and social development. Drama allows a child or young person to explore difficult and hurt feelings in refreshingly novel and creative ways. Some of these include; play, role- play, story, art, music and movement. This may also involve a range of playful and fun activities using puppets, masks, paints and costumes.
The idea is to create an imaginative story that supports a child or young person create a safe space to communicate and explore difficult feelings without this engendering a sense of threat. The storytelling or fictional aspect of drama serves as an emotional filter and creative container. This helps children and young people work with hurt and confusing feelings in ways that offset the fear of being overwhelmed by allowing them to tentatively step towards an exploration at their own pace and more indirectly. Drama therapy works well with groups of children and young people, but also individually. It is an effective therapeutic intervention for a range of psychological and mental health difficulties with children and teens.
What to expect from Drama Therapy:
- Exploring feelings and relationships by using various playful ‘props’ such as puppets and other appropriate performance materials
- Support, encouragement and guidance in the creative engagement of dramatizing and transforming personal stories and painful feelings using artistic interventions
- Joint engagement in ‘make-believe’ as part of a shared experience to discover and self-create new perspectives on the survival of adversity and help build resilience
Dyactic Developmental Psychotherapy (DDP)
Dyadic Developmental Psychotherapy is a neurobiologically informed attachment-focused therapy originally developed by Dr Dan Hughes to work with fostered and adopted children who had suffered from early impaired bonding, trauma and chronic neglect in their family of origin. When a child is exposed to frightening experiences over prolonged periods of time this can result in what is known as developmental trauma. When the world is safe, predictable and nurturing, a child will blossom and grow. If their developing world is chaotic, threatening and devoid of kindness or caring relationships, a child may suffer from overwhelming feelings of sadness, loneliness and despair. The family-focused therapeutic interventions of DDP works towards repairing the trauma of early abuse and neglect.
DDP gently weaves the key neuro nurturing principles of sensitivity, attunement and responsiveness into all its therapeutic interventions. This provides a foundational therapeutic platform to restore trust and safety required to work with a child’s compromised attachment capabilities and relational sensitivities. This approach prioritises the vital role of adoptive parents, foster parents and other key attachment figures in helping a child heal from the trauma they have suffered in early life. Therapeutic parenting based on the key principles of PACE is also regarded as a vital part of the healing process. This involves the kind of parenting that seeks to nurture playfulness, acceptance and curiosity to deepen connection and foster attachment.
What to expect from DDP:
- Working with parents/carers to build on their natural parenting style in ways that enhance sensitivity and attunement to the complex attachment needs of their child
- Supporting parents/carers to reflect on how their early attachment histories shape their parenting style and attachment communications
- New ways of understanding the difficulties traumatized children face in attachment relationships and building key therapeutic resources to cultivate trust and safety
- Working with both parents and children to create opportunities for attunement and override patterns of ‘blocked care’ through playfulness, curiosity and empathy
Eye Movement Desensitization and Reprocessing (EMDR) is a distinct therapeutic intervention or technique that uses what is called bilateral stimulation (BLS) in order to help process distressing memories related to traumatic experiences. When children and young people experience traumatic and negative events like abuse, bullying, violence at home, accidents or the sudden death of someone close to them, the brain creates special memory boxes or files that hold all those painful and distressing thoughts, feelings and body sensations connected to these events. Children who have experienced traumatic events can easily get stuck in defensive behavioural patterns, often reflected in heightened anger (fight reactions) or chronic avoidant behaviours (flight reactions). This is the body’s solution to a perceived threat or danger only it no longer exists.
Unless a child or young person has support in processing distressing and traumatic experiences, they remain vulnerable to being triggered by small everyday reminders that may evoke similar feelings, such as being ignored, a friend or classmate making fun of them or by parents/carers asking them to do their homework or saying ‘no’. EMDR helps the brain reorganise these painful memories so they no longer hold the power to trigger feelings of anger, sadness and confusion, or leave a child thinking and believing that something is wrong with them or they are not good enough.
EMDR is not a ‘magical’ cure but is considered to be a safe and effective therapy for children suffering from post-traumatic stress or who have a history of attachment difficulties. It can also be used alongside other creative therapies such as art therapy and play therapy depending on a child’s needs and age.
What to expect from EMDR:
- One of the many things that happen with EMDR is we move our eyes from one side to the other while thinking about a negative and distressing event
- Listening to special music or tapping hands/knees or moving from one foot to the other to help the brain file away hurt and painful feelings, thoughts and body sensations
- Doing some drawings or art and perhaps puppet work as well as other rhythmic body-based activities to help the brain defrost and process bad experiences
Equine assisted psychotherapy (EAP) is a powerful and effective experiential therapeutic approach that uses the dynamic nature of horses to address a variety of emotional difficulties in children, young people and adults. It allows children and teens to take an active role in their recovery and provides a profoundly enriching environment for healing to unfold. The focus of equine therapy is not on riding or horsemanship but takes place purely on the ground through various structured interactions between children and horses. This often involves activities such as grooming, feeding, haltering and leading a horse that is supervised by a fully qualified Equine Psychotherapist and a Horse Specialist. Such activities naturally strengthen the capacity for assertiveness and development of problem-solving skills as well as relationship building.
During interactions with the horse, the equine therapists will observe certain patterns of behaviour or enquires on thoughts and feelings that may be emerging during a session. Our proximal closeness and/or distance during these interactions shows how the body is mapping the parameters of safety or threat, which is often a reflection of our early attachment experiences. Horses display gentleness and tenderness and their implicit sensory sensitivities together with their natural capacity for attunement and mirroring the patterns of behaviour in those with whom they are working offers tentative opportunities for forging a healing connection.
While Equine Assisted Therapy is used for a wide range of emotional and physical difficulties, for children and young people with traumatised attachment histories who struggle to feel safe in connection with another, the parallel nature of these interactions seems to be naturally attuned to the developmental and emotional needs of the child or adult. Children and teens who have suffered physical/emotional abuse often need to engage in ‘parallel’ relational interactions before they feel safe and secure to enough to be open to more relationally based therapies. The nurturing structure and form of parallel communication occurring during interactional activities allow for moments of emotional connection that can be felt and experienced in new and different ways.
Horses are large and powerful animals inspiring both awe and potentially fear. Taking tentative steps towards approaching a horse or making gestures to invite proximity are often foundational moments to override fear and cultivate the beginnings of relational safety. Moments of interaction where a small task/activity is accomplished provide a new template for dealing with challenging life experiences.
What to expect from Equine Therapy:
- Working on the ground with either one or two horses with two highly experienced practitioners: one a specialist in equine therapy and the other a horse specialist
- Working at a child’s own pace and supporting them make their choices about how they wish to approach and interact with horses
- Participate in simple exercises where appropriate like putting a bridle and saddle on the horse to actively encourage confidence and promote bonding experiences
Family therapy (also known as family and systemic psychotherapy) is an approach that works with families and those in close relationship to support each other in the service of fostering change. This may be parents and children together and also include grandparents or others who are considered important within the family system. Family therapy helps family members share difficult thoughts and feelings in a therapeutic space in the hope of cultivating a shared understanding and appreciation of the differing needs and experience of others within the family system. Family therapy can be particularly helpful in supporting families when they feel emotionally overwhelmed, full of sadness or frustrated and angry. It can also help when families feel stuck in knowing what to do for the best or stuck in patterns of hurtful and harmful behaviours.
Family therapy views relationships as deeply resourcing and seeks to help people who care for each other find ways of coping with emotional distress in more collaborative and supportive ways. It is a particularly helpful relational approach across a broad spectrum of difficulties including; adults struggling with parenting; for children whose parents are suffering from a mental health problem, school-related difficulties, self-harming behaviours, stressful and traumatic life events such as divorce and separation, premature death of a parent or partner. It is a particularly helpful approach in working with looked after and adopted children and the complex difficulties such families often face.
What to expect from Family Therapy:
- Support in understanding how the family is relating and communicating
- Help in feeling safe enough to talk about difficult thoughts, feelings and patterns of behaviour as well as support in talking about the challenges the family may be facing
- Developing specific strategies and skills to work positively with the conflict between adults and children
- Understand patterns of communication within the family and developing skills that strengthen communication and cultivate listening
Mentalisation Based Treatment
Mentalisation-based treatment (MBT) is an integrative form of psychotherapy that combines elements of psychodynamic and systemic therapy with CBT. It was originally developed by Professor Peter Fonagy and Anthony Bateman for people suffering from Borderline Personality Disorder (BPD). The term mentalisation essentially refers to the ability to think about thinking; in other words, understanding what is in one’s own mind and that of another in terms of emotional intention and intentional action.
Mentalisation-based treatment for children (MBT-C) and adolescents (MBT-A) is now widely recognised as being effective for a wide range of emotional and behavioural problems, including anxiety, depression, self-harming behaviours as well as relational difficulties. The ability to mentalise develops in early attachment relationships through emotional interactions with primary caregivers. If a child grows up in an attachment environment that is chaotic and neglectful their capacity to mentalise may become impaired or severely disrupted particularly if the caregiver is emotionally unstable or suffering from significant mental health difficulties.
MBT-C helps to promote a child’s ability to make sense of their own mind and the minds of others around them. It is also a developmental intervention and involves close collaboration with parents. The fundamental aim is to enhance the skills of mentalisation in both the parent and the child. Supporting children develop the capacity to mentalise not only promotes resilience but also nurtures a more positive sense of self, healthy relationships and better emotional regulation. This approach is also very effective with adolescents (MBT-A), particularly those with self-harming difficulties and other low-impulse control problems.
What to expect from MBT for children and adolescents:
- To support parents/carers develop the ability to mentalise so they can hold their child’s mind in mind
- A focus on the present and what is happening now in relationships with family, friends and peers to help a child and adolescent make sense of what is happening in their own mind and in the mind of another
- Working with troubling and distressing emotions in the here and now
- A focus on certain situations or interactions that trigger intense emotions (not behaviour) to enhance the capacity for mentalisation and self-regulation
- Develop the ability for understanding action and thoughts from others as well as their own impact on others in a more realistic manner
Music has been used as a therapeutic tool in the service of healing for centuries. Rhythm is regulating; all cultures have some form of patterned, repetitive rhythmic activity as part of their healing and mourning rituals, which is partly why music is often regarded as one of the most powerful forms of communication. The engaging nature of music itself along with the diversity of musical forms makes music uniquely effective in helping people of all ages, whose lives have been affected by trauma, mental illness, physical injury or disability through supporting their psychological, emotional, cognitive, physical, communicative and social needs.
As an expressive and creative art therapy, music seeks to utilise tempo, rhythm and musical improvisation to enhance the emotional, psychological and physical well-being of individuals. Musical interactions also help in the exploration of deeper feelings where sound replaces words and rhythmic melody becomes the primary vehicle for communication. Music therapy is not about learning music or learning to use a specific musical instrument. It is more simply about using and exploring the different melodies of sound through musical interactions with various instruments and facilitating a musical conversation with the therapist in the service of healing.
Music involves patterned, repetitive rhythmic activation of the brainstem and can be seen as a brainstem modulating therapeutic intervention. This is particularly helpful when working with children and young people who have suffered from early impaired bonding experiences, attachment disruptions and loss. Musical interactions encourage connection and bonding between mother and baby, which is especially helpful for women suffering from postnatal depression. Music therapy is also a widely recognised as a specialist therapeutic intervention for young people suffering from brain injury or other neurological disabilities to assist in rehabilitation and improve quality of life.
What to expect from Music Therapy:
- Working at a pace that is naturally attuned and responsive to your particular emotional and physical needs
- The capacity to explore musical forms of communication that gently encourage self-expression
- Taking part in rhythmic body-based activities to modulate and regulate states of anxiety, enhance relaxation and encouraging creative play
- Playing with musical interactions and alterations in tempo and rhythm as a gentle way of challenging habitual patterns of communication
Non-violent Resistance Therapy
Non-Violent Resistance is a powerful and innovative form of systemic therapy, which has been developed specifically for working with children and young people with extremely challenging behavioural difficulties often involving aggression and violence as well as risky self-destructive behaviours. NVR is particularly effective in working with a child to parent violence, but it has also been adapted to work with children in foster care and residential settings as well as with adoptive families.
This approach originates in the non-violent political struggles led by Marin Luther King and Mahatma Gandhi. Unlike traditional forms of therapy, the success of NVR is not solely dependent on the participation or cooperation of a child or young person within the family. Parents or carers together with their dedicated supporter(s) are coached in ‘taking action’ to reinstate boundaries while raising positive parental presence through the use of various reconciliatory interventions or techniques. Raising parental presence works to strengthen fractured family attachments, reduce conflict and rebuild trust and safety within the family.
What to expect from NVR:
- Working to develop a range of de-escalatory skills to help prevent any symmetrical escalation occurring between parent and child to both manage and reduce conflict
- Developing the skills required to increase parental presence and help refocus attachment interaction away from persistent conflict
- Support in building a web of dedicated supporters once parents disclose the nature and extent of the problem with significant others
- Support and guidance on how to work towards making an NVR ‘announcement’ relating to unacceptable and intolerable behaviours as well as help in making gestures of reconciliation
Sensorimotor Psychotherapy is a body-oriented approach to working with trauma. This approach is fully grounded in contemporary neuroscience research and attachment theory, but also deeply informed by the philosophical and spiritual practices of Buddhism. It has evolved over the last three decades into a complex and elegant form of body psychotherapy that gently weaves kindness, compassion and embedded mindfulness into all its therapeutic interventions. As a ‘bottom-up’ approach, it helps us to think sequentially especially when working with early developmental trauma.
While many therapeutic interventions depend almost entirely on verbal narrative, Sensorimotor Psychotherapy utilises the wisdom of the body as a key therapeutic and self-regulatory resource. It offers a unique lens to explore the language of the body by focussing explicitly on the sensory landscape of body sensations and impulses, micro muscular patterns of tension, body movements, posture and gesture as well as facial expressions, gaze resting responses and respiratory rhythms. By prioritising the somatic narrative, it is possible to access the story the body holds by tracking and sequencing somatic states of arousal as well as working more directly with defensive patterns.
Sensorimotor Psychotherapy is a developmentally sensitive approach to working with children and young people who have histories of early impaired bonding and attachment disruptions or losses. Children who have suffered from early developmental trauma have compromised attachment capabilities and heightened relational sensitivities. This is reflected in defensive patterns of behaviour children with such histories exhibit as well as in their difficulties in tolerating and managing strong emotions. Children and young people are particularly vulnerable to being triggered by body-based physiological reminders of traumatic experience: sounds, smells, touch, body sensations and impulses as well as small shifts in posture, gesture and body movements. Sensorimotor Psychotherapy works directly with children’s disrupted capacity for regulation and disrupted attachment systems by helping them to develop physiological and somatic regulatory capacities. As a “bottom-up” approach, it recruits the wisdom of the body to support children and young people Regulate, Relate and Reason.
What to expect from Sensorimotor Psychotherapy:
- Helps children listen to the story of the body and helps them find words to describe this
- Helps a young person develop skills of sensing the internal world of body sensations, impulses, muscular patterns of tension, orienting patterns, movement urges and postural patterns
- Support children to direct attention to present-moment body-based experience; five-sense perceptions, sensory sensations, micro movement patterns etc, while being motivated by curiosity and playfulness
Video Interactive Guidance
Video interactive guidance is a respectful and non-judgmental intervention that aims to enhance communication within relationships between parents and children, teachers and pupils as well as between professionals to increase reflective practice. The key focus of VIG is to increase parental sensitivity and attunement to a child’s verbal and non-verbal communications. VIG is fundamentally a strength-based intervention that works in collaboration with parents to nurture the skills of communication that enrich and empower attachment relationships.
Parents are invited to think about what they would hope to change and focus on a specific goal. Brief moments of parent-child interaction are filmed and only successful moments are selected to celebrate what is going well. Those small celebratory moments that are captured during filming are shared in a video feedback review. The review also allows for opportunities to reflect more deeply on shared moments of success and to build a better understanding of their parenting role in relation to their children needs and how best to meet them. VIG interventions are also especially helpful in supporting infants and mothers to increase maternal sensitivity and promote bonding and attunement. VIG can also be integrated within broader therapeutic approaches such as parent-infant psychotherapy to support interactions of parents who have trauma histories.
What to expect from VIG:
- Greater understanding and new ways of thinking about parent-child communications
- Filming ten minutes of parent-child interaction using various activities, which is shared during a review to highlight what is working well
- Able to manage difficult and challenging behaviours more effectively
- Feel better about your relationship with your child
Often parents and those involved in caring for a child struggle to make sense of their difficulties and how best to support them. Many parents and carers often seek the support of friends, books or research on the internet to find parenting solutions. This may be helpful, but sometimes a consultation with a professional provides the space for you to share your worries, think about what may be happening and consider possible solutions.
Sharing concerns can make a huge difference in alleviating stress and improving relationships for the whole family. We can also offer additional consultations to help:
Parents to be or new parents:
- Adjusting to the birth of a baby and meeting the challenges of becoming a new parent.
- Developing practical and simple solutions and provide educational and supportive interactive tools.
Mindful Parenting solutions:
- Developing simple and practical positive parenting strategies with young children and teens.
- Therapeutic parenting skills and strategies for children with additional emotional needs.
We can best support a child by collaborating with the network of professionals that may be around them, including teachers, teaching assistants, early years staff, social workers and any other people providing care and support.