supporting young people through secondary school · aims •introduction of common pressures for...
TRANSCRIPT
Harriet Williams2019
Supporting Young People
through Secondary School
42nd StreetInclusive, accessible mental health
services for all
Shared Mission:
To support young people aged
11- 25 years with their emotional
well-being and mental health,
promoting choice and creativity
GREEN PAPER 2017/8
GOVERNMENT VISION:
All Schools will have a Mental Health Lead by 2025: member
of staff trained and responsible for school mental health approach:
Oversee support school provide pupils with mental health
Help staff spot early signs of mental health problems
Offer advice to staff about mental health
Refer pupils to specialist services where needed
Offer training to develop skills in leading mental health work
and support staff delivering whole school approaches
Link to NHS specialist services when signposting
Educational Mental Health Practitioners: will provide support
for low mood and anxiety in schools
3
Healthy Body = Healthy Mind
What the Mental Health Champions told us
last year
Top Issues raised in the consultation
1. Young people need to be listened to and involved
2. Teachers need training
3. There needs to be better range of quality food in schools
4. Students need specific support around specific issues e.g. exams, stress, trauma, self harm, tolerance
5. The school environment needs improving , e.g. a range of spaces, sensory rooms, games
6. Parents need support too
7. There needs to be an understanding of issues inside and outside of school
8. Schools need high quality specialist counsellors/student support
Keeping Schools Mentally Healthy
“Early intervention has saved lives”
Lisa Fathers Director of teaching school, Alliance for Learning
QUOTES FROM YOUNG
PEOPLE
A weight has been lifted
Talking about things helped me become more at ease
People around me do not understand how hard my
life is. Talking about things helps me make sense of it
Talking has taken the heat out of problems that I
have not wanted to face - it has made things easier
AIMS
• Introduction of common pressures for Young People and Parents/Carers during Secondary School
• Introduction of what is going on in a Teen’s brain
• Understanding impact stress has on emotional wellbeing, mental health and Brain
• Gain knowledge & resources to identify stress and low mood in Young People
• Introduction to positive strategies to support young people deal with stress
• Increase understanding and knowledge of parenting strategies to support young people through school
8
TRAINING AGREEMENT
Confidentiality
Respect for others and difference
Listening
Participation
Responsibility for self
Time boundaries
Mobile phones
PARENTING ADOLESCENTS
It is not easy!
More Isolating
Parent/Carer Life stage challenges
Evolutionary influences of the Teenage brain
Shift from Parent/ Carer focus to Peers
Disordered Transition
Average age of leaving home increasing
11
Adolescent Brain
Development
Cortex: abstract/ concrete thought/learning
Limbic: Emotional/ Drives/Attachment/Relationships
Brain stem: Reptilian Brain: Blood pressure/ Temp, Motor regulations/ Arousal: Fight/ Fight/Freeze/ Faint
Spinal cord: nervous system, motion, sensation
BRAIN
ADOLESCENT BRAIN
Second largest development growth of the brain (from pre-adolescence-25yrs)
Risk-Taking behaviour & Pushing away evolutionary response
Problems getting to sleep as Melatonin released in a teen’s brain later
Developing Small Prefrontal Cortex Weak pre-frontal cortex is seen in many MH problems
Blame my Brain: Nicola Morgan
WINDOW OF TOLERANCEDAN SIEGEL
WINDOW OF TOLERANCE
A.C.T
Acknowledge emotion
Communication boundary
Transfer/Target an alternative
Gary Landreth Parent Child Therapy
Dr. Dan SIEGEL
‘Whole Brain Child’ building the
staircase of the mind
Connect and redirect
Use it or Loose it
Name it to tame it
Engage don’t enrage
Move it to loose it
Mindsight
What is
Emotional
Wellbeing?
20
What is
Mental
Health?
21
We all have it!
It relates to how we think, feel, behave and interact with others
‘Child mental health is the strength and
capacity of children’s minds to grow and
develop with confidence and enjoyment. It
consists of the capacity to learn from
experience and to overcome difficulty and
adversity. It is about physical and emotional
wellbeing, the ability to live a full and creative
life and the flexibility to give and take in
friendships and relationships. Children who are
mentally healthy are not saints or models of
perfection, but ordinary children making the
most of their abilities and opportunities’YOUNG MINDS
23
Positive Mental Health
Mental Health disorders
Changing Behavioursshowing distress
Mental Health problems
MENTAL HEALTH CONTINUUM
MENTAL HEALTH
Mental health problems are one of main
causes of the burden of disease worldwide
In UK MH is the largest burden of disease
(28% of total burden)
1: 4 people will experience MH problems in a
given year
Mental health services overstretched/
inconsistent/ waiting lists /higher thresholds
Public spending focus on crisis driven
services not preventative workMental Health Foundations (Fundamental Facts)
24
YOUNG PEOPLE UNDER PRESSURE
PRESSUREIdentity/
Image
Body
Image
Pressure
Bullying
TOLERANCE
Banter or Bully
BANTER is having fun with friends
When someone is getting hurt or upset by
ongoing banter it starts becoming bullying
behaviour
Bullying behaviour is also when someone’s
physical trait or characteristic is picked on and
used as the butt of ongoing jokes
As well as Sexualised language which intimidates
or is inappropriate
Other friends may feel pressure to laugh and not
stop this
www.themix.orgwww.bullying.co.ukwww.childline.org.uk
How might all these pressures impact on a YP if they
don’t receive the right support? 31
32
BEHAVIOURAL CONCERNSHYPER-AROUSAL:
Anxious, clingy, fearful, tearful, panicky
Difficulties in Sleeping: Too much or too Little
Hyperactive, lack of concentration, focus and fidgety
Irritable, frustrated, argumentative
Disruptive, Aggressive behaviour: to others, objects or self
Inability to comprehend rules, boundaries, oppositional
Unable to be independent, needing constant reassurance
Risk taking behaviour
Self Harm, Eating issues, Drug and Alcohol, Crime
HYPO-AROUSAL:
Sad, hopelessness, low mood, depression
Withdrawn, Non-communicative, school non attendance
Difficulties in forming relationships with peers/ adults/isolated
Worthless, shame, lack of self esteem, loss of interest 33
MEANING BEHIND BEHAVIOUR
Young People ‘show’ us how they feel in their behaviour
CYP’s Emotional Literacy can be affected by lots of things:
Experiences in life, Our coping strategies, Relationships,
Loss, Special Needs etc
When a Young Person is in stress their BEHAVIOUR
SYSTEM becomes switched ‘on’ or ‘activated’
When they feel safe and in control it turns ‘off ’
34
HYPO-AROUSAL
HYPER-AROUSAL
REGULATION
CHALLENGES IDENTIFYING
CMH PROBLEMS Knowing what to look for
Presentation commonly hidden/not obvious
They may not want to talk to us?
May look like behavioural issue and Young Person
can feel blamed/ responsible
Multiple causes
May feel challenges at school/home are hard to face
Mental Health Stigma
How do we open up conversations?
37
A Royal Team Talk-Tackling Mental Health 2019
://youtu.be/Yn_shQZz5tw
A Royal Team Talk-Tackling Mental Health 2019
https://youtu.be/Yn_shQZz5tw
You’re their Emotional Coach
You’re a Coach
Modelling Emotional Literacy
Show we have feelings and can get it wrong
Repair/ Active Listening/ Empathy
Time to listen and hear their solutions
Don’t trivialise their feelings or reactions
Open Questions
Don’t bring it back to YOU
www.emotioncoachinguk.com39
https://youtu.be/7KJa32r07xk
https://youtu.be/7KJa32r07xk
THE MOST COMMON CYP
MENTAL HEALTH PROBLEMS
LOW MOOD/DEPRESSION (HYPO-
AROUSAL)
STRESS/ ANXIETY (HYPER-
AROUSAL)
STRESS
Stress is defined as a process that exists over
time
Stress response is necessary for survival
Stress & anxiety are normal features of life
and responsive to external and internal
threats
Perceived threats to safety trigger a set of
chemical and neurobiological events known
as the STRESS RESPONSE in the brain
Stress affects all aspects of ones functioning (Collins & Collins 2005)
FIGHT FLIGHT FREEZE FAINT
Stress Response
STRESS RESPONSE
When stress continues over time, escalates or
increases it can lead to debilitating outcomes
When a YP experiences multiple stresses their
body and mind can become overwhelmed
If continued these responses/behaviours can
become a regular mode of functioning…. Even
when the danger is NO longer there
Pat Crittenden: calls these behaviours a child’s
clever strategies of survival within challenges
Stress: When under
threat changes in body
& brain affect physical/
psychological being
Under threat:
Limbic System engages
Frontal lobes disengage
Safety returning:
Limbic chemical
reaction stops and the
frontal lobes re-engage
Bessel Van de Kolk 2005
PHYSIOLOGY INFORMATION
THOUGHTS
BEHAVIOUR
PHYSIOLOGY
EMOTIONS
Swatting or Stamping out the
NATS & ANTS
ANTS
NATS
NEGATIVE AUTOMATIC THOUGHTSIdentifying Patterns
ALL OR NOTHING THINKING
OVER GENERALISATION
NEGATIVE FILTER
JUMPING TO CONCLUSIONS
◦ Mind Reading
◦ Fortune Telling
◦ Predicting the worst
CATASTROPHISING
EMOTIONAL REASONING
SHOULD/ MUST’S AND OUGHTs
LABELLING AND MISLABELLING
PERSONALISING /BLAMING YOURSELF
PSYCHOEDUCATION
STRESS/ ANXIETY Anxiety is a normal
It is a reaction to any situation that is perceived by the individual to be threatening
Anxiety is a natural human response to danger following the hard wired human responses of:
FIGHT FLIGHT FREEZE FAINT
Anxiety is experienced physically, cognitively and with behavioural changes as a result of physiological changes that we experience in response to stress
Symptoms can be frightening, particularly if someone does not know that they are symptoms of anxiety
We can learn ways to fight stress and anxiety and good idea to practice even when you are feeling well as hard when you feel your stress is escalating
49
Support for Stress/Anxiety
50
How can we Help? BE there…..at any time!
Active Listening and don’t tell everyone
Let them talk and off-load and give space if needed
Support them in de-escalation skills,
Psycho-education
Support to regulate their feelings/ Distraction
‘Be a Thermostat not a thermometer’
Show them exceptions to the Rule
Empathise (imagine how it feels for them)
Don’t do it for them- help them find their Solutions
BE Consistent, Predictable and Nurturing 51
Low Mood
Hypo-arousal
Low-mood affects our Mind, Emotions, Body, Thoughts
Sadness and Unhappiness are normal emotions
Depression can only be diagnosed by a medical profession ie: GP, Psychiatrist
Depression is diagnosed when key symptoms persist over time significantly impacting on a person’s day to day functioning
Depression describes a continuum of moods
MILD MODERATE SEVERE
Struggle to focus or decline in academia
Withdrawal from family and friends
Lost interest in activities/ events or past enjoyment
Sleep problems
Appetite or weight changes
Feelings of guilt or feeling misunderstood
Clinging to a parent
Unexplained crying
Shyness, fears, unexplained physical somatised complaints,
anxiety
Self Esteem Issues
(DSM-V American Psychiatric Association 2013)
LOW MOOD/ DEPRESSION IN YP
Support for Depression
54
Support
Role
Active
Listening
KEY ADULT’S SUPPORT
STRATEGIES (Louise Bomber)
Providing commentaries (Nonverbal and verbal)
Create opportunities for the Young Person to try and
practice new things out
Communicate Empathy, Hope, Aspirations
Affirmations
Advocacy
Responding
Inclusion
Check-Ins
Transparency and Apologies for changes
Communication with young person and other
professionals and Carers/ Parents
PSYCHO-EDUCATION
BARNARDOS (Tony Newman)
Effective strategies for CYP
Strong social support networks.
The presence of a least one unconditionally supportive parent or parent substitute
A committed mentor or other person from outside the family
Positive school experiences
A sense of mastery and a belief and one’s own efforts can make a difference
Participation in a range of extra-curricular activities
The capacity to re-frame adversities so that the beneficial as well as the damaging effects are recognised
The ability – or opportunity – to ‘make a difference’ by helping others or through part-time work
Not to be excessively sheltered from challenging situations that provide opportunities to develop coping skills
THREE R’S REACHING THE LEARNING BRAINDr Bruce Perry, a pioneering neuroscientist in the field of trauma, has shown us that to help a vulnerable child to learn, think and reflect, we need to intervene in a simple sequence.
First: We must help the child to
regulate and calm their
fight/flight/freeze responses
Second: We must relate and connect with the child through an attuned and sensitive relationship
Third: We cansupport the child to reflect, learn, remember, articulate and become self-assured
SECURE BASE MODEL(Schofield and Beek 2009, 2014)
Promotes security and resilience.
Availability- helping the CYP to trust
Sensitivity- helping the CYP to manage
feelings and behavior
Acceptance- building the CYP’s self esteem
Co-operation- helping the CYP to feel
effective
Family membership- helping the CYP to
belong
5 WAYS TO
EMOTIONAL WELLBEING
5 WAYS TO WELL-BEINGBuilding on Resilience and Strengths
Connect ……….. Supporting young people to make
connections in school and community and seek support
Keep learning ….. Try something new, teaching varied
ways, build on a pride of learning new things to build young person’s confidence
Be Active …..Supporting activity homes/ schools
Notice ……… curiosity in the world around us, notice
the extraordinary the beautiful
Give ……Encourage the joy from giving: do something
nice for a friend, stranger, school.
63
www.neweconomics.org.uk
What can we Model & do?
RESPECT FOR ALL
TOLERANCE AND NON- JUDGMENTAL CULTURE
CELEBRATE DIFFERENCE & ACCEPT UNIQUENESS
UNDERSTAND THE MEANING BEHIND BEHAVIOURS
NOTICE AND HELP OUT WHEN YOU SPOT OTHERS BEING DISRESPECTED
THINK ABOUT WHAT YOU WOULD FEEL IF THIS WAS HAPPENING TO YOU
ADDRESS DISRESPECT WHEN WE SEE IT
SUPPORT FOR YOUR YP
If they need help……..
Talk to someone they trust (teacher/parents/carer/ coach etc)
Report any disrespectful behaviour to school
Don’t retaliate
Talk to a friend
Keep involved in things which make you feel good
Ask School for EMHP Support
Don’t join in with friends when you hear unkind banter
Support TOLERANCE and RESPECT in School
Set up a Campaign, Support, or Discussion Group
Get Involved in helping others affected
Become a MENTAL HEALTH CHAMPION
All Websites and Support is available in Pastoral
REMEMBER WE ALL HAVE TIMES WHEN WE ARE AFFECTED BY STRESS AND LOW MOOD AND SEEKING EARLY HELP…
HELPS!
NETWORK OF SUPPORT WEB
Handy Tips Be open to discuss concerns
Acknowledge their feelings with Empathy
Seek support/ advice/ resources when you need it
Quiet /private space to talk with YP
Be clear about the time you have available
Listen calmly & actively and ask open questions
Respect and take seriously what YP tells you
Be clear about what you can and can’t do
Recognise your own limitations and seek help where needed
Look up support they can use on web
Ask school for support where appropriate
Get support for yourself!
How can you be a support if you are depleted
67
MINDFULNESS
DAN SIEGEL
CALMING TOOLS
BREATHING & RELAXATION
TECHNIQUES
Square Breathing
Controlled Breathing
Visualisation
Muscle Relaxation
Belly Breathing
Body Scanning
Mindfulness eating, walking, brushing teeth..
Drawing circles, drawing with water/ colour
Mindfulness Colouring
ATTENTION: Strengthens "mental muscle" for bringing focus back where we want it, when we want itEMOTIONAL REGULATION: Observing emotions helps us recognize their transience, see when they occur and how to respond ADAPTABILITY: Becoming aware of our patterns enables us to gradually change habitual behaviors wiselyCOMPASSION: Awareness of our own thoughts, emotions, and senses develops understanding of other’s experiencesCALMING: Breathing and mindfulness practices relax the body & mind, giving access to peace independent of external circumstancesRESILIENCE: Seeing things objectively reduces the amount of narrative we add to the world's natural ups and downs, giving us greater balance www.mindfulschools.org
BENEFITS TO MINDFULNESS PRACTICE
THANK YOU
