Practical support for identifying and meeting need

Low mood and loss of interest

  • Low mood may present as sadness, anxiety and worry or, conversely, anger and frustration.

  • Low mood may be apparent for a number of days or even weeks and, without intervention, may result in depression.

  • For children, having an emotionally available adult who can listen and help in providing supportive resources is key to recovery.

Resources

Get Self Help

Get Self Help > provide a range of self-help worksheets and information with a Cognitive Behaviour Focus:

The following worksheets might be helpful in working with children demonstrating low mood:

Centre for Clinical Interventions

The Centre for Clinical Interventions > provides worksheets and information about a range of mental health problems, including depression, and offer techniques with a cognitive behaviours focus.

The following worksheets might be helpful where there are symptoms of depression:

Action for Happiness

Action for Happiness > is committed to building a happier and more compassionate society, where people care for themselves and others. They provide ideas on generating positive thoughts and happiness across a number of mediums.

Mentally Healthy Schools

Mentally Healthy Schools > is run by the Anna Freud Centre and offers a range of advice, information and practical resources to support children’s mental health and wellbeing.

The following worksheet might be helpful in terms of low mood:

MindEd

MindEd > is an online learning resource for professionals and parents and provides information to promote understanding of and strategies to manage mental health concerns in children.

The following course might be useful for understanding those feeling lonely, sad and isolated but not clinically depressed:

Parent Info

Parent Info > is a collaboration between Parent Zone and NCA-CEOP and provides advice for families within the context of today’s digital world.

The following resource may be particularly helpful for parents/carers in terms of understanding low mood in their children:

Children’s Society

Children’s Society > provide information which is accessible to young people to help them understand mental health concerns.

The following resource may be helpful in terms of low mood:

Self-harm

  • Self-harm is often a direct result of unbearable feelings.

  • Although it can be difficult to comprehend, self-harm can be an attempt to cope with extreme emotional distress and intrusive thoughts, a means by which an individual can gain some manner of control and/or a cry for help.

  • No matter how shocking an injury may appear, it is important for those supporting children to stay calm, employ active listening skills and ensure that appropriate support is put in place for the underlying emotional needs.

Resources

The University of Oxford

The University of Oxford have worked with key partners to produce this booklet for parents and carers but there are useful resources and strategies which can also be used by professionals:

Calm Harm

Calm Harm > have produced an app which helps individuals to manage the urge to self-harm:

distrACT

The distrACT app > has been produced by doctors and clinical experts to give advice and information about self-harm and suicidal thoughts:

Stem4

Stem4 > support teenage mental health and have a range of information and advice for schools, parents/carers and young people on the website:

Mind

Mind > have a section on their website which provides advice, information and guidance in relation to self-harm:

National Self Harm Network

The National Self Harm Network > have produced information about distraction techniques:

Mental Health Foundation

The Mental Health Foundation > have produced a downloadable booklet providing information and advice about self-harm:

Harmless

Harmless > provide support for people who self-harm and advice for professionals working with young people.

Disordered eating

  • Disordered eating describes an eating pattern which impacts negatively on an individual’s life. While it might not have reached the point of becoming a clinically diagnosable eating disorder, it still has the potential to be harmful.

  • Disordered eating and eating disorders are commonly linked to negative body image, low self-esteem, self-criticism and emotional distress.

  • Young people might start saying they are ‘fat,’ become secretive about their eating, avoid activities which include food, wear ill-fitting clothes, make frequent trips to the toilet and/or exhibit changes in weight.

  • Taking time to listen empathetically without judging is important as a precursor to ensuring appropriate interventions are in place.

Resources

Centre for Clinical Interventions

The Centre for Clinical Interventions > have produced an information sheet about some of the more common eating disorders:

Stem4

Stem4 > support teenage mental health and have a range of information and advice for schools, parents/carers and young people on this website:

Mentally Healthy Schools

Mentally Healthy Schools > is run by the Anna Freud Centre and has information about eating problems and eating disorders:

Young Minds

Young Minds > is a charity which supports young people’s mental health. It provides a range of information about eating problems and eating disorders as well as considering body image alongside mental health problems and strategies to promote body positivity:

BEAT

BEAT > are an eating disorders charity and have produced a downloadable booklet for family and friends which is also a useful resource for professionals:

Anxiety and tearfulness

  • Anxiety is usually underpinned by worry or fear, possibly related to the experience of trauma.

  • It might present as irritability, negative thinking, low confidence, deficient concentration, avoidant behaviours and/or angry outbursts.

  • The support of an emotionally available adult to help explore anxieties, identify coping strategies and build resilience can prevent anxiety becoming a clinical need which requires specialist support.

Resources

Psychology Tools

Psychology Tools provides evidenced based tools for use by professionals working with mental health and social care as well as a range of self-help resources. The following might be useful:

Get Self Help

Get Self Help > provide a range of self-help worksheets and information with a cognitive behaviour focus:

The following worksheet might be helpful in working with children who have a tendency to worry:

Child Line Calm Zone

Child Line Calm Zone > has a wealth of activities for reducing anxiety and promoting a calm mindset.

NHS Inform

NHS Inform > has a useful self-help guide for anxiety.

Recommended reading

  • Helping Your Child with Fears and Worries – Cathy Cresswell and Lucy Willetts
  • Starving the Anxiety Gremlin – Kate Collins-Donnelly
  • Think Good Feel Good – Paul Stallard

Social withdrawal

  • Social withdrawal can result from low mood and depression or as a result of anxiety.

  • It is therefore important to notice signs of social withdrawal and use a trusted relationship to explore a child’s thoughts and feelings.

Resources

Therapist Aid

Therapist Aid > have produced a self-help worksheet to promote social engagement:

NHS Inform

NHS Inform > have produced a self-help guide to manage social anxiety:

Poor hygiene

  • Although some children and young people may be somewhat indifferent to personal hygiene, it is also important to recognise that it might be a sign of neglect.

  • Deterioration in personal hygiene, particularly in young people may also be a sign of low mood and depression.

Resources

Therapist Aid

Therapist Aid > have produced some self-care tips:

Problematic sleep

  • Problematic sleep can be a vicious cycle. For an individual experiencing poor mental health, sleep may be harder to achieve. Poor sleep then impacts on mental health.

  • Achieving a good sleep routine and identifying any underlying worries, which an individual can be supported with, is therefore crucial.

  • It is important to be vigilant to signs of ongoing tiredness in children and young people.

Resources

The Sleep Charity

The Sleep Charity > provides support with sleep issues. They have a wealth of information on children and teenager’s sleep, including specifically on children with SEND:

Teen Sleep Hub

The Teen Sleep Hub > provides young people with tips and a downloadable resource they can use to help improve their sleep:

NHS

The NHS website > has some useful tips to promote a good night’s sleep:

Chilypep

Chilypep > works to promote the voice of children and young people. They have produced a Sleep Toolkit:

Cerebra

Cerebra > supports children, and families of children with brain injuries. They have produced some sleep resources:

Action for Happiness

Action for Happiness > have produced a sleep poster aimed at children:

Unravel

Unravel > are a team of psychologists who provide support for children and young people. Their free downloadable sleep guide can be accessed here:

Attachment, trauma and relationship needs

  • The majority of children will have benefited from a secure attachment experience as an infant, characterised by a consistent nurturing, attuned and responsive relationship with their caregiver(s). Unfortunately, the early attachment experience of some infants is characterised by neglect, inconsistent nurture, fear and/or trauma. An insecure attachment experience can have lifelong implications, both physiologically and mentally, and affects the ability to regulate behaviour and form positive relationships with others.

  • A child with a history of trauma may present with a variety of behaviours from withdrawn, anxious and low in confidence to acting out with aggressive and challenging behaviours. As young people, they may exhibit self-harm, problematic eating, and risky, anti-social behaviours.

  • Providing trauma informed interventions coupled with key relational skills can help to repair the early attachment experience and impact of trauma on the brain, and support a child in developing healthy relationships.

Resources

Babcock LDP

Babcock LDP > support inclusion and engagement of children at risk of exclusion, and provide guidance on relational learning:

Beacon House

Beacon House > provide free resources to support the repair of trauma and adversity:

Trauma Informed PBS

Trauma Informed PBS > offer free subscription to a trauma informed toolkit which provides a variety of strategies to employ with children:

The National Child Traumatic Stress Network

Anna Freud National Centre for Children and Families

Anna Freud National Centre for Children and Families > provides an early years resource which explores attachment and relationships:

Young Minds

Young Minds > have worked with partners to provide a resource which explores the impact of trauma and adversity, and considers what trauma informed practice looks like:

The Children’s Society

The Children’s Society > have produced a FREE guide for parents, carers and professionals which examines trauma and young people which can be downloaded here:

Brave Heart Education

Brave Heart Education > have produced a free downloadable book which examines trauma and attachment issues in educational settings:

Hidden Treasure Therapy

Hidden Treasure Therapy > provide free downloadable resources which support the understanding of attachment:

Australian Childhood Foundation

The Australian Childhood Foundation > have produced a guide to trauma informed practice in schools:

  • Safe & Secure: a trauma informed practice guide for understanding and responding to children and young people affected by family violence

Recommended reading

Trauma Informed Schools UK > provide trauma informed and mentally healthy training for education and a range of organisations.

Overactive, restless, fidgety

  • Although children may be overactive and have difficulty concentrating for a range of reasons, these behaviours might also be an indicator of Attention Deficit Hyperactive Disorder (ADHD).

  • Children with ADHD may have a short attention span, have difficulty in executing instructions and sticking to task, be constantly fidgeting and moving around, act without thinking and have little sense of danger.

  • It is quite common for other conditions e.g. anxiety to co-exist with ADHD.

  • A conversation with the school SENDCo would be most appropriate to establish strategies which will help children to manage this condition.

Resources

ADHD Foundation

The ADHD Foundation > provide a wealth of resources to support children, parents and carers, and schools.

Hypervigilance

  • Hypervigilance presents in children as an increased sense of alertness and sensitivity to their surroundings. This may mean they have jumpy reflexes, overact to loud noises and can be prone to flight behaviours.

  • Hypervigilance can be a characteristic of ADHD but can also be a result of trauma and abuse. In either case, specialist support may be indicated.

Resources

Inner World Work

Inner World Work > provide a range of free resources.

School absence / refusal

  • Absence from school may occur for a variety of reasons but for some children, this may be emotionally underpinned by high levels of anxiety.

  • Overcoming this type of anxiety is likely to require a multi-agency approach as a child may engage in a range of avoidant strategies e.g. not getting dressed, provoking arguments in the family home, complaining about feeling ill (psychosomatic complaints).

Resources

Derbyshire County Council

Derbyshire County Council produced a guide for schools on Emotionally Based School Refusal >.

Hands on Scotland

Hands On Scotland > has a resource sheet for professionals:

Angry / violent outbursts

  • Anger in children can be an outward manifestation of internal emotional distress which may be compounded by a child’s inability to articulate their thoughts and feelings.

  • While unacceptable behaviours cannot be condoned, it is important to engage in relational practice to build a trusting relationship within which a child may find the means to explore their feelings and develop an understanding of the source of their anger.

  • Once this has been reached, a child may be open to strategies to effectively manage and reduce anger.

Resources

Young Minds

Young Minds > provide a resource for young people to help understand and manage anger:

NHS Inform

NHS Inform > provides a self-help guide with worksheets which can be downloaded here:

Get Self Help

Get Self Help > provide CBT orientated suggestions on managing anger:

Centre for Clinical Interventions

The Centre for Clinical Interventions > provides an information sheet which considers ‘normal’ and problematic anger:

Therapist Aid

Therapist Aid > provide a worksheet which might be helpful when working with children to understand their anger:

National Youth Agency

The National Youth Agency > provides a booklet for young people with numerous worksheets:

Mylemarks

Mylemarks > have an anger worksheet for children which is available here:

Peer difficulties

  • Difficulties with peer relationships are common among children and where bullying takes place, the school’s anti-bullying policy should be followed and appropriate support put in place to mitigate any impact on mental health.

  • It is also important to be cognisant that difficulties with peers may be indicative of emotional distress and/or adversity.

  • Children who start withdrawing from peers may be struggling with anxiety and low self-esteem, and may be experiencing other familial and/or social difficulties.

  • Where young people particularly change friendships and potentially socialise with older people, this can in some instances be indicative of child sexual and/or criminal exploitation. It is therefore important to take notice of friendship groupings and be mindful of children’s presentation when these change.

Resources

Young Minds

Young Minds > is a charity which supports young people’s mental health. They have booklets for young people which explore problems in school and help those who are experiencing bullying:

Kidscape

Kidscape > run an advice and support line for parents/carers who are worried about their children being bullied:

Childline

Childline > provide tips for children who are low in confidence and have difficulty in making friends:

Rise Above

Rise Above > have produced a Powerpoint on positive relationships:

Substance misuse, risk taking and anti-social behaviours

  • Evidence shows that the greater number of adverse childhood experiences a child has, the greater the risk of a range of risk taking, challenging and anti-social behaviours including alcohol and substance misuse.

  • One of the protective factors for children is access to an emotionally available adult.

Resources

Young Minds

Young Minds > have partnered with Addaction to produce a detailed briefing around childhood adversity, substance misuse and young people’s mental health:

FRANK

FRANK > provides information on substances for young people as well as tips for keeping safe and confidential contact numbers.

Drinkaware

Drinkaware > provide information about alcohol, health and wellbeing.

Change Grow Live

Change Grow Live > provide information about substances and alcohol for young people under the age of 21:

The Mix

The Mix > provides advice and information for young people under the age of 25.

Therapist Aid

Therapist Aid > have produced worksheets which may be helpful:

Children 1st

Children 1st > have produced advice and information for families in tackling risk taking behaviour in young people which is also helpful for professionals:

Safe4Me

Safe4Me > provide information on educating and nurturing children to help mitigate the risk of them becoming involved in anti-social behaviour:

Divorce/separation

  • Children vary in how they cope with family break-up; this often depends on how well the separation was explained to them, ongoing support from parents and extended family and/or age of the child.

  • However, for some children family break-up is very stressful and it may have an impact on their mental health.

  • This could present in a variety of ways including being withdrawn, appearing anxious and low in mood to acting out and displaying challenging behaviours.

  • It is important to support children experiencing family break-up through consistent, strong relational practice.

Resources

Gingerbread

Gingerbread > provide advice for parents on how to support their children when there is a separation:

Young Minds

Young Minds > have published information and advice for parents on supporting their child through family break-up. This may also be useful for professionals:

Therapist Aid

Therapist Aid > have produced a worksheet which may be helpful in this regard:

Loss and bereavement

  • Children are likely to experience a number of losses as they grow up. Some are unfortunate in that one of these losses might be the death of a loved one. In the first instance, the support of an emotionally available adult is crucial.

  • It is important to remember that with support, the majority of children will undergo normal feelings relating to grief and will recover.

  • For those children where long term changes in behaviour and presentation are observed, this might indicate a need for specialist support.

Resources

Rotherham Educational Psychology Service

Rotherham Educational Psychology Service > provides critical incident support when a school setting is directly impacted by a bereavement and have also produced an online resource which can be accessed at:

Cruse Bereavement Care

Cruse Bereavement Care > provide resources for children, parents/carers and professionals:

Hope Again

Hope Again > is the youth version of Cruse and provides support for young people.

Winston’s Wish

Winston’s Wish > provide bereavement support to children and young people as well as a number of purchasable resources for children, parents/carers and professionals:

Childline

Childline > provides advice and support for children on coping with bereavement:

Child Bereavement UK

Child Bereavement UK > provides support for children and parents/carers as well as training for professionals.

Grief Encounter

Grief Encounter > provides support for children and young people who have been bereaved including a helpline.

Papyrus

Papyrus > is an organisation which works to prevent suicide in young people, offers support and also advice for professionals.

Listening Ear

Listening Ear > provide a counselling service for ages 11+

Rotherham Hospice – Sunbeams

Rotherham Hospice provides a bereavement service for young people called Sunbeams > and they are great if you give them a ring and ask about referring a child for support. They will also support the parent to support the child.

Hope Support

Hope Support > is available to anybody aged 11–25 when a close family member is diagnosed with a life-threatening illness, such as cancer.

riprap

Riprap > is a website designed specifically for young people who have a parent with cancer.

Centre for Clinical Interventions

The Centre for Clinical Interventions > has produced an information sheet:

Nurture UK

Nurture UK > have produced a guide to supporting children and young people through grief and loss:

Unravel

Unravel > provide a practical guide to supporting children with bereavement:

NHS Inform

NHS Inform > has a self-help guide for bereavement:

UK Trauma Council

UK Trauma Council > have produced evidence based resources to support schools working with traumatically bereaved children. There are also resources for parents/carers and young people:

Transitions

  • For some children, the transition between different educational stages and settings can provoke anxiety and worry.

  • Most children will settle quickly following a positive transition experience and the support of emotionally available adults.

Resources

With Me in Mind

With Me in Mind > have produced a transition guide:

Young Minds

Young Minds > have tips, advice and resources for parents/carers and professionals:

Sexuality and gender identity

  • Children who identify as LGBTQ+ often experience problematic mental health for example, low mood, depression, anxiety.

  • Although sexual orientation and gender reassignment are protected characteristics under the Equality Act 2010, the LGBTQ+ community are often subject to prejudice and discrimination which may arise out of ignorance and a lack of understanding.

  • This may increase the anxiety attached to ‘coming out’ and integrating a positive sense of sexuality and gender identity into personal wellbeing.

Resources

The Proud Trust

The Proud Trust > supports LGBTQ+ young people and provides resources and guides, including for professionals:

Say It

Say It > supports LGBTQ+ young people as well as a guide to support Transgender students in school.

Mind Out

Mind Out > is an LGBTQ+ mental health service which provides advice and information.

Mermaids

Mermaids > specifically supports transgender children and young people but also has resources for parents and professionals.

Gender Identity Development Service

The Gender Identity Development Service > provides advice and information for young people who are questioning their gender.

Allsorts Youth Project

The Allsorts Youth Project > provides information for young people who are questioning their identity and coming out: