Practical support for identifying and meeting need

Early support and intervention

If we identify SEMH needs and intervene at an early stage with protective factors, we can prevent difficulties from escalating and hopefully carrying on into later life.

Key to this is engaging with children and young people and working in partnership with parents and carers.

[hyperlink to Genuine Partnerships 4 Cornerstones doc]

Engaging with children and young people

Identify a key adult who can spend time daily with the child or young person building a trusting relationship using warm, friendly, playful approaches. Be curious and get to know the child’s interests, preferences and personality.

PACE is an approach developed by Dr Dan Hughes during his work with traumatised children. PACE stands for Playfulness, Acceptance, Curiosity and Empathy. These principles help to promote the experience of safety and trust in interactions with young people.

Everyday adult language is not the natural language of emotions and feelings for children. Their natural language is that of image and metaphor as evidenced in play, stories and make-believe.

If we want to reach out to children and young people and motivate them to speak freely we are far more likely to be successful if we do it through ‘their’ language using play, art, puppets and other visual and creative approaches.

Margot Sunderland, 2015, Conversations That Matter: Talking with children and teenagers in ways that help

Working in partnership with parents and carers

When children and young people are experiencing mental health needs it can be distressing for parents and carers. There can be a number of responses including:

  • Feeling blamed by others: ‘Is it me, is it my parenting?’ ‘Should I have noticed and done or said something sooner?’
  • Internalising blame: ‘He gets that from me.’
  • Struggling with unexpected trauma as a family: ‘As a whole family we are struggling.’
  • Thinking there is something ‘wrong’ with the child: ‘They’ve always been different.’

Parents and carers can feel in a cycle of negative feedback about behaviours. Try to empathise with the child or young person and parents and carers and focus on the emotions and needs behind the behaviours and any small successes.

Sometimes discussions with parents and carers can reveal difficult circumstances at home such as domestic violence, bereavement, etc. Be prepared to signpost parents and carers to appropriate support agencies and accept that it’s okay to ‘not know at the time’ but then find and pass information on later.

(link to section on partnership working and Genuine Partnerships / Rotherham Charter)

RED FLAGS – when to seek specialist help

For some children and young people, a rapid response is needed that bypasses the process of graduated response and these include:

  • Significant self-harm
  • Immediate risk to self or others
  • Suicidal ideation
  • In the context of a suspected eating disorder, rapid weight loss, significant calorie restriction (less than 500kcal daily) and also physical symptoms such as dizziness, fainting, chest pain, or similar extreme physical symptoms.
  • CAMHS Getting Advice team – 01709 304808

    for any urgent concerns

  • Out of hours Rotherham Crisis Team – 0800 652 9571

    Out of Hours is after 5pm and at weekends – for a mental health crisis access support

Top tips for supporting children and young people with SEMH needs:

  • Provide supervision and peer support for the key adults who are supporting the child or young person
  • Think about how adults, the environment, curriculum and routines can promote calmness and safety.
  • Identify an emotionally available adult who can spend time building a supportive relationship so that they get to know and understand the child/young person, their context and influences.
  • Ensure that this adult also seeks to engage and communicate regularly with family, developing and maintaining close home-school links.
  • See links > section to Trauma Informed Schools UK
  • Identify and build on the child or young person’s strengths and interests so that they can have enjoyment and experience success.
  • Provide activities across the day which help to regulate emotions. It is helpful if these are repetitive, rhythmic and rewarding for the child or young person. See links > section for ‘Brainstem Calmers’
  • Use Emotion Coaching approaches which focus on the emotional needs lying behind the behaviour
  • See links >
  • Promote ‘agency’ with the voice of the child or young person central to plans and interventions. Person-centred planning can help others to understand a young person’s dream and help build practical steps towards it.
  • See links >
  • Specifically teach social and emotional skills 1:1 or within small social skills groups and via group Circle Time sessions
  • See links >
  • Nature can be naturally calming for children and young people. Spending time in green space or bringing nature into everyday life can benefit mental and physical wellbeing.
  • See links > to Mind website
  • Beginnings and endings are important. Meet and greet each child and young person warmly and say positive goodbyes which ‘look forward’ to meeting again.
  • Ensure that big transitions are managed carefully to avoid, for example, feelings of possible further rejection

When a flower doesn’t bloom, you fix the environment in which it grows, not the flower.

Alexander Den Heijer