Many young people have to wait too long for support with their mental health. NHS projections suggest that only around one in three children and young people with a diagnosable mental health condition will receive NHS care or treatment by 2020/21.
Young Minds says that 75% of young people who seek support become more unwell while waiting for help. For some, private therapy can help bridge this gap.
Alice is 15. Her Mum referred her to therapy after she started to have panic attacks before school. Richard is 16. He went to his GP after admitting to his girlfriend how low he felt. He was put on a waiting list for a CAHMS assessment. Someone in an online forum suggested private therapy while he waited.
Alice and Richard agreed on some of they key things we, as therapists, can do to help them get the most out of therapy.
“Help us understand what will happen in therapy”
Richard told me that he had no idea what to expect. He wanted help to feel better but he didn’t know what that would look like.
“To be honest, I didn’t really see how talking to a stranger about it would help…I spoke to someone on the phone and I didn’t know what to say. But they told me to look at the website where there were stories and info from other people about how it helped them. That made me feel a bit more hopeful”.
Reading other people’s experiences and understanding more about what the first session will be like can help young people feel more prepared. This is especially important if they’ve had a bad experience in the past.
“Help us find the right therapist for us”
Alice told me that she’d “given up on counselling, it didn’t work for me”. It wasn’t until she spoke to her Mum that she realised a different therapist might lead to a more positive experience.
“The next person I went to see felt completely different. I felt a lot more comfortable” she said “I wish that first woman in school had explained that it was ok if you didn’t get on with their sessions. I felt bad about not going back and thought it was just that it didn’t work for me”.
“Help us (and our parents) understand confidentiality”
Alice also told me that she wished her therapist had explained more about her right to confidentiality. “Mum was paying so she wanted to know what we talked about. She’d ask me in the car on the way home. I felt guilty that I didn’t want to tell her”, Alice said. “It made the whole thing more stressful. I wish my therapist had explained to Mum that I didn’t have to tell her things”.
Samantha Marks (a child and adolescent psychotherapist) agrees that the relationship with paying parents can add a level of complexity – “if they are paying, they usually want something in return”. She will often talk to the parents first to explain the importance of that confidential relationship.
Depending on age and risk she sometimes meets with the parents, but to offer feedback rather than detail on the content of the sessions. She makes sure the child she is working with feels in control of this meeting by getting their thoughts on what she’s going to say first.
“Help us find ways to make therapy work for us”
Richard is used to instant communication. “I wanted to text my therapist between sessions when things came up”, he told me. “I wanted that more frequent contact”. In the end, his therapist suggested that he wrote things down in his phone, as if he was sending a message, and then they discussed them together at their sessions. “She also helped me work out techniques to use in the week myself when things got hard”.
Alice and Richard are not alone. Many young people are too intimidated to speak to a therapist or potential therapist about their concerns. They turn to online spaces like The Mix. But online support can only go so far.
We, as therapists, can do more. We can use our own websites and profiles as a starting point. Could we share (suitably confidential) examples of how therapy has helped other young people? How about a friendly video introduction explaining what the first session will look like and some simple FAQs about confidentiality.
And let’s stay curious and keep asking questions too. By giving young people the confidence and space to share their ideas we can create a service that meets their needs from the outset.
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