Teachers who are lucky enough to have found the time to become “attachment/trauma aware” will know the incredible power of relationships on children with attachment and trauma issues.
(If you do want to read up on this area please see Betsy De Thierry, Margot Sutherland, Dr Tina Rae or the fantastic book on attachment I am going to discuss here in this article!)
Having read Louise M Bomber’s “Inside I’m hurting” book on attachment I found myself strongly drawn to the chapter on the key adult and attachment, feeling it held a mirror up to much of the work I had been doing in the last 18 months. The role of the key adult is hugely underestimated in terms of the emotional capital that needs to be invested and therefore not every teacher within a setting may be suitable for this type of role. But for those who are the role has immeasurable rewards. The difference that can be made to a child’s life through time and attunement to a child’s needs is unlimited and goes far beyond their time in school. It is a damning indictment of education that so much difference can be made to a child by lending a non-judgmental ear, yet so little of this is built into the timetables, training and prioritisation for teachers to be able to effectively do. The children I have made the most difference with have been the ones I have listened to. To be heard is incredibly powerful for a child.
Children who seek attachments (not attention!) with adults do so in a number of ways and through a number of behaviours. Where this relationship is nourished and reciprocated, it can have a fantastic effect on the child’s wellbeing, happiness and consequently behaviour. Children who seek attachments will take it to get their needs met if it is not given freely. They will demand the time of staff through behaviours that challenge and cause harm to all involved. Giving your time ahead of this can create an environment where a child does not need to act in a way that causes challenges for staff and eventual shame and guilt for the child.
A key adult is someone who as Rita Pierson (see here) said is a “champion” for a child. They provide them with a “secure base” within school, someone who can help to regulate their emotions and build a trusting relationship with. Someone who can model the role of a trusting adult to a child to enable them to understand how to form and maintain trusting relationships with others. This person will work closely with the child and be available to the child on a day to day basis. They will need to be reliable, consistent and warm. They will need to able to assert boundaries but forgive, to challenge but nurture. They will be an advocate for the child and encourage staff to take a view through the eyes of the young person. Children with attachment problems benefit from seeing someone showing protection – the key adult will need to be willing to take steps to negotiate with other members of staff how to better support the child when necessary. An adult who listens and respects a child, empathises with their situation and believes in their abilities has the chance to incredibly alter the future of that child for the better. Furthermore scientific evidence shows that another significant adult to that of the parent is “good enough” to help a child develop new and more helpful ways of thinking, behaving and building relationships. The role of the key adult therefore has proven implications for the bettering of outcomes for students.
“No man is an island” and this belief should be considered when working with all children. Supportive relationships often get dismissed or eyed with suspicion but we know that humans rely on each other for support and need to feel belonging and value to be able to feel ready to learn (Maslow). The key adult may be the only person within a child’s life they truly connect with. A student once said to me that it is possible when working with children that a teacher may be “the only positive conversation they have all day”. As adults we have significant power to cut negativity from our lives. Children do not have this same ability. They have to attend school, they have to go home. We can’t always remove negativity but we can do a lot to introduce positivity. The relationship with the key adult can serve to do this.
A child working with a key adult can show behaviours that are incredible challenging, illogical and hurtful at times. They will push the adult away one day and demand copious amounts of time another. A successful key adult will know that this is not personal. They will maintain the same calm and consistent approach, whilst maintaining respectful boundaries. They will encourage a child to reflect on what has happened but not do so in a way that induces shame. They will help a child to learn to apologise when it is appropriate. They will help a child to learn to how to ask for help, an amazingly difficult and scary prospect for a traumatised child. A key adult will model what a child should expect from other human beings, and show how to respond productively when this expectation is not met. It should be noted that because the key adult needs to model responsible behaviours, they should be prepared to apologise when necessary. Sometimes things can go wrong, bad judgements can be made and we need to be human enough to hold our hands up and admit when something hasn’t gone right.
A key adult should plan ahead, knowing that absence or time out of school will have a negative effect on their key child. The mind of the child can race and wonder what has happened to that member of staff and possibly blame themselves. There can also be resentment to the adult when they return if the leave has not been handled correctly. I have personally had first-hand experience of the challenges of returning to school without giving the appropriate notice to a key child – it led to at least a fortnight of lost time as the child sought to show independence and rejected support despite challenges. This was understandable as I had shown myself to be unreliable despite best intentions. An apology went a long way to resolving this (despite the child insisting it wasn’t a problem). From that point onwards I gave notice of planned absence and if there was any unplanned absence I made sure the student knew the circumstances (e.g. illness) so that the child did not let their mind run wild with possible reasons for my not being there. Where I was out of school on training for a few days at a time I would call in to school at a set time to check in with key students, reinforcing the idea that I could be trusted and relied upon.
Skills and attributes of a key adult
In terms of skills and key qualities a key adult should have a sense of humour it is vital. The key adult should also be well aware (and take good care) of their wellbeing as it is a strenuous (but highly rewarding) role to hold. The ability to listen non-judgementally and actively is also key. It goes without saying other key skills important to the role are empathy and calmness. When forming these relationships the adult must be aware of his or her term within the school – a short term placement in a school will not be helpful to the child, so forming this type of supportive relationship is discouraged.
Not every teacher will want to open themselves to this experience, for some the passion comes for teaching of their subject. But if you really want to make a difference to the whole life of a vulnerable child, I don’t believe there is any more effective way than becoming a key adult in their life.
For more information about the role of the key adult please read “Inside I’m hurting” by Louise M Bomber, available online.
In December 2017 the Green Paper regarding young people’s Mental Health was released by the government with positive and forward thinking ideas for improving mental health. A designated lead was identified as being required within schools as well as mental health support teams working more closely with schools. Whilst it is definitely a step in the right direction, it is also clear there is a gap for a local, informed approach to training, supervising and maintaining these roles.
As schools move to increasingly budget constricted academic focused agenda, attitudes to pastoral work within school follows a similar pattern. Heads of Year become Progress Leader and teaching Progress Leaders become non-teaching Progress Leaders. Whether by the name change or the reduced classroom experience of non-teaching PLs, the nurturing side of the school is becoming marginalised in many settings. Whilst I am sure there are many excellent non-teaching pastoral teams, the principle concept of this
type of role is to save costs, thereby attracting a different skillset to that of a classroom teacher. Again the pastoral skillset is different to that of the classroom teacher, but with such poor pay and conditions given to non-teaching staff already, those with a high skill set in this area will be in demand for better paid roles elsewhere. It is also important to support a class teacher as a PL or HoY so knowledge of the classroom is quite important. To add to this movement away from pastoral work, teachers under pressure prioritise the things that secure their jobs – teaching, results and intervention. Behaviour, attachment, relationships and extra-curricular activities take a back seat (please note I do not allocate any blame to teachers in safeguarding themselves and their futures – it makes sense). Delegating behaviour to a HoY, tactically ignoring those who appear to not want to progress in favour of the majority who do, avoiding following up with detentions due to limited time – these are increasing self-preservation techniques used by some teachers with ever increasing pressures put upon them. This is not all teachers, and not all of the time but it is a logical conclusion where the importance of performance management and results is at the forefront of thinking, responsibilities are increasing and time is decreasing. Add to this the use of non-specialist teachers uncomfortable in their teaching, reduced form time and gap filling supply teachers on short term contracts and the opportunity for relationships is ever decreasing.
Progress at all costs
All of the above creates a climate where, like the Titanic clattering through the iceberg, “progress” continues “at all costs”. The lack of nurturing and pastoral relationships, I believe, is a contributing factor towards poor behaviour and poor mental health within schools. Where student’s needs aren’t being met, poor behaviour occurs. If you are focusing on delivering increasingly content heavy specifications, possibly in a new subject or over fewer lessons, the need to plough on feels irresistible and understanding the functions of behaviour and the needs of students can take a back seat over meeting the educational needs of those already engaged.
Whilst non teaching pastoral teams could be seen as a push towards a more full time approach to pastoral work as they have the advantage of being “always available”(that is that they have no teaching commitment), their experience and qualifications will vary and being a non-teacher, it can make translating support for the pupil into teacher instruction difficult. The role of a HoY is conflicted in some ways, reprimanding poor behaviour whilst trying to navigate the circumstances that have meant the behaviour feels unavoidable to the student at times. Understanding of attachment, mental health, functions of behaviour, sensory needs, classroom management and nurture are all key.
The role of behaviour support teams
It is this that brings me (600 words in!) to the point of this article – the role of behaviour support within the Green Paper proposals.
The key divide between the old definition of BESD or SEBD and SEMH is the area of mental health. Mental health is primarily the remit of the health teams (it is in the name). But with a huge lack of child therapists, pressures on CAMHS, high thresholds and reduced budgets a lot of work is considered “sub clinical” meaning it does not fall within the remit of the mental health services. These issues still cause significant concern for the sufferer but due to thresholds maintained by services, no support is offered by that particular service. This can encourage the escalation of the issue in some students. All of this work is perfectly placed for intervention with the SEMH/behaviour teams remit. With knowledge of wellbeing and group interventions and appropriate training the team can support students to overcome transient emotional problems and low level low mood and worry issues. This essentially over the years has been the role of the teacher in structures where more time and personnel is allocated for form time activities. The children who fall within this work can show behaviours that put them at risk of exclusion but also do not. They show withdrawn behaviours that affect their progress. They sit and listen compliantly but do not learn due to preoccupations that need time to be processed with them. They may leave the room in tears, have poor attendance or not give 100% to their studies due to their emotional wellbeing. These are all behaviours that affect the quality of the child’s life and their future achievement but may not often get appropriate, relevant or prompt support.
With this in mind SEMH/behaviour teams working with this new sub clinical group can make a real difference to progress, achievement, attendance, behaviour and quality of life of the child. By understanding and advising on behaviour and mental health they can support a teacher to have a more positive experience within the classroom thereby improving teacher retention. They can equip the teacher to have the skills and confidence to lead on mental health within the school and give them the support structure to allow them to reflect on their practice and support their own mental health. This team have the capacity to look at the environment of the child inside and outside of the school, medical and SEND issues and Boxall, interpersonal and communication skill development. The team can take a lead on supporting the identification, prioritising and referring of students with mental health concerns whilst putting together plans for the behaviours associated with those concerns. Where it is confirmed it is not a mental health issue, the team has a wealth of strategies and routes to explore to improve the situation in the short, medium and long term. There is a wealth of pre-emptive work that can be done to lay the groundwork for good mental health such as consulting on behaviour policies, job descriptions and school improvement plans – a team like this is perfectly placed to do this.
In summary – we need to train, support and supervise the Designated Leads. We need to support the pastoral teams and the teachers. We also needs to consider those who fall within the non mental illness, low mental wellbeing end of the mental health continuum. Behaviour support/SEMH teams are equipped with the skills to support this – if any ministers are reading, please consider us, we are ready and willing to do the work!
Transforming children and young people’s mental health provision: a green paper – Mental Health Leads – Opinion
The long awaited mental health green paper is finally out. Will it make a difference? Only time will tell. I’ve been looking through it and here are my thoughts on the first of the three key themes:
Designated Senior Mental Health Leads
My initial response to this role’s prominence in the paper was one of elation – this is the role I have been doing in my own school for the last 18 months (give or take and without the “senior” tag). The paper suggests that a member of staff within the school is given the role of “Designated Senior Lead”, in charge of giving “rapid advice, consultation and signposting”. This member of staff will liaise with mental health support services and have an overview on mental health in the school. They will know the places help can be accessed and who to talk to. They will be involved in identifying students with mental health problems, making referrals and tracking the progress through the system. They will look at policies and systems that can help support mental health and train staff to become more confident in working with students with mental health problems.
On first glace this role sounds ideal for any teacher who wishes to specialise in this area. The wide remit and opportunity to make a real difference is somewhat irresistible. However, having done the role the reality can be somewhat different. Schools that can barely afford to keep class sizes as low as they would like and cannot find the staff to cover the shortage subjects are increasingly pulling hours from those with extra curricular responsibilities. Whilst the mental health green paper is incentivising this role with additional funding for training, ongoing funding for this role does not seem to be forthcoming. Any extra hours outside of the classroom must be taken from the teaching budget and this role requires many hours outside of the classroom. Mental health issues don’t comply with a fixed timetable and when help is needed, help is needed there and then. As the single body responsible for (and confident with) dealing with students facing these problems, the Mental Health lead can often be pulled in many directions when they are trying to maintain a teaching commitment whilst supporting those with increasing and unpredictable needs.
To make a teacher free to deal with these issues requires a very light teaching timetable. The role I have undertaken involved me identifying students, building students’ confidence to access counselling, training staff, supporting students day to day and week to week, searching for new support services, creating partnerships with charities and commissioned providers, enabling self help, showing impact, running nurture groups/lunches, dealing with behaviour problems associated with trauma and mental health…and more. At times it is highly likely you can move from emotionally coaching a highly traumatised student through a flashback, to running down to your classroom to begin a lesson minutes later.
There is some merit to being a timetabled teacher in this role however. The students get to know you and they see your personality and perceived trustworthiness. They are more inclined to talk to you and share their feelings. Often students don’t want to talk to counsellors and much of my time is spent helping them to feel confident talking to a strange someone about the things they really struggle to even thing about. They understand the professionals can help them to recover but prefer the safe company of a teacher who cares. Getting them to no longer feel ashamed is a key role in getting them in front of the right support quickly and this can only be done in a trusting relationship.
A teacher in this role needs to be highly visible and well known. Teaching in the early years of the school setting could be key too, so students have early exposure to the member of staff and what their extra role involves. I’ve always made an effort to meet students in a neutral setting (where I have not had to take a disciplinary role) before I begin to try to direct their behaviour or give advice, this way I have shown I am someone worth listening to before they have to do the listening. The more the teacher is in the classroom, the less support they can give but the less they are in the classroom, the less visible they will be. The balance needs to be struck for the benefit of both the staff member and the students they support.
Making it count
Measuring impact in this role is key but often the results of the work done can be hard to prove. Strength and difficulties questionnaires, behaviour and attendance statistics, Boxall Profiles and self assessment all play a role but its hard to measure the impact of issues that didn’t arise. For instance how do we know what didn’t happen because of your successful intervention? The student that wasn’t excluded or the adult who left the school emotionally more stable than they might have been. As an investment made by the school, this role must show clear measurable impact to justify expenditure but if it really is going to be taken seriously and prioritised by schools Ofsted need to be taking a closer look at what schools do.
However “Ofsted for mental health” seems like a disaster waiting to happen – schools may game the system to show they are “making pupils mentally healthy” and pressure could be increased on staff and pupils to show they are “improved”. This could have a drastic affect on the mental health of all involved. Unfortunately though whilst schools can ignore it through the filter of Ofsted priorities it will be seen as something good to have, but not highly prioritised similar like any project that looks good on paper, but isn’t resourced well enough to make the difference required. Schools with tight budgets have priorities and without ringfenced investment year on year, this will be largely an exercise in box ticking.
This leads me to the “Senior” aspect of this role as detailed in this mental health green paper. It seems common sense that the responsibility of making sure every student faces no mental barrier to accessing the curriculum should be a senior role. But (as stated previously) whilst schools provision of mental health support isn’t fully inspected, the role largely seems optional and niche. In decades to come, we will look back incredulous at the idea of this role being a side note to the curricular work that is done. We will see it as the foundations of good learning and a role that has the power and responsibility to enable the work of everyone else in school i.e. it doesn’t matter how many outstanding teachers you have if the students aren’t ready to access the materials. It is my fear the schools will designate a senior member of staff this responsibility but the bulk of the work will be done at a lower level by a less senior member of staff. The implications of this are that the staff member may not be believed when they express concerns about resources and policy and that the person overseeing them may not have full understanding of the issues being discussed. If this mental health green paper is to take the approach of a Senior Lead, it must ensure this lead undergoes appropriate training.
And we’ve arrived at the next announcement attached to this role – a training budget. There is allocated funding in this mental health green paper to “incentivise” schools into putting this into place and allowing the training that is required to go with it. The mental health green paper does not set out what training it believes should be undertaken despite as recently as January calling for all schools to have mental health first aiders. There is a wide range of training available from profit seeking training providers, many without accreditation but appearing very attractive to the unaware. As a Mental Health First Aid Youth instructor, Wellbeing Toolkit Practitioner (attended “Train the trainer”), a Nurture accredited teacher and someone who has undertaken training in Functional Behaviour Assessment I have undertaken a range of training that I have felt has been incredibly useful but none that fully individually encompasses the role of the Mental Health lead. There are many providers that get close to providing professional training on the basics of therapeutic interventions over 4 day courses, providing another angle to the role of the Mental Health lead. I strongly believe the best training I received was in experience as a Head of Year, something you cannot pay for. However what individual schools will choose for their training is concerning as if they spend the money in the wrong places they may have an under experienced or low knowledge member of staff making very serious decisions on mental health provision. Personality is key in this role too, you must be able to show empathy and withhold judgement.
The Mental Health Green paper doesn’t specify this role has to be a teacher however. This role could be undertaken by a qualified Psychological Wellbeing Practitioner, who begin at Band 5 of the NHS scale (around £22,000) which is significantly cheaper than a senior teacher. The benefits of doing so mean a school has an NHS qualified mental health worker in school making informed decisions at a lower cost. Taking on the role full time is an expense for schools that they may feel they can avoid – after all the NHS is responsible for employing these kinds of staff. As an educational institute the supervision of this role might be insufficient too, and that is vital for keeping oversight on what interventions are taking place and their impact. Schools with limited budgets might opt to reduce the role to one or two days a week, but this would lead to students needing immediate support being unsupported at other times. Being a non teacher and possibly not in full time can reduce the students awareness of this person and therefore make them less likely to go to them as a first port of call. Being a teacher is also highly beneficial in this role in understanding the workings of the school and what advice can be given to teachers to support students. The ability to handle and diffuse poor behaviour is essential, again teacher skills and attributes. As someone without the qualification and experiences of being a teacher, it could be hard to place this person inside the management structure of a school, as the Designated Lead role suggests may be required. When you add in the need for this person to cascade training, the need for this person to be a teacher is ever clearer.
Support without support
When this role is established it is hugely important that the Mental Health lead has a place to send referrals for professional support. Schools have limited funds for counsellors and when these funds run out, the services are withdrawn. This can be devastating for the students. Further to this without investment in CAMHS the threshold will stay high and lower level mental health issues will be bounced back to schools. Without fully funded services to refer into, funding to buy services in house and without extra professionals available to be employed to perform these services it is going to be an increasingly difficult role for a Mental Health lead to do that will get ever harder as budgets continue to tighten. Combine this with increased exam pressures, social media, toxic masculinity, body image pressures, under-understood areas of gender dysphoria and LGBTQ+, bullying, addiction, poverty, trauma…(the list goes on) the mental health green paper really is lacking in plans to increase the level of available professional support to meet these emerging needs. The government has further outlined in its mental health green paper the idea of teams working with schools – great in principle but those working in these areas know the services are already hugely overloaded. They need more staff and more investment and they need it now.
So what do we need in a Mental Health Lead? What needs to be in the green paper?
It is my belief, alongside clear investment in training and developing mental health professionals to specialise in early intervention in child mental health, we need the government to incentivise schools year on year to maintain a Designated Senior Lead for Mental Health by providing both a training budget and a salary contribution of around 3 – 4 days a week pay. This role should be encouraged to be within Senior Management teams to advise on upcoming policy and strategy. The role could work with interested, passionate and suitably trained teaching assistants to have a wider impact whilst maintaining a balance of contact time with students. In terms of a training package, a funded Postgraduate Certificate in this area at a similar level to that of the Special Educational Needs Co-Ordinator qualification could be created with universities and IAPT professionals that offers a professionally recognised status for the leaders of Social, Emotional and Mental Health in schools. Encouragement and funding in nurture group provision and Mental Health First Aid (Youth) qualifications included as part of the PGCE qualification (using funding from the increased fees) could also help improve the situation in schools further.
It must be said that none of this will be effective if schools continue to put into place policies that drastically effect the wellbeing of their students in pursuit of the perceived academic achievements. Homework policies that push students to within minutes of the maximum EU dictated working week for a full grown adult are not helpful. Reporting systems that highlight students failure over achievement, intervention sessions that further extend their working week, target that feel unachieveable despite great efforts being made – these are all things that contribute to the stress felt by students. If we can take a whole school look at our policies and change what negatively affects students we can start to make a difference now, without any investment or significant changes in roles. Let’s help our students get enough sleep, turn off their devices, get exercise, eat well. Let’s make them feel valued and worthy of our time, and build their self esteem through meaningful participation in extra curricular activities.We have so much power to change if we are given the tools to do so. Our responsibility is not just to create adults who are educated enough to contribute to society but also to ensure they are emotionally secure enough to want to. It’s time to step back and change the exam factory approach to education, take a Maslow view of our students needs and start manufacturing happy, educated, independent and motivated adults ready to give back to a caring world that appears so new and so exciting.
In a world that is increasingly better connected and where information can travel across the globe in the blink of an eye, the connections we form in school in passing can seem almost insignificant. However the basis on which we form connections with our young people is incredibly important in understanding their needs.
I am a firm believer in the “all behaviour is communication” mantra of the nurture group network (amongst many others). I also believe that the students we work with form attachments with us to get their needs met. I believe that you can offer these attachments to a student willingly or they can be taken via challenging and damaging behaviour. The end result will be the same – the child will be heard eventually but with a degree of shame and regret attached. Whilst tactical ignorance of behaviour is a useful tool to have, to completely ignore the function behind the behaviour is setting yourself on a path to repeated, sanction immune challenging behaviour. This is both stressful (and, again for the YP, shame inducing) to the young person and the teacher.
To explore the child’s needs can take time and the will to empathise and listen non-judgementally is required. This exploration can only be done within a supportive relationship. Whether we like it or not, we have a relationship with all our students, supportive or otherwise. This begs the question – what is the foundation of the connection? What are the conditions of this connection? How was this connection formed and how is it maintained?
In certain types of connections the relationship is formed to solve a “problem”. The problem may be the child’s behaviour or possibly a school defined goal.
Setting goals for (not with) students in itself can present problems as they may not share the same commitment to achieving it as the staff member. Other types of connections are reinforced by bad behaviour e.g. if you get a bad report you will have to come and see me/talk to me after school (attachment/discussion time). Sometimes connections can be formed that can prove dangerous if, for example, the connection is formed on the basis of a discussion of a child’s self harm and the staff member’s desire for the child to stop. The child may need to continue or escalate the self harm to get the same time and emotional response (to be cared for) from the adult. This can prove extremely harmful. [Note in this case the best advice is to remove the device used to cause self harm, provide appropriate medical attention, follow school/organisation safeguarding policy around self harm and discuss thoughts/feelings that young person had around the self harm (but not the self harm itself), e.g. what are you worrying about? What are you feeling?]
In order to avoid these types of connections, we need to be willing to offer our time in structured slots without condition. The attachment time should not be available on the condition that behaviour targets have been met- it should be truly unconditional. The child needs to know that if they need support with classwork, emotional issues, home life or any other issue that they can access this with their trusted adult without having to engage the adult in noticing them through bad behaviour. Some children will only know disruption and the subsequent detention time with the adult as a communication method to get their needs met. When a child knows an adult values them enough to give them time to be heard, their self-esteem will inevitably improve. When a child doesn’t have to go through the shame of being disciplined before they can heard, their self-esteem will inevitably improve further.
It is our responsibility to take a positive behaviour approach to our classrooms and our connections. If you have connections with students that were created by the need to challenge, punish and reinforce, consider how you can change that to understanding, pre-empting and regulating. By this I mean knowing your students situation and the functions of their behaviour, planning for good behaviour by ensuring that the functions can be met without poor behaviour and providing time unconditionally to let the students communicate their needs. You may have not had a say in how the connection was formed, but you can change the purpose, how it is maintained and the goals of it.
Is this relevant to me?
Some teachers with an academic focus may not believe it is within their role to maintain these connections but, as stated previously, these connections are formed regardless of whether the intention is there to do so. Imagine a student who regularly misbehaves – there will be a cycle of poor behaviour and punishment, usually detention time. Now consider asking your student to come and see you once a week at a set time with the intention of discussing your subject and how you can help them, ensuring they know this is not a punishment. It is clear this is time consuming but where time is already being spent reinforcing behaviour approaches, this can be time neutral. This time will have effect of building the child’s confidence in being able to tell you how they are getting on and if they need help but to also humanise you as a teacher, building a relationship that will make them want to work hard for you. It also serves as a point of reflection for the child to consider why they are acting in a certain way, if the function is not immediately clear.
For most students we work with, the connections we form will be instantly positive. These students will largely have their needs met through many other relationships and positive experiences. They will know what to do when things don’t feel right and have a range of ways of navigating challenging circumstances. However for the small percentage that do need a supportive relationship, your time and attunement is incredibly valuable to help them to achieve shared goals. Through modelling and understanding you can subtly teach them the skills to get what they need in life without having to use behaviours of concern. Remember – we invest a lot of time into reactive behaviour strategies, consider how you might invest pre-emptively to avoid challenging behaviour later on (and maybe saving some time along the way!).
Interest in SEMH in schools is growing by the day and Mental Health First Aid Youth is the latest government scheme designed to put a “champion” in every school. But what does it actually look like? Having just completed it, I feel obliged to blog my review.
Mental Health First Aid Youth is a two day course priced at around £300 (incredible value for a two day course of this specialism) and provided by Mental Health First Aid England. This course is the more in depth “sibling” of the to-be-announced schools and colleges MHFA course the government is due to fund later this year onwards. However much of the content is similar and so this hopefully should provide you with a good insight as to what to expect.
The course is split into 4 sections covering Mental Health, Depression and Anxiety, Suicide and Psychosis and Self Harm and Eating Disorders. Each topic is handled with great care and expertise from the qualified trainers (each of whom have completed the course and done a great deal of pedagogical work over the course of a year) and the course is delivered very much in a “facilitator” model.
This was something that particularly impressed me – I have attended and delivered many training courses in mental health but none have been so practical and activity driven as the Mental Health First Aid Youth course. Opportunity for group work was great and the use of video case studies was also very helpful. We were constantly using the information we were given and encouraged to explore our own ideas too.
Throughout the 2 day course there are two main themes – the Mental Health First Aid Youth system for dealing with a concern and the case studies we created at the start of the process. Without divulging the entirety of the course the Youth MHFA system shows you how to deal with a concern right from the initial contact with a person with a mental health concern right through to the aftercare when a suitable referral is made. It is very thorough and leaves the delegate with a clear idea of how to proceed in their organisation. I would recommend delegates target further training in each stage of the process (e.g. listening skills) to help to improve the overall experience for the young person but knowing the process is vital to starting the ball rolling in any given setting.
The second theme of the course centres on the 4 young people “created” during the early stages of the course. These children are designed to represent people at different stages of the mental health continuum and are referred to throughout. This helps the environment from becoming a therapeutic one based on one persons experiences. It also gives an anonymous case study to work from. The young people come alive in the discussions and the delegates will feel emotionally connected to them at the end!
The Mental Health First Aid Youth qualification is a fantastic training course for teachers, education staff and anyone else who works with a young person in a supportive setting. It is not training to diagnose or counsel but it offers the skills and resources to react on the front line to mental health concerns. Delegates will be able to identify issues and respond appropriately, making professional referrals and encouraging the person to access self help in the meantime.
I believe every school should have a qualified Mental Health First Aider (Youth) within their organisation in order to provide a first response to the growing numbers of students presenting with mental health concerns. It is a positive approach focusing on recovery and can be embedded in any organisation in the same way physical First Aid has become a standard.
This course was attended by Dan Hallsworth (site owner and now Mental Health First Aid Youth Trainer!) in early June in London with two fantastically qualifed and outstanding trainers Andy and Dawn.
The Russian philosopher and write Dostoyevsky once said, “To live without hope is to cease to live”. In my experiences within school, the power of hope is widely underestimated as a wellbeing intervention yet has the power to underpin all the good work that is done day to day in a school.
As much as we’d like to be able to pick up every child facing challenging circumstances and drop them onto a new path in life, free from unfair and unrelenting stressors, as teachers we often find our powers limited to make a real difference in the here and now. A family living in poverty, a grieving student, a child struggling whilst waiting a long time for specialist mental health support or a young person in the middle of a messy divorce – unavoidable issues strike the wellbeing of our students at different points and we often find ourselves clamouring to offer the support now to make them as comfortable as we can in school.
What I have found incredibly powerful to lay the foundations of drive and motivation is a focus on the future, whilst acknowledging the challenges of the present. Mapping a child’s future drawing from real life examples can give them a direction and a distraction from the challenges in the present. School life is incredibly short as a percentage of a child’s life but when in school it is all a child has ever known. The idea of finding love, enjoying a career, maybe having children and living a fulfilled life seems so far off. The idea of making their own decisions, living where they want and finding their own fun seems impossible. But this is the future they are working towards whilst at school. Schools is a bubble during term time and many day to day issues that seem unimportant when teachers explain them to a colleague outside of work, often felt like the highest priority at the time, often over your health, diet and sleep. As a teacher I have often reflected incredulous about how much time and energy I invested into things that seem largely insignificant afterwards but it comes from a good place, the desire to do your best for the children. For students this is also true – school is their social bubble, their world and where they spend a good deal of their time. An unhappy childhood in school and at home can seem like a lifetime. Helping to improve the here and now is incredibly important, but knowing the upward curve will continue far into the future is also vital.
The idea that school is the “best days of our lives” is a positive one but not always true. For some children school is a struggle that teachers often have little power to influence – to know that the end of the school road can lead to a place where they have more control, future financial independence and happiness is key. It renders the hopeless question “What’s the point?”, pointless.
Key discussion points:
Happy memories – draw on happy memories in discussions with children and encourage the child to know that there will be many more happy memories still to make
Future mapping – a discussion with a child about where they see themselves going in the future can be helpful, even if they believe they will fail their GCSEs. This is a path that can be discussed, it is important for students to know that failure at GCSE can make life more difficult in the short term, but is not the end of the road.
Bucket list – things a child wants to do in their life. 30 countries before 30? Driving test? Parachute jump?
It’s a challenge most teachers face on a weekly basis – what do we say to support a student who is suffering with a mental health problem? How do we begin that supportive conversation?
It’s a scary moment. We aren’t counsellors but we have been confided in. We can’t say nothing – that will seem uncaring. We want to say the right thing but we are worried about making things worse. So what can we do?
1. Actively listen
It sounds obvious but it is harder than it looks. To actively give your attention fully to a student requires a real degree of mental concentration. We listen at 125-250 words per minute but our brains think at 1000-3000 words per minute and often 75% of the time we are preoccupied, distracted or forgetful. Active listening requires the following steps:
Listen – show you are paying attention in your body language and encouraging statements such as “Ok”, “I see” and “Right”. Avoid interrupting and make appropriate eye contact. Question – Use open and closed questions – these show you have listened and can clarify any issues and gain insight. Reflecting – Reflect the information back to let them know what you are seeing from their words and actions – “You have said you are ok but you seem worried about…..” Paraphrasing – Paraphrase the information you have been given to show them you have listened and get an agreed picture. e.g. “If I am right x has happened which has led you to feel upset and worried…” Reframing – Reframe what you have been told in a positive light. Try to diffuse the negativity and widen the meaning of an issue to allow the student to see there could be other motivations behind situations.
2. Fact vs Opinion
Students will often relay information they feel as confirmed fact. They believe that if they feel something bad is going happen (anxiety/worry) then it must be true. If they feel rubbish about themselves, their negative opinions of themselves must be true. Challenge them with FACT/OPINION cards.
When a student is discussing beliefs they have about circumstances, ask they whether they believe it to be a “Fact” or “Opinion” using the definitions given. This will go some way in training students to challenge negative beliefs and thought patterns that may make them perceive every day events in a way that can affect their confidence and make them feel anxious.
Shame is a big issue in anxiety – when asking students to say if something is a fact or opinion understand that to them it will feel very real so this needs to be respected. Anxiety is incredibly unreasonable and illogical – it can make the most benign and unthreatening situations seem terrifying.
3. Use emotional coaching techniques
Where a student is visibly struggling either through anger, panic or crying (but also at any other time!) emotional coaching is a really useful method to calm a student and reduce the shame an episode like this can often bring about. Emotional coaching happening using the following step:
Empathise – show them you understand what they are feeling- “It must be terrible feeling that way”
Validate – let them know it’s ok to feel they way they do “You must feel angry/sad/frustrated”
Name Emotions – Help them to find names to put to their emotions and direct them to new emotions
Using these simple techniques you can begin to calm a student, reduce shame and help them understand and respond more constructively to their emotions.
4. Use number scales
Sometimes taking a student through their day and asking them to choose a number from 1 – 10 for worry, happiness, mood etc can help you to start a discussion and find problem areas in the school day. This tip can also be really useful for testing is a student’s worry has reduced during your conversation – you can rate at the beginning and end of the conversation. Using numbers to recognise growing anger symptoms and leave stressful situations before problem behaviours occur.
5. ABC approach
How we see the world depends on our own beliefs about situations. Sometimes students may have a perspective that is damaging to their mental health due to thought distortions. Let’s have a look at a situation:
ANTECEDENT – Student’s friend ignores them BELIEF – Student assumes that the friend is angry at them and doesn’t want to be friends anymore CONSEQUENCE – Student keeps their distance, is angry and upset. Leads to further isolation
Let’s change the belief
ANTECEDENT – Student’s friend ignores them BELIEF – Student believes that student must be having a bad day CONSEQUENCE – Student tries again with friend later on, asking what is wrong and trying to help.
By allowing a student to recognise how their beliefs about events influence their behaviour, they can learn to judge situations differently to have better outcomes for their own mental well being.
When trying to encourage students to get in touch with their own mental wellbeing it can often be hard to make it part of the every day conversation. Making that happen is key to getting students on board to be pro active with feeling great everyday. So what can we do?
The 5 Keys are a well known strategy for improving emotional wellbeing and can easily be implemented into every day life. Here’s a plan for how you can make your week, a Wellbeing Week.
– Get your students taking notice of their surroundings, encourage a tech break, meditation, walks….the opportunities are endless.
Time to Talk Tuesdays
– Encourage open discussion on mental health, group students with those they don’t normally work with….even encourage students to think about who they might talk to if they feel they need help. Breaking the stigma around talking through problems is key.
– Give students the chance to give something back. Create volunteering opportunities, mentoring, ambassadors or even just a list of jobs that can be done for teachers on a Wednesday!
Teach Yourself Thursdays
– Life hacks, languages, sports skills, musical instruments, documentaries…encourage students to branch outside of their school learning to improve their mood.
– Discuss how students might incorporate exercise into your weekend. Run active clubs on Fridays. Involve staff with staff football or yoga!
See how you can link your week to wellbeing and get your students discussing mental health!
Over the last few months Derbyshire County Council has been working very hard on a new SEMH resource.
Thanks to their endeavor we now have this guide.
It includes a stage by stage approach to Social, Emotional and Mental Health and well being within school. Under the categories of Introduction, Promote, Identify, Assess, Provide, Review and Celebrate we have multiple strategies to help support schools implementing and improving the support on offer to students.
There is whole school guidance on assessment and tracking as well as plenty of real life case studies dotted throughout. Building emotional literacy is a key theme, as is staff well being. The SEMH resource spans all areas of the school to give leaders ideas for building excellent SEMH within their setting, whether that be primary, special, secondary or other types of educational institutes.
Under the term “Identify” risk and protective factors are helpfully outlined with guidance given on how to improve resilience and reduce the chances of poor mental health. Using this SEMH resource schools can look at the roles of PSHE, nurture groups, mental health education and professional services among many other strategies that can help support the whole child’s development.
The guide even gives a Maslow based assessment of the needs of the child including how to improve sleep, physical activity and more. As SEMH practitioners know, meeting a student basic needs is key to ensuring well being. This includes food, sleep, accessibility, safety, a comforting attachment, self worth and esteem. Meeting these needs is entirely possible in the school setting and this SEMH resource will help to show you how you can put it into practice in a sustainable way.
Supporting students with SEMH needs can be a real challenge. Not only are teachers not trained mental health practitioners, access to the kinds of support some students need is restricted both by overwhelming demand and funding cuts. Higher tier services have had to raise the severity of cases to be accepted in order to prioritise those with the highest level of need. This leaves a large section of the school population with serious (but less severe) mental health issues that struggle to get the support that is needed. There is a range of SEMH provision pastoral staff can put into place that can make a real difference to the lives of these students and many of them require a low level of funding (if any).
1. In school counsellors
Although not the cheapest option for schools, access to counsellors in school is vital. These members of staff provide specialist support to the highest level of need (yet not meeting threshold for higher tier services) and are possibly the fastest response mental health practitioners available to schools. Local charities can sometimes offer counselling services that can be offered at a variety of prices. Some schools may opt to employ counsellors directly. Although counselling is not regulated by law, it is strongly advised that counselling is undertaken by those with professionally recognised qualifications. In some schools staff may have or wish to undertake basic counselling qualifications that will enable them to begin low level work with students (as advised by course tutors). This is an opportunity for both the school to increase counselling provision and SEMH provision, encourage CPD and develop opportunities for staff.
2. External Psychotherapeutic Organisations
In some areas NHS funded counselling and cognitive behaviour services for adults begin to accept referrals at 16. This can mean a school can directly refer or support a student in self referring to these services to help them access support that may be faster than that offered to under 18s. It can also relieve the pressure on in school services and existing SEMH provision.
3. Self Help Resources
Books and worksheets focusing on common, easily identifiable issues such as excessive worry and low mood can be a very low cost and effective form of SEMH provision. Excellent titles include the “Starving the… Gremlin” series and the “Overcoming” (for older students) series that can both be found on Amazon. Other useful books include the “Workbook for Teens” series, an example of which can be found here.
These books can be loaned out to students from pastoral staff or worked through in sessions with students either one to one or in groups. It is also useful to mention these resources could be bookable for staff too in order to help increase their own awareness or help them manage their own stress levels.
4. A Quiet Room
Having a quiet space available for social times is a vital tool for pre-emptive SEMH provision. The unstructured nature of break and lunch times can be especially stressful for students with a variety of needs. Some students also may wish to occupy their minds in a quiet space to reduce their stress levels. This space does not have to be over-complicated – a simple room in a quiet area of the school would suffice. Being able to provide colouring books and pencil crayons for students to use would provide students with mindfulness activities too. A quiet room would ideally have a “no talking” policy with comfortable seating provided by cushions and bean bags. Low lighting and lamps with a calming background music provided by Youtube can really benefit the environment too. Materials can be provided by staff donations where possible – often staff will volunteer to man the rota for this room too for their own serenity. Using this room as a point of referral for students suffering from stress and anxiety.
5. Active Strategies
Evidence shows that physical activity helps improve mental well-being. Encouraging staff to follow their passions and set up physically active clubs that get students moving can act as a great point of referral in an SEMH plan. Similarly clubs that allow students to learn new skills and follow their interests can give them a self esteem boost that can improve overall mental wellbeing.
6. Worry Box
Giving students an opportunity to share their worries via an intranet worry box is a good way to gauge the key stressors within the school and also allow students to pass on concerns for you to act upon. Giving the students the options (with a clear safeguarding disclaimer) of “I just wanted to share and don’t want to discuss”, “Please let my teachers know” and “I want to discuss this with…” will enable them to share worries in a non verbal way, something they may find more accessible.
7. Education on mental health
Educating students on their own mental health is key to any successful SEMH provision strategy in school. Students need to know how their brain works and the key symptons that they may need support. Knowing which feelings are normal teenage worry and mood shifts and what is chronic anxiety and depression is vital for ensuring the right students receive the right support in the fastest possible time. Students will be better educated to seek support and report problems. They will also understand how to support each other and be a good friend in a time of need.
8. Staff Mentoring
Training staff mentors in low level support roles can really benefit students in providing them with accessible, trusted members of staff with whom they can work to reduce the stressors in their life. Training can be delivered through the use of self help resources or dedicated school procedures for supporting students with certain needs. Sometimes students with heightened stress levels need support organising their lives better to reduce stress. Staff mentors can help to reduce these stressors by teaching organisational skills. Some students will struggle with toxic relationships – again staff can assist in advising students how to reduce these stress inducing friendships.
9. Nurture Groups
Nurture groups have a long history of supporting students with social, emotional and behavioural difficulties (SEBD) in school. When the government introduced the term “SEMH” (replacing SEBD) they acknowledged the close link mental health has with social, emotional and behavioural difficulties. Nurture groups use evidence based approaches over a short term in small classes of 6 to 12 students. The aim of these groups is to teach social and emotional skills thereby removing barriers to learning that help to make students more “classroom ready”. Nurture provision can be delivered in a variety of methods in both primary and secondary settings to support students with SEMH needs with a measurable, high impact approach.
Last but not least, the use of mindfulness in classrooms and across the school has been shown to be very effective in reducing stress levels in schools. Mindfulness activities at the start of lessons can focus a child’s mind and calm the distracting narrative operating in a students mind at the beginning of any new lesson (particularly after lunch!). Teaching students how to use mindfulness in their own time can help students take control of their stress and worry and Youtube offers a range of guided meditation exercises students can use. Photocopiable mindfulness activity books are available from most major book retailers too, allowing students to perform these tasks as starters or as SEMH interventions.