Psychological therapies can be helpful for a range of different emotional and behavioural problems. Common psychological problems include anxiety, phobias, low mood, Post Traumatic Stress Disorder (PTSD), low self-esteem, anger, self-harm and bereavement. Psychological therapy can also address a range of different issues related to living with a physical health condition, such as accepting a diagnosis, adhering to medical treatment, and managing pain.
Therapy will be adapted according to the child age and level of cognitive function. The decision which therapy to use is made based on the presenting problem, the evidence base for a particular therapy for a particular problem and the preferences of the family.
CBT looks at how your thoughts and behaviours influence the way you feel. By changing the way you think and how you act in certain situations, it can influence the way you feel. CBT focuses primarily on problems and difficulties in the here and now, although it will take into account past events that have led to the current difficulties.
CBT has been thoroughly researched and is a recommended psychological treatment for a range of different problems, including anxiety and low mood.
Family therapy seeks to understand problems in a contextual framework rather than addressing the problem on an individual level. Working with children and young people, Family Therapy strategies are often incorporated into other therapies (like CBT), recognising the fact that when a family member has a problem, this will affect the rest of the family, and their actions will in turn influence the problem.
ACT is a form of cognitive therapy which instead of challenging negative thoughts (as in traditional CBT) focuses on accepting that difficult feelings and thoughts will be part of peoples' lives. By learning to stop struggling with these thoughts and feelings, they will become less influential and frees people up to focus on their values in life and on taking positive action despite their difficulties. ACT also emphasises the importance of living mindfully (see below for more information about Mindfulness).
ACT has an increasing evidence base for dealing with psychological problems, in particular in the area of chronic pain.
Mindfulness is not a therapy per se but has recently been incorporated as a skill to use as part of CBT or ACT. Mindfulness means paying attention in a particular way: on purpose, in the present moment, and non-judgementally. It can change the way you relate to a problem and reduce the impact of negative experiences, thoughts and feelings.
Most children and young people who go through a bereavement do not need professional input. There is no such thing as a 'normal' bereavement and children will react differently to a loss. However, if the child has strong reactions that continue over time (including drastic behaviour changes), school performance is seriously affected, and the child or young people isolate themselves from family and friends, bereavement therapy can be of benefit. In cases where the child is bereaved by suicide or murder, the child has witnessed the death, or the child had responsibility for the death or responsibility for the dead person, early professional contact is recommended.
Susanna has substantial training and experience in CBT and of adapting this to the child's age or cognitive function. She has successfully used CBT approaches with children presenting with a range of different emotional and behavioural difficulties, including low self esteem, anxiety, low mood and anger. She has developed her practice in line with new evidence and as such incorporates Mindfulness and ACT into her work. Since a child is inevitably affected by the context in which they are living, Susanna will always incorporate systemic therapy elements into her interventions. Her work in the NHS with children with cancer means that she regularly meets bereaved children and adults.