Love isn’t always enough…
Many of the children waiting for a new adoptive or permanent foster family are receiving support from Child and Adolescent Mental Health Services (CAMHS) to help them manage their behaviours and emotions. That support can take different forms, often involving helping the carers too, as Ann, a Child and Adolescent Consultant Psychiatrist, explains to Sophie Offord…
“Adopters or foster carers may initially feel that love will be enough to deal with their child’s difficult behaviour or strong emotions. Our sessions help them to realise that it can take years to repair the effects of early abuse or neglect.” Ann’s work with looked after children goes beyond simply focusing on the child’s needs. That far-reaching approach applies to the whole of CAMHS, which are formed of a wide network of professionals who are all there to provide support for children with mental health issues.
In addition to people like Ann, whose work as a consultant psychiatrist is very specialised, there are many others within CAMHS who work with children with mental health problems, such as teachers or GPs. Some children may have input from CAMHS at several levels – for instance, from a health visitor or youth worker. “That kind of support, especially if it’s from the child’s social worker, is extremely important and is sometimes underestimated,” stresses Ann.
Being in the care system doesn’t necessarily mean a child will need support from specialist CAMHS. Children will only do so if they have been referred by someone who feels that they could benefit from support for their emotional well being or mental health. This could be their GP, teacher or, more usually, social worker.
Children are referred to Ann’s team for a large number of issues – there is no one reason. The child may have depression, be self-harming, have obsessive compulsive disorder or be incredibly distressed, or there may be concerns about their placement possibly breaking down.
The amount of time that Ann and her team spend with a child depends on what their particular needs are. “At the beginning, we work with a child or young person, and their carers and social worker, to determine what outcomes they are looking for, and how we are going to decide when we’ve reached that outcome.”
If Ann is working on a very specific issue, for instance a medical one, setting that outcome can be relatively easy. “If a child has been referred to me for an eating disorder, then we might work together until the child has reached a certain weight. If a child comes to me because they are terribly upset about what’s happened to them in their past, then the outcome may be that they are less distressed and can make sense of what has happened to them. The outcomes might need to be continually reviewed. The children may then be discharged from specialist CAMHS, and support, such as in a social work setting, may be enough from that point.”
But it’s not just children whom Ann works with. The children’s carers are also invited to go along to the sessions. “CAMHS works to the principle that you cannot see a child in isolation from their home and social situation,” says Ann. The younger the child, the more work might be done with carers and parents. Sometimes, the child will only be seen during the initial assessment of their needs.
The loss and trauma that most looked after children have experienced means that their behaviour can sometimes be very difficult. Their new families might understandably find this challenging and upsetting. “When we work with carers, we are supporting them to manage their emotions by answering questions, giving them advice, and talking about their feelings,” explains Ann. Understanding that they are not to blame for the child’s behaviour is really important for carers. “We help them realise that no parent is an ‘expert’, and they are usually very grateful for the support.”
Understanding CAMHS
Child and Adolescent Mental Health Services (CAMHS) provide help and advice to children and young people with mental health difficulties, and to their parents or carers. CAMHS are made up of many professionals, including psychiatrists, teachers and nurses. They work with the child or young person at their home, school or doctor’s surgery, or perhaps the local hospital.
CAMHS regard ‘mental health difficulties’ as any difficult feelings or behaviours that do not go away and which seriously interfere with everyday life. As this covers a broad range of issues, support will vary, depending on the needs of the child or young person. Often it will involve different forms of therapy, sometimes medication and, rarely, time in hospital.
For children who are in the care system, CAMHS will usually only provide support if they feel that the child is settled in their placement.
For more information, visit the CAMHS website.
Originally published in the Be My Parent newspaper in September 2008.
This article is published with the kind permission of the people involved. You may download it for your own reference but if you wish to use it for any other purpose, please contact Be My Parent for authorisation: Be My Parent, BAAF, Saffron House, 6-10 Kirby Street, London EC1N 8TS. Telephone: 020 7421 2666/5/4.
Last updated: 14 October 08
