At CAMHS, we work closely with the children and young people who come to see us in order to make decisions together about the therapy or treatment that will best help. If it's appropriate, we also work with parents or carers too, to agree the right way to offer support.
When you first come to CAMHS, we will take the time get to know you, and talk about who might help you and how they might do that. You can read more about what to expect from a CAMHS appointment here.
The type of therapy or treatment we agree on will depend on your individual needs and the kind of issues you're experiencing. You can learn more about the different types of therapy and treatment that CAMHS provides below.
Our behavioural practitioners work with young people who display challenging behaviours that are linked to a mental health difficulty or neurodevelopmental condition such as attention deficit hyperactivity disorder (ADHD) and autism (ASD). The practitioner may also work with parents, carers and teachers to develop behavioural strategies that will help.
The strategies will be different depending on the needs of the young person. A behavioural support plan will usually be agreed that aims to reduce the risk of certain behaviours occurring, and also helps the young person to manage their behaviour when it does escalate. Specific strategies for conditions such as ADHD/ASD might also be introduced if they are appropriate.
Sessions with behavioural therapists will identify current behavioural concerns and the environments where the behaviours are displayed, look at communication tools, consider sensory needs and embed strategies to help the young person express their emotions in a safe way.
This type of behavioural therapy is different to cognitive behaviour therapy, which you can read about below.
Cognitive behaviour therapy (or CBT) is an evidence-based therapy that can be effective in treating a wide range of difficulties including anxiety and mood disorders. CBT is suitable for children, young people and adults. Treatment usually lasts between 6-20 sessions depending on the type and severity of the problem.
The therapy works on the theory that our thoughts, emotions, physical feelings and behaviours are all connected, so making changes in one or more of these areas can lead to a reduction in symptoms and an improvement in your everyday functioning.
In CBT, we work with you to make your own discoveries – your therapist will not tell you what to do. It requires a willingness on your part to ‘give it a go’ and try things out both during and in-between sessions. Activities range from doing things such as keeping a record of your experiences, to carrying out practical experiments. Your therapist will work with you to agree which activities might help you to understand and challenge the beliefs and behaviours that may be holding you back from achieving your personal goals.
Although treatment is time-limited, you are encouraged to devise your own ‘stay well plan’ at the end, summarising the strategies you have developed in therapy. This will allow you to revisit and practice skills to stay well, and keep moving in the right direction long after therapy ends.
Eye movement desensitisation and reprocessing (EMDR) is a type of therapy often used to help people who have experienced very frightening, traumatic experiences. It can also be helpful for people experiencing a range of other problems, including anxiety, depression, and other specific problems such as obsessive compulsive disorder (OCD), for example. It can be used with children and adults.
EMDR is different to other forms of talking therapy because you don’t have to describe difficult memories or experiences in very much detail. That means it can be particularly useful if you struggle to put your thoughts and memories into words, or if you prefer not to. However, the treatment does require you to bring these memories into your own mind, and think about them in sessions. You will learn a range of soothing and calming coping strategies before you begin any specific work on your memories or fears, so you will feel able to cope with the ‘reprocessing’ part of therapy.
EMDR is unique because, while holding specific parts of a difficult experience or memory in your mind, your therapist will stimulate both sides of your brain by asking you to watch their fingers, or a light on the end of a bar, while they move it from side to side. This then causes your eyes to move from side to side, following their fingers or the light bar, and is called ‘bilateral stimulation’. When you move your eyes in this way, your brain is encouraged to process difficult information so it is organised and stored in the same way as less emotional memories or experiences. It sounds a bit strange, but it really does work for many people, and you soon get used to the process. Some people don’t like moving their eyes in this way, so they choose to use different approaches such as tapping alternate hands on each knee, or using small hand held buzzers.
Family therapy, also known as systemic psychotherapy, provides the opportunity for the family around a child to explore their relationships when a child or young person is experiencing a difficulty. Family therapists are skilled in drawing out everyone’s strengths and resources so that problems can be seen in a wider context and everyone can become part of the solution.
We usually meet with the family first to see if the approach seems to fit for them, and whether it's the right time to undertake it. Family therapy often asks all family members to consider change, so it can be a tough but highly rewarding process. One family recently explained that the family therapy had enabled them to ‘disentangle their problems’ and find a way forward, with the result that their daughter no longer needed the individual sessions they had initially thought necessary.
The animation below explains more about how family therapy can work.
We run a number of different types of groups with other agencies at CAMHS. They include:
- Therapy groups
- Information groups (sometimes called psycho-education)
- Support/shared experience groups.
The benefit of meeting in a group can sometime be that you realise that you are not on your own, and that there are many other people with similar shared experiences to you. The facilitators or therapists running the groups may not always have all the answers but usually in a group, someone will know. Many people who attend these groups describe feeling less isolated and benefitting from a whole range of people's experiences.
Therapy groups usually include 4-12 sessions, whereas the information sessions are usually one-off sessions. Some of these are for young people and some are for parents, carers or professionals. If there is a group running in the service that we think could be helpful for you then your CAMHS practitioner will share information about it and let you know when it is next running.
Sometimes young people who are experiencing mental health issues will be prescribed medication to help them. A wide variety of medication can be prescribed to support the treatment of mental health conditions, and it is the job of the person who prescribes that medication to fully explain how it works.
When patients are given medication by a nurse prescriber, they will be told more about the theory and evidence of how the medication works, what type of side effects to expect, when things might typically start to improve and the duration of treatment.
If you are prescribed medication as part of your treatment, ask as many questions as you need to about it.
Evidence shows that when an individual has a good understanding of their treatment, they tend to take more responsibility for helping CAMHS to help them. For example, when using antidepressant medication, there is a period of time at the start of treatment when things can feel worse (physically and emotionally). If a young person is aware of this, they can prepare for difficulties, and may be more inclined to seek the help of their parents, teachers or their CAMHS worker. Parents also report that young people are more likely to continue with treatments if they are aware of the common, short-term side effects of medication and how to limit or manage these.
Motivational interviewing (MI) is a technique that clinicians can use to help people work through uncertainty or doubt and encourage change
Motivational interviewing can help anyone who is thinking about making changes in their lives. Clinicians take a 'directive approach' to discussions, which means they use open-ended questions and listening techniques to help a person discover their own motivation to change. How effective this is will depend on the relationship between the young person and clinician.
Motivational interviewing can be helpful for young people in particular as they can often feel that systems around them such as school, family or social care are against them. It should help young people feel that they have been listened to without judgement.
The benefits of motivational interviewing are that the plans and ideas for change truly come from the individual, meaning they are more likely to follow through with the plan and see positive changes.
CAMHS offers a number of parenting programmes to groups of parents or carers of young people who are using the service. The parenting practitioners co-deliver the programmes with therapists. These programmes include:
FLASH – (Families Learning About Self Harm)
ASCEND – (Autistic Spectrum Condition Enhancing, Nurture & Development)
Incredible Years 18 week Parenting Programme for ADHD/ODD/CD
Overcoming Your Child’s Fear & Worries CBT approach for anxious children
The programmes focus on strengthening interactions between parents and children through a greater understanding of specific problems. Parents can learn strategies to support the young person whilst at the same time increasing their social and emotional competence.
As well as the above, the parenting practitioners can offer one-to-one support to parent or carers where a clinician has identified this as the most appropriate intervention.
Child and adolescent psychotherapy is a psychoanalytic treatment for children, young people and their families. Psychotherapists at CAMHS treat a range of emotional and behavioural problems that may have been resistant to other treatments.
They can also apply their framework of thinking to work with parents, families and carers, and to training and supporting other professionals who work with children and young people.
Child and adolescent psychotherapists tailor their approach to the individual child or young person and can use a combination of talking, observation and play to understand what the child is struggling with.
The aim of the work is to help individuals have a deeper understanding of why they feel and act in the way they do. The child psychotherapist is trained to understand communications at a deep level, and this has been proven to lead to long term benefits in terms of mental health.