COM0010
Written evidence submitted by the Association of Child Psychotherapists
Understanding and celebrating childhood.
- We support the Children’s Commissioner’s plans laid out in Ambitious for Children and advocating for children to have a clearer and more confident voice in our society. We support plans to establish a new taskforce in order to examine and explore children’s experiences, ambitions, needs and concerns about the digital world, but emphasize that children need to have the support of adults they trust who have built consistent relationships with them. We also strongly recommend that children are given more opportunities to play and develop their personalities. We strongly support children and young people having the opportunity to be ambassadors highlighted in this document, but we want to challenge the emphasis often placed on grades and targets for young people.
Being ambitious about every child in care.
- We support plans over the next five years, to build on improvements to secure a seismic shift in ambition for all children in care, which puts the voice of the child, continuing and constant relationships and a recovery at its heart. We fully support consistency from social workers and the extending of support for all children to the age of 25. We would strongly support a commitment to guarantee all children the therapeutic support needed to build a confident future. As a profession working with looked and adopted children for over 60 years, we have a great deal of experience and growing evidence. The ACP has recently commissioned a joint research project with University College London to work on a study examining psychodynamic therapy for children in care with histories of maltreatment and abuse. We can provide further information about this if needed. We would also add that children in care often struggle to have their own ambitions, as they often blame themselves for the breakdown in their relationship with their parents. Adults around them may not have “time” to show that they are ambitious for them or interested in their achievements. For children and young people who find it hard to settle, concentrate and listen to or trust others, achieving academically and completing a project can be a real challenge. Allowing children to learn at their own pace, sometimes in smaller stages is key. We would advocate for more emotional support and specialist consultations for teaching staff and professionals working with children in care. There is a need to build an evidence base around what is most effective in supporting the mental health and emotional needs of our most vulnerable children such as looked after and adopted children and young people. We also note that these children are often supported through specialist services which sit outside of IAPT. Our members also report that rather than being ambitious for children in care, the state school system tends to exclude and punish those who are different and struggle to learn in conventional ways. Young people who have not achieved a grade C GCSE in Maths and/or English are being made to sit them over and over again – feeling more of a failure each time they don’t succeed.
“If you don’t get good grades you’re like classed as a forever fail, I’ll always be reminded that I’m not as good as the ones who get the A grade and have the A grade lives to go with it…” (Adopted young person, 16)
“Everyone expects us all to have had a similar start in life. Educating people about being different – different kinds of families and different kinds of ‘normal’ is really important to us. That’s where stigma comes from – not understanding each other and being willing to listen – properly.” (Young person leaving care, 17)
See a major reduction in children being harmed.
- We support the intention to help ensure that children will know where to turn for help when they need it, but would highlight again the importance of sustained and consistent relationships. This also links to championing approaches to help children and young people recognise and tell about abuse and neglect. Children may communicate their experiences of abuse unconsciously, perhaps through play, and it is important that they have the opportunity to be understood. We would highlight the need to have specialists, eg psychoanalytic child psychotherapists, trained to observe and respond to distress (however well disguised). Our members have completed a two-year observation course before beginning their clinical NHS based training. They therefore have an understanding of how even very young children communicate and show or hide their distress and fear. We are aware of patterns of harm and how these get repeated. Parents in care are more likely to have children who end up in care and vulnerable and unsupported adults are more likely to influence negatively, vulnerable children and young people. We would therefore also support services being more joined up so that adult and child services, health, education and social care professionals as well as police and community based services, communicate with each other. Most adult services are crisis and diagnosis focused, which means that vulnerable young adults and care leavers find it very hard to get a mental health service at all. Knowledge about risky behavior towards self and others can also get lost in transition (if there is a managed transition). We support extending social work provision beyond 18 to 25 but highlight that many mental health services have a cut off at 18, so there is a disparity here.
See sustained action to reduce inequalities for children.
- Sustained action requires sustained resources and again access to specialist treatments and therapies for those who really need them, rather than those who can pay for them. The Taskforce report, Future in Mind (2015), does attempt to address these inequalities and provide more resources to child mental health services However, the nature and quality of provision needs to be regularly monitored. We support radical improvements to children and young people’s health over the next five years, especially around mental health and we too are concerned about growing levels of anxiety, self-harm and drug use (self-medicating). One of our more current preoccupations is that we are seeing generic and less experienced staff providing therapy and initial assessments in CAMHS, replacing specialists, who have been trained to manage high levels of anxiety, trauma and risk. Indeed, many of the most vulnerable and risky children and young people are being turned away without being seen, as they apparently do not meet the criteria for acceptance into CAMH services.
See a machinery of Government that best helps children flourish.
- We would support a Cabinet post for the Children’s Minister, but highlight the need for children to be regularly involved with decision making and policy discussions. We would want to know more about a national children’s test with assessment and how this will ensure that the best interests of children are taken into account when all policy is made.
October 2015