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“The qualities of good parenting (and of close relationships in general) are essentially regulatory qualities: the capacity to listen, to notice, to shape behaviour and to be able to restore good feelings through some kind of physical, emotional or mental contact, through a touch, a smile, a way of putting feelings and thoughts into words.”
Source: Sue Gerhardt, 2004
Why Love Matters: How affection shapes a baby's brain
Source: Sue Gerhardt, 2004
Why Love Matters: How affection shapes a baby's brain
Feel Good People Make Feel Good Wards
Attachment is the most basic need of a young person, topping even hunger in its importance. That means parents, primary carers, teachers and ward staff are the heroic driving force behind great relationships. Empathy, warmth, patience, encouragement, mutual trust and acceptance are all relationship biggies. The parent-child relationship is at the heart of how young people develop all the most important feel-good qualities, including honesty, kindness, loyalty, generosity, a commitment to justice, self-esteem and the capacity to problem-solve. Research has shown that the best predictor of a young person’s health, and the most effective deterrent to risky behaviour, is a close relationship with a parent. A secure emotional connection with a significant adult figure reduces the risk that a young person will suffer from emotional stress, have suicidal thoughts or behaviour, engage in violence, or use substances (Dooley & Fedele, 1999 - ref link).
In this theme, we’ll focus mainly on staff members’ relationship with young people on the ward. We’ll touch on how staff are the compassionate experts who build-up, enable and support young people’s relationships with everyone involved in their lives, including families, carers, friends, schools and even pets. By expertly inspiring caring relationships, staff are socialising agents, and it’s essential that therapeutic work is always collaborative, and the impact it has on a young person’s needs is carefully and systematically monitored (The Centre for Social Justice 2011 - ref link). We also emphasise the importance of giving liberal, generous and sincere praise.
The ‘therapeutic alliance’ is the ability to form and nurture therapeutic relationships in which staff create a 'bond' with young people and their family, so they can work together to reach shared decisions. In this sense, it’s primarily about supporting healthy attachment, so young people and those involved in their recovery can have trust, and are able to be honest about their needs. The healthiest relationships are those which are honest, flexible, committed, warm and safe.
Happy One-to-One-ness
As we explore in the Relational and Physical Safety theme, young people are more able to focus on building positive ways of coping when there is a structure to the ward day. For example, through staff and young people thoughtfully organising space and time. This can be especially vital for young people who feel muddled or detached, or whose home lives have not provided secure attachments. Here the ward becomes a substitute, a kind of surrogate ‘attachment figure’.
Mental health professionals need to establish attachment-like relationships with their young patients in order to support their recovery. Truly caring relationships are not based on detached supervision, observation and discipline alone, but on safety, comfort, support and mutual enjoyment and sharing.
The skill of remaining present with flexibility and clarity within ourselves allows us to be more wholly connected in relationships (therapeutic, professional or otherwise) and to respect each person's individual perspective. Being flexible with our responses gives us a way of choosing communication with the most therapeutic benefit.
Clearly, successfully building a positive alliance leads to happier outcomes. Warm, one-to-one support provided by ward staff is the most significant element in improving young people’s inpatient experience, and is an essential ingredient in any effective intervention. All fruitful efforts to positively shape a young person’s thoughts, feelings and behaviour come from safe and secure attachment. Which is why happy CAMHS ward partnerships count on generous staff members truly connecting with the young people in their care, and the significant figures in young people’s lives. The quality of these relationships has an enormous impact on the outcome of any CAMHS intervention, ideally providing a relational space in which everyone can be their most authentic self. This is a truly powerful gift. Undeniably, relationships are, in and of themselves, a transformative intervention, matched bar none, and that’s why they’re the catalyst for all the COLOURFUL themes.
It’s not surprising that research shows children and young people with a variety of mental health problems and their families tend to prioritise a healthcare practitioner’s ability to listen, and their accessibility, approachability and child-centredness over anything else. Find out more
Good relationships are key.
Clearly, successfully building a positive alliance leads to happier outcomes. Warm, one-to-one support provided by ward staff is the most significant element in improving young people’s inpatient experience, and is an essential ingredient in any effective intervention. All fruitful efforts to positively shape a young person’s thoughts, feelings and behaviour come from safe and secure attachment. Which is why happy CAMHS ward partnerships count on generous staff members truly connecting with the young people in their care, and the significant figures in young people’s lives. The quality of these relationships has an enormous impact on the outcome of any CAMHS intervention, ideally providing a relational space in which everyone can be their most authentic self. This is a truly powerful gift. Undeniably, relationships are, in and of themselves, a transformative intervention, matched bar none, and that’s why they’re the catalyst for all the COLOURFUL themes.
It’s not surprising that research shows children and young people with a variety of mental health problems and their families tend to prioritise a healthcare practitioner’s ability to listen, and their accessibility, approachability and child-centredness over anything else. Find out more
Good relationships are key.
The Six Stages of Attachment
Psychologist Gordon Neufeld (2006) has developed a brilliant model for understanding the way healthy relationships evolve. He’s set out six stages of attachment that create the foundation for almost every relationship a young person will ever have; starting with parents, and later with siblings, friends and intimate partners. Every relationship will follow the six-stage path of attachment. In her excellent book, Parenting Without Power Struggles
, psychotherapist Susan Stiffelman (2012) helpfully describes the stages making up the relational journey this way:4. Significance
If our connection goes deeper, the other person lets us know that we - and our connection - are uniquely special to them.
5. Love (or the appropriate equivalent)
Going deeper still, there comes the expression of fondness and affection.
6. Being Known
When we look at the people who become truly and deeply close to us, we’ll see that they have let themselves be known by us.
If our connection goes deeper, the other person lets us know that we - and our connection - are uniquely special to them.
5. Love (or the appropriate equivalent)
Going deeper still, there comes the expression of fondness and affection.
6. Being Known
When we look at the people who become truly and deeply close to us, we’ll see that they have let themselves be known by us.
Obviously, these experiences must happen for both people in the relationship, if there’s to be a balanced and healthy connection.
Quality Time
The quality of the therapeutic relationship has an enormous impact on the outcome of any intervention with young people and their families. Of course, these relationships are, in and of themselves, a means for therapeutic growth. They require a fine balance of both professional skills and boundaries and the therapeutic use of self, which certainly takes dexterity at times! Such a relationship creates a strong therapeutic connection, helping young people to feel cared for, grounded, supported and able to move forward. While on a CAMHS ward, young patients need staff who will listen, notice, encourage and be able to boost good feelings, through a caring and genuine connection.
Helpful and therapeutic relationships are:
Source: Adapted from Geldard & Geldard 2013
Counselling Children: A Practical Introduction 4th (fourth) Edition by Geldard, Kathryn, Geldard, David, Yin Foo, Rebecca published by SAGE Publications Ltd (2013)
- Protected
- Safe
- Authentic
- Confidential (subject to limits)
- Non-intrusive
- Purposeful
- And have a connecting link between the young person’s world and the practitioner.
Source: Adapted from Geldard & Geldard 2013
Counselling Children: A Practical Introduction 4th (fourth) Edition by Geldard, Kathryn, Geldard, David, Yin Foo, Rebecca published by SAGE Publications Ltd (2013)
Source: Influenced by a great summary of factors that contribute to successful parenting in ‘How To Behave So Your Children Will Too
’ by Dr Sal Severe, 2004.)Listen to young people discussing what makes the ideal CAMHS worker:
A Mindful Core in the Moment
Young people learn about themselves through the way we relate to them and mindfulness is at the core of caring relationships. Ward staff have a responsibility to make sure they create harmony in their relationships and partnerships with young people.
Young people respond to and reflect adult’s mood – especially their parents'. If you're feeling stressed, annoyed or tired, they’ll probably sense your mood and amplify it! So to positively manage both the moods and behaviour of young people, staff have to be able to manage themselves.
When staff are mindful, they’re rooted in the present moment and are conscious of their own experience, as well as the experience of the young person. They’re more able to imagine and appreciate the world (both theirs and the young person’s) in all its emotional shades. Conversely, when we’re distracted by what’s already happened, or worried about what might happen next, our bodies are physically present but our minds are elsewhere. It’s not always easy to work out what young people need, but mindful listening helps staff evaluate and adjust what they’re giving. Mindfulness shows respect for the uniqueness of a young person’s mind, and their own emerging recovery pathway. This level of attention is the glue that holds relationships together.
Both ward staff and parents need to handle young people carefully, if good relationships are to be maintained. It takes time to develop trust and to put a young person at ease, so they feel they can express themselves freely. This isn’t always easy, especially when they come across as rude or aloof. But it is possible to have an open and approachable style while always keeping an eye on professional standards. All children and young people need to be offered dedicated, one-to-one time in a safe, comfortable space, away from intrusions and distractions.
Staff take time to nurture positive relationships and build trust with patients through their consistent responses to them.
As well as the practical elements, like finding the right room, this protected space is created by relational qualities, such as rapport and trust. Listening sensitively and actively not only ensures a good quality interaction, it also helps develop trust and build relationships.
There is great strength in listening.
Coupled with all of this are warmth, sincerity and belief. Showing belief in a young person while they’re being open about what they’re finding troubling will mean a lot to them, especially if they already respect the person encouraging them.
There is great power in openness.
There is great strength in listening.
Coupled with all of this are warmth, sincerity and belief. Showing belief in a young person while they’re being open about what they’re finding troubling will mean a lot to them, especially if they already respect the person encouraging them.
There is great power in openness.
Acceptance is fundamental to creating a mindful relationship. This doesn’t mean staff have to like or agree with everything they see or hear, but if they accept the young person for who they are in the present moment, and embrace them in an attentive way, their connection with the young person will be more secure and they’ll be more likely to have a positive influence in their recovery. Mindfulness isn’t just a new bag of tricks, it’s a fresh way of thinking, noticing and being aware. It’s remarkable what can happen when we listen very carefully to another person, without coming to fixed conclusions about what they’re saying, or who they are.
Skilled helping
Skilled helping creates a sense of involvement, or a caring presence when working with another person. The main techniques of skilled helping can be learned by anyone and are remembered by the acronym SOLER:
(Egan, G. 1965 - more info here)
Within a safe, nurturing, open setting many young people may feel more able to share their feelings, but those who self-harm (self-cutting is the most frequent form of self-harm among young people) often find it difficult to ask for help, because they:
- Believe their physical injuries are not serious enough to need help.
- Are anxious that ’going public’ with their self-harm will limit their future career opportunities.
- Are concerned they will lose control over the situation if their behaviour becomes public knowledge.
(Source: adapted from National Workforce Programme, 2011- read more here)
Getting Connected
Emotional connection is supported by getting perspective on one’s own internal state, including our thoughts, needs, desires, feelings, beliefs, goals, purposes and reasons, while being able to acknowledge another person’s state without reactivity. Young people flourish when they feel truly connected and understood. It’s within their emotional connections with others that they gain a deeper sense of themselves, and develop healthy means for relating. The brain undergoes a total overhaul in the teenage years and throughout this time, young people are operating more from their 'emotional brain'.
“Relationships are the absolute heart of humanity. We are neurobiologically designed to be in relationships. We are neurobiologically designed to be able to read and respond to other people. And we are neurobiologically designed to reach out and seek relationships with other people.”
Bruce Perry, M.D., PhD. 2003
Cited in Loving Parents: Raising Hurting Children
Bruce Perry, M.D., PhD. 2003
Cited in Loving Parents: Raising Hurting Children
The way the CAMHS ward team communicates with young people plays a part in their ongoing development. Staff members’ ability to offer sensitive, ‘give-and-take’ interaction fosters their sense of safety, and has an impact on lots of other aspects of their lives. Young people need to feel deeply connected to dedicated staff, so they feel secure, and their brains can work well to regulate their emotions and benefit from the caring help they are offered.
This involves meeting the young person exactly where they are, in their own world, and sensitively journeying with them towards their unique recovery. After all, the young person’s recovery belongs to them. They’re able to feel rooted in the relationship with an open and mindful staff member who believes in them and their unique journey.
It's an awesome feeling for your patients when you sit alongside them, being aware of their feelings and connecting with their experience. The impact of empathy on young people cannot be overestimated: it can be used positively in any part of ward life.
This involves meeting the young person exactly where they are, in their own world, and sensitively journeying with them towards their unique recovery. After all, the young person’s recovery belongs to them. They’re able to feel rooted in the relationship with an open and mindful staff member who believes in them and their unique journey.
It's an awesome feeling for your patients when you sit alongside them, being aware of their feelings and connecting with their experience. The impact of empathy on young people cannot be overestimated: it can be used positively in any part of ward life.
Once safety is provided, young people are more able to explore and blossom based on their talents, interests and fullest potential. What is safety? Safety comes from the rupture and repair of everyday caring relationships, as the young person feels able to express the full range of their feelings - from murderous rage to overwhelming feelings of love, from a frightening falling apart to being safely held. You can teach a young person that their feelings are not enemies or threats to their existence; that each one of them deserves kind and uncensored attention, exploration and integration. Sometimes powerful energies just need to rage in them for a while. Sometimes the tender tears and emotions need to flow or stream out of them in order to accommodate more hope and love. They may need to feel their emotions more deeply and fully before they can connect with sources of healing. When young people are helped to face the present moment, however forcefully the storm rages in them, within a climate of curiosity, gentleness and honesty, they can uncover surprising gifts.
When trusting relationships and the comfort that comes with them are sustained, both the staff member and young person are more able to be ‘mind-aware’ (to mentalise), and get a sense of each other’s feelings and thoughts. The superb clinical psychologist Daniel Hughes (2009) describes this as a ‘vital connection’ and highlights four things (formed around the mnemonic PACE) that boost the young person’s emotional and reflective skills within a relational space of safety and exploration.
Flexibility, Regular Reflection and Consistency
Although it’s not always straightforward, consistency is crucial for boundaries to be clear and maintained. Boundaries are what young people crave, even when, and especially when, they’re not able to be consistent themselves. For example, sticking to a commitment is a massive thing to young people and it builds trust. They need to know you mean what you say. They need people who follow through. You can significantly enhance the inpatient experience by being more consistent. Consistency is the most important element in your relationship with young people, yet it’s the most frequently overlooked (Dr Sal. Severe
, 2004). Combining consistency with mindfulness will increase your flexibility and responsiveness. Adding proactivity, which is about communicating effectively, will help you stay flexible enough to adapt to changing circumstances. As we say throughout CAMHeleon, mindfulness is about giving focus, and focus takes energy and attentiveness. Each moment on the ward brings something new and will require something different from us. Perhaps one of the biggest challenges of being a member of staff on a CAMHS ward is always being able to respond in flexible ways - it’s also one of the greatest skills.
All of us, young people and adults alike, are open to powerful emotions that we can’t always ignore or switch off. Instead of shaming ourselves when these emotions are triggered, we need to step back, work out what we’re thinking or feeling, and identify the underlying source of what we’re experiencing. Self-control and self-regulation are two crucial qualities of a mindful staff member. Mindfulness helps you evaluate your own reactions, to make sure they won’t inadvertently manipulate or influence the way you relate to a young person.
Of course, regular supervision and reflective practice is a massive help here.
All of us, young people and adults alike, are open to powerful emotions that we can’t always ignore or switch off. Instead of shaming ourselves when these emotions are triggered, we need to step back, work out what we’re thinking or feeling, and identify the underlying source of what we’re experiencing. Self-control and self-regulation are two crucial qualities of a mindful staff member. Mindfulness helps you evaluate your own reactions, to make sure they won’t inadvertently manipulate or influence the way you relate to a young person.
Of course, regular supervision and reflective practice is a massive help here.
In the words of Siegel and Hartzel (2003):
“Response flexibility is the ability…to sort through a wide variety of mental processes, such as impulses, ideas and feelings, and come up with a thoughtful, non-automatic response. Rather than merely automatically reacting to a situation, an individual can reflect and intentionally choose an appropriate direction of action. This ability is a cornerstone of emotional maturity and compassionate relationships.”
Source: Parenting From The Inside Out (Mindful Parenting)
“Response flexibility is the ability…to sort through a wide variety of mental processes, such as impulses, ideas and feelings, and come up with a thoughtful, non-automatic response. Rather than merely automatically reacting to a situation, an individual can reflect and intentionally choose an appropriate direction of action. This ability is a cornerstone of emotional maturity and compassionate relationships.”
Source: Parenting From The Inside Out (Mindful Parenting)
Response flexibility applies equally to staff and patients, but it’s particularly hard to maintain when feeling powerful emotions, especially negative ones. So what’s the answer?
We think it all comes down to a relational approach that combines high responsiveness with clear boundaries and loads of warmth. Warm responsiveness. The basic principles of this approach are very familiar to ward staff and include:
We think it all comes down to a relational approach that combines high responsiveness with clear boundaries and loads of warmth. Warm responsiveness. The basic principles of this approach are very familiar to ward staff and include:
When these principles are followed non-punitively, in a space of empathy and respect, they become gifts you should feel proud of and one of the best demonstrations of compassion.
Committed Conversations
Young people love it when caring adults commit (with flexibility of course) to their request for individual quality time. The Mental Health Act Commission (2008) concluded that all wards should make sure patients have guaranteed time with nursing staff, away from all other activities, by introducing ‘patient protected time’ arrangements and we wholeheartedly echo that proposal! However, opportunities for purposeful conversations and interactions aren’t limited to set times; they’re ongoing, often spontaneous and absolutely part of the fabric of the ward. And they don’t have to be formal or stick to a certain framework or approach. What matters most is that they take priority, are young person-focused and caring.
Upon a secure relational base, we're more able to help young people explore, to learn new, healthier patterns of behaviour and to develop new relationships. Heroic staff understand that a young person who's ‘acting out’ is communicating they need help with their emotions, and they see ‘mischief’ as an opportunity for growth. Every action communicates something of importance, but it’s not always easy to navigate difficult conversations, especially about particularly tricky issues. Staying committed throughout will definitely help young people to eventually have healthy grown-up relationships and teaching them the art of speaking their truth is essential (Susan Stiffelman 2015).
2015).- Tempting though it is, try not to focus on fixing people's problems. Give space for the person to discuss what’s happening for them, and only give advice when invited to do so.
- Strive for clarity.
- Ask what people need and say what you need.
Source: adapted from Kendall, R, 2014
Blamestorming: Why Conversations Go Wrong and How to Fix Them
Praise You Like I Should
A young person’s special blend of skills, attributes and talents should be highlighted and celebrated at every available opportunity. Interestingly, experts propose that young people need to hear about four positive statements for every negative comment to offset the effect of negative comments. Relating to ward staff is an unusual situation for a young person, especially if they usually experience adults talking about them, rather than with them. Praise is one of the most undemanding rewards to give; it costs nothing, takes very little planning and is enormously rewarding for you to give and for young people to receive. While ‘descriptive praise’ works wonders, every young person can benefit from praise that isn’t necessarily associated to a specific achievement, but simply reflects a more overall appreciation of who they are.
Positive feedback is the most powerful tool you have to improve a young person’s behaviour and self-esteem. All children need encouragement, especially those with poor self-esteem and/or those who lack persistence and determination. By praising specific behaviour, you clearly encourage healthy decision-making (Severe 2004). More here: How To Behave So Your Children Will Too
- Motivates young people to seek goals.
- Develops responsibility: ‘When I make good decisions, I feel good’.
- Promotes healthy family relationships.
- Encourages young people to talk.
- Teaches young people to be positive to others.
- Is easy to use effectively.
Source: adapted from Fenwick and Smith 1998
Adolescence: The Survival Guide for Parents and Teenagers
“…tune in when they speak, listen to them when they’re attempting to express feelings and avoid ignoring them when they’re speaking their teenage language, either verbal or nonverbal; then you will surely hear something worthy of praise. If possible, praise the way they’re thinking about things, praise their problem solving skills and certainly praise any displays of empathy or kindness they discuss.”
Greenberg and Powell-Lunder, 2010
Teenage as a Second Language: A Parent's Guide to Becoming Bilingual (Paperback) - Common
Greenberg and Powell-Lunder, 2010
Teenage as a Second Language: A Parent's Guide to Becoming Bilingual (Paperback) - Common
Point out strengths and improvements:
Teach young people to learn from mistakes:
Encourage responsibility:
(Adapted from Dr Sal. Severe, 2004)
- ‘It looks as if you worked hard at . . .’
- ‘Look at the progress you’ve made in . . .’
- ‘You’ve really improved in . . .’
Teach young people to learn from mistakes:
- ‘So you made a mistake. What can you do about it?’
- ‘If you’re not satisfied, what can you do?’
Encourage responsibility:
- ‘It’s up to you.’
- ‘If you want to.’
- ‘You can decide that for yourself.’
- ‘Your decision will be fine with me.’
(Adapted from Dr Sal. Severe
, 2004)Applauding the ‘small’ achievements is one of the simplest, but most effective ways to boost young people’s happiness. Praise needs to be specific, succinct and enthusiastic. A quick touch, a smile, eye contact and words of appreciation recreate the attachment cycle of touch, talk, and eye contact, and show the young person that they’ve been noticed (Gregory & Kupecky 2002). Praise also needs to be genuine. Young people are disproportionately sensitive to adults’ inner feelings and aren’t easily fooled by a few nice-sounding but hollow words. So praise won’t do any good if deep-down the praiser isn’t being honest.
From a solid foundation of self-worth, helped by your generous appreciation of them, everything else becomes a little easier for the young people in your care.
From a solid foundation of self-worth, helped by your generous appreciation of them, everything else becomes a little easier for the young people in your care.
3. Slow down, stop what you’re doing and mindfully pay attention to exactly what the young person is doing that impresses you - even if it's something like the extent of their anger/explosion showing you just how strongly they feel about the situation or issue!
4. Only ever say what you mean and mean what you say. Young people are great at spotting false praise.
5. Focus on the young person’s own progress, while trying to make sure that in every conversation with them, you’re consciously trying to give them hope for a better future.
6. Connect a specific strategy (for example, mindfulness) that led to a particular outcome (for example, feeling calmer).
Check out 100+ ways to praise a young person here
4. Only ever say what you mean and mean what you say. Young people are great at spotting false praise.
5. Focus on the young person’s own progress, while trying to make sure that in every conversation with them, you’re consciously trying to give them hope for a better future.
6. Connect a specific strategy (for example, mindfulness) that led to a particular outcome (for example, feeling calmer).
Check out 100+ ways to praise a young person here
Young people’s emotional development is boosted when they’re able to develop their reflective skills. Warm and sensitive validation of their thoughts and emotions helps them work out what triggers their feelings and can neutralise difficult parts of their experience.
With your compassionate presence - your ability to hold even the darkest feeling or thought - the unacceptable can find a place to rest in acceptance. Painful memories and future fears can surface without shame, the darkness can meet the light of secure and sensitive disclosure, be felt as much as possible and integrated in a space of relational safety.
With your compassionate presence - your ability to hold even the darkest feeling or thought - the unacceptable can find a place to rest in acceptance. Painful memories and future fears can surface without shame, the darkness can meet the light of secure and sensitive disclosure, be felt as much as possible and integrated in a space of relational safety.
This approach welcomes safe exploration of different responses, giving the young person the capacity to cope with adversity and accept their limitations and qualities more easily, while feeling better about them. Individuation (the process by which we become distinguished from one another) is an important part of growing up but it involves a commitment, from both staff and young people, to invest in the young person’s unique values and actively explore new ones.
There are a number of remarkable qualities that can promote lasting wellbeing and prosocial qualities and they should be the main emphasis of therapeutic relationships.
Non-Mental Health Staff
While all nursing staff usually have excellent communication and interpersonal skills, those without specialist mental health knowledge or training can sometimes feel unable to tap into these skills, due to their own anxiety and lack of confidence over the distressing presentation of conditions such as self-harm or psychosis. This often comes from a fear of saying the ‘wrong’ thing, or a belief that it’s problematic to help someone with a mental health condition (the whole ‘can of worms’ thing) without being a specialist.
Happily, CAMHS staff are characteristically more than willing to offer support and guidance to their non-mental health colleagues, whether in person or on the phone. Every hospital should have liaison mental health services with specialist staff, trained in mental health, who are on hand to make sure that young patients get the right care, and are referred for further support if needed. Similarly, some of the more well resourced services have a primary mental health worker, who can provide specific training and advice.
The confidence of non-specialist professionals can also be boosted by recognising that they almost certainly already possess the communication and interpersonal skills needed to support young people with these kinds of problems. (You can find out more about this here)
This is part of the message of Brief Encounters. Brief Encounters (www.brief-encounters.org) looks at how relationships between staff and emotionally vulnerable patients are nurtured through ‘caring conversation’. It’s informed by the evidence of the recovery power of conversation to help people with mental illness or those in extreme distress, where there is no actual diagnosed mental illness.
The magical thing is that even a simple, sociable conversation can have a profound impact on someone who is in a vulnerable emotional state. It can also increase ‘relational security’ - having someone to relate to emotionally increases feelings of safety, and therefore they’re more likely to stay on the ward and participate in their treatment.
The magical thing is that even a simple, sociable conversation can have a profound impact on someone who is in a vulnerable emotional state. It can also increase ‘relational security’ - having someone to relate to emotionally increases feelings of safety, and therefore they’re more likely to stay on the ward and participate in their treatment.
Featured Tools and Ideas
Click on the headings below to read more and add a selection of ideas and tools to you own "Palette"
My Shared Pathway - My Relationships Workbook
My Shared Pathway - My Relationships Workbook
The following extracts are from the 'My Relationships' workbook produced by My Shared Pathway:
"The relationships we have with other people are very important to our well-being and our recovery from mental health difficulties. We have relationships with many different people in many different areas of our life. We have relationships with our family, our friends, our neighbours, people who help support and care for us, all the professional people we come into contact with and, while in hospital, the other people we live with on the ward. We will probably have relationships with some professionals we might not have had relationships with befor"
"All of our relationships have an effect on our lives, on how we feel and on how we behave. Those around us can have a very strong influence on us and our recovery from mental health difficulties. We will need to build relationships with people who understand where we’re coming from, how we are now and how we want to change. There may already be people in our lives that support us and we will need to make sure we maintain these. There may also be relationships that have a negative effect on us, and we may require help deciding what to do about these"
"In this part of My Shared Pathway, we’ll look at all your relationships, the ways you relate to other people and how to make sure your relationships are helpful to you in your recovery from mental health difficulties. We will look at how healthy, positive relationships can help reduce your harmful risks, while supporting you to take positive risks to live the lifestyle you want to lead."
Click here to download the booklet in pdf format. Also, be sure to check out the Unique Recovery Journeys theme page of CAMHeleon.
The importance of affiliation, structure and autonomy support
Study: The importance of affiliation, structure and autonomy support
Drawing on decades of evidence linking authoritative parenting to better mental health outcomes for children, a team of Montreal-based psychologists note how warm, nurturing parenting (‘affiliation’) and clear, consistent expectations and discipline (‘structure’) have been acknowledged as key components. But they argue that a third important dimension - parental respect for children’s own ideas, feelings and initiatives (‘autonomy support’) has received less attention than it deserves.
The results of their study showed that parental skills relating to structure and affiliation both increased significantly, following an intervention to introduce autonomy support into the parenting of a group of parents. There was also an increase in positive attitudes towards autonomy support, with parents making more use of relevant strategies. Parents reported that their child’s mental health had significantly improved and that problematic behaviour had reduced. Children’s feedback also suggested that their sense of happiness, self-esteem and life satisfaction had significantly improved too.
You can read more about their work here.
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Ensure that the young person's whole journey works well - both in terms of early intervention and prevention.
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