Depending on your and your family’s particular needs, we offer the following services:
- Multidisciplinary Assessment
- Child & Adolescent Psychotherapy
- Family Therapy
- Cognitive-Behavioural Therapy (CBT)
- Trauma Therapies
- Cognitive Assessments
- Neurodevelopment Assessments for ADHD or ASD
- Parent work
- Foster Care and Adoption Support
The first meeting you have with us is a multidisciplinary assessment. For this assessment we see parents and children together, and we meet for up to 90 minutes. You will meet two clinicians, with different areas of expertise, who work jointly to gain a thorough understanding of your concerns and needs, and what has brought you to seek support at this time.
Depending on the nature of your concerns, we may suggest that we carry out a school observation and/or speak with other professionals who know you and your child. We would only do this with your agreement.
This initial assessment allows us to make personalised recommendations about the next steps. This could be individual work, family sessions, parent support or further assessment. We may recommend a single therapeutic approach, such as individual sessions for the child/young person or parents, or we may suggest a package of care, such as individual sessions alongside family sessions and/or meetings with a psychiatrist. If we have significant concerns about risk, we may recommend another service.
Child & Adolescent Psychotherapy
Child psychotherapy helps children and young people to make sense of troubling feelings, thoughts and experiences, particularly those which are difficult to express in words. It provides a safe, reliable space in which children and adolescents can communicate sad, angry, painful or confusing feelings, so that these feelings do not have to be expressed through behaviour or physical symptoms. Although child psychotherapy can make a difference very quickly, the treatment is not just about getting rid of unwanted symptoms. It also builds emotional resilience, by helping the child or young person to manage and make sense of difficult feelings. This usually has a beneficial effect on family relationships, school engagement and behaviour, and can help the individual make better use of future opportunities and relationships.
Child psychotherapists work with a range of issues including low mood and/or low self-esteem (depression), anxiety, difficulties in relationships (including bullying), self-harm and behaviour problems. When there is confusion about what might be causing the child’s or adolescent’s difficulties, child psychotherapy can support children, parents or carers to disentangle and gain a better understanding of the problem.
Child psychotherapy begins with an assessment of around three or four sessions. This helps the child, parents and psychotherapist decide together on the length and frequency of the treatment, which can be anything from a few sessions to over one year. Sessions are offered regularly, at the same time and in the same place each week. The psychotherapist meets individually with the child or adolescent, and will usually arrange to see parents or carers every few months. Depending on the age of the young person, it can be helpful for parents to have some additional sessions with the child’s therapist or with a colleague, to support the changes that the young person is making through the therapy.
More information about child and adolescent psychotherapy can be found here.
Family therapy explores relationships and family dynamics and can be helpful for families that feel overwhelmed, worried, stuck, or not sure what to do for the best.
Issues that families often have to face, such as illness, bereavement, adolescence and changes in the make-up of the family, can make family life more stressful. The therapist recognises that family members will probably have different views and feelings and works to ensure that family members feel safe to explore these differences, in order to help the family better understand and support each other. It can be useful to look at what is going well in a family as well as to explore some of the difficult patterns families often get into.
Frequency of sessions varies according to need. Each meeting lasts for an hour and can involve the whole family, some members of the family or individuals. Who attends each session will be discussed and decided with you.Cognitive-Behavioural Therapy (CBT)
Cognitive-Behavioural Therapy (CBT)
CBT is a psychological treatment that aims to help you understand how your problems began and what keeps them going.CBT works by helping you to link the way you think (thoughts and beliefs) with how you feel (your emotions) and how you behave. CBT has been found to be effective in helping young people with a wide range of problems including: depression, anxiety, OCD, PTSD and low self esteem.
If you think that CBT might help you then you will be offered weekly sessions. The number of sessions depends on the problems you are struggling with. This will usually be between 6 and 20 sessions, typically 55 minutes long.
Together with your therapist you will try to understand your difficulties and discover ways of dealing with them. You will be encouraged to practise the CBT skills in between the sessions and then discuss how this went at your next session.
Parents are sometimes involved in the therapy ‘co therapists’ with a shared understanding of the problem, understanding of the therapy, shared goals and to support you practice in between sessions. Whether or not your parents are involved and to what extent with be discussed with you.
A traumatic event is any experience during which you fear for your own or someone else’s safety. It is very common and normal to experience various symptoms after a traumatic event, including recurring thoughts, nightmares and intense emotions. These symptoms are thought of as a normal reaction to an abnormal event. The recurring thoughts and nightmares are understood to be our minds way of making sense of something terrifying that has happened. It is also thought that these symptoms occur as a result of trauma memories being stored in a different way to every day memories. Trauma memories are thought to be stored in a more raw and sensory form (e.g. in sights, sounds, smells), and so are unpredictably triggered and brought back out-of-the blue by things in the environment which represent part of the trauma memory. This could be hearing a similar sound or seeing something that looks like something that was present during the trauma. For some people, trauma symptoms naturally reduce over time. For others, the symptoms can continue or worsen. If trauma symptoms are very very intense or continue beyond 3 months then trauma-focussed therapy would be recommended. If symptoms last beyond 3 months you may meet the criteria of Post Traumatic Stress Disorder. However, you do not need to have a diagnosis of PTSD in order to benefit from trauma-focusssed therapy if you are experiencing distressing symptoms following trauma.
We are able to offer the three main types of trauma-focussed therapy: Trauma-focussed Cognitive Behavioural Therapy (TF-CBT), Narrative Exposure Therapy (NET), and Eye Movement Desensitisation and Reprocessing (EMDR). These trauma-focussed are different in the way they are administered but they all aim to reprocess trauma memories so that are stored in a less raw and emotive form, and in turn reduce or even resolve the frequency and intensity of trauma symptoms. Trauma-focussed therapy also aims to give you back a sense of control back and to reduce any ongoing feeling of current threat, which is so common and understandable following trauma.
Trauma-focussed CBT involves talking about the traumatic event in a safe space in order to make sense of the experience and re-process the memory and any beliefs you may have developed about yourself, others or the world. Narrative Exposure Therapy (NET) is similar to TF-CBT, but has been developed for people that have experienced a number of traumatic events and so involves developing by a broader narrative of your life and re-processing the different traumatic events you have experienced. EMDR is quite different to TF-CBT and NET, and involves you holding images of the traumatic event(s) in your mind whilst having both sides of your brain stimulated (either my following eye movements, alternate tapping, or bilateral sounds). EMDR is quite a different type of therapy and so if you would find it helpful to read some further information about EMDR please click here. It is important that you feel in control of what treatment you choose for yourself. If you would like further information about PTSD and recommended trauma treatments then please click here.
Cognitive assessments are formal assessments of a child’s strengths and difficulties. They may include an assessment of a child’s intellectual ability, verbal and non-verbal skills, attention, memory and processing speed. Cognitive assessments are particularly helpful when a child is struggling at school as they can help to determine where support is needed. We will meet with the young person and parent/s or carer for an initial assessment to consider what the difficulties are and which cognitive assessment would be most helpful. Cognitive assessments involve verbal, non-verbal and visual tasks and the assessment usually takes place over one or two appointments. A full report will be provided and an appointment arranged to feedback the findings. Further discussion with school professionals can be arranged if required.
Neurodevelopment Assessments for ADHD or ASD
Autism assessments Autism spectrum disorder (ASD) is a condition that affects social interaction, language and communication, interests and behaviour. Statistically, around 1 in every 100 people in the U.K has an ASD. The symptoms will be present before the age of three but often a child will not get a diagnosis until primary school, and for some children the condition is not diagnosed until secondary school. At FITZCAF we use evidence based diagnostic tools to assess for autism as recommended by NICE (National Institute of Clinical Excellence) guidelines. We will meet with the young person and family for an initial assessment to consider whether further specialist assessment of autism is required and may use screening questionnaires. Following this, it may be helpful to undertake an ADOS-2 (Autism Diagnostic Observation Schedule) with the young person and to complete a full developmental history of the young person with a parent/s or carer. The ADOS-2 is a play based assessment which is based on level of spoken language, with more verbal tasks when language is fluent. In addition there will be a discussion with a teacher at the young person’s school and where helpful, a school observation. A full report will be provided and a further appointment to feedback the outcome of an assessment. If a diagnosis of Autism is given, if needed we offer support about discussing the diagnosis with the young person and other professionals involved in your child’s care. At this time we will also consider whether therapeutic support would be helpful.
All parents experience difficulties at some point in knowing how to best support their child(ren) or young person. It can be deeply distressing to witness their sadness or anxieties and to see how these feelings are being conveyed to others – for instance this might be from being quick to anger, withdrawing from spending time with family and friends or through worries about school work. Transitioning from adolescence into young adulthood is one of the most strenuous and toilsome of the developmental achievements. There are many tasks involved including adjusting to being in a sexual adult body, regulating one’s emotions, developing independence, forming an identity and self-concept, managing and re-negotiating family, peer and sexual relationship. Due to the pressures of these tasks your young person will rely on you for some kind of emotional refuelling at times, as well as also perhaps needing to be able to reject you at other times. They may want to both be left alone and to be loved at the same time – seemingly contradictory wishes. It might be feeling as if the attempts you are making to help your child or young person with their distress are somehow redundant or ineffective. Or perhaps it feels that what are you doing is causing more difficulties in your relationship with them. Gaining some professional advice might be a useful source of support for you. Our approach to supporting you will be tailored to the developmental stage of your child; we offer a range of interventions for parents of children and young people of all ages. Please contact us to find out more.
Foster Care and Adoption Support
We have experience in providing therapeutic intervention to children who have been looked after, working with both foster carers and adoptive parents and children. We often first meet with the carers/parents to help them think about the needs of their children and we can then also offer direct work with young people if indicated, either individually or as part of a family. Some of our clinicians have experience of working with foster care agencies and the Local Authority to support children and adolescents and prevent placement breakdown or to give advice about the needs of children or a sibling group. We can also run groups for foster carers to teach skills in understanding and managing children who might be showing distress as a result of difficult early environments.
Individual therapy can be offered across a range of modalities depending on preference and discussion about what would work best. Additionally, we can provide systemic family therapy to support families develop a different understanding which can help everyone learn to live together and identify and change patterns of behaviour. Some of us are trained to deliver Dyadic Developmental Psychotherapy (Dan Hughes) which has a good research evidence base with adoptive parents and assists in helping manage challenging behaviour that children can bring as a result of adverse early experiences.