Transcript for
Child mental health implementation strategies – part one
Emi (00:00): To that kid, having their outside life be a part of the whole process, it’s almost like an equalising thing because it’s not something that’s come out of a book, it’s something that is actually for them and with them, because they bring their whole selves into the room, not just their problem. And in that way, they’re not just something that goes back into a book after.
Narrator (00:23): Welcome to the Emerging Minds podcast.
Chris Dolman (00:28): Hi, everyone. My name is Chris Dolman. Earlier this year I consulted with some practitioners, who work with children and families, go about ensuring that children can actively participate in developing and tailoring interventions that support them to respond to the problems that they’re facing. I also spoke with parents who’ve accompanied their children in conversations with psychologists or other professionals about what’s effective in terms of their children’s participation in conversations with professionals.
(00:57): This is the first of a two-part episode, where we explore this and related themes. During those conversations I just mentioned, a key question we were examining was how about sharing their practice wisdom and expertise with children, offering tools and strategies and ideas without erasing children’s experience or inadvertently disempowering them. We can also turn that question around and ask, how might practitioners honour children’s skills and creativity and know-how without diminishing their own practice skills and expertise. This is one of the practice challenges covered in Emerging Minds online course, Practice strategies for implementation. So if you are interested in this free online course, please visit our website at emergingminds.com.au.
(01:44): So in these two podcast episodes we’ll be hearing from three of these practitioners. Angela Coppi and Jane Walch, they’re psychologists with Adelaide Paediatrics. And Sara McLean, a child psychologist with Emerging Minds.
Hearing from Jess and Emi, two of Emerging Minds’ family partners who have contributed to the development of our practice strategies courses and share from their lived experience of working with practitioners in relation to their children’s mental health and wellbeing.
In the second podcast for this series, we’ll be looking at responding, as well as some practise ideas for future-proofing children’s newly-acquired or developed or discovered skills.
But for now, let’s begin by hearing from child psychologists Sara McLean, Angela Coppi and Jane Walch. I asked them, when sharing ideas or tools with children to assist them to deal with problems, how do you encourage children to collaborate with you. Here’s Sara.
Sara McLean (02:35): I find it really helpful right from the start to set up a space where children are curious about themselves as their own experience. For me, it’s about striking that balance between myself as the expert, who actually I have some things to offer, some ideas to offer around what might work, what other kids have found helpful, what other families might have found helpful, but also ideas that they can contribute as well. So it’s valuable for them to learn those skills kind of about themselves to build their knowledge about themselves, not only in the here and now, but stuff that they can take into the future. So collaboration is incredibly important within keeping them safe.
Chris Dolman (03:18): I asked Sara how she begins to create this context for collaboration.
Sara McLean (03:22): So I might lean into it by saying, lots of children tell me this, this, this about fears and worries or lots of children have told me some good ideas. Is that something you’d be interested in hearing about? Do you want me to tell you about that? Or do you have your own ideas? And they might want to hear a little bit of whatever or they may have their own ideas. And then I might say something like, “Some kids find paced breathing breaths or some kids might prefer to write in a journal or something. So do you have any idea about that?”
(03:55): So what I’m trying to do is set up an expectation right from the start that I have some things to contribute, and that’s mostly based on what children have told me. So at the start, it’s normalising that fears and worries are normal and that lots of kids have them. And luckily for me, they have told me a few things about what’s worked for them. And I can share those ideas with you. But you’re the boss, you need to make a decision about what you think might work for you. And some things you might not know about, and I can show you how those work.
Chris Dolman (04:27): I also asked Angela Coppi how she begins to encourage children to collaborate with her in her practice.
Angela Coppi (04:34): I also talk to them about different learning styles, that might have been a conversation that we’ve already had about how everyone learns differently. So the way we work together might look different depending on how you learn. So some people learn best by listening to people talk about things. Other people like to really play things. Some people like to be doing things or have things demonstrated. So we might have already had that conversation, and that would then guide how I incorporate them in therapy. So I have lots of craft and art materials that they can use, or it might… So using programs like Canva to create a poster or actually doing hands-on craft activities.
(05:14): So I’ll talk to them about that mountain metaphor about life being a mountain, a journey. And at the top of the mountain is our best life, the best version of what’s important to us, so our values. So sometimes we are heading straight up that mountain and the pathway is really clear and we know exactly where we’re going. And other times it might be like an avalanche has hit, so we feel really stuck. Or we might think we’re on the right pathway and we recognise we’re going round in circles and we’ve ended up right back where we started. So it’s about recognising that we’re on the right or wrong pathway, whether we’re making helpful choices or unhelpful choices, to be the best version of ourselves. It’s not to say that I’m any further up my mountain than the other people in the room. But I can just see their mountain from a different perspective, so I can guide them and help them choose the right pathways to be the best version of themselves.
Chris Dolman (06:07): And here’s Jane Walch.
Jane Walch (06:08): So I’m really honest with kids when I don’t know much about what… So I’m not a big computer gamer, but a lot of the kids that I see are. So by default I’ve got good at computer games. But I will say to them, “Look, I am…” And try and use their language. So I’ll say, “I am a noob.” So that’s someone that’s new to computer gaming. I’m a noob at that, but you’re a pro. I really would love it if you taught me about that, or even with… I have no idea about hockey. I’ve never played hockey. I’ve never even seen a game of hockey. Can you teach me about that? And they love that, right. They love that because it’s not often that an adult acknowledges they’re not good at something, and then they’re open to that suggestion too. So the more that they see you being interested in them, forms the connection too.
(06:54): It all comes together with the importance of taking the time to get to know the child, the family and what their interests are, what makes them tick, what they do in their spare time, what they do outside of school, what they find joy in that then helps you develop that rapport in you. That is the basis for any good work, whatever you then move into. But if you don’t take that time and often you might be three or four sessions in and you’re thinking, “Oh, I haven’t even started on anything in particular.” But to race, rush through that important foundation, you can’t get to the treatment point or you can’t get to the tool-building time because they’re not there yet with you. So it’s so important that beginning time for them, that collaborative work or/and the trust to happen. And then they’re more likely to engage in things with you.
Chris Dolman (07:53): I asked Jess from her perspective as a parent, how important is it and why is it important that practitioners find ways to encourage children to collaborate with them and together… Mentions that the child can draw upon in everyday life?
Jess (08:08): Yeah, I think it’s important to involve the children because if they don’t have a good buy-in, then they’re not going to succeed with whatever the tool is. So the practitioner has an idea about how outcome will impact the child, but the child will help make the decisions on how to use that tool.
(08:26): Learning about their specific circumstances as well, finding out how that’s going to fit into their daily life, into the household but also the physical space of the house. Different tools might require different places or equipment and trying to get the child to become a part of the problem-solving aspect of whatever the tool is.
(08:48): I think when we are looking at tools and have success with the child and the family, if you just give them something that’s generic, it’s probably going to miss the mark. Like you might have a kid who’s really into space and space exploration. So you might aim that tool interest area. If you try that with another child, it might not work. So you need to make sure that they’ve got interest in it. Also making sure that the family’s equipped to do it. If they need to purchase something or needed something printed out, can be real barriers if they’re not discussed early on. And it’s not going to be successful.
Chris Dolman (09:31): I asked Sara and Angela how important it is in their practice to be understanding the child’s capabilities and interests, like what they are into, what they’re good at in order to support that collaboration. Here’s Sara McLean.
Sara McLean (09:43): I think it’s incredibly important. So if you can follow their interests and use an example from their lives, it really brings it to life for them. Straight away they can empathise with that character or that event, or that skill. Have experience of being successful in that space, which straightaway changes the conversation into one of I’ve succeeded before and I can do that again. And it also brings to life their experience maybe of tolerating or persisting through frustration.
Sara McLean (10:12): An example I’m thinking of would be a young person I’m working with, who has anxiety. If I were to ask him off the bat to generate some ideas about strategies, that might be a bit tricky. However, he’s also a basketball player. So we talk about going back, playing basketball, what was the first thing he learned and would you expect a person to be able to dribble the ball while running straight away, yes or no? Or do you expect those skills to develop over time? So straight away he’s able to relate to the journey and every day he might get a little bit better at whatever it is that I’m asking him to do or he might have days where he just can’t pull it together. So straight away, he’s in that world and he can draw on his own experiences of mastery and success and optimism and interest.
Chris Dolman (11:03): I appreciate Sara’s emphasis here on these conversations around children’s skills and capabilities and how they can help children speak about and reconnect with their own successes and competencies. Now here’s Angela.
Angela Coppi (11:16): I think knowing what their interests are helps you come up with examples that they find interesting and they’re going to relate to. So for example, I had a kid recently, really into computers. And every time he walks into the room, he’ll comment on any new technology. So I know that technology is going to really bring him in. So when we’re talking about his meltdowns, we talk about the computer shutting down and he calls it blue screen mode, where the computer just freezes and goes into blue screen. So we’re able to use that example that he really connects. Now becomes language that his parents can say to him.
(11:51): And I think it’s more relatable too. And I think parents find it easier to use that language because it seems rehearsed if it’s language that’s coming from me, if I’m telling them, “Say this, do this.” Where if it’s something that’s organic therapy that’s related to the kids’ interests, then it’s more often going to be language that’s used in the house anyway. And it doesn’t seem like, oh, this is something that Angela’s telling us to do. This is just something that’s part of our family now.
Chris Dolman (12:15): Jane Walch was also adamant about the importance of drawing on children’s creativity in developing interventions with children.
Jane Walch (12:23): So the effectiveness of the tools that you create with a child is so dependent on making sure it’s personable to them. So whenever I start working with children, I always in building and my getting to know you, it is about working out where the interests are. So we do activities like 10 things about you. So I’ll know are they a Minecraft kid, are they a soccer kid. So I’ll have some idea about their interests and then into, okay, so let’s look at some tools that we need to work on. I’ll then try it, as best I can, to incorporate what I already know is their interests. And then always put to them how that might fit for them as well.
(13:08): To create if you’re working on emotional regulation and a child is really into Roblox, which is a really common computer game at the moment. So we’ll look at recreating some of the Roblox characters and look at their facial expressions. So we all own emotional recognition flip book or something and we use those, but it’s using something that they’re interested in. So they’re already engaged because they’re already loving the Roblox pictures or I’ve done some things around anxiety management with kids that are really into sport. Talk about, say a football team, and we’ll talk about moments in the games and what might be anxiety provoking for that player, when they’re about to kick the goal and what do they do? You ask the kid, “What do you do when you’re about to kick the goal?” Oh, well some of the players, they pull up their socks or they take their mouth guard or whatever. What do you think they’re thinking? So you’re trying to create what’s already part of their world and include that in the tools that you then develop with them.
Chris Dolman (14:08): Angela and Jane have highlighted for us the significance of finding cultural metaphors and symbols that are resonant for children. I asked Emi, one of Emerging Mind’s family partners, from her perspective as a parent, how important it is that the practitioner is familiar with the child’s interest and makes good use of this in the child and family.
Emi (14:30): It’s completely vital, 100%. So for the practitioner, for a start, to be finding out about this stuff, signals to the child that the practitioner is interested in them and wants to get to know them. It for the child to be more than their problem. So they’re there as a person, as a whole person, not just as somebody who needs something fixed.
Chris Dolman (14:53): I asked our interview guests, what difference do they think it makes to children to have a sense of contributing to the innovation, these tools and ideas that they can subsequently use to respond to the problem. Here’s Angela and then Emi.
Angela Coppi (15:08): I think they feel validated, yeah, that they have taken part and they have some ownership over. It’s not just something that their therapist just told them, “You need to go away and do this.” They actually want to do it because they’ve been involved in the creation of that particular strategy. You can use those different examples in therapy sessions with other children and say, “Hey, I had this really great session with, he recommended doing this or this was his idea or this was her idea. And she did that.” And some kids go, “Oh yeah, wow, that’s amazing. I’m going to do that too. Or I’ll tweak that a little bit and make that mine.” So it’s a collaborative approach with other different clients, without them necessarily having to work together.
Emi (15:48): Kids, they’re used to school and even parenting, where they’ve really told what to do, how to do it, why and why they’re doing it. And I think a child would be expecting the same thing to happen in that situation. So to actually get in there and find out that I must be a part of this process and my opinions matter and they mean something and it’s not just tokenistic, it’s real, I think that would be surprising.
(16:14): So that when they’re getting the help for that problem, it’s more than that because they already have that. So they need to start to build up a sense of who they are beyond what’s going on. It’s like an open wound. To me, when I think back at the times of trauma, it’s very much like an open wound. I used to feel like everyone could see that. And I think the kids probably feel a little bit like that too. Maybe that’s how people experience trauma. I don’t know. That’s definitely how I did. So they need to find other ways to see themselves in the world, apart from this wound that they’re trying to…
(16:52): In their life, their outside life be a part of the whole process means that it’s almost, again, like an equalising thing because it’s not something that’s come out of a book. It’s something that is actually for them and with them. They bring their whole selves into the room, not just their problem. And in that way, bringing their whole selves into the room, they’re not just something that goes back into a book after. And when they finish the session they go back and the person they are, everything. So it would seem illogical to walk in the door and throw out the rest of you. You walk in the door with all of you, you might as well make all of you a part of that process. I think they own the process and it’s empowering, it makes it real and authentic and it makes it more doable.
Chris Dolman (17:45): Both Angela and Emi highlight the potential for these conversations to also be contributing to a child’s sense of ownership of the tools or strategies that are being developed as well as how they see themselves and how they see their relationship with the problem. I also asked Emi and Jess, what it was like for them as parents to see this tailoring of interventions for their children.
Emi (18:08): Yeah. Oh really relieving. I would who believed in what they’re doing. They’re there to actually make a difference because they’re taking the time to make this session about my child, that my child isn’t just anyone, they’re actually a child or a real child with real going on and a real life. And it would mean that I could feel like things could be brought to the table and listened to. Yeah, definitely was make a huge difference. Give me a lot of relief.
Jess (18:40): I think that it’s quite powerful because as a parent, point of asking a professional for help, you’ve tried everything, right, you’ve exhausted the options. So by going to a professional and them saying, “Your child’s not the problem, actually we can solve this together as a team and effort,” I think it gives them the idea that this is actually solvable, this is not my child, there’s this other thing going on. And I guess it gives them hope as well that there is actually some steps we can take. Here’s the practical. We want this to be better. Here’s how we start that journey.
Chris Dolman (19:21): These comments by Emi and Jess highlight for me how the process of tailoring interventions collaboratively with children can be significant for parents as well and can contribute to shifting paths of their child and really support their hopes that things can turn around in the future. That brings us to the end of part one of this two-part podcast series.
(19:43): Thank you again to our guests, Emerging Minds family partners, Emi and, for sharing their ideas and insights from their lived experience. And thanks to Angela Coppi Jane Walch and Sarah McLean for their generosity in sharing their practice reflections from their work with children and families. In part two, we’ll be exploring some practice ideas for responding where families experience setbacks in dealing with problems, as well as some practise ideas for future-proofing children’s newly acquired skills in dealing with problems. So thanks so much for joining us today, and we look forward to your company next time.
Narrator (20:20): Visit our website www.emergingminds.com.au to access a range of resources to assist your practice. Brought to you by the National Workforce Centre for Child Mental Health, led by Emerging Minds. The National Workforce Centre for Child Mental Health is funded by the Australian government Department of Health under the National Support for Child and Youth Mental Health program.