One of our Senior Health Mentors explains how he supported a child with anxiety over a period of time. Please note the name of the child has been modified for data protection.
On the surface, Will is a typical 8-year old boy. He comes from a stable home and has a settled family life where he is clearly loved and cared for by his parents. He enjoys a close friendship group with other boys in school and he loves his football. Will has a cheery demeanour and his big brown eyes are never too far away from breaking into a big smile, which envelops his entire face.
He is bright, polite, hard-working and helpful. He has no problems with behaviour or his school work. So what reason has he to be suffering from anxiety? He has not had a childhood trauma such as a parental breakup, bereavement, seeing a loved one suffer illness. Many of the children I have worked with have endured a much tougher start to life and not succumbed to anxiety, why has he?
The definition of anxiety is: “A feeling of worry, nervousness, or unease about something with an uncertain outcome.”
Will was referred to me as the school’s Health Mentor over concerns raised by his Mum. He had recently not wanted to go to football training and was showing signs of stress and worry over upcoming matches for his local team, despite enjoying playing for them for several seasons. He was making excuses to avoid going to friends’ houses or have them come over to his. Increasingly, he was getting worried about his Mum being late picking him up from school at the end of the day.
To discover the cause of Will’s anxiety, we had regular 1-1 mentoring sessions, I used a combination of art therapy, CBT (Cognitive Behaviour Therapy) techniques, counselling skills and mentoring methods. Over the course of a few sessions it became clear that the reasons for his worries were multiple. For football – the fear of being dropped from his team or losing a game due to a mistake were a big cause of his worry, despite that never happening in the past. His worry about Mum being late from school was again without basis. Mum had never been late picking him up and, if she ever was, he would simply stay in school for a few minutes until she got there. He was worried about going to his friends’ houses in case they fell out, even though they never previously had such issues.
The cause of Will’s anxieties were cognitive distortions. These are false thoughts which are irrational and purely without foundation. I devised a workbook which we called “Will’s ANT Thoughts” (automatic negative thoughts) and over the next few sessions, working together, we challenged all of his worries and replaced irrational thoughts with rational ones.
The breakthrough moment was quite emotional. I pointed out to him that he had begun to refer to his worries in the past tense, and Will realised that he had conquered them.
The next few sessions were spent concentrating on a CBT technique known as ‘Relapse Prevention Therapy’ (RPT). This is to help him recognise and deal with future false thoughts. He is now enjoying playing football again, isn’t worried at the end of the school day and is continuing to see friends out of school.
I have introduced him to an article by Dr Sam Kyeremateng, who brilliantly uses a metaphor of a terracotta jug to demonstrate that fear of something going wrong can impede something more important going right.
Having a Health Mentor in a primary school, who is known and trusted by the child and can pick up on teachers’ or parents’ concerns and deal with a potential mental health issue quickly and professionally, can negate the need for intervention by the NHS Children’s and Adolescents Mental Health Service (CAMHS). The CAMHS process can take months to get an initial assessment and further delays in treatment starting.
Using an in-house mental health professional such as a Health Mentor, ensures that children like Will not only recover from their anxieties in a few sessions rather than months or years, but they are given on-going support for the remainder of their years in the school.
So, in answer to my earlier question, ‘many of the children I have worked with have had a much tougher start to life and not succumbed to anxiety, why has he?’
“10% of children and young people (aged 5-16 years) have a clinically diagnosable mental problem3, yet 70% of children and adolescents who experience mental health problems have not had appropriate interventions at a sufficiently early age.”
Jug by Dr. Sam Kyeremateng.
A terracotta jug sits on a stone floor, in a dark space. A dim light illuminates the spot on which it sits. The jug ponders its existence in the world. It surveys the gloominess of its surroundings.
Why am I here? Who am I? What am I? The unspoken questions are unanswered. The jug ponders itself. It was crafted with care. Someone had lovingly sculpted its form. Taking great care, moulding its short spout and stout handle. Despite this the questions remain unanswered. The labours of its maker could not fully explain its purpose. It understood it was a jug. By its own admission it knew jugs could hold all manner of things. But it could not hold all things at once, and it could not decide what it should hold. It was not enough to be simply a jug, was it?
It did not think it wished to be an empty vessel, and it did feel so very empty. It thought of all the things it could hold; water, wine, oil, or even marbles.
If it held water it could be used to sustain people or to hold beautiful things like flowers. If it held wine it could bring life to a party, solace to the lonely, and joy to the sad. If it held oil it could fuel a fire, or ease the workings of some great machine. If it held marbles it could be an ornament to be admired and adored. As the thoughts danced through its imagination the jug realised that in the darkness of this room it could see no water or oil or wine or even stones let alone marbles and even if it could, it could not decide how to choose between them all. The jug sat empty.
The jug sat in silence. In the distance the sound of footfalls tapping the flagstones pierced the darkness. The jug pondered a new thought. Perhaps someone would come and make the choice. Someone would find it and fill it up with something that would make it something worth being. Delighted by the prospect it sat thinking soon it would find the answer to all its questions.
As the steps drew closer the jug’s excitement changed to anxiety. What if the person chose the wrong thing? Once filled with wine it could no longer hold water for fear of tainting the taste and vice versa. Would oily marbles have the same appeal? Panicked by the new dilemma the jug remained frozen in the spotlight. The steps stopped. The jug sensed the gaze of the unseen figure.
After a moment the silence that had nurtured its thought, became unbearable. The steps clacked back into life then faded. The terracotta jug sat on a stone floor. In the silence it decided it was better just to be and not ask too many questions. To be an empty jug was enough for now.