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Feeling safe and comfortable internally and externally: that’s what this theme is all about. Young people, and their families and carers, expect ward staff to be safe and accountable practitioners. Safety is the basis of human development and our social life; in other words, it’s really essential that everyone feels safe.
The young person may be coming from experiences that made them feel, or be, distinctly unsafe, externally and/or emotionally. Young people living in prolonged fear states are often opposed to adult intervention, because they feel anxious about putting their faith in others; specifically, to trust the notion of adult affection. When we feel unsafe, it’s hard to think about anything else other than trying to re-establish safety, and other things that are typically important or of interest are overlooked.
The young person may be coming from experiences that made them feel, or be, distinctly unsafe, externally and/or emotionally. Young people living in prolonged fear states are often opposed to adult intervention, because they feel anxious about putting their faith in others; specifically, to trust the notion of adult affection. When we feel unsafe, it’s hard to think about anything else other than trying to re-establish safety, and other things that are typically important or of interest are overlooked.
As well as their presenting mental health problems, 11 to 14 year olds are also likely to be worrying about the appearance of their developing body and feeling awfully self–conscious. Parents or carers are the primary source of the safety and security needed by children and adolescents. Parents are hopefully doing their best to cope with their child’s common feeling ‘it’s not fair’, but striking a balance between freedom and over-protection isn’t easy! Parents of young people in the last four years of adolescence often feel anxious about risk-taking, and have to work out how and when to set limits. They may try to discourage activities they consider unsafe, but risk antagonising their child. And although it’s characteristic behaviour of 15 to 18 year olds, parents’ endeavours are especially challenged when the young person tries to guard their privacy and seems secretive.
In fact, parents' anxiety about their child's safety and feelings may make them appear too intrusive, and their natural desire to protect their child may trigger tension. Whether you’re a parent or not, we’re sure you can relate to these issues based on your CAMHS experience. And again, all of this is exacerbated by whatever difficulty they’re in hospital for.
"What would it be like to grow up in an environment where you had to be alert and vigilant all of the time? It must be a bit like the difference between swimming in a shallow swimming pool and being in shark-infested waters. If you see a black shadow under the water, you would probably have two very different reactions: in the shark-infested water you would probably feel certain that the shadow is a shark, a threat to you, even if you cannot see under the water. Your brain would slip automatically into the ‘fight-flightfreeze’ response, a physiological response to perceived threat whereby the body releases a combination of a neurotransmitter called epinephrine and various hormones, which work together to create a boost of energy. Well the same goes for children in chronically traumatic environments. They become hypervigilant to threat and danger, although in their case the threat is their parents."From Cooper and Redfern, 2015 - read more here
Containment
CAMHS staff do a fantastic job of providing emotional and psychological support, which is no mean feat! Setting up and keeping up a sense of safety is the main responsibility of the adults young people are attached to. Once safe, young people are able to explore and blossom. This takes consistency, mindfulness and patience, the ability to connect with young people with presence (by ‘presence’ we mean being really tuned-in and alert, opening our senses and truly being with the other person) and give them space, the use of good boundaries and the strength to ‘hold’ even the strongest of feelings and experiences while the young person explores them.
By using your present-moment mindfulness, young people are more able to appreciate that they have your attention, and that you have theirs. You do your best not to become distracted, or do several different things at once while you’re with them. You meet them exactly where they are, without needing them to change according to your own agenda or schedule. You embrace their first-hand, direct experience - honour it, accept it, stay with it and explore what they need to explore with you.
It’s not always easy to keep hold of - to contain - difficult feelings (theirs and yours) and they can feel disproportionately overwhelming. Young people often push boundaries because they know intuitively that they need the safety of an adult’s calm, confident responses, and to offload the painful feelings bubbling inside them (Lansbury, 2014
). Thoughtful CAMHS staff encourage emotional expression, and are patient with any outbursts.
Once the team starts to think about noticing their own thoughts and emotions, they can then develop their ability to be more reflective practitioners.
). Thoughtful CAMHS staff encourage emotional expression, and are patient with any outbursts.Once the team starts to think about noticing their own thoughts and emotions, they can then develop their ability to be more reflective practitioners.
Although we can’t see containment with our eyes, or easily describe it with words, we all know (often unconsciously) how good it feels; when we feel securely embraced by someone we’re more likely to feel better and move forward through the bad times.
Containment is the soothing space the ward community creates, conveying a foundation of safety to help young people move more comfortably through their recovery journey and move forward emotionally, socially and educationally. A safe and stable space allows young people to move between various thoughts, feelings and behaviour, without getting stuck in one extreme or another. “It gives them a center, a plumb line to use as they learn to self-regulate,” says Kim John Payne M.ED, author of the fab book, Simplicity Parenting. “The emphasis is on creating a calming, supportive atmosphere, so they can get through what they need to get through.” Being in a mindful space stops strong emotions from overpowering the therapeutic relationship, and instils greater trust and non-judgmental acceptance. Stay present and open, beyond all ideas of right and wrong.
Before young people can feel contained, it’s crucial that you also feel held, and have enough time to speak about things and get support from others in your team.
Containment is the soothing space the ward community creates, conveying a foundation of safety to help young people move more comfortably through their recovery journey and move forward emotionally, socially and educationally. A safe and stable space allows young people to move between various thoughts, feelings and behaviour, without getting stuck in one extreme or another. “It gives them a center, a plumb line to use as they learn to self-regulate,” says Kim John Payne M.ED, author of the fab book, Simplicity Parenting. “The emphasis is on creating a calming, supportive atmosphere, so they can get through what they need to get through.” Being in a mindful space stops strong emotions from overpowering the therapeutic relationship, and instils greater trust and non-judgmental acceptance. Stay present and open, beyond all ideas of right and wrong.
Before young people can feel contained, it’s crucial that you also feel held, and have enough time to speak about things and get support from others in your team.
It’s sometimes helpful to engage young patients in a relaxed ‘storytelling’ conversation, in which they are totally free to chat about anything. Not only can this feel safe to a young person, but it encourages them to talk about the most difficult things. When they feel safe, young people are more able to be open to, and influenced by, guidance and structure. Conversely, since some young patients (especially those who’ve been hurt in home life) have been deprived of just about everything, more deprivation (the use of seclusion or refusing to listen to them, for example) won’t be of any help. You can’t deprive the deprived. It just doesn’t chime with them.
Promoting Mind-Awareness
In TalkWell, our guide on encouraging the art of conversation on mental health wards, we refer to the skill of mentalising or ‘mind-awareness’. Mind-aware staff diligently focus on the continuous, complex and often fraught process of talking with people experiencing mental health problems. “The skills required to communicate with us when we’re at our most unwell and not always super-reasonable (!) tend to be under-rated,” says TalkWell’s author, Marion Janner. “Yet they are the ones most valued by patients and which deserve a lot more attention, training and support.”
The main principle of TalkWell is that all conversations on wards have a therapeutic value. Being ‘mind-aware’ helps maximise these exchanges, by being in touch both with what we’re thinking and feeling, and what other people are thinking and feeling. By being aware of what’s in the patient’s mind, you will be in a much better position to see things from their perspective, and work out how best to resolve the situation.
It’s also about being aware of your own thoughts and feelings, especially if they’re so strong (perhaps because their behaviour has triggered something in you) that they get in the way of you being properly in tune with your patient. A mentalising stance helps you to identify what you’re feeling (e.g. scared, angry, empathetic, calm etc) and crucially, what your patient is feeling. Here’s a short extract from TalkWell, which, by the way, you can download here.
It’s also about being aware of your own thoughts and feelings, especially if they’re so strong (perhaps because their behaviour has triggered something in you) that they get in the way of you being properly in tune with your patient. A mentalising stance helps you to identify what you’re feeling (e.g. scared, angry, empathetic, calm etc) and crucially, what your patient is feeling. Here’s a short extract from TalkWell, which, by the way, you can download here.
While we're on the subject of thinking about our own responses and triggers, Alistair Cooper and Sheila Redfern (2015) provide this helpful list in their very excellent book Reflective Parenting: A Guide to Understanding What's Going on in Your Child's Mind
.
Try to work out your triggers for experiencing certain strong emotions. Triggers can come in many forms and may include the following:
.Try to work out your triggers for experiencing certain strong emotions. Triggers can come in many forms and may include the following:
- A particular situation or interaction
- A tone of voice the child uses sometimes
- A comment someone makes
- A thought you have
- A strong belief system
Cooper and Redfern say that being aware of how you're feeling offers the opportunity to analyse whether or not to react, and how. The more you're able to name what you feel, the more you can bring the feeling into your consciousness and moderate it if necessary. By making sense of the feelings you're experiencing, instead of just reacting, you can start to temper your emotions and become better able to express them constructively and therapeutically.
This is where regular reflective practice proves to be an essential part of work on the ward. Being aware of how you’re coming across to others when you're experiencing difficult emotions is really important. Young people are very receptive to subtle communication cues and are sensitive to the whole range of emotions (Cooper and Redfern, 2015).
This is where regular reflective practice proves to be an essential part of work on the ward. Being aware of how you’re coming across to others when you're experiencing difficult emotions is really important. Young people are very receptive to subtle communication cues and are sensitive to the whole range of emotions (Cooper and Redfern, 2015).
Discovering the Blue Sky Together
If young people can learn to be aware, to find some inner space of clarity, everything will feel easier. Teach them how to be self-aware of their own thoughts, emotions and sense perceptions, and also those of others. Make awareness a central focus - through games or activities like meditation, for example. You don’t have to use the word ‘awareness’; just teach them to practice this way of being. Indeed, the best way to teach it is to practice it yourself. How you are with a young person is more important than what you do with them (although routine and structure are really important). Your acceptance and presence encourages their acceptance and presence. Emotions and thoughts become less destructive, less heavy and static, and are instead experienced within a safe space that’s big enough to explore and contain them; awareness. Like clouds moving through the vast blue sky.
Witnessing and allowing our inner ‘weather’ to alter and move through us is both incredibly powerful and freeing. Provide a background of unconditional spaciousness for the young person to be their true self, until they’re able to find their own inner space - their own blue sky. Do your best to set and promote stable yet peaceful boundaries, as opposed to reactive ones. Reactivity is nearly always the less effective stance to take. Being proactive on the other hand, is about being prepared and having the right understanding to have moment-to-moment positive discernment.
It’s all about strengthening an open, honest and on-going dialogue.
Experiment with using the principles of Nonviolent Communication (described below).
It’s all about strengthening an open, honest and on-going dialogue.
Experiment with using the principles of Nonviolent Communication (described below).
Nonviolent Communication
Nonviolent Communication (NVC) is a process developed by Marshall Rosenberg. “It’s a way to communicate with greater compassion and clarity,” says Sarah Newton, a leading authority on how to connect, engage and motivate young people. NVC “focuses on two things: honest self-expression - exposing what matters to oneself in a way that's likely to inspire compassion in others, and empathy - listening with deep compassion.
Nonviolent Communication (NVC) is a process developed by Marshall Rosenberg. “It’s a way to communicate with greater compassion and clarity,” says Sarah Newton, a leading authority on how to connect, engage and motivate young people. NVC “focuses on two things: honest self-expression - exposing what matters to oneself in a way that's likely to inspire compassion in others, and empathy - listening with deep compassion.
NVC postulates that conflict between individuals or groups is a result of miscommunication about these needs, often because of coercive language or manipulative language (e.g. inducing fear, guilt, shame, praise, blame, duty, obligation, punishment or reward). One aim of NVC is to create a situation in which everyone's needs are met.
NVC advocates that in order to understand each other, the parties express themselves in objective and neutral terms (talking about their factual observations, feelings and needs) rather than in judgmental terms (such as good versus bad, right versus wrong, or fair versus unfair).”
NVC advocates that in order to understand each other, the parties express themselves in objective and neutral terms (talking about their factual observations, feelings and needs) rather than in judgmental terms (such as good versus bad, right versus wrong, or fair versus unfair).”
All types of observation on the ward - formal or informal - should convey concern, as opposed to suspicion. Learn more about Nonviolent Communication here:
Structure and Support
When young people feel a connection with the person making a request, their instinct to work together is awakened, enabling them to receive what is being asked of them. Those who have outbursts when they don’t get their own way, almost always long for their parents to create some real connection and structure (Susan Stiffelman, 2015).
“Most kids, especially adolescents, thrive in structured and predictable situations,” says Dr Greenberg and Dr Powell-Lunder, who are both Clinical Directors at Four Winds Hospital in the US. “Rules offer explanations about which behaviors are appropriate and what is expected of us. They also define boundaries, without which the world would feel chaotic and unsafe. In addition, rules take the emotion out of the equation and tell us what is expected.”
Structure helps create a sense of relational and physical security. Obviously, a mug without sides would be incapable of holding a welcome hot brew! In the same way, the ward needs structure - not just the building features, although they definitely help - but reliable routines and realistic rules and boundaries, in order for it to be a holding and healing place.
“Sometimes, the hardest thing about introducing a formalized set of rules is selling the concept…” observe Dr Greenberg and Dr Powell-Lunder. “Teens fight hard for their independence and the idea of predetermined rules may sound threatening - especially if this is a new proposal. Just because their initial reactions may not be welcoming, do not be discouraged.” Dr Greenberg and Dr Powell-Lunder suggest we should remember that “teens are supposed to fight against the idea of rules and, in reality, teens from homes with structure and rules fare far better than teens from unstructured, permissive homes.” When expectations are too difficult, young people become discouraged. On the other hand, when expectations are too easy, they may take advantage.
Dr Greenberg and Dr Powell-Lunder also have this advice: “The rules and consequences you create should be written and posted in a place where everyone has access to them. The process of actually writing down the rules makes them real. A system should also be established to discuss and revisit rules that are not working. Think of this as an ongoing interactive process. If a rule or consequence is not helpful or enforceable, do not get stuck. Rules were meant to be rewritten. They should serve as helpful guidelines and become useless if they are not realistic. It is important to discuss with your teens that there will be situations for which no rule currently exists. In these cases your teens need to defer to your judgment, especially if the issue involves potential safety risks. This can be difficult for your teens to understand because again, your perception of high-risk situations may not be consistent with their perceptions. However, it must be clarified that your concerns for your teens’ safety trump any existing rules.”
Dr Greenberg and Dr Powell-Lunder also have this advice: “The rules and consequences you create should be written and posted in a place where everyone has access to them. The process of actually writing down the rules makes them real. A system should also be established to discuss and revisit rules that are not working. Think of this as an ongoing interactive process. If a rule or consequence is not helpful or enforceable, do not get stuck. Rules were meant to be rewritten. They should serve as helpful guidelines and become useless if they are not realistic. It is important to discuss with your teens that there will be situations for which no rule currently exists. In these cases your teens need to defer to your judgment, especially if the issue involves potential safety risks. This can be difficult for your teens to understand because again, your perception of high-risk situations may not be consistent with their perceptions. However, it must be clarified that your concerns for your teens’ safety trump any existing rules.”
Staff can set up predictable structures around things such as getting up, bedtime, tasks, meals and school work, as they understand a sense of order is important for young people, especially if their home-life has been unstable. Of course, the ward structure is flexible, focused on the young person and not over-rigid or punitive. Young people need to feel reassured that the team will provide a safe space and accept their need for care and support without them being controlling.
Anyway, attempts to control young people are often futile, as you’ll no doubt know! Staff need to encourage young people to co-operate with the rules, boundaries and expectations in place. Part of this is about trusting them to make their own decisions. Young people need to think for themselves, so when they’re faced with making choices, they’ll ask, ‘Is this good for me?’
Of course, recovery is about them taking back control over their life.
Of course, recovery is about them taking back control over their life.
Involvement
Structure makes a group of people feel like a community and helps everyone feel involved. Playing games and offering other fun activities can put everyone at ease and welcomes acceptance. Laughter is a glorious remedy! Humour and fun let us see things from different perspectives more easily, and helps us to be more playful with new ideas. Laughter is healing - it releases feel-good chemicals into the brain, reduces stress and boosts our mood. As we laugh together, divisions and tensions dissolve, creating a shared understanding.
Providing a well-thought-out structure for family work is also important. To help put in place safety, respect and understanding, young people are often introduced to a ‘behavioural agreement’, or the equivalent, as soon as they arrive, and there are regular reminders of this. Getting to know others on the ward and making friends put a stop to some of the understandable anxiety, self-consciousness and fear they might be experiencing. One example of this is being involved in a community meeting - this gives everyone the chance to ‘test the waters’ and say anything that might be troubling them. Here’s a taste of how we sum up involvement in Wardipedia:
“Involvement – and information, inclusion, influence, independence. The 5 ins. All key ingredients in inpatients having a therapeutic, empowering, admission, which equips them well for maintaining their stability when they’re back home.”
Read more in Wardpeida
And since we’re on the subject of involvement (and Wardipedia), here’s how we big up the fab term and resources on ‘relational security’ conceived by the Department of Health:
“[Relational security] neatly captures the vital element of safety on the wards - the quality of relationships between staff and patients. Relational security is not simply about having ‘a good relationship’ with a patient. It is best seen as the knowledge and understanding staff have of a patient and of the environment, and the translation of that information into appropriate responses and care. But even when these are robustly in place, it’s the relationship between staff and patients which can make all the difference between preventing fraught situations from escalating and calmly diffusing a crisis.”
Read more about relational security
A safe ward gives young people supportive and containing boundaries, together with opportunities for the young person to learn, and try out fresh ways of being, relating, responding and functioning. This theme also reflects the importance of personal space, since everyone needs their own private safe base and some temporary distance from the clamour and commotion of others - a comfortable and homely bedroom or the use of a quiet room, for example. Having this base feels validating; it sends a message to the young people that they’re welcome on the ward, and a valued part of the community.
Validation
When young people’s emotional worlds are met and validated with sincerity and presence (being there fully with them), they’re more able to safely work out triggers of their distress, get some head space, find personal skills and resources they already have, and explore fresh, positive solutions and possibilities. A solution with which everyone involved can be happy with is only possible after everyone has shown real validation for the young person’s wishes and perspectives.
One of the most important ways of trying to help young people manage, or regulate, how they're feeling is to validate their feelings. This is vitally important because it helps them to be more comfortable with how he or she feels and to be reassured that they have a right to feel this way (Cooper and Redfern, 2015).
Take your time to offer validation of their present experience. Young people thrive when they’re validated for their feelings and supported in feeling them. Validation invites young people to make connections between their thoughts, feelings and behaviours, and to look at them to develop constructive, rather than destructive, ways of living and relating to themselves and others. It can feel liberating to learn that it’s okay - and healthy - to experience the whole range of emotions. Your approval and validation for their thoughts, feelings and behaviours will support them in finding balance and stability.
Take your time to offer validation of their present experience. Young people thrive when they’re validated for their feelings and supported in feeling them. Validation invites young people to make connections between their thoughts, feelings and behaviours, and to look at them to develop constructive, rather than destructive, ways of living and relating to themselves and others. It can feel liberating to learn that it’s okay - and healthy - to experience the whole range of emotions. Your approval and validation for their thoughts, feelings and behaviours will support them in finding balance and stability.
The latest personality research shows that there’s a genetic factor involved in how young people react to their environment and relate to others. Researchers have revealed that temperament encompasses biological, neurological and physiological influences, that affect a young person’s mood, ability to calm themselves and activity level (Kurcinka, 2006).
A young person having a distress outburst, for example, is in genuine pain and needs lots of calm, compassionate support from you. Although ‘tantrums’ can be challenging, they present a great opportunity to help young people develop vital brain pathways that enable them to manage stress in the future (Sutherland 2008). Teaching young people how to regulate their powerful emotions enhances their physical and mental wellbeing. Whatever they’re at war with within themselves, help them soften towards it, understand it and find a place for it.
A young person having a distress outburst, for example, is in genuine pain and needs lots of calm, compassionate support from you. Although ‘tantrums’ can be challenging, they present a great opportunity to help young people develop vital brain pathways that enable them to manage stress in the future (Sutherland 2008). Teaching young people how to regulate their powerful emotions enhances their physical and mental wellbeing. Whatever they’re at war with within themselves, help them soften towards it, understand it and find a place for it.
If they become more practiced at understanding their feelings and managing them more successfully, they'll be less likely to react strongly or behave impulsively (Cooper and Redfern, 2015).
Young people need to see adults as being steady and calm - irrespective of their moods or behaviour. They need to feel they can chill out, with the understanding they can rely on you to get them through their struggles. They need help with understanding their temperament and triggers, and someone to emphasise their strengths and provide them with the guidance they need to express themselves constructively, using a strengths-based approach. And what’s also crucial in all situations, is if they don’t want to talk, do your best to honour that. Young people can’t be forced to open up about what’s going on for them, but you can communicate that you’ll be there when they want to talk and make doing so feel safe.
When offered at the right time, mindfully worded guidance, even over difficult subjects, will usually help to increase your rapport with a young person, and get across that you’re trying to support them.
When offered at the right time, mindfully worded guidance, even over difficult subjects, will usually help to increase your rapport with a young person, and get across that you’re trying to support them.
The questions that all parents and therapists who help parents must answer:
Adapted from Sudsberry, Richard, 2014
Source: Loving Parents: Raising Hurting Children
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- Are we causing relationship responsiveness within this child and within this adult who leads that child?
- Are we influencing emotional regulation through parent leadership?
- Am I being someone with perspective, interest, curiosity, empathy, and compassion, who causes this child to benefit from my adult influence?”
- If the relationship is becoming toxic and insecure, what support does the child need?
- What supports do I need in order to develop or maintain a secure “good enough” parent perspective?
- What does each person in the relationship need to receive in order to maintain responsiveness through difficult moments, and to create a healthy reciprocal relationship?
- If I am not able to do this as an adult leader and if the child is not responding to what I provide, what other supports do I need to bring to the family that will help this relationship mature?
Adapted from Sudsberry, Richard, 2014
Source: Loving Parents: Raising Hurting Children
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Safe Spaces
A main purpose of CAMHS wards is to create an environment (both a physical and relational space) that reduces anxiety and enables young people to feel emotionally and physically secure, especially when in crisis. This involves them having both a much-deserved rest and lots of supportive care, so they’re able to face and work through their difficulties, to get new skills and to go back to their normal lives.
Wards can manage a balance between the setting being homely and the need to carefully keep an eye on everyone and run daily activities. Staff can help the ward community feel safe enough to take part in their healing journey, and they do so by expressing and being a good example of respect and acceptance.
Within this safe space, created by caring collaborations and a thoughtful environment, young people and their families can safely explore and grow. If a young person is to feel secure enough to behave reasonably, the adults around them must first form a foundation of trust. Establishing safety is especially tough for young people with insecure attachments, because they’ve learned that the world is not a safe place.
The most conducive space for healing is not merely within a tangible building or the workings of a clever model, but within a palpable relational connection: within a womb of presence, stillness, listening, warmth and immediacy.
Within this safe space, created by caring collaborations and a thoughtful environment, young people and their families can safely explore and grow. If a young person is to feel secure enough to behave reasonably, the adults around them must first form a foundation of trust. Establishing safety is especially tough for young people with insecure attachments, because they’ve learned that the world is not a safe place.
The most conducive space for healing is not merely within a tangible building or the workings of a clever model, but within a palpable relational connection: within a womb of presence, stillness, listening, warmth and immediacy.
The Importance of Privacy
No matter how sociable or outgoing they are, from puberty onwards young people start to need more and more emotional and physical privacy, both of which create a safe space. The environment in which they’re recovering, resting and learning is really significant, and having a space they can call their own is a must. Young people recover, rest and learn better when they feel emotionally secure and physically safe.
Easing Conflict
As anyone who has lived with adolescents knows, there are loads of ways you can inadvertently put a foot wrong! We must model the behaviour that you’d like to see. We cannot expect patients to behave appropriately if they see adults contradicting our expectations of them. Being a good role model and sensitively adjusting our own behaviour is probably the best way of meeting teenage "stroppiness" and calming the relationship. Tolerance is essential, although this doesn’t mean that anything goes. What works is consistency and calmness when managing behaviour. Most of all, young people need carers who are warm, compassionate and accepting - and those who do their best to remain that way even when conflict erupts.
Again, school psychologist Dr Sal Severe (2004), offers this helpful advice: “Use conflict as an opportunity to teach them acceptable ways of expressing disappointment and resentment. Teach them how to manage their feelings in a prosocial way. Communication is always more effective when everyone has had time to calm down. It also helps to intervene early, before tempers explode.”
In her magnificent book Toxic Childhood, Sue Palmer (2006) offers a four-point ‘conflict resolution’ technique for bringing calmness and resolving arguments, which can be taught to young people. Staff can model this themselves, and whenever a problem arises young people can be helped to go through the four points:
Although it isn’t always easy, almost every dispute can be more effectively calmed by negotiation, rather than by direct confrontation or simply ignoring the young people involved (or even worse, shutting them away). Adolescents who feel they’re being persecuted feel totally justified in using challenging behaviour in response. Moreover, under-sixteens especially, tend to see things in rigid or absolute terms.
Following confrontations about behaviour, staff can make sure they notice positive attempts by the patient to behave considerately, even if these are small, praising them makes a big impact. They'll be more likely to repeat the positive behaviour, as they'll get positive attention for it.
Following confrontations about behaviour, staff can make sure they notice positive attempts by the patient to behave considerately, even if these are small, praising them makes a big impact. They'll be more likely to repeat the positive behaviour, as they'll get positive attention for it.
Sometimes, just acknowledging the tough time they're having can make the difference between their feeling alone and feeling connected, between feeling judged and feeling held in mind. The importance of connectedness with young people around times of conflict is most important. Within a safe and secure relationship, conflicts can be resolved in a positive way, without leading to distancing in the relationship (Cooper and Redfern, 2015).
So as you’ll know, this takes heaps of patience and flexibility, and negotiating always means that everyone needs to give and take a little and make some concessions. And ultimately, clear thinking and calm emotions play a big part in neutralising otherwise explosive disagreements. Tough conversations go far better if we put aside our negative stories and judgements, which would otherwise affect how we respond. We can acknowledge and attend to our own distress, so we can be the cool, clear-headed adult (and role model) a young person needs when they’re upset, angry or aggravated.
It’s always crucial to explore the meaning your team are assigning to a young person’s problematic behaviour. Taking a reflective stance to managing young patient's difficult behaviour means seeing the times when they 'act out' as an opportunity to support their emotional development, and to help them to understand themselves and others (Cooper and Redfern, 2015).
It’s always crucial to explore the meaning your team are assigning to a young person’s problematic behaviour. Taking a reflective stance to managing young patient's difficult behaviour means seeing the times when they 'act out' as an opportunity to support their emotional development, and to help them to understand themselves and others (Cooper and Redfern, 2015).
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