CAMHS

[Weetabixchanger]

Sorry unsure if this is the right topic or if there is another where I should be posting.

But my 6 year old has been referred to CAMHS due to severe anxiety. We have been told our appointment will be in the next 2-4 weeks.

Anyone any experience - what's the first step normally? Any other advice?

YOu might want to post on the Special needs: cb=hildren topic

Thank you I'll try there.

Sorry but this is not a special needs issue! Special needs and mental health are quite separate.

You may see a nurse or maybe a psychologist at your first appointment. They will do an assessment to find out exactly what is happening and what may be causing it.

They may then need to discuss the outcome with colleagues in a meeting. This is usually done anonymously.

The outcome can be wait and see, parental guidance (where you are advised how to help your child) or a short course of therapy. Cognitive Behavioural Therapy can work in children, really well. Not sure if 6 is too young though.

What a big worry for you - hope it goes well.

Weetabix, my ds had cahms support after his diagnosis with a serious illness. They were lovely, and he's coming through it well. I've also used a great book 'what to do when you worry too much' with him as well as a recent course of hypnosis with a specialist children's therapist.

As someone working in sn, I find that sn and mh often do go hand in hand, so I hope you find help wherever you post and wish you well.

Thank you all for the information.

I'm going to look for that book daveschooks.

Sorry madmouse -I wasn't trying to imply special needs are mh issues, more that some people seem to post in that topic regarding CAMHS and how MH issues affect their child.

Upwardandonward - I would hope whereever anyone posted, when looking for reassurance/advice on their child's health, be it a permanent physical problem, temporary physical problem or permanent/temporary mental health problem that if someone was able to offer the comfort, that they would do so, regardless of topic heading.

you might find it useful to kep a clear diary/journal over next weeks before the appointment - noting each bout of anixiety -
so every day for every incident/bout -

what triggered it
how child reacted
how long it took to calm down / how did child calm down
what happened next

ie ABc chart antecedent
behaviour
consequence

this will help you to explain why you at the appt - ie how often does child get anxious? what triggers it? or is it random things? how does it manifest? how long does it last each time?

and also think about what you want from them - strategies? help at school or home? or?

I think with CAMHS as with most other things, it does depend on the workers allocated to you. I worked in social services for many years and to be honest I didn't rate CAMHS, as they seemed to pick and choose which cases they were willing to take on, and in the vast majority of cases, service users were disatisfied. They used to be called "Child Guidance" but changed to CAMHS. I know others have a more positive view of CAMHS - maybe we just had not good-enough workers in the locality where I worked.

C'estlavie makes some interesting points but just to say that very often the triggers are internal and so they won't be observable.

I think the only therapy suitable for a 6 year old is play therapy but it is expensive and LAs won't usually pay for it. Could you afford to pay privately for a play therapist if necessary.

upwards you are right of course - I'm sorry - you know my ds has SN and I was just too touchy xx

yes a journal of bouts of anxiety might simply say "no trigger, child suddenly did xxxx"

but by keeping a clear journal - parents might spot a pattern of sorts. what kind of things appear to set it off. journal might also record regualr routines too. eg got up had breakfast. child suddenly did xxxxxx. went to school. came home. was calm.
ate tea.
child suddenly xxxxx

umm something to do with the food? with the meal routines? who knows - by keeping records of behaviour taking data then you can see more easily - sometimes =- how to tackle the issues . see appatern, or just see how many times a day certain behaviours are displayed and what they are. this is done a lot at my son's special school before deciding on strategies. (he has ASD)

any data / daily journal is useful for CAMHs to know. and two weeks of data recording would be v useful for all.

if there are certain triggers - or if apparently no trigggers. then they know what they working with.

Totally agree with ceslavie's suggestions. ABC is a great way to monitor behaviour.

I hope it goes well.

I had to do that record for the month beforehand for the GP to make the referral, so I will just keep that going - so they'll have about 6-8 weeks worth of that.

Play therapist - please talk to me about that.

We are in a fortunate position that as long as we are not talking thousands of pounds, but hundreds we could consider that.

I have a friend who is a play therapist and we are both retired social workers. She explains it as being a very non-directive situation, in which the child comes and plays with whatever toys he wants also sand tray, lego people, houses etc. She observes the play and only intervenes if something is dangerous or just too messy like throwing sand around the room! I can't tell you about the observation or the conclusions that can be drawn from it because I am not trained in play therapy. She does though say it is mostly quite obvious to interpret from the child's play what is going on for them - many children are angry she says and this can be seen from their play. That is just one example. She also advises parents on doing play therapy at home, which really means letting the child direct the play, with you being alongside him, but not making any comments or suggestions - amazing how many people find this difficult.

With a child of 6 I think it is the only way to go quite honestly and she has a lot of success. It's all very well looking for these triggers, but many of them will be internal and so it will look as though there was no trigger.

There is a National Assoc of accredited Play Therapists - I'm sure if you google you will find one in your area. Not talking about thousands - most private therapists charge around £50 per hour but it does depend where you live. You can also think about a private clinical psychologist who is experienced with working with this age group - I have no knowledge of the success of otherwise of this method though, so suppose it depends on the expertise of the psychologist. Again there is an accredited body of Clinical Psychologists and again I'm sure you could get it from google. I think most of them tend to work with adults but it might be worth a look.

I think looking for and recording the antecedent before the behaviour is useful in a school environment where there are different influences. In one to one play situation there is unlikely to be a trigger.

What you say about parents learning to sit back and let the child lead is very important. Children have different play styles (schemas) and sometimes seem crazy to us but it's a normal developmental stage (eg hiding inside things, covering themselves up). It seems to a parent that the child been doing this forever and there is something wrong with them but really it's something they just have to go through, til they get to the next one - maybe fascination with water, or tying things together with string. Some parents worry about these things too much and tell them to stop whatever it is which is destructive on many levels. The other thing they do is to expect them to play 'the game' - in a certain order, in a certain way - this very rarely happens and results in children not wanting to play with their parents.

Sorry, got sidetracked but I hope that's useful. Modelling good play with parents is enormously beneficial and where play therapy involves parents it can work wonders.