So many factors affect children and young people’s psychological wellbeing. I work with children who are struggling with this. Interventions in children and young people take account of the “whole child”. This includes what is going on in their minds, but also in their relationships, their environment, and their general health. Below I have summarized some of the areas clinical psychologists consider when they try to help improve children and young people’s psychological wellbeing.
Unhelpful thoughts and mental health
This is often the place mental health practitioners start. They are a cornerstone of evidence-based treatments for common mental health difficulties, such as CBT for anxiety. We often refer to thinking patterns as “cognitive processes”. Most children and young people who have anxiety, low mood, behavioural problems, or other difficulties, have bad or unhelpful thoughts. A child with anxiety might think: “I can’t cope with school today, what if I get told off?”. If his mood is low a child might think: “I do not fit in” or “I am not good enough”. A child with longstanding behaviour difficulties might think: “The teacher is going to pick on me anyway, so I might as well carry on”.
Clinical psychologists will work hard to dig out these unhelpful thoughts. They work towards helping adapt or change them. Their ultimate goal is to improve children and young people’s psychological wellbeing in the long-term.
I would argue that unhelpful thoughts and of course, difficult emotions, are the common factors in poor psychological wellbeing. However, we need to look at what causes, maintains or exacerbates these unhelpful thoughts.
This section explores factors that contribute to whole-child wellbeing. Here is a summary:
Clinical psychologists always explore family relationships. They want to see whether there are things about the relationship that are helping or hindering children and young people’s psychological wellbeing. For example, if a child is anxious about dogs and starts to avoid all parks, what should a parent do? A parent might unwittingly make the problem worse by allowing the child to avoid parks. Though well-intended, the child’s brain never gets to have a positive experience of a park. Therefore, parks become more and more “scary” in the child’s mind.
Most children spend around 30 hours per week in school. This is a very long time if, for some reason, the environment causes them distress. Many schools are nurturing places. Children feel safe, and their individual needs are recognised. Some schools however, cannot provide safety and nurture for all their children. Perhaps the school is too big, and some children disappear “under the radar”. Or perhaps the culture of the school focuses on academic attainment over nurture. It may not help students develop resilience and well-rounded character traits. I believe this is a huge problem in the UK.
Very few people realise that food affects children and young people’s psychological wellbeing so massively. For example, the microbiome (the combined set of trillions of microorganisms in the gut and elsewhere in the body) is strongly linked with mental health. Wholefoods (ie not processed foods), fruit and vegetables, help feed the microbiome in a positive way. This contributes to a healthy brain and nervous system. A child with a poor diet is more likely to have poor mental health.
Humans were originally hunter-gatherers and moved much of the time. The body is not meant to stay still. Exercise releases the build-up of stress chemicals, such as cortisol. It produces chemicals which help balance brain and mood, such as serotonin. A person can completely change their state of mind by taking a break for exercise . It halts anxious, depressive or angry thoughts because the body is forced to be “present” and focused on its movements. If the exercise is outside, the senses can be stimulated by all the things to be seen, heard, smelt and felt.
Sleep is pivotal in children and young people’s psychological wellbeing. A well-rested brain, which has had a chance to repair and regenerate aspects of itself, can easily face the challenges of the day. If sleep problems are persistent and a child’s brain consistently doesn’t get what it needs, it will not function optimally. The brain will produce stress chemicals such as cortisol and adrenaline, just to try to keep going. This may cause irritability, burnout, a sense of being “wired”, and struggles with new learning or making rational decisions.
Difficult life events or circumstances
A child feels less safe and secure if she faces difficult life events. These might include family illness, bereavement or divorce. Feeling unsafe or vulnerable can make a child feel anxious and low. It can negatively affect a child’s behaviour, as she may feel “out of control” feeling. Alternatively, she may withdraw from the world, feeling that no-one else could understand. We may not be able to control life events, but as parents we can do our best to provide increased nurture at such times.
Pre-existing health conditions
Growing up is already difficult. If you have a physical health condition or a neurological difference (such as autism) the challenges can seem even bigger. For example, going from primary school to secondary school is a big deal for all children. To a child with autism however, there are multiple hurdles to jump. This includes learning how to deal with a much noisier and more crowded environment. It may overstimulate the senses, causing stress and anxiety.
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