For Health Professionals
Anxiety
Depression
Self-harm
Eating disorders
Addiction
General Resources
About anxiety
Anxiety is the most common presentation in children and young people and can present in a variety of different ways including fears and phobias, Obsessive-Compulsive Disorders, self-harm, post-traumatic stress, panic disorder.
All children and teenagers experience anxiety as part of their normal development and there are appropriate fears to feel at different developmental stages – e.g. a fear of the dark at three years old. Anxiety becomes a problem when it goes on for a long time and prevents the young person from enjoying their life. This is when anxiety can lapse into depression. About 25% 8-year-olds and 21.7% 17-year-olds report with anxiety. It is more common in girls than in boys.
Four signs of anxiety
Four steps to bringing about change
Why not suggest our Clear Fear app to your patients?
This clinician-developed app can be downloaded free from the App Store or Google Play. It can be password-protected and uses the evidence-based treatment CBT to focus on learning to reduce the physical responses to threat by learning to breathe, relax and be mindful as well as changing thoughts and behaviours and releasing emotions. Find out more at www.clearfear.co.uk.
Depression
What is depression?
Depression is a serious problem for teenagers. Common features of depression include hopelessness, sadness, irritability and anger, isolation, withdrawal and worthlessness.
Young people do not often express their depression in a straightforward way and can show they are affected through passive or negative behaviours.
About depression
Most people, including children and adults, feel low occasionally. This is a normal reaction to events that are stressful or upsetting. It is even more common for teenagers to be affected by a range of moods, particularly feeling ‘blue’.
However, sometimes these feelings continue and turn into clinical depression. Depression can affect children as young as eleven although it is less common in the younger age group. Clinical depression, requiring appropriate treatment, is thought to affect around every 5 out of 100 teenagers.
Four signs of depression
Four steps to bringing about change
Support the child or young person through the following steps:
Why not suggest our Move Mood app to your patients?
This clinician-developed app can be downloaded free from the App Store or Google Play. It can be password-protected and has a range of tasks you can do to help manage the behaviours associated with low mood and depression. Find out more at www.movemood.co.uk.
Self-harm
What is self-harm?
Self-harm is when someone hurts themselves on purpose (not associated with some of the habitual behaviour associated with developmental conditions such as autism).
In most cases, there is no suicidal intention but a teenager’s safety must always be kept in mind. Risk assessment is one of the key tasks for a professional.
About self-harm
Self-harm is not a new phenomenon, but it appears to be growing in frequency. Whilst both teenagers and adults, male and female, self-harm, it is most prevalent in teenage girls. However, boys who self-harm tend to cause more damage to themselves and suicide is more common in boys and men.
Self-harm is a serious problem for teenagers with around 1 in 12 children aged between 10 and 16 carrying out a variety of self-harm behaviours.
The self-harm management techniques that are described, are separate to those that are recommended for autism, or for children with neurological damage or special needs, where the intention of the self-harm and therefore the management, has a different focus.
Identification
Self-harm is usually identified by regular self-inflicted injuries that are noted on various parts of the body.
Why change?
The first part of a professional’s job is to increase motivation to change. It’s really important to manage self-harm early because it can become habitual and increase in intensity. A good starting point is to explore what benefits the person sees in self-harming and to ascertain negative reasons for why it would be helpful to make positive change. Once motivation to change is established, children and young people can be referred to the ‘Steps to change’ part of the stem4 website and to our Calm Harm app whilst they wait specialist treatment.
To build up your assessment skills and to learn about prevention and evidence-based treatments ask to be on our mailing list for our professionals conferences.
Some benefits to self-harm
- “It helps me calm.”
- “It lets others know that everything is not alright.”
- “It takes my mind off upsetting things.”
Some negatives to self-harm
- “It makes me feel alone.”
- “Others think I’m weird.”
- “I hate the marks it leaves on my skin.”
- “I can’t wear revealing clothes.”
- “It doesn’t help me sort out my real problem.”
Four steps to bringing about change
- Self-harm minimisation
- Educate on sterilising equipment, how to prevent infection, using ‘safe’ implements, teach basic first aid
Encourage the child or young person to take positive action to break the circle of self-harm.
Try and help them think about what their self-harm is expressing:
- If it’s COMFORTING suggest they do alternative comforting actions instead – for example, have a bath, cuddle someone or something, do something relaxing, listen to some music
- If it RELEASES FEELINGS, recommend some other outlets of feeling release instead – for example, talk to someone, exercise, write down how you feel, draw your emotion
- If it RELEASES TENSION, suggest another way to release tension instead – for example listen to some very loud music, run on the spot as fast as you can, rip some paper. PRACTICE for at least 5 minutes
- DISTRACT from the temptation to self-harm. Do something – go for a walk, give yourself something difficult to do. Sit it out – the urge will pass
This clinician-developed app can be downloaded free from the App Store or Google Play.
It can be password-protected and has a range of tasks you can do to help manage the urge to self-harm.
Calm Cards are also available from our Shop.
- Encourage maintaining the strategy that works over the long term. Keep regular contact to monitor
- Try it. Give yourself a seven day period to put into action. If you have success, try another seven days. Build up to 30 days
Why not suggest our Calm Harm app to your patients?
This clinician-developed app can be downloaded from the App Store or Google Play. It can be password-protected and has a range of tasks you can do to help manage the urge to self-harm. Find out more at www.calmharm.co.uk.
Eating disorders
What are eating disorders?
Eating disorders: Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder (compulsive over-eating) are serious mental illnesses affecting 1.6 million people in the UK. They are most likely to develop during teenage years and although more girls are affected, around a quarter of those who experience an eating disorder at school age are boys.
What signs and symptoms indicate an eating disorder?
Eating disorders are a group of mental illnesses characterised by a severe disturbance in eating habits with an aim for weight (and other) control. They cause significant distress to the sufferer and their families and need both physical and psychological intervention. They include Anorexia Nervosa (AN), Bulimia Nervosa (BN), Binge Eating Disorder (BED) and atypical variants. Eating disorders have the highest mortality, so early identification and intervention is invaluable.
The SCOFF questionnaire is an early screening tool useful for GPs Ref: Morgan J. F. (1999). British Medical Journal, 319: 1467.
Anorexia Nervosa
Anorexia Nervosa is an illness where there is a clinically established weight loss, measured either using the Body Mass Index (BMI) or weight and height criteria. There is a relentless aim for weight loss, mainly through restricted eating; excessive exercise and other behaviours aimed at weight control may also occur.
Bulimia Nervosa
Bulimia Nervosa is a condition where there is a relentless pursuit of thinness, which includes periods of starvation mixed by periods of binge eating. The person thinks and feels fat. A number of behaviours are carried out to lose weight and these may include vomiting, the use of laxatives or diuretics and excessive exercise.
Binge Eating Disorder
Binge Eating Disorder is a condition where the person regularly binges, usually with weight gain. This can lead to obesity.
Four steps to bringing about change
Why not suggest our Worth Warrior app to your patients?
This clinician-developed app can be downloaded free from the App Store or Google Play. It can be password-protected and uses principles of Cognitive Behaviour Therapy for Eating Disorders (CBT-E) to manage negative body image, low self-worth, and related early-stage eating difficulties or disorders. Find out more at www.worthwarrior.co.uk.
Addiction
Many teenagers face some form of addiction at some point in their life. Although addiction to drugs is most commonly reported – alcohol and nicotine in particular – there are a number of other substances and activities that create the same sense of dependency and resistance to withdrawal.
These include gaming, gambling, sex, pornography, food, exercise, the Internet and other technology such as mobile phones, work and compulsive buying.
Four facts about addiction
- Lack of control
- Dependence
- Tolerance
- Withdrawal
Four steps to bringing about change
Support the child or young person through the following steps:
Visit our Further Advice page for details of other organisations that can help.
