Wellbeing workshops for
parents in Caerphilly.
A preventative approach to
promoting good mental
health for families.
Our Context
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the parent therapist sits within a team that is set up to
offer time limited and focused interventions to children
and their families, supporting emotional and behavioural
development.
the parent therapist offers an additional service for adults
(parents) that supports mental health and wellbeing.
the parent therapist receives referrals from within the
team
the parent therapist sits within an action for children
project- the family intervention team but is funded by the
big lottery’s mental health matters fund.
Models
systems thinking
 solution focused brief therapy
 cognitive behavioural therapy
 attachment theory
 risk and resilience model
 mindfulness
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Methods
Individual counselling
 Psychotherapy
 Couples therapy
 Family therapy
 Wellbeing workshops
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How it looks
PARENT THERAPIST SERVICE
SYSTEMIC PSYCHOTHERAPY
INDIVIDUALS AND
COUPLES
FAMILY THERAPY CLINIC
COGNITIVE BEHAVIOURAL THERAPY
SOLUTION FOCUSED BRIEF THERAPY
WELLBEING GROUPS
INDIVIDUALS
INDIVIDUALS
INDIVIDUALS AND COUPLES
HOW IT LOOKS IN WIDER
CONTEXT
SYSTEMIC THINKING
MENTAL HEALTH PROMOTION
WITHIN THE TEAM
PSYCHOTHERAPY
FAMILY THERAPY CLINIC
CONSULTATION TO CASES/
REFLECTING TEAMS
COMMUNITY DEVELOPMENT
CONSULTATION TO
MENTAL HEALTH TEAMS
EARLY INTERVENTION
IN PSYCHOSIS
INTER-AGENCY
COLLABORATION
GOFAL, HAFAL, MIIND,
MINDFULNESS CENTRE,
CAMHS, PMHT, PSYCHOLOGY,
GP COUNSELLING SERVICE, CMHTS
HEALTH CHALLENGE CAERPHILLY
Research
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In our own research 2006/07
80% of parents/carers identified as having
mental health issues
Other researchWHO Report 2001 suggests at least 1 in 4
families have at least one member with a mental
health “disorder”, with depression as most
common. Up to 3 x more common in women
60% of adults (receiving services) with
diagnosed mental health had children under 16
Further research
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National averageIs significantly higher in Wales than in England.
An example of cross studies across boroughs –
at any one time approx 320 adults may receive
community based mental health support in Wales in
2008 (compare to average of 169 in England)
(Local Govt Data Unit Wales 2008)
A higher percentage of women (12%) than men (7%)
reported being treated for a mental illness. This pattern
applies to all age groups.
This is significant in thinking about parental mental
health and often the primary (or sole) care giver is the
mother.
Local Research
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Local statisticsCaerphilly scored 4th lowest out of the 22 Welsh
boroughs in rating individual mental health.
“Caerphilly CBC Mental Health and Wellbeing
Promotion Action Plan” (2008)
Caerphilly residents were the 4th highest in
receipt of mental health services.
The prevalence of mild to moderate mental
health problems in Caerphilly is 18.2%
Why a service for adults in Action
For Children?
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2001 Everybody’s business (CAMHS) suggested
that 40% of children and young people have
recognisable risk factors in mental health. 3040% will experience a problem at some point.
Up to 25% will have a diagnostic disorder
Rutter and Quinton (1984) highlight the
relationship between parental mental health and
increased rate of psychopathology in children.
Why is this important?
“When the main carer is a parent who has
mental illness …. is preoccupied or
emotionally unavailable, it would be hard
for a child to have a sustained experience
of feeling contained, of having their
distress or confusion understood and
returned to the child in a more digested
form”. (Bion 1962 in Hindle, 1998)
Outcomes
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To enhance the quality of life for families
To improve emotional wellbeing
To improve and maintain positive relationships
For families to make informed choices about their
health and wellbeing
For families to have improved health
To increase family stability
To increase parents’ capacity to cope with
difficulties
To decrease referrals to higher tier mental health
services
Evaluation
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Pre and post questionnaires
CORE (clinical outcomes in routine evaluation)
Verbal feedback and case studies
Telephone interviews
Parents forum
Current External Evaluation- University of Glamorgan/
Family Institute
Previous service evaluation includesNEF and Red Kite Consultancy.
http://www.neweconomics.org/press-releases/investingyoung-would-save-%C2%A3486-billion-150909
http://www.actionforchildren.org.uk/uploads/media/36/98
12.pdf
Some further links
DVD from bbc 3 series
http://www.bbc.co.uk/iplayer/episode/b00tf
1zt/tulisa_my_mum_and_me/
 Dr Alan Cooklin DVD (available from royal
college of psychiatry)
 http://www.rcpsych.ac.uk/mentalhealthinfof
orall/youngpeople/caringforaparent.aspx
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FOR MORE INFORMATION
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Contact Leah atLeah.Salter@actionforchildren.org.uk
Check out :Salter, L and Hardy, B (2010) “Crossing
the bridge: to dip our toes in the water? Learning to take tentative steps towards setting
up and delivering a service for adults within a
children’s voluntary organisation.”
In Context, April 2010
Context - The Association for Family
Therapy in the UK
http://www.aft.org.uk/publications/Context108.asp
Referrals in to FIT/5+
Health
Social Services
Education
Voluntary
Case study
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1st hand account- Sarah
In 2009 I contacted my GP with the very much needed help from someone who could give me
some advice.
I found myself at the point of no return with my 8 year old son Jack.
Our home life was very much concerning me. I didn’t seem to have any control or respect from
Jack. His behaviour got to a point that everyone and everything in our home was very unsettled.
Jack didn’t seem to have any control of his own temper and moods. Jack would lash out on
anyone or anything that was in his way. I felt totally lost and couldn’t do or say anything to calm
him down. I’m sure Jack felt very much the same in his own mind.
With the help of (the family therapist) I was able to understand that our friendship had broken
down, and that we needed to rebuild.
We really want Jack to feel safe and sure that he can open up and talk to us about anything on his
mind.
Over time, meeting with the Family Therapist, I started to feel my confidence to (talk with) Jack,
and find the right way to start talking.
Jack seems calmer now. With difficult days and I’m sure more to come, I’ve been able to talk to
Jack through his moods.
I now feel that I can cope with all that happens with us as a family.
I’ll always be very grateful for the Family Intervention Team for their listening and helpful
suggestions.
The therapist’s view
Sarah had previously been in an abusive relationship with Jack’s father, and though she has
remarried and in a very different relationship this past experience was effecting her own sense of
self and her perception of her relationship with her son.
Sarah and (the family therapist) met on a 1-1 basis for 6 sessions, opening up a space to talk
about Sarah’s previous experiences and process the feelings that this had left her with.
We were able, though talking, to begin to shift Sarah’s perception of the relationship from being
about failure to being about competence. A new story emerged of a woman who had freed both
herself and her children from an abusive relationship.
Issues at point of referral
50 A: Beh < 1 yr
45
D: M anagement
40
35
30
25
20
15
E: Separation
B: Relationships
K: Other
F: Trauma
H: Eating
5
C: Stimulation
0
I: School
G: Anxiety
10
J: Attendance
Wanless Report and local action plan
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This project fits with the overall aim of improving access to services through primary
care.
To borrow directly from the Wanless action plan which asks forpartners (to) work together to manage demand within the most appropriate parts of the
system
….. to meet appropriate demand in primary and community settings. …
to radically reform primary health and social care service provision in Caerphilly
Borough
increase capacity in non-institutional settings ….to maintain patients’ independence
avoid deterioration in patients’ conditions by more active primary and community-based
support.
involvement of the Voluntary Sector as crucial in all of this work.
increase opportunities and access to healthy lifestyle choices. The wrong choices are
currently having a major impact on levels of disease and are seriously affecting many
people’s lives.
AimsImprove local access to services
• Develop a sustainable system of services
• Improve integration between services and providers
• Minimise institutional care
•(create a ) balance i.e. maximising service user choice and minimising risk
• Promote equity of access and social inclusion
• Ensure Continuous improvement
• Be supportive of carers
Risk/ Resilience matrix
Resilience
“Normal development under difficult conditions” e.g. being female, secure
attachment experience, an outgoing temperament, sociability, problemsolving skills
Adversity
Protective Factors
Life events or circumstances
which pose a threat to
healthy development, e.g.
racism, parental depression,
domestic violence
Factors which buffer
the effects of
adversity e.g. a good
school experience,
an alternative caregiver
Vulnerability
Those characteristics of the child, their family circle
and wider community which might threaten or challenge
healthy development e.g. an “unusual” temperament,
isolated parent, lack of community support, poor housing
From Child Development for Child Care and Protection Workers by Brigid Daniel, Sally Wassell and Robbie
Gilligan, 1999, Jessica Kingsley, p.61
Further local stats
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A recent review by CSCB highlighted a number
of key factors in registration. Caerphilly has a
greater number of children added to the CPR
than the national average. Re-registrations and
lengthier registrations are most likely to be under
the category of neglect. In the cases reviewedDomestic violence was a factor in 55%; parental
drug and alcohol misuse in 60% and parental
mental health in 55%.
Some more quotes
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“I was completely satisfied with the help I received with my daughter
which has shown a big improvement in her attitude and confidence.”
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“The project was fantastic – I don’t know how I would have managed
without them.”
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“The work that s/he (project worker) has done with myself and my
child has helped a great deal and family life is much better than
before.”
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I would like to thank the team for their support during this hard time
– it was much needed support.”