Child and Adolescent Psychotherapists are a core profession in the Child and Adolescent Mental Health workforce. The Association of Child Psychotherapists is accredited by the Professional Standard Authority. As such, it is a discipline that has an important contribution to make to the mental health and emotional and psychological wellbeing of children and young people in paediatric settings.
Why is psychological support needed within paediatrics?
Children living with long-term physical illness are twice as likely to suffer from emotional or conduct disorders.
There is considerable overlap between children with medically unexplained symptoms and long-term conditions, with both being significant risk factors for chronic mental and physical ill health in adulthood. In addition, approximately 10 per cent of children and young people frequently experience somatic symptoms not fully explained by medical assessments yet causing significant impairment.
Government guidelines recognise the need for psychological and emotional support for children and families in this area as stated in the National Service Framework:
“CAMHS Paediatric Liaison (CAMHS-PL) is concerned with providing a bridge between acute paediatrics and psychiatric and psychosocial care. This is an essential service for the ill child, siblings, parents and carers in cases where the presenting illness has a psychological component, or where psychological distress is caused as a result of the illness. Too often CAMHS-PL have insecure funding, with no local champions and are therefore vulnerable. However, in London for example, virtually all CAMHS offer some out-patient referral, consultation and emergency service to their local paediatric service, though not necessarily a dedicated PL service."
There are also guidelines outlined for specific medical conditions, e.g. diabetes, which recognize the need to address emotional and psychological issues in young patients and also the impact of this on the family. The document Making Every Young Person with Diabetes Matter (2007) states,
“Diabetes may result in additional psychosocial vulnerabilities such as eating problems, social isolation, fear of stigma, depression and psychiatric difficulties, depending upon factors such as coping skills, support and resilience. The long- term implications and life-threatening nature of this condition make the psychological and social challenges particularly complex. For diabetes services to respond to these emotional needs and the varying levels of complexity, psychological provision must be a central component. The challenge is to integrate psychological developmental principles into routine provision for children and young people.” (p.51)
Similarly The Department of Health’s Toolkit for High-Quality Neonatal Services (2009) highlights access to psychological services for parents and siblings of a baby on the special care baby unit as one of their markers of good practice (p.49). Research (Carson, 2015) shows that parents of very preterm children are at increased risk of having psychological distress in comparison to parents of term babies.
The documents produced by the department of health recognise the importance of considering the mental health and emotional and psychological well-being within paediatric medical settings. Furthermore, they acknowledge the importance of multi-disciplinary work. Looking after the emotional and psychological welfare of a child will not only give the patient and their family an integrated experience of care, but it will most likely also relieve stress on the medical system, with a probable reduction in the length of hospital stay, reduced medical appointments, etc.