Q&A with Young Somerset: Exploring Risk and Asking the Right Questions
We we're thrilled to recently welcome Ruth Gavenlock and Gemma Fitzjohn, Service Managers – Mental Health and Wellbeing at Young Somerset to present on risk. Due to the high levels of engagement and large volume of questions asked during the Q&A section of our latest webinar for Mental Health Support Teams on June 5th, Young Somerset have kindly put together answers to all outstanding questions.
Q – Can you explain Rational Compassion please?
A – Young Somerset: In short, the more absorbed you are into a client’s problems and the more you take on, the more blinkered your perspective is, the less rational your decision making is and the less boundaries you become which can lead to burn out (which has been seen a LOT in medicine, teaching, social and mental health work, as well as the emergency services).
If you employ logical thinking i.e. rational compassion then you reduce your risk of burnout. It’s often a case of saying yes isn’t always kind and no isn’t always cruel – it’s the objective thinking that makes the difference. Against Empathy, by Prof. Paul Bloom is the guy who advocates it and there is ‘The Super Helper Syndrome’ too by Jess Baker and Rod Vincent
Q – I am aware we have some trainees at university who are being taught to ask about staying safe online – do you include this?
A – Young Somerset: Yes we would have conversations about staying safe and would also talk to parents of younger children about online safety and screen time-we signpost to CEOPs
Q – Managing the risk assessment for younger and primary age children in terms of the questions and how these are posed is something that it would be good to have further advice on
A – Young Somerset: We would use age appropriate language-we would make sure that the parent/carer knows we are going to be asking the risk questions-explain the rationale and normalise speaking about risk. We reassure parents/carers that speaking about this subject does not make it more likely that it will happen. It can be useful to use a drawing of a body or use toys and figures. It can also be useful to depersonalise the conversation, i.e. ‘some children when they are sad hurt themselves’.
Q – Do we still use DV (Domestic Violence)? My impression was that we avoid this and go with Domestic Abuse now, which covers all abuse and helps people understand that it is not just about physical, which is what the word violence is associated with
A – Young Somerset: I would use whatever term your service has agreed is acceptable.
Q – You may be coming to this, but if not, what is the process for risk assessment and risk checks for parent-led/parenting interentions when the CYP isn’t part of the sessions?
A – Young Somerset: Ideally the child would be at the initial session and so the comments about the risk questions above would apply. If the child is not in the session then you would still need to go through the risk questions with the parent. Sometimes it is helpful to support the parent in knowing how to ask their child and how to respond. In all cases if parents are concerned then we would signpost to appropriate sites such as Young Minds or Papyrus.
Q – Do you cover gaming / gambling harm at all?
A – Young Somerset: We would cover this if it is raised, we would ask questions about all social media use and gaming use-Gaming consoles, apps, TV, porn, sexting, sharing nude pictures-this is affecting younger and younger children, peer on peer abuse, conspiracy theories, incel ideology, YouTube, TikTok. Generally it is important for parents to keep themselves up to date as there are always new trends.
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Q – Are there any further questions you would recommend to ask if the CYP does disclose that they are in contact with unknown people (i.e. not known in real life) on social media?
A – Young Somerset: How long have they been in contact with them? What do they talk about? Do they say anything that makes them uncomfortable? How old are they? Have they asked to meet the yp in real life? Does a trusted adult know that they are talking to a stranger? If the answers to these questions make you concerned then take to your safeguarding lead and let the yp know that you have to share. Dependant on age you would also want to be telling the parents.
Q – At what point would you suggest asking all of these questions? The assessment session includes so much already, I imagine a thorough risk assessment including all of these questions can take another hour on it’s own
A – Young Somerset: As we are a Low Intensity CBT service it is unlikely that you would be needing to ask all these questions, we are suggesting these as supplementary questions if specific topics are raised.
Q – I would be curious to hear if anyone has some good ideas on how to manage these risks working therapeutically with young people while keeping in mind that there are no other services out there who will see these young people in a timely manner, and we are often asked to either work with young people presenting with risky behaviour/self-harm. We can of course signpost family to 3+ years of waiting for Tier 3 CAMHS.
A – Young Somerset: I think it is always important to emphasise that Low Intensity CBT providers are not crisis services and therefore the parent/carer is ultimately responsible for keeping their young people safe. Absolutely if the yp is presenting with immediate risk then we would take to safeguarding lead/phone emergency services. There are apps that yps can use such as Kooth or Tellmi, some services have Wellbeing Navigators who can see a yp while they are waiting for intervention.
Q – I am curious the time allowed for assessment and the details possibly expected from these ideas? Often a judgement call.
A – Young Somerset: As a Low Intensity CBT service provider most assessments should not be resulting in disclosures of major risk and therefore we should be able to keep the assessment within the prescribed limit. I think nationally services have seen a rise in complexity of cases presenting or being referred to services-ASD, ADHD, trauma, complex family situations.
It is important for service providers to remain boundaried within their remit however uncomfortable rather than trying to fill gaps that we are not commissioned to fill. We could be doing more damage than good if we work with CYP outside of our remit.
Q – This applies to working in an NHS trust – working as an outside agency in a school, at what point is it enough to share the risk with parents only as responsible for child’s safeguarding and when to share with school as the venue in which you are meeting the young person?
A – Young Somerset: We cannot really answer this question as it will be up to your individual service and the advice from your clinical and safeguarding leads. As a rule, if we are working in a school, and the young person is registered at the school, then we would inform the safeguarding lead of any concerns.
If you would like to request a topic for our next sharing and learning webinar for MHSTs, or are interested in being a guest speaker, please get in touch at events@mayden.co.uk