How can a clinical psychologist help your child with SEN?

Clinical psychologist Elizabeth Kilbey chats to My Child about what her job involves and how a clinical psychologist can support a child with special educational needs.

What are the causes of special educational needs and mental health issues in children?

This is extremely difficult to say as the issues are wide ranging and often unique to each child. It can range from issues such as ADHD which can be of medical origin, including various factors within a child. There can be Autistic Spectrum Disorders and behavioural problems syndromes which arise from with the child and can often be very specific to that child.

Often children are very affected by their environments. Behaviour is directly linked to communication. If a child finds it difficult to articulate the way they feel about something, it can manifest itself in their behaviour. A clinical psychologist is rather like a detective, we need to consider why a child is presenting this behaviour and think about possible factors that could be changed in order to fully support the child. It is about finding clues, and building up an accurate picture of that individual child’s life in order to offer the best possible support and seek the best possible outcome. This is why we work closely with educational psychologists, and in partnership with a variety of colleagues, to communicate all areas of a child’s life and work towards a positive and effective outcome.

What is the difference between an educational psychologist and a clinical psychologist?

One of the differences is the settings we work in. Educational psychologists are based within the educational system and work in schools, so where a child is presenting an emotional or behavioural difficulty within a school setting, the school will consult with their educational psychologist about what might be happening. Clinical psychologists are based within the NHS. We work in clinics, similar to where GPs work.

Clinical psychologists are interested in difficulties that children present that appear to be related to their life in general rather than specifically at school. So if a problem existed outside of school, or there was a strong feeling that the difficulties they were having were related to more global issues, either something about them – a developmental problem, or something about their life or social situation that was a bit broader, then that would be where a clinical psychologist could help.

Clinical means a disorder or disfunction within the population, whereas educational is more school-specific.

What can a clinical psychologist do to help a child?   

The starting point would always be an assessment and we would do a thorough assessment, that would include meeting the child and talking with them, depending on how old they are or where their verbal skills are at.

We would also want to talk to the people around the child who know them well - usually parents or carers - and we would contact schools to hear about how the child is doing there. It's all about helping us build up a picture of that child, what the difficulties are, where and how they present themselves. We look at some of the background and history of the child that goes right back to when they were born or before they were born, and we often to ask parents to give us some of that early history.

Once we have a good understanding of what we think is going on, we can begin to think about where the treatment needs to happen. This could be either:

• Individually with the child – the clinical psychologist meeting on a one-to-one basis with the child, doing some therapy with drawing, playing or talking,
• Involving other people - do we need to have sessions with families together, or do we need to involve other people in doing what we call systemic (group) sessions  looking at the whole system.

Based on what the assessment tells us helps us think about how we would offer an intervention. 

What should parents do if their child has a special educational need?

For a parent who thinks their child may be developing symptoms of ADHD, Austistic Spectrum Disorders, or complex behavioural difficulties, the first port of call would always be to talk to the people who know their child. Raise your concerns with the school, but also talk to the GP about requesting a referral to your local CAHMS (Children and Adolescent Mental Health Service) service, or talk to the school about perhaps having a meeting with the school SENCO and see if they share the same concerns as you. Push the system to have meeting with a professional to talk through what your concerns are.

Is there enough support outside of schools for children with SEN?

The thing that most parents want is a quick response and practical help. They don’t want long drawn out referrals and waiting lists. If we can offer help quickly before problems become serious then that is helpful, but unfortunately we need to prioritise. It is in a sense a 'Catch 22' situation – we would like to work more with preventive approaches before the issue escalates, however, we must prioritise more serious cases.