Service Detail

Assessment

The foundation of our interventions is a thorough individualised multidisciplinary assessment. It provides a comprehensive formulation of the child’s strengths, difficulties, needs and protective factors – across the whole range of mental health disorders.

We consider information from different sources and the child's presentation in different settings, such as home, at school, and in our clinic.

We use the formulation to develop a care plan, which may address a range of problems, for example mental health, educational engagement, and home needs. Behavioural problems can be, for example, the expression of a child’s high levels of irritability, or frustration due to problems with learning or inability to focus, or a traumatic experience, a mood disorder, sensory overloading, etc. In addition, it can appear together with “Limited Prosocial Emotions” (for example, with unusually low levels of guilt or remorse) or not. Disentangling the above will guide us into what treatment to recommend (see below).
 

Treatment

Our clinicians are skilled in a range of evidence-based therapeutic interventions that includes one-to-one sessions, individual parent work (PIPT), group sessions, and medication advice. All of these options can be tailored to suit your family's needs.

Parenting support: personalised individual parent training (PIPT)
Also known as the parent-child game (PCG), PIPT is an intensive parenting program designed to promote a positive attachment relationship between a parent (or carer) and a child by reducing children's oppositional and antisocial behaviour and increasing their prosocial behaviour and compliance.

We work collaboratively with families, using our expert knowledge and the parent's understanding of their child. It is based on social learning theory and attachment theory principles, and is evidence-based, which means that it has been shown to be effective in multiple trials and settings. This approach is also recommended by the NICE guidelines for more complex family situations. Its effects can be seen fairly quickly, so it is very popular with parents.
 

Individual therapy

Our clinicians are trained in a range of evidence-based individual therapies and have a wealth of experience working with children and young people that present with behavioural problems. Some of the treatments we offer include:
 

• Cognitive behaviour therapy (CBT) to assist young people with conditions including depression and anxiety disorders which can co-occur with behavioural problems, or be masked by the disruptive behaviour presentations
• Trauma-focused CBT for children that are experiencing Post-Traumatic Stress Disorder (PTSD)
• Psychoeducation: for parents, teacher and the child if we identify triggers that regularly upset the child and present as “meltdowns”
• Psychoeducation for the parents on the neurodevelopmental basis for irritability and emotional regulation work for the child
• Psychoeducation for the parents on Limited Prosocial Emotions (LPE), as these children will not respond to standard parenting techniques
• Social skills work for the child
• We can also work closely with schools to help generalise the effects of intervention and to provide psychoeducation

 

Medication

We only recommend and use evidence-based interventions. Medication follows diagnosis of a particular condition, so we will only prescribe if it is supported by research and recommended in the NICE guidelines for each specific disorder.

If we decide to do a trial of medication, we provide written information, so the family can read this in their own time and return with any questions. Then we will have a session of psychoeducation with the family to discuss the different options. We understand that this is an important decision and that parents and the child need to understand the rationale behind this.
 

Consultation

In addition to our regular clinical work and training provision, we provide consultation regarding complex cases especially for older children and young people with complex presentations, in which challenging behaviours co-occur with identified or suspected neurodevelopmental problems, issues of mood or anxiety, limited prosocial emotions, or other complicating factors.

Although not a routine part of our work, we can also provide expert assessments for Courts in certain cases, especially those that have a specific issue around parenting capacity for managing challenging behaviours in the light of child factors.
 

Training

We offer professional and bespoke training for professionals from a range of different services, and directly to parents, carers and pre-adopters.

For example members of the team lead the challenging behaviours programs for London and the South-East as part of the Children and Young People’s Mental Health training (formerly CYP-IAPT) for the Postgraduate Diploma in Parent Training; Child Well-being Practitioners (CWP) and Education Mental Health Practitioners (EMHP).

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Research

Our service has strong links with several academic institutions, particularly King's College London, with a strong emphasis on parenting and attachment, and especially the influence of child factors that complicate the delivery of standard, “off-the-shelf” parenting programmes and also the personalisation of parenting training to better address engagement and barriers to access.

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