# 2.4 Supporting Lily and her parents

Read the last part of the case study of Lily below.

## Case study: Lily

Lily’s GP refers her to CAMHS and when Lily’s parents ask what treatment will include, the GP says it will likely be cognitive behavioural therapy (CBT). CBT is a form of therapy that consists of both behavioural components (i.e. understanding and making strategic changes to behaviours/activities) and cognitive components (i.e. making sense of and shaping/changing thinking patterns/cognitions). The evidence base supports CBT use for child anxiety issues, as it is an effective treatment given its focus on both the cognitive and behavioural aspects of her clinical presentation (National Institute for Health and Care Excellence/NICE, 2013). CBT is frequently employed in CAMHS, including in specific formats such as manualised (specially formulated and structured) versions of treatment (Merry et al., 2020). This approach is then well suited to CAMHS, because for many clinicians working in the field their training in empirically supported treatments takes place after qualifying, either informally on the job or via courses which support a manualised approach (Merry et al., 2020). Note that Lily is fortunate to live in an area where she is seen fairly promptly by her local CAMHS, which is not always the case.

The case study above notes how Lily is supported by her family doctor, but parents also need to consider their own wellbeing. In the next activity you will listen to a parent talk about their experience of supporting her child who refused to go school.

## Activity 4 How to cope when your child can’t

Allow about 15 minutes

‘All in the Mind’ is a BBC Radio 4 Open University–BBC co-produced series. Listen to the following audio where a parent (Ursula) and clinician (Roz) talk to the presenter (Claudia Hammond) about how to cope when your child can’t. Note down who is responsible in situations when a child refuses to go to school and the strategies cited that can help parents cope.

Access the audio at the following link and listen from 05:46 (‘And that was something …’) to 09:38 (’... does multi-tasking help you or not help you?’).

How to cope when your child can’t

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### Discussion

Answers will vary, but Ursula estimated with a child who was 11 at the time (i.e. younger than Lily) that the responsibility for her child going to school wasn’t entirely hers (or that of parents generally). However, the responsibility is spread across the parents (who she estimated are about one-third responsible), the child and their school. Ursula queried whether it was necessary for a child to be happy all the time (i.e. this isn’t realistic) and it was identified that there are ‘no quick fixes’. Instead, parents need to find out what works for them – including the use of appropriate boundaries.

OpenLearn - Child mental health: is it in crisis?
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