Exploring the role of therapeutic conversations in classrooms

Dr Margot Sunderland, director of education and training at the Centre for Child Mental Health and co-director of Trauma Informed Schools UK, explains why schools can – and should – be places of both learning and healing

Despite a rise in mental health issues amongst both students and teachers, outdated conceptions of what schools ‘should’ look like still persist – with many arguing that academic attainment and learning outcomes must be prioritised rather than the emotional wellbeing of the school community. Teachers and school staff often worry that they may open up a ‘can of worms’ if they engage in therapeutic or conversations on difficult topics with pupils. There is widespread anxiety and fear amongst the teaching community that they will only complicate, not clarify, the situation.

In the face of cuts to both the NHS and Child and Adolescent Mental Health Services (CAMHS) the job of tackling mental health issues is frequently left to schools – described by Professor Tamsin Ford as ‘our default line service in relation to mental health’. In November 2019, figures obtained by the mental health charity Mind revealed that CAMHS in England cancelled 175,094 appointments with vulnerable patients between August 2018 and July 2019 – an increase of 25% when compared to the same period in 2017-18.

However, with children spending 190 days a year at school, on average, teachers and learning staff are well-placed to provide appropriate support to children. In fact, the UK government’s green paper, Transforming Children and Young People’s Mental Health Provision asserts that, ‘appropriately trained and supported staff, such as teachers, school nurses, counsellors and teaching assistants, can achieve results comparable to those achieved by trained therapists in delivering a number of interventions addressing mild-moderate mental health problems’.

The ‘can of worms’

Despite compelling evidence supporting the importance of open, therapeutic conversations in schools, the ‘can of worms’ myth appears very much alive, with as many as two-out-of-three teachers worrying that, if they have a conversation with a teenager who self-harms, they will simply make matters worse.

However, all too often, the can of worms is already wide open and spilling over, manifesting in difficulties with behaviour, relationships, cognition and socialising. Bottling up feelings has a hugely negative impact on learning as children’s brains are flooded with stress hormones which dramatically interfere with the ability to focus and comprehend. Moreover, when children lack a safe space to discuss painful life events with a trusted adult, they are likely to ‘behave their trauma’ and risk re-victimisation, doing to others what has been done to them.

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It’s more than understandable that teachers are tentative about approaching sensitive topics, but turning a blind eye can result in problems ‘snowballing’ and taking on a life of their own. The need for children experiencing trauma to be able to express their feelings was powerfully illustrated in the recent case of Kyle Schwartz, a teacher at an American primary school, who asked her students to complete the sentence “I wish my teacher knew_____.” The answers were honest and often heartbreaking.

“I wish my teacher knew that my mum and dad fight all the time and that’s why sometimes my homework is rubbish because they are too busy fighting to help when I find the sums too hard.” Schwartz’s initiative demonstrated the inseparable connection between children’s home lives and their learning outcomes.

An emotionally available adult

The evidence is now overwhelmingly in favour of the need for children of all ages to have access to an emotionally available adult – be it teacher, caregiver or parent. The benefits to the body and brain are wide-reaching, including:

  • reduction in the levels of toxic stress;
  • boosted immune system;
  • activation of brain regions associated with social connection and reward;
  • development of frontal lobe function (the home of important cognitive skills like problem-solving, memory, language and judgment);
  • reduction of activity in the amygdale (one of the brain’s alarm systems).

As observed by Dr Bruce Perry, renowned psychiatrist, “The more healthy relationships a child has, the more likely he will be to recover from trauma and thrive. Relationships are the agents of change and the most powerful therapy is human love”.

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