Attention to the total field: The school setting

It is inevitable in working with adolescents and young people who present with embedded problems, that these problems cannot be contained within the family but overflow into school and other areas. Embedded problems such as severe anxiety, obsessive preoccupations and rigidities as they emerge in adolescence, cannot simply be dismissed as ‘phases’. Many schools put in place good pastoral and counselling services to try to address these problems as best they can. When we take a dynamic view of the problem in which the different domains are connected, then we recognise that the core problem of anxiety within the young person overflows into the family as well as into the school community. Teachers and school counsellors need support and clarification to manage their anxiety so that they can work effectively with the young person in the school setting. For this reason dissolving of the therapeutic boundaries where the therapist with the consent of the patients, has explanatory meetings with the relevant staff, is particularly apposite and provides positive containment for all concerned. For the young person it also demonstrates the concern and support of the adults around them. For example a 14-year-old boy who had suffered from depression and crippling anxiety was unable to attend school for several months. As he made a slow recovery a decision was taken for him not to return to his old school at which he had been unhappy, but to commence at a different school. The therapist was concerned that no plan had been put in place about how he was going to literally cross the threshold on his first day. The therapist therefore worked with the parents and the school to ensure that he would be able to establish connections with key teaching and support staff as he entered the building and that they would be available to him to ensure he would successfully establish himself in this new environment.

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