Beech Lodge School Therapy Booklet

THERAPEUTIC INTERVENTIONS

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THERAPIES AT BEECH LODGE SCHOOL

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ost of the pupils who come to Beech Lodge require additional therapeutic support at school for a variety of reasons. They may require help to make sense of early life experiences, techniques to manage emotional regulation and anxiety or just someone else to

talk to when things are tough.

Overseen by our Senior Leadership Team and our Educational Psychologist, our dedicated Therapy Team delivers all therapies in the Meadow Building, our Therapeutic Hub on site.

Our range of therapies includes:

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Arts Based and Expressive Psychotherapy

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Attachment & Trauma Related Therapy (DDP)

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Cognitive Behavioural Therapy

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Compassion-Focused Therapy

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Equine Therapy (off site)

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Music Therapy

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Occupational Therapy

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Zones of Regulation

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Interoception Curriculum

Play Therapy •

Aut-Therapy

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SMART (Sensory Motor Arousal Treatment

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Therapeutic Life Story Work

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Safe & Sound Protocol

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Speech & Language Therapy

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OUR TEAM EDUCATIONAL PSYCHOLOGIST Alastair Lidster BSc(Hons), PGCE, MSc, C.Psychol.,(FRSA)

OCCUPATIONAL THERAPIST Loulette Schieke B.Occ.Therapy

OCCUPATIONAL THERAPY ASSISTANT Shashi Prakash BSc

SPEECH & LANGUAGE THERAPIST Lizzy Connolly PGDip (Distinction) Speech & Language Therapy Member: The Health and Care Professions Council Member: Royal College of Speech & Language Therapists

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PLAY THERAPIST Kelly Higgins BA(Hons), PGDip, Certified Child and Adolescent Trauma Specialist Sensory Motor Arousal Regulation Therapist (SMART) AutPlay Therapist

SAFE & SOUND PROTOCOL Guy Higgins ILS Safe & Sound Practitioner

CLINICAL PSYCHOLOGIST Dr Kerstin Thirlwall BSc Hons, DClin Psych, PhD

CHILD & ADOLESCENT PSYCHOTHERAPIST Louis Sydney MA, UKCP, SEAUK, UKOP

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EDUCATIONAL PSYCHOLOGY Alastair Lidster

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ducational Psychologists use psychological research and methods to generate change. My work with Beech Lodge follows three strands, assessment, consultation, and Fagus. Fagus is the

developmental toolkit I created with Dr Becci Best to help Beech Lodge understand children’s social and emotional development. We continually improve the resource, and the latest addition is a booklet describing interventions that are recognised to support different aspects of children’s development.

Consultation is a core part of an Educational Psychologist’s (EP) work. This involves working with an adult who brings a concern about a child to the discussion, exploring their concern and considering together what needs to change. One of the strengths of a consultation process is that insights can be achieved because of the expertise both parties bring to the discussion.

Educational Psychology assessment is a process of gathering information about a child or young person that is relevant to the brief the EP has agreed. It typically involves listening to people who know the pupil well, observation in relevant situations, and direct work with a child or young person using a variety of properly researched materials. With this information I consider the child/ young person’s strengths and needs and make evidence-based recommendations for teachers to explore.

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T

OCCUPATIONAL THERAPY Loulette Schieke he Occupation Therapist (OT) works with students to support independence in all areas of their lives. OT’s work with students who might have difficulty in joining with activities they need or want to do every day e.g.,

dressing, using cutlery, riding a bike, writing, paying

attention to schoolwork or playing with friends.

These difficulties may be due to poor gross and fine motor coordination, poor core stability, poor motor planning skills, visual perceptual difficulties, sensory difficulties or early life experiences.

In our Nelson cohort, we have many students whose presentation has been impacted by disrupted attachment and early/developmental trauma. Our OT service plays an integral role in supporting these students by using a trauma informed, sensory and relationship-based approach in working towards better self-regulation.

During therapy sessions we work with students to look at how their sensory systems and motor skills are impacted by their early trauma, the interplay of how their body manifests fight and flight responses and the impact of stress triggers on daily life at home, school and play. We work with students and staff in close collaboration to explore and implement strategies to support better regulation. 1:1 or small group sessions include programs such as The Zones of Regulation Curriculum and The Interoception Curriculum to support students towards building independent self-regulation.

A common manifestation of difficulty with many of our students involves handwriting – it being one of the key ‘occupations’ students need to master to succeed at school.

Working closely with staff and parents, we assess and identify what might be the underlying problems that might contribute to the handwriting difficulty. This could 8

include previous negative experiences in addition to gross or fine motor, visual

perceptual or sensory capabilities.

Other examples of the tasks and skills OTs might focus on include: •

Self-care routines like getting dressed (fine motor skills and motor planning);

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Drawing and copying notes (fine motor skills, hand-eye coordination);

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Holding and controlling a pencil, using scissors, rulers (fine motor skills, motor

planning, bilateral hand function); •

Throwing and catching (gross motor skills like balance and coordination);

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Organizing a backpack (motor planning, organization skills);

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Reacting to sensory input (self-regulation skills);

Occupational Therapy consists of exercises and activities to strengthen specific skills that are weak or adapt tasks or activities to allow for greater independence. At Beech Lodge Occupational Therapy input is provided in the following forms: •

Individual therapy sessions

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Small groups run in class

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Sessions run with other professionals working in the school

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Tailored motor programs or individual sensory diets

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Classroom programmes, overseen by OT team and delivered by the class team (e.g. Daily sensory circuits)

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Advice and guidance on assistive equipment, where appropriate

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Training for school staff and parents.

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SPEECH AND LANGUAGE THERAPY Lizzie Connolly

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ur Speech and Language Therapist Lizzy Connolly has worked for a number of years in Special Schools, supporting children with complex emotional and communication

challenges. She works 1-1 with many of our students, liaising closely with Teaching staff to support and monitor progress. She is currently training two of our Learning Support Assistants who hope to take on a more specialist SaLT support role in future.

The types of communication difficulties SaLT supports include: Speech difficulties •

Stammer / stutter

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Articulation / pronunciation

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Dyspraxia of speech

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Phonological impairment

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Selective mutism

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Cleft palate

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Voice difficulties

Language difficulties •

Auditory memory

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Word finding difficulties

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Delayed vocabulary

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Following instructions

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Sentence and narrative structure

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Higher level language including figurative language, multiple meanings, sarcasm, humour, inference

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Social communication difficulties •

Conversation skills

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Use of language in context

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Emotional regulation

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Social Thinking

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Perspective Taking

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Higher level language (as above)

Specific programmes are tailored to each child depending on their needs. And the overall therapeutic approach also takes in to consideration the early life experiences of the children here, with PACE principles running through the core of everything we do.

In addition to therapy, our SaLT also assesses children where there is a need to understand in more detail their baseline skills and to monitor progress. This assessment can help

tease out where specific linguistic difficulties may lie and how these interact/overlap with other developmental and emotional factors.

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PLAY THERAPY Kelly Higgins

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elly delivers a number of interventions at Beech Lodge including Play Therapy, AutPlay Therapy, S.M.A.R.T and Therapeutic Life Story Work.

Play therapy helps children to express themselves,

explore their thoughts and feelings, and make sense of their life experiences. Play is a natural activity of learning, exploration and communication for children, and so the medium is considered highly effective for helping children to 'play out' what they may find difficult to put into words. I work predominantly 1:1 in a non-directive way and provide a ‘tool-kit’ of materials and toys which allows the child to process thoughts, feelings and emotions in a non-confrontational way.

The main aim is to equip children with adaptive behaviours and better coping mechanisms for everyday life. This is to help them develop a more positive view of their place in the world. Play Therapy is a way of untangling brain pathways that are causing distress, and therefore directly helps the creation of healthy new connections.

As a result, children can gain greater self-respect, greater self-control and increased decision making and problem-solving skills. Play Therapy can help meet schools’ objectives by improving participation in group work, improved and increased communication with others, improved self-regulation, listening, concentration, reduced exclusions and improved attendance.

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AUT-PLAY THERAPY

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utPlay® Therapy is a play and behavioural therapy approach to working with children and families affected by autism, attention deficit hyperactivity disorder, dysregulation issues, and other neurodevelopmental disorders. It integrates therapeutic models of play

therapy and behavioural therapy along with relationship development approaches together in a collaborative model to assist children and adolescents in gaining needed skills and abilities.

AutPlay Therapy is a combination of behavioural and developmental methodology that is both therapist-led and parent-led.

AutPlay Therapy has Shown Effective Treatment Outcomes for the Following Areas: •

Increasing Emotional Regulation Ability

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Improving Social Skills and Functioning

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Improving Relationship Development and Connection

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Reducing Anxiety Levels

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Improving Sensory Processing Challenges

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Increasing Concentration, Focus, and Attention

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Reducing Unwanted Behaviours

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Improving the Parent/Child Relationship

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SMART

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ensory Motor Arousal Regulation Treatment is an innovative mental health therapy for complexly traumatized children and adolescents as well as those with neurodevelopmental difficulties for whom regulation of emotional, behavioural and interpersonal life is a primary problem.

SMART: •

Utilizes an array of therapeutic equipment, such as weighted blankets, balance beams, fitness balls, large cushions, swings and shared play to support children’s natural ways of regulating their bodies and their emotions, facilitate attachmentbuilding and allow for embodied processing of traumatic experiences.

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Blends movement and relationship to regulate arousal states and powerful affect,

thereby , engaging the subcortical, cortical, and attachment neural pathways to increase behavioural and psychological integration.

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Widens the child’s window of tolerance for both positive and negative emotional states, and for interpersonal connection so that healthy development can proceed.

What makes SMART Different?

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Does not rely on language and awareness as an entry point. A coherent narrative and cognitive understanding emerge as a result of fully embodied play engaging the sensory, motor, limbic, and arousal systems for self-exploration.

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Engages the sensory motor systems, especially the vestibular, proprioceptive and tactile sensory systems for emotional, psychological, and relational regulation and repair.

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Follows the child’s lead while tending to safety, uses full body participatory play with the child, to work with the unfolding process in real time in session as the path to developing new skills and processing traumatic experience.

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THERAPEUTIC LIFE STORY WORK

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or children who have been removed from the care of their birth family and suffered placement breakdowns or transitions, their life history can be extremely fragmented, leaving the child feeling lost and with no sense of belonging (Perry, 2012). This can impact hugely on their well-being and make the child very

vulnerable in their present and future.

Therapeutic Life Story Work empowers a child’s voice and provides them with a safe space to feel and express their thoughts and emotions when making sense of past experiences and the relationship these have to their current thoughts, feelings and behaviours.

The Therapeutic Life Story Model consists of three stages; The Information Bank, the Internalisation and the Life Story Book.

Through this therapeutic process and the relationship with their caregiver, the child can develop further insight into their responses to trauma (developed in order to protect and keep themselves safe). Often this can present in a variety of behaviours and without knowledge of the child’s history it is difficult to see the communication behind them. By supporting the child’s awareness of this and the influences it has upon their present, there is an opportunity to change, move forward and develop a positive sense of self.

The experience of this journey supports the therapeutic understanding and care provided for the child within their family home.

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DYADIC DEVELOPMENTAL PSYCHOTHERAPY (DDP)

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yadic Developmental Psychotherapy (DDP) was created by Clinical Psychologist Dan Hughes as a treatment for families with adopted or fostered children who had experienced neglect and abuse in their birth families and suffered from significant developmental trauma.

DDP is based on and brings together attachment theory, what we understand about developmental trauma, the neurobiology of trauma, attachment and caregiving, intersubjectivity theory and child development.

These children may have had many changes in the people who look after them and find it hard to trust adults. They may believe that parents aren’t safe and can’t always be turned to for comfort and help. They may develop insecure attachments and try to stop their new parents from becoming emotionally close to them.

The therapy helps the children learn to trust. It is family-based and involves the child with his or her caregivers.

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SAFE & SOUND PROTOCOL (SSP) Guy Higgins

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he Safe and Sound Protocol by iLs (Integrated Listening Systems) is an evidence-based intensive listening programme aimed at those with anxiety, social communication difficulties and trauma that has been developed as a result of over four decades of peer-

reviewed research, based on Dr Stephen Porges’ Polyvagal Theory.

Music is played through over-ear headphones, which has been specially filtered in order to gradually expose the auditory system to different sound frequencies. It works by

stimulating the facial and vagus nerves and helping the autonomic nervous system to regulate, improving concentration and social engagement.

The Safe and Sound Protocol is the only auditory intervention that directly re-tunes and regulates autonomic state, moving a person out of fight/flight/freeze and into a rest and digest/parasympathetic state. When faced with what the body perceives as threats or danger, it responds by re-tuning the nervous system into states of defence – either “fight

or flight” (sympathetic) or “freeze” (dorsal vagal). The brain and body’s first priority is to keep us alive.

When the nervous system remains in a chronic state of defence, it affects both the mind and body – impacting how we feel, think, and connect with others.

This can adversely affect our health and day-to-day experience in the world. A proven solution is to look from the bottom up.

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In addition to acute, repetitive, complex and developmental trauma, the Safe and

Sound Protocol has been proven to help the following difficulties and challenges: •

Social and emotional difficulties

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Auditory sensitivities (Misophonia, Hyperacusis)

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Auditory processing difficulties

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Anxiety and trauma related challenges

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Inattention

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Stressors that impact social engagement

It is a short intervention of 5 hours (either 5 one hour sessions or 10 half hour sessions) plus 'top up' sessions parents/carers can administer at home as and when needed. It can be done face to face or remotely if appropriate.

This intervention is highly suitable for many children and young people at Beech lodge School who may struggle to regulate their nervous system and who may find social engagement difficult. Our aim in using SSP is to enable children to feel safer and live life in a lower state of perceived threat, thereby allowing them to thrive.

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CLINICAL PSYCHOLOGY Kerstin Thirlwall

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Clinical psychologist is a mental health professional who has undertaken extensive research and clinical training to understand the factors that contribute towards human

behaviour and emotional distress. At Beech Lodge many of our students arrive with heightened defense mechanisms and coping strategies instinctive from negative life events and trauma.

Our Clinical Psychologist is equipped to recognise and support the complex psychological needs of these students, as well as those who are experiencing unsettled mental health due to current stressful or turbulent times.

This may include (but is not restricted to) supporting young people experiencing the following: •

Attachment difficulties

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Anxiety

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Low moods/depression

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Adjusting to life transitions

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Low self esteem

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Anger and difficulties regulating behaviours

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Emotional dysregulation

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By observing and connecting with students at the school, our clinical psychologist is able

to offer a fully flexible and informal approach. The therapeutic work undertaken centers around building a non-judgmental and trusting – where students are first and foremost given a space to share and process their feelings. Students experiencing mental health difficulties are not regarded as being broken or disordered, but are instead understood as having typical reactions to difficult circumstances (perceived or otherwise).

Effective therapeutic approaches and evidence-based strategies are integrated depending on their suitability and the preference of the student.

Therapy techniques most commonly drawn upon are those from •

Cognitive Behavioural therapy (CBT)

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Acceptance and Commitment Therapy (ACT)

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Dialectical Behavioural Therapy (DBT)

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Narrative Therapy

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Compassion Focussed Therapy (CFT)

Collaboration with parents, teachers and other support staff is also regularly sought and encouraged.

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ARTS BASED and EXPRESSIVE PSYCHOTHERAPY Louis Sydney

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he psychotherapy service at Beech Lodge School

provides a weekly therapeutic service for children and young people. The therapy is attachment, trauma and neuro-developmentally informed and aims to meet the

unique needs of each person referred to the service.

Louis is also trained in Theraplay, Dan Hughes’ DDP, arts based therapy and is a Somatic Experience practitioner.

For each child/young person referred for therapy, there is the opportunity and place to reflect upon their thoughts, feelings and experience. This can include talking about: •

Peer relationships

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Issues around stress, anxiety & well being

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Behavioural issues

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Concerns about life at home

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Frustration with teacher relationships

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Loss or bereavement

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Anxiety and/or frustration re the covid pandemic

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Thoughts, feelings and experience of being adopted

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A current or historic trauma

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And more besides……

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Understandably, not all children or young people are comfortable with speaking about

their feelings. With this in mind, there is opportunity to use arts based or creative ways to express themselves such as art, sand trays, music, role play, poetry/writing, puppetry and drama.

Louis has extensive experience of working with parents and there is also an opportunity for parents to access support or advice re parenting strategies, attachment focussed parenting and crisis or trauma intervention related to your family.

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Stubbings Lane, Maidenhead SL6 6QA, 01628 879384 info@beechlodgeschool.co.uk www.beechlodgeschool.co.uk

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