Happy Easter! I have had a good day making Sri Lankan lamb with potatoes and greens. It was a peaceful day spent with family.

Following on from yesterday we can focus on the second session. In meetings it is good to check in with young people with a summary of what they have taught you. It is important for young people to know that you have done your best to understand their views. There will be doubts and worries and it is best to try to get a young person to talk about their issues in their own words. It is important to think about the very words and feelings and body movements in the room, especially during important moments in therapy. It is harder to get a strong sense of these in online consultations.

Successful therapists will be good at checking in with young people, noticing if they have got something wrong or need to make adjustments. We don't have to worry about having the perfect consultation because if we are checking in with people we can navigate to where we need to get to in a consultation in a genuine and meaningful way for a young person. Imperfect consultations are definitely OK. Something that was previously impossible now can be looked at differently and issues reworked for young people in ways they can relate to more easily.

If a young person is saying that they want to die or cannot live anymore, then it is a very serious matter. Suicidal thinking and fear of suicide are common phenomena. However opening up discussions about suicidal thinking for young people can actually help because we can understand the extent of their thinking and the limits of their thinking. In conversations about suicidal thinking we can understand what a young person visualises especially if they have made previous attempts or have known people who have died.  

In talking about any difficult subject a young person is usually allowing us into an important space for us to observe and understand deeply. If a young person is able to articulate their dilemma then we can learn a great deal. This is moment for the the therapist to reflect and check with a young person they have understood. At this point in the meeting we can move with a young person deeper into how they can resolve the dilemma or express to us the barriers to them for progress.

Quite often these therapeutic discussion sits alongside discussions of social context, risk assessment, medication and drug/alcohol harm reduction.

I want to pause at this point and illuminate the blog with this recent reference:

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Perspectives of Young People Who Access Support for Mental Health in Primary Care: A Systematic Review of Their Experiences and Needs.

Appleton R, Gauly J, Mughal F, Singh SP, Tuomainen H.

The British Journal of General Practice : The Journal of the Royal College of General Practitioners. 2022;72(716):e161-e167. doi:10.3399/BJGP.2021.0335.

Our next blog will focus on reflections on this article and trust and confidentiality.