1. 04.11.11 SG/PMHP/Wrexham CAMHS/Inspire 104.10.20111 Welcome to the F.R.I.E.N.D.S Workshop Presented by Sophie Gorst Primary Mental Health Practitioner

2. 04.11.11 SG/PMHP/Wrexham CAMHS/Inspire 2 Aim:Aim: To demonstrate examples of adapting the F.R.I.E.N.D.S programme for children and young people who are presenting with various complex needs.

3. 04.11.11 SG/PMHP/Wrexham CAMHS/Inspire 3 Objectives:Objectives: 1.Introduce the incremental components of the F.R.I.E.N.D.S programme 2.Understand the need for creative interventions to meet the age and stage of development of children attending the groups in Wrexham 3.Identify at least three models of practice promoting the F.R.I.E.N.D.S conceptual framework 4.Discuss your own experience of running groups based on cognitive behavioural principals

4. 04.11.11 SG/PMHP/Wrexham CAMHS/Inspire 4 FRIENDS is a world leading evidence-based early intervention and prevention programme designed to equip education, social care and health professionals with the resources to help children and their families develop effective strategies to deal with worry, stress and change.

5. 04.11.11 SG/PMHP/Wrexham CAMHS/Inspire 5 A structured 10 week programme delivered to groups of children (or individuals) Children learn practical skills to:  identify anxiety increasing thoughts and to replace them with more helpful thoughts  identify anxious feelings and learn to manage them learn to overcome problems rather than avoid them.

6. 04.11.11 SG/PMHP/Wrexham CAMHS/Inspire 6 Why is it called ‘the FRIENDS for Life Programme’? The word FRIENDS helps children and young people to remember each of the skills taught throughout the programme. In other words, each letter represents a different skills learned in a sequence. FRIENDS helps children and young people to remember that the skills they learn throughout the programme are lifelong skills, and that they can practise them across different life situations involving family, friends, school, work and their neighbourhood.

7. 04.11.11 SG/PMHP/Wrexham CAMHS/Inspire 7 Feelings Remember to relax I can do it. I can try my best Explore solutions and coping step plans Now reward yourself. You’ve done your best Don’t forget practice Smile. Stay calm for life.

8. Session 4: Unhelpful & helpful thoughts Session 5: Developing helpful self talk and coping plans Session 2: Identify Feelings Session 3: Emotional Management Session 6: Block problem solving plan Session 7: Reward yourself Session 8: Practice FRIENDS plan Session 9: Practice using plan for a range of problems Session 10: Review, praise and enjoy Cognitive Feelings Behaviour Session1: Psycho-education and Introduction

9. 04.11.11 SG/PMHP/Wrexham CAMHS/Inspire 9 Group exercise:Group exercise:

10. 04.11.11 SG/PMHP/Wrexham CAMHS/Inspire 10 To ensure this programme is accessible to all children and young people sometimes presenting with complex needs the programme has had to be delivered more creatively. Dr Caroline Smith on her facilitators training days encourages facilitators to use creative methods of delivery as long as … “they follow the structure and sequence of the skills taught in the session Barrett (2005, p10).” This is reiterated in the FRIENDS evaluation study completed in 2001, “The manuals permit flexible implementation to allow for family individuality and the needs of any specific group (Barrett et al)”

11. 04.11.11 SG/PMHP/Wrexham CAMHS/Inspire 11 What creative methods have the facilitators used in Wrexham when delivering FRIENDS? “Using story recognises the limitations of talking about feelings to children in everyday language. Stories can speak to children on a deeper level and far more immediate level then literal, everyday language.” Sunderland, M (2008, p4)

12. 04.11.11 SG/PMHP/Wrexham CAMHS/Inspire 12 “Games provide an opportunity for the child to learn the consequences of his actions without having to suffer them. In a game mistakes and exposure of ignorance are more tolerated. Games, usually encourage laughing and joking, which can be instrumental in relieving anxiety and facilitating involvement.” (Cartledge and Milburn 1981 p. 100) What creative methods have the facilitators used in Wrexham when delivering FRIENDS?

13. 04.11.11 SG/PMHP/Wrexham CAMHS/Inspire 13 “1. Drawing, 2. painting, 3.collage, 4.construction. All of these media are powerful because they allow children to express and communicate internal thoughts, feelings and experiences by using their own individual imagery and symbolism.” Geldard & Geldard (2005, p164) What creative methods have the facilitators used in Wrexham when delivering FRIENDS? Picture depicting red and green thoughts by children with EAL, Wrexham 2011

14. 04.11.11 SG/PMHP/Wrexham CAMHS/Inspire 14 Developing resources to successfully engage children and young people in the FRIENDS programme can be time consuming at first. However these resources only have to be adapted for subsequent programmes. The effort is worth it when you see, hear a child grasp and use the skills as part of their day to day activities.

15. 04.11.11 SG/PMHP/Wrexham CAMHS/Inspire 15 Group exercise:Group exercise:

16. 04.11.11 SG/PMHP/Wrexham CAMHS/Inspire 16 References 1.Barrett et al (2001) Evaluating the FRIENDS Program: A Cognitive–Behavioural Group Treatment for Anxious Children and Their Parents. Journal of Clinical Child Psychology Vol. 30, No. 4, 525–535 2.Barrett, P (2005) FRIENDS for Life Group Leaders Manual for Children. Australian Academic Press 3.Gavigan, K et al (2011) Bibliotherapy as an intervention approach for children and adolescents with emotional disabilities. In Norton, C (2011) 4.Gerald, D & Gerald, K (2005) Counselling Children A Practical Introduction. 2 nd Ed. Sage. 5.Nath Dwivedi, K (2005) Group Work with Children & Adolescents A Handbook. Jessica Kingsley 6.Norton, C. Ed (2011) Innovative Intervention in Child & Adolescent Mental Health. Routledge 7.Stallard, P (2005) A Clinician’s Guide to Think Good – Feel Good: Using CBT with children and young people. John Wiley & Sons 8.Sunderland, M (2008) Using Story Telling as a Therapeutic Tool with Children. Speechmark

17. 04.11.11 SG/PMHP/Wrexham CAMHS/Inspire 17 Please complete the evaluation forms placed on your seats. If you would like to share your ideas and thoughts please don’t hesitate to contact: Sophie Gorst Email: sophie.gorst@wales.nhs.uksophie.gorst@wales.nhs.uk Tel: 01978 726002