Talking Treatment Endings

Autumn has been a time of travel for the Anna Freud Learning Network. Along the way, we have experienced the delights of the great British railways and explored some fantastic towns and cities. But crucially, we have been Talking Endings with child and youth mental health practitioners and with young people around the country at nine roundtable events.

Children and young people’s mental health services are facing high levels of need with limited resources. For many practitioners, a belief that anyone can potentially be helped through treatment is appealing - – a position of compassion and hope. However, outcomes data (for instance CORC’s analysis of data from the CYP IAPT programme) indicates that not everyone improves or gets better.

Past conversations with practitioners brought to light some of the challenges of discussing endings with clients. Without a language to talk about endings we run the risk of raising expectations of the young people we are working with, or of young people blaming themselves if they don’t get better.

So we wanted to have an open conversation about what makes ending treatment feel difficult both from the perspective of the young person and the practitioner and to explore how to improve the experience of both.

The discussions have been fascinating and wide-ranging. Therapists have reflected on their own feelings when treatment ends without resolution. They also discussed the difficulty of getting support for families who remain anxious after treatment ends.

And what helps? Well transparency from the start is key, but remaining hopeful helps too. Some feel that offering a ‘safety net’ once a course of treatment has ended has been positive, and for others it is endings-focussed supervision that has felt most valuable.

We will publish a report summarising the findings and recommendations emerging from our Talking Endings work in the New Year. Join the Anna Freud Learning Network to be kept up to date.