Sooner rather than later: The benefits of early intervention.

What do we mean by ‘early intervention’?

Early intervention means stepping in to support an individual and their family before a problem arises or before a small problem becomes embedded or grows out of hand.

How do we know who to help?

We can never predict exactly who will develop psychological difficulties. However, research can tell us characteristics of those who are vulnerable. We call these ‘risk factors’ and they can present themselves in any area of our lives. A risk factor could be something external to us such as living in absolute poverty or an area of high crime. Or it could be something more personal such as difficulties with language skills or a tendency to avoid dealing with problems.

Just as we have risk factors, we also have people, things or characteristics that protect and help us avoid psychological problems. We call these ‘protective factors’. We also refer to ‘psychological resilience’.

Risk factors and protective factors may both sides of the same coin. For example, a young person may have an overly critical teacher who lowers their self-esteem. In their lessons they may feel anxious to answer questions for fear of humiliation and the class laughing at them. On the other hand, the young person may have a supportive teacher who encourages them to make mistakes, as this is how we learn and come to fully understand a subject. This teacher may raise the young person’s self-esteem. These two teachers have the same role in a young person’s life but their presence has different outcomes.

A diagram to show the different systems in a person’s life and the risk factors which may present. (Diagram taken from the Early Intervention Foundation)

How can early intervention help a young person?

The Early Intervention Foundation talks of four key developmental areas in young people. These areas give us more of an idea about whether we need to provide support.

  • Physical development: We look to see that a young person is physically fit and well and whether they are maturing in line with their age. Early intervention in this area might include actions to reduce the risk of health problems, such as obesity.
  • Cognitive development: Here we look to see if a young person is able to communicate competently, both in speech and writing. Also, we pay attention to a young person’s ability to read, complete basic numeracy and problem solve. Early intervention in this area might include support with schooling and help to gain secure employment.
  • Behavioural development: If a young person is not able to regulate their behaviour and control their impulses, they may find it difficult to form friendships. Any friendships formed might be with those who aren’t a good influence, leading to involvement in crime. Early intervention in this area may provide a young person with strategies to control aggression, enabling them to form friendships with peers who positively influence their lives.
  • Social and emotional development: Youth is a turbulent time for most and we need to be able to manage our own emotions and have an awareness of other’s needs. Early intervention in this area might involve helping a person to develop their self-esteem and interpersonal skills, preventing a diagnosis of a mental health condition.

There are many early intervention teams working around the country. Let’s take a closer look at those designed to help young people with psychosis…

Psychosis is a condition which significantly impacts the way a person thinks and feels but also a person’s behaviour. Common symptoms of the condition include hallucinations, where a person perceives an object or sound which isn’t there; delusions, where a person has a strict belief in something, even when there’s concrete evidence to suggest otherwise; speech problems and emotional apathy; social withdrawal and self-neglect.

Early intervention teams are located nationally to help those who have experienced psychosis for the first time or those who are at significant risk of experiencing psychosis. They work with people as young as 14 years old to provide education around the condition, develop their ability to cope with symptoms, warn of the dangers of alcohol and drug misuse and prevent relapse. This help is available to a young person for three years and supports their family and carers too.

The National Institute for Health and Care Excellence (NICE) have outlined what a young person should expect from this service, based on the psychological evidence surrounding psychosis.

  • No young person should have to wait longer than two weeks for an assessment from the point of their referral. They should also be assigned a care co-ordinator, who is their main point of contact.
  • A young person should be offered a psychological intervention, such as cognitive behavioural therapy (CBT) to explore and manage their thoughts and feelings more appropriately. This should include education about psychosis too.
  • The young person’s family should have access to support and education, allowing them to better understand the condition and how to respond to their loved one in situations of distress.
  • The young person should receive a comprehensive care plan which gives advice for healthy living, adjustments for education or employment where required and guidance of what to do/who to contact in a crisis.

How effective are early intervention teams for those experiencing psychosis?

The research suggests they’re very effective. Those who received care from an early intervention team went on to have better outcomes with their condition of psychosis (Bird et al., 2010). These better outcomes may be due to the fact that young people have access to a CBT sooner when receiving care from an Early intervention team.  Perhaps they were able to understand their condition and implement coping strategies more effectively. Evidence suggests that CBT might be powerful enough to prevent those at risk of psychosis from developing a full-blown episode for the first time (Van der Gaag et al., 2012). Lastly, it was shown that family interventions offered by an early intervention team really do make an impact. They were able to better understand their loved one in times of crisis and respond appropriately to their needs, this led to 40% decrease in relapse rates, compared to those whose families had no support (Knapp et al., 2014).

So, what does all of this mean?

Stepping in early to support those who are at risk really does pay off! Providing help before the problem becomes too big prevents us from using more intrusive methods of treatment, like high doses of medication and hospitalisation.

We are all about empowerment and early intervention at Pocket Family Psychologist. Our online programmes and consultations are all about addressing worries and niggles before more serious psychological problems takes root. We think this is much better than young people acquiring psychiatric labels, believing there is something seriously wrong with them/’ill’, needing time out of school and drifting apart from their parents.

Our programmes and consultations help children with their social and emotional development and give parents the knowledge, skills and resources to help their children too. Click here for more information on Taming your lion, our programme for 7–11-year-olds. Our programme for teens is in the making too!

If a problem is becoming out of hand and disrupting family life, we also offer the option to talk through your concerns with one of our psychologists, using a single session consultation model.

As always,

Take care

Pocket Family Psychologist

Written by Ellie Harper

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"Dr Andrea Shortland’s session for MediaCom on a children’s mental health was incredibly informative"

“Dr Andrea Shortland’s session for MediaCom on a children’s mental health was incredibly informative. During the second period of lockdown and home-schooling; parents and children found themselves again in a period of upheaval and transition. Many parents and carers were extremely worried about their children’s mental health and their own ability to be present and engaged whilst also playing the role of teacher and care giver. Dr Shortland gave attendees an insight into how many parents were feeling; tips on supporting children and helping them cope whilst studying from home and also managing their mental health. She also helped us realise the importance of taking care of ourselves in order to effectively support our children. It was such a useful session that we realise it was also pertinent for not only children’s mental health but also adults! We will be holding another session with Dr Andrea and MediaCom soon.”

Avelon Thompson, MediaCom (following a parenting workshop)