Creative Youth Network received a referral for Janet from her school. Janet was experiencing constant panic attacks caused by a serious level of social anxiety and found it difficult to even leave her house, let alone attend school. Her lack of attendance however was a cause for real concern amongst her parents and teachers.

Janet was assigned a CYN Wellbeing Practitioner called Rebecca and an initial assessment was done over 2-3 sessions. Janet was frightened and often became very tearful in sessions and so it was important that the session content was paced to provide a supportive and safe space. Rebecca also arranged sessions to be held in school as agreed with Janet and her teachers to help support Janet with her attendance.

Whilst completing the assessment, it was determined that Janet was presenting different triggers for her anxieties and suffered from low self-esteem, and mood swings. Janet herself felt that social anxiety was the biggest problem and wanted to focus on improving this to be able to attend school full time and start doing things that she had stopped doing. Janet was on a reduced timetable to support her attendance when lockdown had been lifted and her school had fully reopened.

During Janet’s assessment, some risk was identified and therefore it was necessary to put a safety plan in place for Janet. This was to ensure Janet felt safe and knew how to cope when experiencing suicidal thoughts. Alternative reactions to punching walls when feeling angry or frustrated were also explored with her.

Rebecca undertook some work regarding psychological education on anxiety. This consisted of analysing Janet’s experience of different symptoms and how she interacts using the CBT hot cross bun model. Janet and Rebecca also covered how anxiety works and how it’s maintained by avoidance, to normalise her experience and difficulties. Janet demonstrated some very distressing thoughts and so she and her Wellbeing Practitioner spent a bit of time completing psychological education on anxious and intrusive thoughts to understand what these were and how to manage them. Breathing techniques and grounding exercises also helped Janet who practised them. Together, Rebecca and Janet reflected on how they may be helpful to use outside of the sessions and in the real world.

I was absolutely dreading meeting Rebecca for the first time. I thought she was just going to try and force me to do things I’m not comfortable with. To be honest it made my anxiety go through the roof, but when I met Rebecca she put me at ease and let me work through things at my own pace. I’m not going to lie and say it’s been easy, but it has been easier than I thought. I’m definitely feeling a bit better about things. I still have a long way to go and school still terrifies me. My suicidal thoughts are less frequent now as I have tools to help me cope when I can’t see a way out. I’ve also learnt about how to channel my frustration which is caused by my anxiety. For the first time I can see light at the end of the tunnel and the future doesn’t terrify me like it did before I started speaking to Rebecca.

Rebecca says:

“The intervention techniques I used were behavioural experiments which are a recommended intervention practice for social anxiety. Janet completed her own hot cross bun model, hierarchy ladder, identifying negative automatic thoughts and planning behaviour experiments. Although Janet didn’t feel ready to complete the behaviour experiments in the later sessions, we completed relaxation and grounding techniques to support her in managing her physical symptoms of anxiety in school, particularly in lessons.

As a result, Janet’s goal is to be able to attend 5 full days at school for several weeks in a row. Janet is still working towards achieving this goal. Her attendance has very recently been affected by physical ill health, and so I am working with Janet to organise a final session remotely when she is well enough.  This final session we have planned is to review information on anxiety and panic attacks; this will equip Janet with the resources to continue to look after her wellbeing, as well as planning for accessing further support. We have worked with the school nurse and the wider school for Janet to feel safe and supported when she attends. To achieve this, we have shared information, regarding Janet’s experience of bullying and her mental health difficulties. This has been shared with her consent. Unfortunately, Janet feels the panic attacks have got a lot worse recently owing to the severe bullying escalating again. However, Janet’s attendance is now 4/5 days a week on average, which is a vast improvement. Janet has done very well to continue to attend school and attend sessions and we have agreed that higher intensity support is the next best step.”

Next steps: Janet is on a waiting list for the school counsellor, while Rebecca is working with school to complete referral to CAMHS for higher intensity support.

*Rebecca referred Janet to Youth Moves for a 1-2-1 mentor for further support in building  confidence whilst waiting to access higher intensity support.

 

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