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Advice, Help & Signposting

Websites and telephone numbers of organisations that offer help and advice: 

SEND Support

SEND Gateway 

First stop for information about SEND

Undiagnosed SEND

Change Organisation - Learning Disabilities Rights Charity
http://www.changepeople.org

British Institute of Learning Disabilities (BILD)
Support for people with learning disabilities and family carers.
http://www.bild.org.uk

Foundation for People with Learning Disabilities
Works to influence government and local authority policies and services.
https://www.mentalhealth.org.uk/learning-disabilities

Mencap
Mencap is the leading voice of learning disability. 
https://www.mencap.org.uk

Queen Elizabeth's Foundation for Disabled People
A registered charity that provides services for disabled people.
http://qef.org.uk

United Response
A wide range of services for disabled people.
http://www.unitedresponse.org.uk

Acronyms (abbreviations) used in Education

Acronyms

ABA            Applied Behaviour Analysis – intensive therapy programmes

AEN            Additional Educational Needs

ADD            Attention Deficit Disorder

ADHD         Attention Deficit Hyperactivity Disorder

AIO            Attendance Improvement Officer

ALN           Additional Learning Needs

ALNCO       Additional Learning Needs Co-ordinator

AP              Alternative Provision 

APD            Auditory Processing Disorder

APP            Assessing Pupil Progress – linear tracking of expectations through CAPPS / StAPPS

ASD            Autistic Spectrum Disorder

BAAT          British Association of Art Therapists

BACP          British Association for Counselling and Psychotherapy

BESD          Behaviour, Emotional and Social Difficulties

BAME         Black, Asian and Minorty Ethnic

BME            Black and Minority Ethnic

BSL             British Sign Language

BSP             Behaviour Support Plan

BTEC           Business and Technology Education Council / examinations in school

CAMHS       Child and Adolescent Mental Health Service (old name for PALMS)

CAPPS         Collett Assessing Pupil’s Progress System

CARS          Childhood Autism Rating Scale

CATs           Cognitive Ability Tests

CF               Cystic Fibrosis

CHAT          Comprehensive Health Assessment Tool

CLA            Child Looked After (or, LAC)

CME           Children Missing Education

CoP            Code of Practice – SEN Code of Practice

CP              Child Protection / Cerebral Palsy

CYP            Children and Young People

DD              Disability Discrimination

DDA            Disability Discrimination Act

DfE             Department for Education

DSA            Disabled Student's Allowance

EAL            English as an Additional Language

EBacc          English Baccalaureate

EBD            Emotional, Behavioural Difficulties (old name for SEMH)

EHC           Education Health Care

EHCP         Education, Health and Care Plan

EP              Educational Psychologist

EYFS          Early Years Foundation Stage

FE              Further Education (college of further education)

FSM           Free School Meals

Gatekeeper  Special Needs Team identified person with the file for a Special School

GCSE          General Certificate of Secondary Education

GDD           Global Development Delay

HI              Hearing Impairment

HLTA          Higher Level Teaching Assistant

HoD           Head of Department

HoS            Head of School

IEP             Individual Education Plan

IQ              Intelligence Quotient

FLO            Family Liaison Officer

KS              Key Stage

KS1             Key Stage 1 (Reception, Years 1 & 2)

KS2             Key Stage 2 (Years 3,4,5,6)

KS3             Key Stage 3 (Years 7,8,9)

KS4             Key Stage 4 (Years 10, 11)

KS5             Key Stage 5 (Years 12, 13: sixth form)

LA              Local Authority

LAC            Looked After Child

LDD            Learning Difficulties/Disabilities

LO              Local Offer

MLD           Moderate Learning Disabilities

NC             National Curriculum

NCES          National Council for Special Education

NDA            National Disability Authority

NQT            Newly Qualified Teacher

NVQ            National Vocational Qualification

OCD           Obsessive Compulsive Disorder

ODD           Oppositional Defiance Disorder

OFSTED      Office for Standards in Eductaion

OFQUAL      Office of Qualifications and Examinations Regulation

OT              Occupational Therapist

PALMS        Positive Behaviour, Autism, Learning Disability and Mental Health Service

PDA            Pathological Demand Avoidance (an aspect of ASD)

PDD            Pervasive Developmental Disorder

PECS           Picture Exchange Communication System

PEP             Personal Education Plan

PGCE          Post Graduate Certificate in Education – 1 year teaching qualification

PIVATS         Performance Indicators for Value Added Target Setting

PLTS           Personal Learning and Thinking Skills (curriculum for pupils)

PMLD         Profound and Multiple Learning Disabilities

POS           Programme of Study

Post-16        Provision for children after the age of 16 (e.g. school, college of further education)

Post-LAC     Adopted from care

PPA            Planning, Preparation and Assessment

PPF/ PPG    Pupil Premium Funding/ Grant

PRU            Pupil Referral Unit

PSD            Personal, Social Development (curriculum for pupils)

PSHE          Personal, Social, Health Education

QTLS          Qualified Teacher Lifelong Sector

QTS            Qualified Teacher Status

SaLT           Speech and Language Therapy

SATs           Standard Attainment Tests

SEAL          Social and Emotional Aspects of Learning          

SEMH         Social, Emotional & Mental Health

SEN            Special Educational Needs

SEND          Special Educational Needs and Disabilities

SID              Sensory Integration Disorder/ Dysfunction

SIDP            School Improvement and Development Plan

SLD             Severe Learning Disabilities

SLCN           Speech, Language and Communication Needs  

SLT              Speech and Language Therapist

SN               Special Needs

SN Team       Special Needs Team of the Local Authority

SpLD            Specific Learning Difficulties

StAPPS         St Luke’s Assessing Pupils’ Progress System

STEM           Science, Technology, Engineering and Maths

TA                Teaching Assistant

TEACCH        Treatment and Education of Autistic and Related Communication Handicapped Chn

UPS               Upper Pay Scale (teachers)

VI                 Visual Impairment

VMI              Visual Motor Intergration

Addiction

Addaction - www.addaction.org.uk 
Addaction is a UK-wide treatment agency, helping individuals, families and communities to manage the effects of drug and alcohol misuse.

ADFAM - 0207 553 7640 - www.adfam.org.uk 
Offers Information and advice for families of alcohol and drug users.

Al-Anon UK - 020 740 30 888 - www.al-anonuk.org.uk 
Worldwide organisation Al-Anon offers support and understanding to families and friends of problem drinkers, whether the alcoholic is still drinking or not. Confidential Helpline open from 10am to 10pm.

Alcohol Concern – 020 7264 0510 - www.alcoholconcern.org.uk 
Alcohol Concern is the national agency on alcohol misuse for England and Wales. It offers general information about alcohol and can help put you in touch with your nearest alcohol advice centre.

B-eat – Helpline 0845 634 1414 & Youthline 0845 634 7650 - www.b-eat.co.uk 
Support for eating disorders.

Beating Addictions - www.beatingaddictions.co.uk
Support to recognise and beat all types of addiction.

Down your drink www.downyourdrink.org.uk
An online self-help programme for anyone worried about their drinking; confidential, free and accessible 24 hours a day.

FRANK - 0800 77 66 00 – www.talktofrank.com 
Confidential drugs information and advice 24 hrs a day for young people and parents/carers.

HertsSpeak – 01438 312055 or 07918 641535
Support for families affected by alcohol misuse

Turning Point - 01923 213015 - www.turning-point.co.uk
Turning Point is a leading health and social care organisation. They provide services for people with complex needs, including those affected by drug and alcohol misuse, mental health problems and those with a learning disability.

Adult Learning and Work

Dacorum Learning Partnership - www.dacorumlearningp.btik.com
To promote access to and participation in lifelong learning for residents of Dacorum.

Disability Alliance – www.disabilityalliance.org
Working to relieve poverty and improve the living standards of people with disabilities.

Job Centre Plus – www.jobseekers.direct.gov.uk
Help and advice when looking for a job and claiming. 

Learn Direct – www.learndirect.com
Careers and Training advice.

NIACE – www.niace.org.uk
National Institute of Adults Continuing Education aims to encourage all adults to engage in learning of all kinds.

Working Families – 0800 013 0313 – www.workingfamilies.org.uk
Advice for working parents/carer to help achieve a work life balance.

Counselling

Asian Family Counselling Service - 020 8571 3933, www.asianfamilycounselling.org.uk
Offers free and low-cost counselling for Asian relationships, individual and family
problems. 

British Association for Counselling and Psychotherapy - 01455 883 300, www.itsgoodtotalk.org.uk
Can provide details of reputable counsellors near you.

Counselling Directory www.counselling-directory.org.uk
Registered Counsellors and Psychotherapists around the UK.

Open Toy Box – www.theopentoybox.co.uk
A client centred Play Therapy Practice with a team of qualified Counsellors and Play Therapists.

Journey Therapy – 01442 213152 - www.journey-therapy.co.uk
Healing/therapy which can help with a wide range of emotional and physical issues.

NYAS www.nyas.net
Offer information, advice, advocacy and legal representation to children, young people and vulnerable adults.

Bereavement

Cruse Bereavement Care- 0844 477 9400 - www.cruse.org.uk
Offering understanding support to the bereaved of any age.

St Albans Bereavement Network – 01727 841841 - www.sabn.org.uk
Support for bereaved in St Albans District.

The Child Bereavement Charity – www.childbereavement.org.uk
Supports families both when a child dies and when a child is bereaved.

Winston’s Wish - 0845 20 30 40 5 - www.winstonswish.org.uk
Provides practical support and help for bereaved children and their families.

Debt

Benefits Enquiry Line – 0800 882200
All enquiries about entitlements.

Child Maintenance Options - 0800 988 0988 - www.cmoptions.org
Helps parents to make informed choices about child maintenance and related
issues.

Christians Against Poverty (CAP) - 0800 328 0006 - www.capuk.org 
Free Debt counselling for everyone.

Consumer Credit Counselling Service (CCCS) - 0800 138 1111 - www.cccs.co.uk
CCCS offer free advice including debt counselling, welfare benefits checks, mortgage counselling and specialist debt advice for the self-employed, over the phone on, or online 24/7.  

Dacorum First Credit Union - 01442 240250 – www.dacorum.gov.uk 
A savings & lending co-operative, owned and run local volunteers.

Dacorum First Credit Union - 01442 240250 – www.dacorum.gov.uk 
A savings & lending co-operative, owned and run local volunteers.

Debtline Direct - www.debtline-direct.com 
Advice and support to get finances back under control.

Loan Shark Helpline - 0300 555 2222 - www.direct.gov.uk/stoploansharks
Advice for those who have been the victim of a loan shark.

Money Advice Service - 0300 500 5000 - www.moneyadviceservice.org.uk
Money Advice Service offer free, clear and unbiased advice to help you manage 
your money. 

National Debtline - 0808 808 4000 - www.nationaldebtline.co.uk
Offer free phone and email advice on financial problems. 

Turn2us www.turn2us.org.uk
Helps people access the money available to them through benefits, grants and other financial help.

UK Insolvency Helpline Debt Advice Service - www.insolvencyhelpline.co.uk - 0800 074 6918
Confidential debt advice.

Domestic Violence

Futures without violence - www.endabuse.org  
Advice and support including how to help boys grow into non violent men.

Hertfordshire Domestic Abuse Line - 08088 088 088
Helpline for victims of Domestic Abuse.

Herts Sunflower – 08 088 088 088 - http://www.hertssunflower.org/ or in an emergency dial 112. Picked upon? Controlled? Hurt by someone you love? Herts Sunflower can help.  A confidential and free service.

Men’s Advice Line - 0808 801 0327 - www.mensadviceline.org.uk 
Help for male victims of Domestic Violence.

National Domestic Violence Helpline - 0808 2000 247 -
Helpline for victims of Domestic Abuse.

The National Centre for Domestic Violence – 0844 8044 999   www.ncdv.org.uk
Free fast services to survivors of Domestic Violence.

Respect - 0808 802 4040 - www.respect.uk.net
Advises men and women who are concerned about their abusive behaviour towards their partner.

Women’s Aid – 0808 2000 247 - www.womensaid.org.uk 
Help and support for women living with domestic violence. 

Refuge https://www.refuge.org.uk/

Freephone 24-Hour National Domestic Abuse Helpline: 0808 2000 247

Education and Special Educational Needs

ADHD
www.add-vance.org
http://www.adhd.org.uk
http://www.adhdfoundation.org.uk

Autism
http://www.autism.org.uk/
www.autism.org.uk/about/what-is/asperger.aspx (Asperger’s Syndrome - Autism without the cognitive disability)

Cerebral Palsy
www.cerebralpalsy.org.uk

Down Syndrome
http://www.downs-syndrome.org.uk/

Search results (hertfordshire.gov.uk) for Down Syndrome.

Foetal Alcohol Syndrome 
www.fasaware.co.uk

Fragile X Syndrome
http://www.fragilex.org.uk

Global Development Delay
http://www.specialeducationalneeds.co.uk/global-developmental-delay.html

Williams Syndrome
http://www.williams-syndrome.org.uk/

Council for Disabled Childrenhttps://councilfordisabledchildren.org.uk/
Support for people with learning disabilities and family carers.

ACE - 0300 0115 142 - 
http://www.ace-ed.org.uk/advice-about-education-for-parents 
Aim to offer a comprehensive range of advice and information on education issues

Change Organisation - http://www.changepeople.org

Learning Disabilities rights charity
 

Check The Map - www.checkthemap.org

Guide to services in different areas of the UK

The Counselling Directory - https://www.counselling-directory.org.uk/

A directory of counsellors for a range of physical and mental conditions.

Dial UK - 01302 310 123 - www.dialuk.org.uk

Information and advice for disabled people.

Family Fund – 08449 744 099 - www.familyfund.org.uk
Financial help for equipment or services for a disabled child. 

Literacy Trust -

www.literacytrust.org.uk/familyreading/parents/index.html

SENDIASS SEND Information Advice Support Service (IASS) - 01992 555847 - www.hertsdirect.org/parentpartnership
Impartial advice and support for parents of a child with Special Educational Needs (previously known as Parent Partnership)

United Response - https://www.unitedresponse.org.uk/
A wide range of services for disabled people. 

Education Psychology (Hertfordshire)

Hertfordshire Education Psychology Service:  Click here for their website page

The Hertfordshire EP service:

  • Gives training to staff at educational settings, giving them the confidence to support their pupils.
  • Works together with schools in order to plan how to support a pupil's issues when current interventions aren’t working.
  • Gives advice about Education, Health and Care assessments.
  • Works closely with schools and other settings to support them with critical incidents such as serious injury or the death of a pupil or member of staff.
  • Works to improve whole school systems and approaches to helping pupils with certain needs.

Hertfordshire EP service Contactline: 

Contactline: 01992 588 574 : Wednesdays, 2pm - 4.30pm

This is available just for parents who want to speak to an educational psychologist.  

Families First & Accessing The Local Offer

Health

Afasic - 0845 – 355 55 77 - www.afasic.org.uk
Support for children and families to help them overcome their speech and language difficulties.

Brainwave – www.brainwave.org.uk
Therapy and information for families with children who have developmental delay, cerebral palsy, genetic disorder or brain injuries.

British Red Cross –   0844 871 11 11 - www.redcross.org.uk
Global Voluntary network who help people in crisis whoever or wherever they are.

Cassiobury Court Guide to Free Mental Health Helplines
http://www.cassioburycourt.com/article/98/guide-to-uks-free-mental-health-helplines
A compiled source of help and information regarding mental health in the UK.

Child Accident Prevention Trust – 020 7608 3828 – www.capt.org.uk
Helping prevent accident.

Citizens Advice Bureau – 0844 411 1444 - www.adviceguide.org.uk
Free, independent, impartial advice and information.

Community Mental Health Team – 0300 123 3393 – www.mind.org.uk 
Care advice and support for adults who have issues with mental health problems.

Cystic Fibrosis Trust – 0300 373 1000 – www.cftrust.org.uk
Support for people with Cystic Fibrosis.

Eating Disorders - Beating Eating Disorders
https://www.beateatingdisorders.org.uk/tips

Family Information Service – 01438 737502/01923 471502 – www.hertsdirect.org/younginherts 
Information, advice and support on the services available to families in Herts.  Available Mon – Fri 8.30am – 4.30pm.  Email: younginherts@hertscc.gov.uk 

Galley Hill Children’s Centre – 01442 426753 - www.hertschildrenscentres.org.uk/galleyhill/ 
Children’s Centre covering Gadebridge, Warners End and Chaulden.

Go Smoke Free -www.gosmokefree.nhs.uk
Support to give up smoking Great Ormond Street – 020 7405 9200 (main switchboard) - www.gosh.nhs.uk
A free general health information site for young people and families run by Great Ormond Street Hospital.

Heath Lane Children’s Centre – 01442 261043 – www.hertschildrenscentre.org.uk/heathlane/ 
Children’s Centre covering Hemel Hempstead central area including Boxmoor, Apsley and the new and Old Town centres.

Herts Urgent Care Advice Service - NHS 111 –http://hucweb.co.uk 
For urgent advice and treatment outside of your GP opening hours, in an emergency please dial 999.

Macmillan Cancer Support – 0808 808 0000 – www.macmillan.org.uk
Practical, medical and financial support for people suffering with cancer.

Multiple Births Foundation – 020 3313 3519 - www.multiplebirths.org.uk
Support for families and professionals working with multiple birth families.

National Deaf Children’s Society – 0808 800 8800 – www.ndcs.org.uk
Advice and support for Deaf children.

National Autistic Society – 020 7833 2299 – www.nas.org.uk
Leading charity for people with Autism.

National Eczema Society – 0800 809 1122 – www.eczema.org
Support for people suffering from eczema.

NHS Direct – 0845 4647 – www.nhsdirect.nhs.uk
For health advice and reassurance 24 hours a day, 365 days a year.

Nits – 01908 561982 –www.nits.net
Advice on detecting and curing head lice and nits.

Royal National Institute of Blind People - 0303 123 9999 – www.mib.org.uk
Support for blind and partially sighted people.

One Stop Doctors - www.onestopdoctors.co.uk
An Autism Assessment service for children and adolescents is available at One Stop Doctor's private clinic in Hemel Hempstead. Self-pay or insured options available.

Understanding Childhood www.understandingchildhood.net
Provides downloadable information leaflets to help raise emotionally secure children.

Young Minds – 0808 802 5544 - www.youngminds.org.uk 
Support for child mental health issues.

Youth Talk  http://www.youthtalk.org.uk/

Hertfordshire SEND

Housing

Dacorum Rent Aid – 01442 253923 - www.homelessuk.org/details.asp?id=UK16035
A scheme to allow single homeless people access private rented sector accommodation.

DBC Housing Solutions – 01442 228900 - www.dacorum.gov.uk/default.aspx?page=2774
Advice line and internet info for Dacorum Borough Council housing services.

DENS – 01442 262274 – www.dens.org.uk
Emergency night shelter in Dacorum.

Shelter – 0808 800 4444 - www.shelter.org.uk 
The housing and homelessness charity.

Local Services

Children’s Centre covering Gadebridge, Warners End and Chaulden Heath Lane Children’s Centre – 01442 261043 – http://www.hertsmere-children.co.uk/childrenscentres/heath-lane/

Dacorum Borough Council www.dacorum.gov.uk

Dacorum First Credit Union - 01442 240250 –  www.dacorum.gov.uk
A savings & lending co-operative, owned and run local volunteers.

Galley Hill Children’s Centre – 01442 502762 - 
http://www.hertsmere-children.co.uk/childrenscentres/galley-hill-childrens-centre/

Herts direct www.hertsdirect.org

SNAP – 07979 612363 – http://www.stalbansmencap.org.uk 
A leading organisation that offers holiday play schemes to young people aged 3-19 years with varying learning disabilities.

The Sunflower Centre - Domestic, Abuse, Race and Hate Crime Centre
For Domestic Abuse – Dacorum - 01442 270679
For Race and Hate Crime – Watford and Dacorum – 01923 472085

Parenting Support

Dad Info -  www.dad.info
Support for Fathers.

Dads' Space –www.dads-space.com
Advice and information based on Dad’s experiences and research.

Dad Talk – www.dadtalk.co.uk
News, advice and support for Dads.

Bubbalicious – www.bubbalicious.co.uk
A site for young parents.

Help Paying for Childcare Costs
https://www.gov.uk/help-with-childcare-costs

TAMBA  - 0800 138 0509 – www.tamba.org.uk
Support and information for parents of multiple births and professionals involved in their care.

One Parent Family – www.oneparentfamily.co.uk
Information, support, advice and help from other single parents.

One Space – www.onespace.org.uk
Parenting site for single parents.

Separated Families Matter – www.separatedfamiliesmatter.org.uk
Practical and emotional support for separated families.

NFPI – www.familyandparenting.org
National Family and Parenting Institute.

SupportLine – 01708 765200 – www.supportline.org.uk
Confidential Emotional support for children, young people and adults.

ChildLine - 0800 1111 - www.childline.org.uk 
A free, 24-hour, confidential telephone helpline for children and young people. Also at www.achance2talk.com you can email your problems for reply by an adviser plus chat.

NSPCC - 0808 800 5000 - www.nspcc.org.uk
Advice for anyone worried about a child.

Directgov – Childcare - www.direct.gov.uk/childcare 
Advice for parents on childcare and parenting.

Netmums – www.netmums.com 
Netmums is a unique local network for Mums (or Dads), offering a wealth of information on both a local and national level.

Family Lives – 0808 800 2222 or text 0800 7836783 – www.familylives.org.uk 
Provide confidential, impartial advice and support line for parents.  Open 24 x 7.

Home Start – 0800 686368 – www.home-start.org.uk 
Trained volunteers offer support, friendship and practical help to families with 1 child under 5 years.

Contact a Family – 0808 808 3555 - http://www.cafamily.org.uk/what-we-do/ 
Support families of disabled children across the UK, whatever their condition or disability.

ADD-Vance – 01727 833963 - www.add-vance.org 
Supporting parents and carers of children with Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorder

Disability, Pregnancy & Parenthood International – 0800 0184730 - www.dppi.org.uk 

Youth Connexions - 0300 123 4043 -   
http://www.youthconnexions-hertfordshire.org

Relationship and general emotional support.

Couple Counselling – www.ukcouplescounselling.com
Counselling for couples and individuals at any stage of a relationship.

Gingerbread - 0808 802 0925 – www.gingerbread.org.uk
Advice and practical support for single parent families.

MIND - 0845 766 0163 - www.mind.org.uk
Information and advice to promote and protect good mental health for everyone.

Relate – 0300 100 1234 – www.relate.org.uk & www.relateforparents.org.uk
Relate offers advice, relationship counselling, sex therapy, workshops, mediation, consultations and support face-to-face, by phone and through their website.  Local branches can be found via the website or in the local phone directory.

SANE  - 0845 767 8000 -  www.sane.org.uk
Support to improve quality of life for anyone suffering from mental illness.

Way Inn Counselling, Hemel Hempstead 01442 216621 
info@the wayinn.co.uk 

Trauma

Understanding Trauma

After Boris announced a lockdown for the UK, there was a spike of 40% people requesting help with depression & anxiety.

To add to his, Young Minds recorded the following after a longitudinal survey;

‘Unsurprisingly, the coronavirus and the public health measures designed to prevent its spread are having a profound effect on many young people with a history of mental health problems. When asked what impact the pandemic was having:

  • 32% agreed that it had made their mental health much worse
  • 51% agreed that it had made their mental health a bit worse
  • 9% agreed that it made no difference to their mental health
  • 6% said that their mental health had become a bit better
  • 1% said that their mental health had become much better’

One young person who gave their opinion in the survey said that ‘Self-isolating and social distancing was a bad habit I worked really hard to get out of. Now I’m being made to do it and being told it’s the right thing to do. It’s very confusing and I’m scared of falling back in to that cycle.’ You can find the full report here.

It could be assumed that they had perhaps found the experience of the pandemic ‘traumatising’, as many of our students could have also. Poses idea of a strong need for EARLY INTERVENTION: - statistics show scary emphasis on the importance of early intervention for all children.  In addition, there is a reported 70% increase in people requesting help with eating disorders in the first week of lockdown.

Trauma symptoms

People with Post-Traumatic Stress Disorder (PTSD) may present with these following symptoms. These symptoms may present during or at least 6 months AFTER the traumatic event (it is interesting to note that a lot of mental health charities etc. won’t provide bereavement advice until at least 6 months after the death of a loved one because of this)

  • Increased anxiety & panic attacks
  • Lethargy; may present as tiredness, withdrawal or boredom
  • Racing minds & restlessness
  • Irritability
  • Self-harm

Medicalised versions of the symptoms (NHS UK) include, repetitive:

  • Nightmares / images
  • Physical pain / sweating
  • Flashbacks & re-experiences
  • Negative shameful thoughts
  • Avoidance
  • Regular flight or fight actions that may seem irrational
  • Difficulty falling asleep or staying asleep
  • Reduced tolerance to noise
  • Feeling distrustful & paranoia
  • Physical aches and pains with no recognisable cause
  • SEN setting; non-verbal children & young adults may show an increased manifestation of unhelpful symptoms / communications that they may already have presented with.

Sometimes, worsening in symptoms could lead to these medicalised symptoms of complex PTSD (as mainly diagnosed/seen in adults)1

  • Instability in relationships
  • Disassociation
  • Somatisation
  • Questions over student’s own identity

[Complex PTSD is very similar to Emotional Unstable Personality Disorder (EUPD, formally, Borderline Personality Disorder). Very simply put (and by no means formulaic), the above diagnoses can come from adult events in complex PTSD, but not EUPD.]

 

Existing Psychodynamic Theories on Trauma

  • Not just ‘nature’ & not just ‘nurture’.
  • Adverse childhood experiences & how they’re dealing with it NOW as well as years to come matters.
  • The pandemic could mean that past traumas are being brought into the present
  • Pandemic could also mean that parents / carers / siblings are more likely to repeat past traumas / develop unhelpful coping mechanisms.

Freud

  1. ‘Fright, fear and apprehension are incorrectly used as synonomous expressions: in their relations to danger they admit of quite clear distinction. … Fear requires a definite object of which one is afraid; fright is the name of a condition to which one is reduced if one encounters a danger without being prepared for it; it lays stress on the element of surprise. [Freud, 1920]
    1. Fright = surprise? Fear = more tangible?
    2. Ideally we’d have a ‘psychic ego’ so that we can concentrate on living our lives!
  2. ‘A 'repetition compulsion', Freud proposed, was the tendency for someone to re- enact a traumatic event and its circumstances repeatedly. He also described it as the following: “the desire to return to an earlier state of things”..............................
  3. Once trauma is experienced, it leaves something stunted.’
  4. Remembering, repeating and working through.
  5. We do the first two because we haven’t worked through
  6. Therefore, anything you forget, IS important = it’s just in the unconscious (you may dream it, repeat it in dreams or repeat it subconsciously in your reality)
  7. You’re destined to forever repeat what’s in our unconscious if you cannot bring it into the conscious mind.

Melanie Klein

  1. While Klein is not a natural trauma theorist, aspects of her work generate some intriguing insights. In opposition to the paranoid-schizoid position, Klein set the depressive position.
  2. Theories on trauma are very, very extreme to us as readers. However, she was known to be very traumatised herself & suffered with depression, ‘annihilation’; is this some of our student’s reality
  3. Splitting; more likely to happen in times of panic & trauma? Always seen in MH?
  4. Anxious = ‘attacked’, ‘persecuting voices everywhere’?
 

Physiological & Neurological Experiences

(Tavistock & Portman NHS & Mayo Clinic Online)

Our body’s stress response system should help us respond to stress by putting us in fight or flight mode. This dates back to at least Neanderthal times, where a caveman would have to respond to e.g. a passing bear on the attack.

Our amygdalae, located in each of the central hemispheres of the brain, are responsible for the perception of emotions. They help trigger the body’s stress response system by “rubber stamping” red flag stressors, to divert cognitive processing to become more alert of the stimuli leading to a stressor. Our brain sets off an alarm system if a perceived threat is encountered. A combination of hormonal and neural triggers prompts our adrenal glands (above our kidneys) to release hormones including adrenaline and cortisol:

  • Adrenaline
    • Increases heart rate
    • Elevates blood pressure
    • Increases energy supplies
  • Cortisol
    • Increases sugars in the bloodstream
    • Enhances the brain’s use of glucose
    • Increases the availability of substances that
    • repair tissues
    • Curbs non-essential/detrimental functions for
    • a fight/flight situation

Our body’s stress response is usually self-limiting; once a perceived threat has passed, our adrenaline and cortisol levels lower, bringing our heart rate and blood pressure back to baseline. When stressors are always present, however, we constantly feel under attack, and our stress response system is always turned on. Over-exposure to cortisol can disrupt almost all bodily processes.

Traumatic memories are not like the usual filing cabinet memory (e.g. here is a lovely thought about that time we went on a picnic, which I can access and put away back into my filing cabinet at will), but more like an airport baggage conveyor belt memory. A memory is triggered and thrown onto the conveyor belt, where it circles round and round, being relived and re-experienced, until something changes and the memory can come off the conveyor belt.

Useful Reading & Links

  • Bicknell, J. (1983) The Psychopathology of Handicap. British Journal of Medical Psychology, 56:2, pp. 167-78.
  • Freud, S. (1920) Mourning and Melancholia. On Metapsychology. London: Penguin, pp. 245-268.
  • Garland, C. (2002) Thinking about Trauma. In C. Garland (ed.) Understanding Trauma: A Psychoanalytical Approach (Tavistock Clinic Series). London: Routledge, pp. 9-31.
  • Herman, J. (2015) Trauma and Recovery: The Aftermath of Violence - from Domestic Abuse to Political Terror. Updated edition. New York: Basic Books.
  • Sinason, V. (2010) The Handicapped Smile. In Mental Handicap and the Human Condition, 2nd edition. London: Free Association Books.
  • Van der Kolk, B. (2015) The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma. Updated edition. London: Penguin.-

All above links are either free or online suggestions to texts referenced. All are available on Amazon and other chain or independent bookstores. All of the books above are also available from Karnac Books (a specialist psychoanalysis and psychotherapy bookseller).

Psychological First Aid training courses

Johns Hopkins University (free, with option of completion certificate for £38) https://www.coursera.org/learn/psychological-first-aid 

MHFA England (a variety of courses and price points) https://mhfaengland.org/