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Mental Health

Open the conversation

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If it’s ok with you, can we spend a few minutes focusing on what you and your parents think might be some help for you?

Insight

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Setting the scene for both the child and parent/guardian allows a constructive person-centred conversation around behaviour change. With younger children the emphasis needs to be around short-term goals. The more concrete and specific – the better!

Did you know?

Toddlers and pre-schoolers should spend at least 3 hours per day in a variety of physical activities spread throughout the day including active and outdoor play.

All physical activity counts towards moving more.

Children and young people should aim to minimise the time they spend sitting for extended periods of time, including watching TV, playing computer games and travelling by car when they could walk or cycle and should replace sedentary time with light intensity physical activity wherever possible.

Real impact

When I dance it makes me smile

Make sure you speak to school and your teachers, make a plan about how you can participate!

Physical activity is not just sports – have fun!

Assess impact of the condition

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How does your condition affect your playtime?

Insight

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Living life with a long -term condition commonly affects physical activity beliefs and behaviours. Focusing on this can be a useful way to introduce the topic.

Young children lack experience and their goals are short term. Engaging with parents is key to establishing behaviour change in this age group.

Learning motivational interviewing can help you avoid common pitfalls that sometimes make conversations about behaviour change unrewarding and ineffective. Visit our education section to learn more.

Did you know?

Toddlers and pre-schoolers should spend at least 3 hours per day in a variety of physical activities spread throughout the day including active and outdoor play.

All physical activity counts towards moving more.

Children and young people should aim to minimise the time they spend sitting for extended periods of time, including watching TV, playing computer games and travelling by car when they could walk or cycle and should replace sedentary time with light intensity physical activity wherever possible.

Real impact

When I dance it makes me smile

Make sure you speak to school and your teachers, make a plan about how you can participate!

Physical activity is not just sports – have fun!

Find out what they already know

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What do you know about the benefits children get/achieve from physical activity?”

Insight

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Children relate to other children and peers more readily – than hearing adult advise. Helping them identify how they might benefit from being more active is key. Engaging both the child and parents about what they understand about being more active, allows opportunity for you to more collaboratively share the benefits with them.

Did you know?

Exercise increases your “happy hormones” so helps improve mood, so whether you’re having a good day or a bad day, get moving and get the hormones working.

Particularly for older girls, body image concerns can reduce levels of physical activity. Enquiry and support about these concerns may facilitate future engagement in exercise.

Real impact

Look at people you look up to for inspiration whether that be athletes, musicians, or actors

Physical Activity helps you get to sleep at night

Make it sociable. Find a buddy – friend/pet/family member

Share benefits

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Can I share some other things people find beneficial to see what you make of them.

Insight

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Based on your discussion so far, choose to share the benefits you judge will be most relevant and important to them. Some benefits are quite generic and others will be condition specific.

Remember the conversation won’t work if you take away their control. Ask permission and keep this a conversation not a lecture.

Did you know?

Exercise increases your “happy hormones” so helps improve mood, so whether you’re having a good day or a bad day, get moving and get the hormones working.

Particularly for older girls, body image concerns can reduce levels of physical activity. Enquiry and support about these concerns may facilitate future engagement in exercise.

Real impact

Look at people you look up to for inspiration whether that be athletes, musicians, or actors

Physical Activity helps you get to sleep at night

Make it sociable. Find a buddy – friend/pet/family member

Encourage reflection

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What’s most important for you and I to talk about next?

Insight

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Children typically don’t reflect the depth of adults on their own change behaviours.

Focusing on things of particular importance to them will facilitate change in their behaviour. This will allow them to make very short -term goals, which are easier for them to adhere. Ask if they need anything clarifying and what concerns they or the parents might have about how the information applies to them.

Listen and reflect their concerns: ‘you’re worried about X’. Help them to address these issues by sharing the experience of children  ‘other people I’ve worked with have had those concerns, but what typically happens when they get started is…’  or  ‘whilst there is a small risk of X when you get started, this is outweighed by the risk reduction you experience once you have started moving more’. Ask what they think about what you have said.

Did you know?

Exercise increases your “happy hormones” so helps improve mood, so whether you’re having a good day or a bad day, get moving and get the hormones working.

Particularly for older girls, body image concerns can reduce levels of physical activity. Enquiry and support about these concerns may facilitate future engagement in exercise.

Real impact

Look at people you look up to for inspiration whether that be athletes, musicians, or actors

Physical Activity helps you get to sleep at night

Make it sociable. Find a buddy – friend/pet/family member

Make it personal

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What would be the most important reason for you to become more active?

Insight

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Help kids and parents/guardians to generate and articulate their own reasons, with short term goals in mind. This may or may not be health-related.


Did you know?

Exercise increases your “happy hormones” so helps improve mood, so whether you’re having a good day or a bad day, get moving and get the hormones working.

Particularly for older girls, body image concerns can reduce levels of physical activity. Enquiry and support about these concerns may facilitate future engagement in exercise.

Real impact

Look at people you look up to for inspiration whether that be athletes, musicians, or actors

Physical Activity helps you get to sleep at night

Make it sociable. Find a buddy – friend/pet/family member

Summarise without adding anything

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If it’s OK, can I go through what we have been talking about just now?

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“Let’s pause for a second, to make sure I’m getting everything you have said.”

Insight

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Don’t be tempted to impose your own plan at this stage – kids easily fatigue and can become bored with too much conversation and may agree with you just to end the conversation. Summarise the main points of the conversation and find out what they are thinking. Consider adding breaks at this juncture in the conversation to help them refocus and engage if they are less interactive at this point.

This may sound something like: ‘Some of the things that being active would help you are X, Y and Z. You would like to do more of X and that’s where being more active may help’.

Using a summary can be a good way to demonstrate and express empathy, and allows both the child and caregivers know you are seeing the world from their perspective.

Did you know?

It is easier to get moving when the whole family is involved, so look for activities that everyone will enjoy!

Stopping exercise if it feels too difficult or you are too tired that day is ok. Freedom to reduce or stop the activity without consequence is important for building engagement.

Physical activity helps develop neuromuscular awareness (i.e. coordination and movement control)

Real impact

There are lots of different ways to exercise; individually, with friends or a group, playing sport on your own or as a team, in public or at home. Online videos can be a useful for home exercise.

Be realistic about what you can achieve and don’t be hard on yourself if you don’t always manage to fit exercise in when planned or if you’re exercise session doesn’t always go as well as you’d like!

Set a family challenge, make up an obstacle course to do together, walk the dog, move more at home or in the garden, get outside more – embrace the mud and rain!

Ask the key question

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What do you think you might try out/do next?

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“Getting more active doesn’t always have to be a chore. What are some things you all could do together to become more active as a family/together – that would be fun for all of you?”

THEN move on to planning. Continue to keep the focus on them generating their own ideas for change, rather than telling and instructing. People are much more likely to make successful changes if they develop their own plans.

Insight

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The child and the parents have heard about the benefits of physical activity for someone like them and they have had the chance to consider the benefits they would most like to experience. They have heard their ideas spoken back to them, which can help to reinforce them. Now it’s decision time.

Asking an open question ‘what do you think you will do?’ rather than a closed question, such as ‘are you going to do physical activity?’ helps remind them that they – not you – are the decision maker.

Did you know?

It is easier to get moving when the whole family is involved, so look for activities that everyone will enjoy!

Stopping exercise if it feels too difficult or you are too tired that day is ok. Freedom to reduce or stop the activity without consequence is important for building engagement.

Physical activity helps develop neuromuscular awareness (i.e. coordination and movement control)

Real impact

There are lots of different ways to exercise; individually, with friends or a group, playing sport on your own or as a team, in public or at home. Online videos can be a useful for home exercise.

Be realistic about what you can achieve and don’t be hard on yourself if you don’t always manage to fit exercise in when planned or if you’re exercise session doesn’t always go as well as you’d like!

Set a family challenge, make up an obstacle course to do together, walk the dog, move more at home or in the garden, get outside more – embrace the mud and rain!

Agree a plan

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There are some things that some, but not all children and parents find helpful when making a plan. Can I share with you some of these with you now and you both can let me know what sounds most interesting to do next?
We could also discuss your plan using new ideas too! Not everything works for everyone – and you both have great ideas!

If they agree, ask them which of these might suit them

Share the relevant resource from the list below with your patient

Activity Wheel

Children can pick an activities which they would like to do and brings an element of fun when choosing what to do. This can be done spontaneously and with the family.

Idea Board

This allows children to be creative and chose what activities that they may have seen on TV or in a magazine and bring them to life.

Reward Chart

The reward chart provides aprogress incentive for children to use with the support of their parents/guardians. When an activity is achieved a smiley face can be drawn or sticker will be received in the appropriate box.

Insight

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At this stage it is important to engage parents when making a plan, as they will need to facilitate any physical activity which occurs. There is not strong evidence around the following in children and a lot of this will have to actioned by parents.

Did you know?

It is easier to get moving when the whole family is involved, so look for activities that everyone will enjoy!

Stopping exercise if it feels too difficult or you are too tired that day is ok. Freedom to reduce or stop the activity without consequence is important for building engagement.

Physical activity helps develop neuromuscular awareness (i.e. coordination and movement control)

Real impact

There are lots of different ways to exercise; individually, with friends or a group, playing sport on your own or as a team, in public or at home. Online videos can be a useful for home exercise.

Be realistic about what you can achieve and don’t be hard on yourself if you don’t always manage to fit exercise in when planned or if you’re exercise session doesn’t always go as well as you’d like!

Set a family challenge, make up an obstacle course to do together, walk the dog, move more at home or in the garden, get outside more – embrace the mud and rain!

Arrange follow up

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Would you like to come back and talk to someone a little more about this and tell us about all the fun things you have been getting up to?

Insight

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Ongoing support is a key factor of successful behavioural change.

Useful things to organise for people with mental health issues may include:

  • A follow up appointment with you or a colleague
  • Onward signposting

Signpost the patient information section, which contains links to physical activity opportunities regionally.

Did you know?

It is easier to get moving when the whole family is involved, so look for activities that everyone will enjoy!

Stopping exercise if it feels too difficult or you are too tired that day is ok. Freedom to reduce or stop the activity without consequence is important for building engagement.

Physical activity helps develop neuromuscular awareness (i.e. coordination and movement control)

Real impact

There are lots of different ways to exercise; individually, with friends or a group, playing sport on your own or as a team, in public or at home. Online videos can be a useful for home exercise.

Be realistic about what you can achieve and don’t be hard on yourself if you don’t always manage to fit exercise in when planned or if you’re exercise session doesn’t always go as well as you’d like!

Set a family challenge, make up an obstacle course to do together, walk the dog, move more at home or in the garden, get outside more – embrace the mud and rain!

Signpost support organisations

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We can also give some information which you can provide to your school, any clubs you might be interested in joining or any other family members so they can understand your condition a little more, and how being active can help

Support organisations
Mind

Mind, a national mental health charity, offer a programme to help people with mental health issues get active through specially designed physical activity projects.

Young Minds

There are free publications to download about various mental health issues from school problems to mental illness in families. There is a guide to the NHS’s Child and Adolescent Mental Health Services (CAMHS) and a Parents Helpline.

The YoungMinds resources library is full of useful toolkits, publications, reports and policy information about children and young people’s mental health

Also part of Young Minds is their sport for charity work which promotes activities for fundraising and have events that are planned and everyone can join in.

Childline

Childline is a free, confidential counselling service for children and young people for anybody under 19 years old, where anything can be discussed. They can be contacted by phone and email anytime, day and night. Childline doesn’t show up on the phone bill. A counsellor can also be contacted through a British Sign Language (BSL) interpreter.

The website also contains useful information ranging from advice about stress to bullying and abuse.

Insight

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Did you know?

It is easier to get moving when the whole family is involved, so look for activities that everyone will enjoy!

Stopping exercise if it feels too difficult or you are too tired that day is ok. Freedom to reduce or stop the activity without consequence is important for building engagement.

Physical activity helps develop neuromuscular awareness (i.e. coordination and movement control)

Real impact

There are lots of different ways to exercise; individually, with friends or a group, playing sport on your own or as a team, in public or at home. Online videos can be a useful for home exercise.

Be realistic about what you can achieve and don’t be hard on yourself if you don’t always manage to fit exercise in when planned or if you’re exercise session doesn’t always go as well as you’d like!

Set a family challenge, make up an obstacle course to do together, walk the dog, move more at home or in the garden, get outside more – embrace the mud and rain!