mooth sailing”: Some of my experiences CAMHS disability service


Refl ecting puppet shows to playfully engage young children or children with additional needs and their families, to share ideas visually rather than solely through spoken language


Family genograms Team sharing of their family of origin genograms through the lens of disability. Used with families to explore the infl uence of the child’s diagnosis on family relationships, and to explore their family and cultural beliefs and experiences of disability


Preparation and hypothesising framework to fi nd out about and to be curious about the infl uences of the child’s abilities and their disability on their family relationships. To plan and talk about how to support the child to communicate in family therapy sessions.


Family-autism mapping framework to support conversations about the meanings of a child’s interactions and to think about diagnosis in a non-totalising way, to hold multiple perspectives, including family member’s relational knowledge alongside professional knowledge and ideas about the possible meanings of a child’s interactions


Mapping an episode To invite family members to “show” using a mini sculpt, what happens during an episode. The use of “stop” “pause” and “fast forward” symbols to support the process


What we added to our systemic suitcases in our work with families with a child with a disability Alfie is a six-year-old boy with a


diagnosis of autism and a suspected learning disability; he lives with both his parents and with his older brother, Teddy, who is nine, and his younger sister, Sophie, who is four. Alfie’s parents, Jeremiah and Kate, share that they both experienced difficulties with learning at school themselves. Jeremiah can see similarities between himself and Alfie and wonders whether he may also have social communication difficulties. The family was initially referred


to CAMHS because of Alfie’s challenging behaviours. An assistant psychologist in the team had offered


Context 170, August 2020


some behaviour support work but, due to the complexities of communicating and because working at the level of “inter-action” hadn’t led to change, we decided to offer family therapy sessions. Members of the multi-disciplinary team wondered what Jeremiah and Kate understood and thought about Alfie’s diagnosis of autism and were concerned that the family hadn’t put in place the recommendations from occupational and speech therapy. There was also concern about the impact of Alfie’s behaviours on the family relationships including with his older brother and younger sister.


Communication in family therapy with a child with autism and a learning disability In an early post-session, one of the


team members shared that they hadn’t felt confi dent about speaking to Alfi e as they weren’t sure how to communicate with him owing to his diagnosis of autism and his intellectual disability. In the post-session, I asked some more


about the team member’s knowledge and experience of working with children with a diagnosis of autism. I asked how they usually communicate with children in family sessions and what ideas they had about what might be similar or diff erent


27


Personal experiences


Visual symbols and pictures to support communication in family therapy, including about feelings. Includes using comic strip conversations and social stories to fi nd and share preferred and alternative ways of going on.


Knowledge of autism and learning disability


Social GRACES


(e.g. gender, race, religion, ethnicity, ability, age, sexuality)


Professional


experiences and knowledge


“Systemic suitcases, storms and smooth sailing”: Some of my experiences of supervising a family therapy team in a CAMHS disability service


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