Teachers or Therapists?

In a recent interview with Huffington Post (Wearmouth 2019), OFSTED Chief Inspector Amanda Spielman is reported to have voiced concerns about school teachers endeavouring to address the mental health issues of their students. Spielman said:

“There are some kinds of support that [a teacher] might give a child that might look superficially like you are being helpful but actually people who are professionally trained in mental health know that it is exactly the wrong thing to talk to children about … A school is not a social services department… I don’t think we should be asking teachers to be therapists”.

This question of whether teachers should assume a therapeutic role is of much interest to those of us who teach Special & Inclusive Education at NTU. We know that teachers (to varying extents) do a wide range of activities which might be considered ‘therapeutic’: in addition to the usual pastoral role expected of teachers in the UK and delivering SEAL (Social & Emotional Aspects of Learning) or PSHE (Personal, Social & Health Education), they may also lead assemblies on sensitive issues, run interventions such as nurture groups, peer mentoring schemes, buddy schemes, psychodrama, circle time, relaxation and mindfulness sessions, to name but a few. Such a list might be argued to add up to quite a lot of ‘therapeutic’ activity!

The interview with Spielman does not break down how she feels about each of these activities, although she does express particular concern about teachers pre-emptively broaching topics such as anorexia or suicide in assemblies or lessons, as in her words ‘you are more likely to encourage them to think about those things’.

Several of the above strategies are taught in our Year 2 Inclusive Strategies module (which forms part of the Special & Inclusive Education strand of Joint Honours in Education). I find it fascinating that students are often very enthusiastic about the idea that a teacher’s role should be largely therapeutic, perhaps reflecting their own recent exposure to school education imbued with a therapeutic dimension (at least for the recent school leavers).

In the module we encourage students to question their assumptions and to critically engage with the question of whether such ‘therapeutic’ work should fall within the remit of a classroom teacher. They discover in the academic literature arguments for and against Spielman’s recently expressed concerns. For instance, the authors of the 2019 book The Dangerous Rise of Therapeutic Education seem to share Spielman’s concerns:

“Children who are emotionally damaged need therapy from mental health specialists outside the classroom. Playing with children’s feelings is personally damaging and profoundly anti-educational”. (Ecclestone and Hayes, 2019, p.147)

Similarly, concerns have been expressed about the Circle Time approach in particular, questioning whether children are being expected to reveal things about themselves in the circle which may need careful and experienced handling from a safeguarding perspective (Leach and Lewis 2013).

However, there are also several compelling arguments to support teacher involvement in mental health management. Firstly, the law suggests that schools do have a responsibility to address mental health issues in their students. For example, under the Equality Act (2010) schools have a legal obligation to make ‘reasonable adjustments’ for students with a disability (and mental health can be considered a ‘disability’, if it has a substantial and long-term negative effect on your ability to do normal daily activities).

Additionally, the 2014 Code of Practice for Special Educational Needs and Disability (SEND) sets out four broad areas of need, one of which is Social, Emotional and Mental Health. This category may include for example anxiety, depression, self-harming, substance misuse, or eating disorders, and the Code states that ‘schools and colleges should have clear processes to support young people’. Taken alongside the Equality Act, it is difficult to see how schools can avoid some form of ‘therapeutic’ dimension to their role.

A further argument for the involvement of teachers in issues around mental health is that the issue simply cannot be divorced from the students’ academic achievement. For instance, as long ago as 1943, Abraham Maslow argued that humans have a ‘Hierarchy of Needs’ and until our more basic physical and emotional needs are met we will not be able to focus on ‘self-actualisation’ or making the best of ourselves. More recently, neuroscience has pointed to the likelihood that stress blocks the parts of our brain responsible for higher-level thinking (Schwabe et al. 2011). These findings are unlikely to surprise a classroom teacher, who will be acutely aware from their own experience of the difficulties of trying to foster academic learning with a student who is clearly experiencing high levels of stress, anxiety, depression or other unresolved mental health issues.

Finally, a classroom teacher might raise the simple argument: If not me, then who? This is a compelling question with no easy answer. According to Spielman, the ideal answer would be highly qualified health professionals such as psychologists, psychiatrists and CAMHS (Child & Adolescent Mental Health Services). The problem here is that we know that mental health services are woefully under-resourced and frequently turn away referrals or else put children on lengthy waiting lists whilst their mental health continues to deteriorate (Children’s Commissioner, 2016). This may go a long way towards explaining why school staff feel the need to assume a therapeutic dimension to their role if experience tells them that it is difficult to access timely support from health care professionals.

In conclusion, where does this leave teachers? Perhaps between a rock and a hard place. It is clear that students present with a diverse range of issues which impact upon their ability and motivation to engage with learning, and that teachers struggle to access a readily available and supportive network of health care professionals. The work of teachers is located within multiple and competing demands from the law, government policy, accountability for academic progress and now a possible shift away from therapeutic education by the OFSTED Chief Inspector. It remains to be seen whether the ‘therapeutic turn’ is on the cusp of turning once again.

Lauran Doak

References

Children’s Commissioner, 2016. Lightning Review: Access to Child and Adolescent Mental Health Services. Children’s Commission, London: Children’s Commissioner for England. Available at: https://www.childrenscommissioner.gov.uk/wp-content/uploads/2017/06/Childrens-Commissioners-Mental-Health-Lightning-Review.pdf

Ecclestone, K. and Hayes, D., 2019. The dangerous rise of therapeutic education. Routledge.

Leach, T. and Lewis, E., 2013. Children’s experiences during circle-time: A call for research-informed debate. Pastoral care in education, 31(1), pp.43-52.

Maslow, A. H., 1943. A Theory of Human Motivation. Psychological Review, 50(4), 370- 96.
PSHE Association, 2019. Why PSHE Matters [online]. Available at: https://www.pshe-association.org.uk/what-we-do/why-pshe-matters

Schwabe, L., Joëls, M., Roozendaal, B., Wolf, O.T. and Oitzl, M.S., 2012. Stress effects on memory: an update and integration. Neuroscience & Biobehavioral Reviews, 36(7), pp.1740-1749.

Wearmouth, R., 2019. Ofsted Chief On Equality, School Cuts And The Widespread ‘Confusion’ Over Mental Illness. Huffington Post [online], 8 June. Available at: https://www.huffingtonpost.co.uk/entry/ofsted-chief-on-equality-school-cuts-and-the-widespread-confusion-over-mental-ilness_uk_5cf9a22ae4b0b08cf7eb652a

One comment

  1. Well written Lauren. And for a teacher with a child in front of them, the “if not me, then who?” question will win the day – they’ll do their best whether trained, skilled or not.

    Like

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