Parents need to be “agents of change” to help prevent children from developing mental health issues such as depression, anxiety and withdrawal.
With a psychologist-patient ratio of 1.4:100 000, South Africa is alarmingly under-resourced to deal with the rising incidence of childhood mental health disorders, said Dr Jenny Rose, a clinical psychologist and lecturer in the University of the Western Cape’s Department of Psychology. “We know in SA that we are under-resourced, especially when it comes to specialist treatment such as psychiatry and psychology.”
In a presentation hosted by UWC’s Faculty of Community and Health Services, based on insights derived from her PhD research on attachment-based parenting, Dr Rose said shifting to the notion of parents as agents of change would have a profound impact on resource availability. “So often, when children enter the system, it is potentially a long and tedious process that includes a referral, a waiting period, and a full assessment before an intervention is recommended.” Lengthy waiting lists, difficulty accessing hospitals and transport costs involved in frequent visits to a facility create barriers to effective treatment.
Dr Rose found that by introducing the Circle of Security Parenting programme, which encourages parents to be the agents of change, children’s behaviour improved significantly even though they were not being treated directly. “The work is done exclusively with the parents. Shifting the parents’ perspective can bring about significant changes in a child’s behaviour.” Her study focused on the use of this parent-based attachment intervention to treat internalised behaviours, which often manifest in children as depression, anxiety and withdrawal.
Unlike externalised pathologies, evident in children who act out or display aggressive behaviour, these internalised disorders are often overlooked by parents and teachers. Dr Rose was surprised that the rates of internalisation among children in her study were so high. “It called into question a much greater concern about the development of children in children. More children are presenting with pathology at a younger age, and with more severity.”
By developing a solid attachment relationship before disorders progressed, a child would be more likely to withstand adversity and develop resilience, she explained. “There is therefore a strong case to be made for strengthening the attachment relationship early on as a preventative measure.” The study found that attachment parenting had a positive effect on the child being treated, as well as siblings.
Her study also revealed discrepancies between how a parent assessed a child, and what a teacher observed. “We underestimate the role of the teacher. The teacher is the first line of intervention with children who struggle.” They therefore need to be adequately trained to identify these potential disorders, she said.
Dr Rose concluded by emphasising the importance of the early years of a child’s development; the first 1 000 days in particular; “The earlier we intervene, the better the outcome.”
Listen to Dr Rose talk on Cape Talk about whether parents can help treat childhood anxiety and depression.