KIN & KiDS Marriage, Family and Child Therapy Centre director Charis Wong talks about the student-counsellor ratio and treatment methods for children with mental health issues.
Question: Why are we seeing an increase in mental health issues among children?Answer: I think the increasing awareness among parents, teachers and caregivers (about mental health issues) has led to more people reaching out to get psychological support for children with mental health issues compared with before, when ignorance, denial or feeling shame over such issues often led to them being dealt with inappropriately or swept under the carpet.
Question: Do schools have enough counsellors?Answer: When I was a student, our counsellor was a teacher who had to juggle teaching and counselling duties. The teachers would attend some basic counselling courses. There was also a former teacher who was approached by the school to become the school counsellor and she took the initiative to do a Bachelor in Psychology on a part-time basis.
I visited a large Chinese secondary school a few years ago and its counsellors had at least a Bachelor in Counselling. For private schools, it’s not a requirement for them to have a school counsellor, and small private schools may not have the funds to hire a full-time school counsellor.
Large international schools do typically hire full-time licenced or qualified counsellors. Some schools that cater to children of expatriates usually hire an expatriate counsellor to take up the position, while some even have psychologists.
Question: Most school counsellors are not equipped with the right tools because they are not educated in psychology or counselling. Do you believe it’s time this is a prerequisite?Answer: It should be mandatory for every school to have a school counsellor. There should be a ratio to determine the number of school counsellors required. The American School Counsellor Association recommends a ratio of 250 students to one counsellor.
Question: Is it true that children with mental health issues, if untreated by a mental health professional, will likely grow up and repeat the behaviour with their children?Answer: Research does indicate this. But I believe most children are resilient, and if given the right support and environment, they will thrive. Counsellors not only work with the child to help them with their problems, but they also work with parents and teachers and other care providers, such as paediatricians and psychiatrists.
Question: In terms of therapy or treatment, how does handling mental health issues differ between adult and children?Answer: We use a systemic approach, which includes both child and parents, and other caregivers. We provide parenting support and coaching to parents, as well as a safe place for children and teens to work through their issues. For children, sitting on a chair and doing talk therapy does not work, so we cannot use adult intervention. So we have play therapy and use specially designed playrooms, where we use sand trays, clay, art, puppets and role play toys.
For teens, we use resources based on what works best for each client. With some teens, they just want to talk and process their thoughts, while others prefer a more creative approach, such as using art therapy, sand tray therapy, clay or games. When working with children and teens, our aim is to eventually have family therapy sessions where members of the family learn to hear each other’s needs and respond to these needs in an effective manner.