22 May

Helping Beryl, 14, Explore her Mental Health Issues

Beryl* came to Kooth with a number of issues she wanted to explore. These included sexuality, relationships with family and friends, school, body image, and anxiety.

Beryl had also realised recently that she is gay, and didn’t know how to ‘come out’ to friends, family or in her school. She was worried that if she told anyone, she would be the subject of gossip and teasing.

Beryl had also been struggling with an eating disorder for the last few months. She revealed that she does not like the way she looks or is developing as she gets older. She skips meals at school and generally doesn’t eat properly, recognising that this behaviour is linked to generally not feeling ‘good enough’, isolated and unhappy.

Initial risk assessment
Beryl was offered a full assessment on joining Kooth. During this process we gained a picture of Beryl’s life, presenting issues, risk level and protective factors, along with her reasons for seeking support. She was assessed as medium risk due to her eating difficulties and a lack of identified on-the-ground support.

Beryl was also offered the opportunity to consider engaging with a named counsellor for structured therapeutic work. This was to ensure ongoing monitoring of risk, ongoing support through her difficulties, and to prevent any further deterioration.

A safety plan around eating difficulties was created collaboratively, which included alternatives, distraction techniques and self-care strategies. Crisis service details and emergency contacts were also included.

Beryl chose not to share her personal details with Kooth; we continued to check in with her and explore the benefits of being able to refer her to specialist mental health services.

What intervention was provided by your service?
Intervention in Beryl’s case has mainly taken the form of support within chats. Counsellors have helped Beryl explore her feelings of worry, listened in an empathetic, non-judgmental way and given her a safe space to discuss her feelings. Giving Beryl positive feedback and praise when she is able to achieve her therapeutic goals has proved vital in increasing her motivation for engagement – as has offering coping mechanisms and alternative and healthier coping strategies.

Further exploration around available support was conducted to encourage Beryl to reach out and share her difficulties with a trusted adult and widen her social and protective support networks.

As Beryl did not want to speak to anyone face to face about her issues, this online support provided her with a vital alternative to enable her to address her difficulties. This early experience of help seeking enabled Beryl to have a positive experience of therapeutic support, helping to break down the fear surrounding accessing face to face help.

Counsellors ensured Beryl had a clear action plan, with strategies, hobbies, interests and contacts, to stay safe when feeling distressed.

During the assessment phase and subsequent work, the Kooth team continued to ‘check in’ with Beryl regularly regarding her eating difficulties and to ensure risk was thoroughly monitored and that Beryl understood Kooth is a safe place to continue sharing her thoughts and difficulties.

What impact and outcomes were achieved?
Beryl continues to come to Kooth, using the journal function as a way to record her thoughts, and contributing to Kooth’s online magazine and discussion boards. She continues to work towards her goals in relation to the difficulties she is motivated to overcome and manage. These goals are created collaboratively and reviewed regularly.

*Beryl is a Pseudonym
This is a summary of detailed case notes; information has been excluded/changed to protect Beryl’s identity.