Our poll has revealed that nearly three quarters (73%) of therapists who work with children said they’re seeing an increase in children seeking support for ‘more complex issues’.

Our survey of more than 680 child therapists found that more children were presenting with ‘more complex issues’ – which includes substance misuse, self-harm, and eating disorders.

Anecdotally, some therapists attribute this to the prevalence of unsupervised access to social media, family issues, the pandemic, cost of living crisis, as well as many other changes and pressures in modern society. Therapists also said that some issues wouldn't be considered complex if they were standalone issues but together they’re causing chronic distress for some children and young people.

Rise in safeguarding issues

The survey, which provides an in-depth look at what therapists are experiencing in their practice, also showed:

  • Nearly half (46%) reported a rise in safeguarding issues with children and young people
  • Around one in five (21%) witnessed a rise in children who are being groomed online.
  • Around two in five (43%) therapists also reported a rise in children coming to therapy who are being bullied online. 

Concerns for future 

Jo Holmes, Children, Young People and Families Lead, said:

“We’re deeply concerned for the futures of our children and young people and their mental health - particularly now that so many are presenting with more complex issues which in turn impact day to day life. We hear of children and young people feeling helpless, overwhelmed and scared.  Counselling provides that safe space to explore what is going on in a child or young person’s life as well as protecting them from future harm by helping to develop strategies to say safe in line with safeguarding practice and protocols.

“It’s more important than ever that children and young people have access to vital support to reduce psychological distress that could ripple through into their adult lives, we know the earlier the help, the better the outcome.

Inadequate mental health support

“We believe that things are only going to get worse unless the Government commits to including the counselling and psychotherapy workforce into their plans around access to a mental health professional in every primary, secondary school and further education college in England. The universal mental health support available in England for children is simply inadequate and needs to catch up with other nations in the UK. A trained school counsellor gives a child or young person a place that is focused 100% on their needs – a safe space to help them to understand and cope with what they’re going through and put plans in place to keep safe.”

Struggling to support

Alison Roy, registered consultant child and adolescent psychotherapist, said :

“I’m witnessing an increase in young people who are coming to see me with a combination of complex issues. Some of these wouldn't be complex if they were standalone issues but when you put them all together, they are causing real, even chronic, distress. Understandably parents and carers are struggling to know how best to support their children or young people and becoming distressed themselves. For example, I am seeing more schools refusing young people - which isn't just about them experiencing social anxiety but can also be a symptom of intense loneliness, depression, eating difficulties, body dysmorphia or additional traumas relating to bullying, sexualised or intimidating behaviours and confusion around identity. 

Hall of mirrors

“I don't fully understand why there is such an increase in complexity but in terms of smart phones and social media, it’s affecting how they view themselves and it’s more difficult for them to see themselves accurately. They exist within a hall of mirrors which is disturbing their usual and healthy patterns around sleeping, eating and how they relate to each other. My sense is that parents too are facing additional pressures - they may have money worries, work stresses, climate anxiety but there are so many additional pressures on their time and on their relationships. They may also be struggling to manage their own boundaries around phones and screens and therefore can't do this for their children.”

Exams and social pressures

Lauren Street, registered psychotherapist, said:

“Our clinic in St Albans has seen a 36% rise in clients under the age of 16 in the last 12 months. We've seen an increase in children seeking help for OCD, anxiety/ panic disorder and eating disorders. This increase has been driven by exam pressures and social pressures creating a need to perform at the highest level so they can meet the standards they've set for themselves. A lack of control around their exam performance creates a need for control elsewhere, whether that be of their own ruminating thoughts or issues with eating.”

Increase in anxiety

Heidi Soholt, accredited therapist, said:

“There has been an increase in children and young people (CYP) experiencing mental health problems such as anxiety, with recent figures showing over 500 CYP per day being referred to mental health services in England – a figure that is more than twice the pre-pandemic rate and the highest number of referrals ever recorded.1 As the number of CYP needing mental health goes up, so does pressure on services such as CAMHS, and due to long waiting-lists many are seeking other ways of accessing treatment through school counsellors or private therapists. This is something that I have noticed in my work, particularly in terms of referrals of children who are awaiting assessment and support for suspected ASD or ADHD.

The pandemic aftermath

“The COVID-19 Pandemic, its associated lockdowns and social isolation has also been linked to a rise in CYP mental health problems. Children missed a significant amount of face-to-face learning and socialisation with peers, while some were living in families that had been cut-off from usual supports. This put a great deal of emotional and/or financial strain on many families, sometimes impacting parents’ ability to look after their own and children’s mental wellbeing.

“Post-pandemic there appears to be a rise in children needing mental health support due to a range of factors linked to lock-down. Examples of this include children who were happy and settling into the first few years of school struggling to cope with things like learning, friendships or the busy school environment in general. Some children have also reported feeling worried about their families while at school, and these types of issues could be a factor in rising cases of anxiety.

Online dangers

“Children are also spending more time online and parents are reporting feeling increasingly worried about how to monitor and control their children’s engagement with the internet. Young children in particular are not always able to separate fact from fiction, or assess a stranger’s motives for befriending them online. While children are increasingly made aware of the dangers that can lurk on the internet, they are often drawn into situations beyond their ability to handle and frightened to seek support. These types of situations can cause extreme anxiety for children and is something I am becoming increasingly aware of in my practice.”

The survey also revealed that almost two thirds (64%) of therapists working with children under the age of 18 reported that their mental health has deteriorated compared to last year, and 69% of therapists said that they’re seeing an increase in children coming to therapy who have been waiting more than a year for access to support elsewhere.

 

References

1. https://www.theguardian.com/society/article/2024/aug/27/nhs-referrals-for-anxiety-in-children-more-than-double-pre-covid-levels-england

All figures are from our annual Mindometer survey of BACP members. Total sample size was 2,658 therapists. Fieldwork was undertaken between 3 – 17 September 2024.  The survey was carried out online.