Health and Wellbeing

The purpose of this module is to engage the young person in thinking about how they how to look after their health and wellbeing.

Its objective is to encourage the young person to set goals and take action to improve their health and wellbeing.

Other Better Life modules also address health and wellbeing issues:

  • People in My Life offers the opportunity to talk about girlfriend or boyfriend relationships;
  • Managing Emotions supports young people’s emotional health and their ability to relax;
  • Drugs and Alcohol addresses the impact of substances on health and wellbeing.
  • Beating Boredom addresses healthy recreational activities.

You should choose only those sessions that are relevant to the individual.

  • Session 1 – Physical health
  • Session 2 – Sexual health
  • Session 3 – Mental health

These sessions are designed to stimulate discussion and raise awareness. If any substantial problems or issues are uncovered, young people should be referred to appropriate specialist agencies.

Before attempting this module with young people with sexually harmful behaviours there should be discussions with the referring Local Authority regarding risk and safety.

If not already done so, a Community Safety Plan should be drawn up. You should pay attention to any particular risk factors e.g. location of activity or if a young person is engaging in activities with others who are more vulnerable. You need to be prepared to discuss this with the young person as you may need to pass on information to the risk management team. The young person should be made aware of this.

Each of these modules is integrated by a common theoretical and practice model. The aim is to enable young people to become more resourceful.

These modules are designed to enable young people to develop resources in their lives which both protect them and enable them to have a safe and happy life.

The Protective Resources

Relationships which support a pro-social lifestyle.

Expectations by significant adults of the young person’s positive future potential.

Skills to develop relationships, meet expectations and take advantage of opportunities.

Opportunities to meet individual needs and to make a contribution to community life.

Understanding of oneself, one’s behaviour and one’s environment.

Responsibility for choices, action and consequences.

Commitments which enable the young person to live consistently to values and rules.

Evaluation of action and its results so that the young person is continuously learning.

Success in achieving goals creating self confidence and self worth.

I don’t like feeling uncomfortable

But I know I can bear it

NOW try and think of some of your own statements.

Session 1 - Physical Health

Issue 1 – Preparedness to Use Health Services

Ask: when was the last time you visited the doctor? (Do not press the young person to divulge confidential information on why they attended. You are more interested in the individual’s attitude to seeking treatment). What was it like? How do you feel about seeing a doctor? Does your attitude ever stop you seeking treatment when you are not well?

‘Do you have any health worries at present?’ (No need to say what they are). ‘Are you avoiding or putting off making an appointment?’ ‘ What are your fears?’

‘What would you need to do and what support would you need to make an appointment with the doctor if you needed to?’

Emphasise the importance of getting treatment. Some conditions do not just go away on their own accord.

Repeat this process in relation to dentists and opticians or others relevant to the young person.

Issue 2 – Healthy Lifestyles

This session invites the young person to think about their current lifestyle and decide whether it supports them to have a better life. It focuses specifically on diet and nutrition, physical activity and fitness, relaxation and sleep, body image and self esteem, and smoking (other habits which affect health are covered in the Drugs and Alcohol module). There may be other areas which are more relevant to individual young people e.g. a specific condition such as asthma or a specific disability. If so, feel free to add these and work through them in the same way outlined below.

Step 1 – Inquiry

Inquire into current situation and behaviour in relation to:

  • Diet and nutrition;
  • Physical activity and fitness;
  • Relaxation and sleep;
  • Body image and self esteem;
  • Smoking;
  • Other relevant areas.

If you need to explore any of these areas further, use the diary format (see below) to enable the young person to record and monitor patterns.

Step 2 – Benefits and risks

Assess with the young person the effects of their current behaviours and patterns. Identify and affirm benefits. Identify risks to health, relationships, education/employment, etc.

Note: be aware of the risks of excessive use of sunbeds. Often young people are more engaged by body image and looking good than health. So facilitate thinking in this area.

Complete the benefits and risks form below.

Step 3 – Action plan

Address the risk areas and the positive benefits and encourage the young person to commit to actions to manage risks and develop the benefits further.

Complete the action plan below. Explain that you will commit to supporting this plan.

health_wellbeing - action_plan
Session 2 - Sexual Health

Do not assume that the individual is sexually active.

Puberty

CHANGES: using a body outline, get young person to draw/write and indicate the changes to their body during puberty. Discuss how these changes were experienced by the young person. Did they feel strong emotions? Did they compare their development to others? How did that affect them?

Explain why these changes occur and how variations in the pace of development is normal.

Advise the young person on who they can turn to for further information and advice.

The 4 Boys & 4 Girls material are useful basic guides to sexual development.

Safe sex

Explain the importance of safe sex and both boys’ and girls’ responsibilities.

Cover:

  • Infections, their symptoms, and how to protect oneself (ensure you have up to date material);
  • Pregnancy and contraception (kite mark and date, how to use).

Allow the young person to ask questions and express their fears and worries without embarrassment.

Inform the young person where they can further information and advice.

This conversation should be conducted in a holistic way i.e. not purely factual and biological. Explore emotions, psychological needs and moral dilemmas (though not in a moralistic way).

Some questions you could explore include:

Why sex? Why do you do it? What do you get from it?

  • Identify the young person’s underlying beliefs and values about sex (is it about proving you’re a man? Do you think that boys won’t have anything to do with you unless you offer sex? etc.)
  • Explore the risks – of being taken advantage of, physical and emotional health, being abused and exploited, etc.
  • Are there other ways of meeting your emotional needs that are safer? How will you keep yourself safe? What are the conditions for a safe, healthy sexual relationship? (refer to the People in My Life module e.g. trust, reciprocity).

It might be useful to explore some of the following questions around mutual sexual decision making in order to promote discussion and reinforce reciprocity, respect etc:

  • Who makes decisions about sexual behaviour in a relationship?
  • Who has responsibility for sexual health in a relationship?
  • How should you talk about sex in a relationship?
  • How soon should you have sex after starting a relationship?
  • Why might people want to have sex in a relationship?
  • Does having sex change a relationship – if ‘yes’ then how?
  • How do you know if someone wants to have sex?
  • What kinds of things influence your decision about whether to have sex?
  • What things might affect a girlfriend and boyfriend’s decision about whether to have sex?
  • How might feelings affect decisions concerning sex?
  • Do males differ from females in their decisions about sex – if ‘yes’ then how?

Does the young person need to talk about these issues with someone with more expertise?

Session 3 - Mental Health and Wellbeing

Feeling Low

If this is a concern to the young person, ask him or her to draw how they feel. Discuss what the image means to the young person.

Ask the young person to draw a life line showing the history of their moods. It could take the form of a graph showing when they felt most down and when they felt better. Were these linked to events or does it seem to take on a life of its own? If the young person is currently experiencing low moods, you could ask him or her to keep a weekly diary and see if there are any triggers e.g. family conflict, use of drugs etc.

Ask the young person to rate their mood each time on a scale of 1(very low) to 10 (happy). Also explore feelings of ‘numbness’, detached, apathetic.

How did they cope when they felt really low? Who or what helped?

Ask: How could they get back to the good ‘place’. If there any good ideas, agree an action plan. Consider a healthy diet, exercise, getting out into the fresh air and daylight, getting involved in sport or other social activities.

If the condition seems more serious, refer to specialist services.

Feeling anxious or stressed

Stress happens when a situation creates so much pressure on you that your usual way of dealing with situations is not working. Sometimes this can be exciting and challenging in a good way. Can you think of examples?

‘But sometimes things can get on top of you so you feel hopeless and worn out. Can you think of examples?’

‘How do these situations affect you?’

Examples of stressful situations:

Family conflict

Moving home or school

Falling out with a good friend or break-up with boy/girlfriend

Being bullied

Parents arguing/splitting up

School work/exams

Death of someone close

No money

Examples of the effects of stress:

Emotional Thinking Physical
  • Depression
  • Anxiety
  • Inability to relax
  • Fear or panic attacks
  • Irritated
  • Impatient
  • Bad moods
  • Can’t concentrate
  • Can’t think straight
  • Can’t make decisions
  • Can’t solve problems
  • Always tired
  • Headaches
  • Muscle aches
  • Skin problems
  • Bowel problems
  • No energy
  • Rapid breathing
  • Loss of appetite
  • Comfort eating
  • Can’t sleep

Exercise

Purpose: To enable the young person to become more aware their stress and how to deal with it. Ask him or her to describe a stressful situation.

health_wellbeing - dealing_with_stress

To cope with stress you need to build your resilience. This means the ability to bounce back if you experience a negative event.

Can you think of ways you cope with stress that work and don’t work?

Examples:

Do:

  • Talk to someone – a parent, friend, a professional (teacher, social worker etc.)
  • Go for a walk and think it through;
  • Listen to music;
  • Play sport;
  • Relax;
  • Get involved in a hobby.

Don’t:

  • Comfort eat junk food;
  • Smoke;
  • Drink;
  • Take drugs;
  • Take it out on someone else.
health_wellbeing - self_talk

If the young person has a serious anxiety disorder, make a referral.

Self Harm:

If they have mentioned any self harm activity, then go on to self harm.

Ask for the young person’s understanding: ‘What is self-harm?’ Discuss generally and then if it seems safe ask about the young person’s experience.

Discuss: ‘Why do people self harm?’ Again talk generally before you ask for the young person’s reasons.

Consider: Using a body sketch indicate what self harm methods can be used.

Ask: Which does he or she use?

Consider: ‘What triggers your self harm?’

  • Events?
  • Moods?
  • Anything else?

Identify: How did you feel

  • immediately afterwards?
  • much later?

Discuss any differences between the immediate satisfaction or relief and any lingering bad feelings – shame? Does this create a vicious circle? i.e. the bad feelings caused are escaped through further self harm?

Ask: what are the long term consequences of this behaviour?

  • To relationships;
  • To health;
  • To opportunities i.e. jobs, meeting people, making friends, leisure activities.

‘What else could you do when you feel like self harming?’

‘Where could you get support?’

Refer: If you see any indication that the young person needs further support for self harm, refer to the appropriate service e.g.

  • Lifeline;
  • Breathing Space;
  • NHS 24.

Suicide:

If there is any indication of suicidal thoughts, encourage the young person to tell someone about it (friends, family, GP etc.)

Ask the young person:

  • Have you a plan – how and when do they intend doing it?
  • Listen for reasons for feeling so low;
  • Acknowledge their feelings and empathise but make it clear that you do not want them to act on these feelings and thoughts.
  • Agree a plan to keep himself/herself safe;

If you have concerns about suicidal thoughts speak to an ASIST trained colleague and your line manager.

health_wellbeing - plan
End of Module Evaluation
Structured Coaching Conversation

Structured coaching conversations are designed:

  • To reinforce the commitments the young person has made;
  • To enable the young person to develop self respect;
  • To enable the young person to learn from experience;
  • To support the young person to achieve goals.

When the young person keeps commitments:

Use questions

  • What happened?
  • What result did you get?
  • How did it feel?
  • What did it take for you to get that result?
  • How do you feel about yourself now?

Give feedback as specific as possible relating to the commitments the young person has made to change attitudes and behaviours. Express your respect.

Ask what the young person has learnt from the experience.

Ask the young person in what other situations he/she could use this attitude or behaviour.

Encourage the young person to use the attitude or behaviour again soon. Try to identify a specific situation which is likely to happen or can be planned in the near future.

Record with the young person what he or she ‘got’ from the Experience in the appropriate ‘Doing it’ form.

Guide the young person in filling in the ‘Success!’ form

When commitments are not kept:

Use questions

  • What happened?
  • What result did you get?
  • How did you feel?
  • What caused the result?
  • How do you feel now?

If the young person reverts to attitudes and behaviours they committed to change, gently point this out. Connect these to the result.

Explore how this may be an example of what is going wrong in his/her life. Identify other situations where this attitude or behaviour has not worked.

Imagine how the situation would have turned out if he/she had employed the attitude or behaviours to which he or she had committed.

Ask what the young person has learnt from the experience.

Encourage the young person to use the positive attitude or behaviour again soon. Try to identify a specific situation which is likely to happen or can be planned in the near future.

Record with the young person what he or she ‘got’ from the experience in the appropriate ‘Doing it’ form.

Guide the young person in filling in the ‘Success!’ form

health_wellbeing - success_form
Resources
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