Supporting students with SEMH (Social Emotional and Mental Health) difficulties can be very challenging for us as therapists, including parents and teachers alike, as none us are mental health practitioners! In addition to this, access to support is frustratingly limited due to overwhelming demand and funding cuts. So, for this blog post, I’d like to share my own top tips for managing very challenging behaviour.

My experience working with adolescents with SEMH

For one year, in the very first year of my practice as a therapist, I worked in a specialist setting with boys aged between 11 to 16 years. Typically the boys were referred to the setting by their Local Authority after multiple school placement breakdowns (including exclusion from maintained SEMH Special Schools). Most of these boys had a history of abuse, neglect and/or criminal behaviour. Suffice to say their social, emotional and behavioural needs were highly complex! It was a steep learning curve for me, and I quickly understood the value of being flexible as often my days were as unpredictable as their moods.

Understanding SEMH

The new code of practice defines SEMH in the following way:

“6.32 Children and young people may experience a wide range of social and emotional difficulties which manifest themselves in many ways. These may include becoming withdrawn or isolated, as well as displaying challenging, disruptive or disturbing behaviour. These behaviours may reflect underlying mental health difficulties such as anxiety or depression, self-harming, substance misuse, eating disorders or physical symptoms that are medically unexplained. Other children and young people may have disorders such as attention deficit disorder, attention deficit hyperactive disorder or attachment disorder.” (Department for Education & Department for Health, 2015).

The term refers to children and young people who present with disturbing and/or disruptive behaviour that interferes with their own and others’ social functioning and academic engagement. Their behaviour may be termed ‘acting-out’ (disruptive) or ‘acting-in’ (showing withdrawal and/or avoidance).

Many of the boys I worked with exhibited the following challenging behaviours: • Difficulties with sustaining attention • Difficulties regulating physical movement • Verbal and/or physical aggression towards others • Violent/destructive behaviour • Uncooperativeness • fearfulness

• Avoidant behaviour • Withdrawn behaviour • Feelings of low self-worth or hopelessness

In the school setting these normally manifested in: • Defiance of staff • Persistent rule-breaking • Bullying others • Disruptive behaviour in class • Social isolation • Refusal to engage in learning tasks / refusal to complete learning tasks

My top tips for managing challenging behaviours!

Below I have listed strategies I found useful. Most of which I learned just by trying things out, seeing what worked and what didn’t work. These are also strategies that teachers may find useful:

• Adapt the environment – organise and provide structure. For example, I always ensured their workspaces and equipment were all set out and ready to go before they arrived for sessions. This reduced chances of them getting distracted.

• Remove anything that could distract them.

• Alternate tasks – doing something fun and motivating then try something hard. They are less likely to give up or get agitated if they are already in a positive framework.

• Give choices but maintain some control in the choices that you offer e.g. when students were being uncooperative/oppositional, I’d usually offer them an alternative writing task for them to complete quietly alone. Most of the time they would opt for the original task I had set out as written tasks were less appealing!

• Be positive – feedback to them what they do well in and what they could improve on.

• Set up clear reinforcement systems – use simple, predictable processes that reward the student for positive behaviour and sanction the student for negative behaviour. We used a credit system where students could collect credits which would be calculated at end of each month. Rewards went to student with highest number of credits. Sanctions included lunch time detentions, seclusion or exclusion.

• When delivering sanctions/disciplinary action, the message needs to be clear, simple and non-negotiable. Then move on quickly. Avoid waiting around for the student to change their behaviour as they may need more time and space to think over their actions. You don’t want to get caught up in a lengthy confrontation as this could mean more chance of a defensive reaction/escalation! Deliver the sanction and quickly move on with session or engage another student in positive conversation.

• Don’t allow them to take control over your behaviour – this is when you’ve exhausted all of your positive reinforcement, warnings and sanctions and the student still shows challenging/uncooperative behaviour… resist all temptation to address this in the moment. Remember that these are all designed to push your buttons/test you/gain a furious response/intimidate you. In such a situation, I usually gave my students only calm and considered responses and quiet time.

• Countdown technique – this is a good technique for getting attention from whole of the class. Countdown from 5 or 10 to allow students to finish up their conversations or work and listen out for the next instruction. This is a fairer warning than asking for immediate silence.

• Avoiding building barriers between you and the students and get out and about – this is probably my biggest tip of all. It’s easy to avoid social areas in schools with challenging students. However, personally, I found having my coffee in the playground or having my lunch with them had a positive impact on their behaviour. It gave them more opportunities to get used to me and engage with me outside of the classroom.

Final word

Remember you are dealing with children and young people who have real difficulty with understanding and regulating their emotions. They will show behaviours that are illogical and hurtful at times. Please do not take their words or actions too personally, no matter how tempting it may be. Maintaining the same calm and consistent approach, whilst maintaining respectful boundaries, will more likely build a successful relationship with them and you need to model responsible behaviours to them!

References and resources:

Cross, Melanie (2018) ‘Children with Social, Emotional and Behavioural Difficulties and Communication Problems: There is Always a Reason’

Young Minds website (https://youngminds.org.uk/)

Mental health and behaviour in schools: departmental advice for school staff. March 2016. Available at: www.gov.uk/government/uploads/system/uploads/attachment_data/file/508847/Mental_Health_and_Behaviour_-_advice_for_Schools_160316.pd


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