A therapist's view – Dr Sarah Helps on 'Troubled Girls'

Mental distress and the journey towards mental wellbeing are often in the news at the moment. The rising rates of poor mental wellbeing for our children and the shortage of specialist services feature daily in most newspapers. Books, plays and journal articles are written to show what it might be like to be in therapy or indeed to be a therapist. This is all important stuff, to demystify and destigmatise the use of services for those suffering mental distress.

So, being involved in making a TV programme about kids' mental health is a great way to reach out to a large audience  and share messages of hope.

But, I have found, it's not without its challenges.

Since being part of filming about what the Tavi does, I've spent a lot of time thinking about ethics. I've been perturbed (and ultimately assured) by the ethical dilemmas of asking patients who need help to add a layer of scrutiny and exposure to their lives, where the camera and the film team are involved in their most intimate and fragile moments.

As a family therapist I believe in the value of having multiple perspectives to help me find ways of most effectively helping families. I often video record my therapeutic conversations so that I can re-view them and show them back to families so as to improve what I do. But when that recording is for national consumption, well that really changes things.

What gets captured brilliantly on the screen is the dramatic stuff, the moments of absolute fear, despair, anger and desperation. I guess what makes less good telly are the smaller moments of connection, the diamonds in the dust of talking together, the slow, intricate exploration of the problem and the care-full ways in which seemingly ordinary conversations lead to a difference that makes the difference.

What goes on screen shows maybe 2% of the 'work'. It's so difficult to capture the care with which clinicians, multi-disciplinary teams and film crews have talked about what gets filmed and how, and the range of potential consequences of filming the real-life, real-time unfolding process of mental distress. It's impossible to capture the in-my-head conversations that I have with myself and others about how best to go on with a family.

Like tattoos, films create a permanent record. None of us can fast-forward to know the effect on our future lives of being involved in a film but imagining this has been a key part of ensuring the safety, the relational ethics, of the process.

I'm really pleased to have been involved in this project. If one young person and family in distress feels more able to understand themselves and their actions, or finds the courage to navigate their way to services that can help then it's been worth it.

In watching the films I hope that audiences will be moved by what they see and encouraged to seek out services that might help. I also hope that people will be curious about what didn't make the cut – the ordinary, vital and vitalising bits of the therapeutic process that we know are the things that make a difference to finding ways to go on in the world.

Dr Sarah Helps is a Consultant Clinical Psychologist and Systemic Psychotherapist at the Tavistock and Portman.

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