On the occasion of October 10, World Mental Health Day, the Schoollegium spoke with Belma Žiga, a child and adolescent psychotherapist
For years, Belma Žiga has been taking care of the mental health of the youngest and most vulnerable groups in society: children and adolescents. This year she became one of nine first-generation psychotherapists for child and adolescent integrative therapists. She spoke for the Školegijum about good and bad experiences in practice, the work of the Wings of Hope Foundation, cooperation with schools and parents, but also class stratification, loss, trauma, minority stress and other challenges of growing up.
Perhaps it is best to start the story of the mental health of children and young people with a story about numbers. The statistics obtained by psychotherapist Mirela Badurina in her research say that every fourth early adolescent between the ages of eleven and fourteen develops a mental disorder, which somehow coincides with the statistics of the World Health Organization.
In principle, mental disorders are divided into externalized and internalized, where the former are directed outwards, and thus are easier to spot and recognize by school or community, while the latter are often hidden, the child struggles with them alone, so the suffering and pain of such Children are often not recognized by society, but also by families – says Belma Žiga at the beginning of our conversation in the room of the Wings of Hope Foundation, fully equipped for child psychotherapy.
He adds that the main problem and great obstacle to the destigmatization of children psychotherapy is precisely the delusion, the myth that childhood is a period of necessary and almost imperative happiness, joy of life and carefreeness.
That, of course, is not true. Children suffer, and they show that suffering in different ways. Sometimes they seek the help of parents, sometimes teachers, sometimes peers. Sometimes they don’t ask for it at all, on the contrary, they reject it. In the case of externalized disorders, they show it through various forms of resistance, disobedience, defiance … In others, internalized, children are depressed, closed, have panic attacks or anxiety, there are different types of phobias, fear of separation, most often from parental figures (separative anxiety) … While in these first problems the school gladly accepts the cooperation of therapists in working with such children, for professional help in the case of others, parents usually decide for themselves, if they recognize that their child is suffering.
We were also interested in the correlation between children’s mental health and their gender, to which our interlocutor replied that girls are generally more prone to internalized and boys to externalized disorders, except in cases of trauma and loss, where, of course, there are no gender differences.
We will pay dearly for the absence of school psychologists
Individual psychotherapy with children and adolescents, as well as their parents, Belma Žiga works in the Wings of Hope Foundation, but also, for the fourth year, in primary schools in Sarajevo municipalities Novo Sarajevo and Novi Grad through the project Cognitive-behavioral treatment of violent behavior at school.
I am extremely proud of this project, because it really gives good results. It was very important for us that the school was recognized as a safe zone and that parents had confidence in us, because we entered that space to help children, to work in partnership with the school. One of the main problems when it comes to the mental health of our children is the lack of school psychologists according to the systematization of jobs in the Federation of BiH. Republika Srpska has a bit more hearing here, so schools have psychologists.
In order to remove the stigma from one profession, it must be close to us, children must have people around them from the profession, just as they have teachers, professors. They need to recognize them as partners. We come to this individually and in small steps in the individual schools in which we are implementing this project, but that is, of course, insufficient. Ideally, we should be able to do this with every school, and every child.
In the following, our interlocutor describes the experience of working with children in schools. He explains how school staff detect certain behavioral problems that the profession recognizes as a risk of developing externalized mental disorders, and then do both training of teaching staff and individual therapy with the child and parents.
It is also interesting to include peers in the process, and the existence of children peer educators.
We are often in a situation where children who, for example, suffer peer violence at school do not want to talk about what they are going through. The reason is most often insecurity and fear. Here, as professionals, we rely on the help of the children themselves, calculating that the child will be easier to open up or entrust to another child than to an adult. That is why we are working on educating children who are, conditionally speaking, socially more skilled and emotionally stable, so we are making them peer educators. All of this could and should be the job of school psychologists and psychologists. But not only that, but also everything related to the processes of learning and solving the challenges that the school poses to children and parents. There is so much work that we do not get to do with individual initiatives.
Adolescence as the most fragile period of life
Children are vulnerable, but adolescence (which, Belma Žiga notes, is divided into early, middle and late, and covers the period from the twelfth to the twenty-first or second year) is the most fragile period of life that requires exceptional commitment of the whole community if we want to have mentally healthy society.
It is absolutely not surprising that so many spears are broken during this period and that this is the period when we most often have the beginnings of mental disorders. We often do not see, neither parents, nor school, nor society, how much pressure a person is facing in early, and especially middle adolescence. The hormonal picture changes, we enter into the first partner relationships, we establish power relations in society, we choose professional orientation and even if all other external circumstances are perfect, it is enough to make us feel like an inflated balloon. Eh, now, if you add to that anything else that bothers the adolescent, homosexuality, bad family relationships, peer violence at school, there are instantaneous breaks. These are the moments where you need to react.
And who was invited to react? What is the correlation between family, school and public health institutions?
Belma Žiga thinks that the key is always in the partnership, not in passing the ball. He says that it is not good for parents to see school as their service, nor is it good for the school to transfer responsibility to the family.
It is ideal to work together. Practice in this offers a number of good examples and it is important to point them out. In a society generally unprepared for the destigmatization of mental disorders, unprepared for the essential acceptance of diversity, these examples are mild to us. From my practice, such is, for example, the story of a transgender boy to whom we won the right to be addressed in the desired gender, to be respected, all the way to being placed in a room with boys on an excursion, all thanks to very good family cooperation and schools. In the second example, we had a different situation, the school and the parents did not agree and demanded otherwise, but the profession managed to protect the child, the school sided with him, even when the parents included many more instances like line ministries.
Class stratification and other challenges
There are many challenges facing school today. With the lack of professional staff, it is becoming increasingly difficult to bridge them.
The profession should be noticed, watched, observed, in order to recognize the risk – says Belma Žiga.
We need to be aware of the changes. Class stratification is happening before our eyes, overnight. You have, on the one hand, parents who are overwhelmed with work in the race for a bare life, a wild capitalism that makes them hardly see their children, let alone notice changes in their behavior. On the other hand, you have those, conditionally speaking, loud parents, class privileged, who expect the school to be at the service of their children, and if it is not, it is not competitive, and the children are transferred to other classes or schools. I regret to admit that my experience shows that such parents are the main obstacle to inclusion in schools. It seems that the school is not ready for that, that it has not risen to some challenges.
Literature and therapy
At the very end of our conversation, when our team was already heading for the exit, we stopped by the cupboard with the dolls. We learned from our interlocutor that these are special therapeutic dolls intended for the therapy of younger children, which she herself, from private initiatives, supplied from the USA.
Dolls like this are not hard to make. That could be done in our country as well. As therapeutic stories could be written in our country. There are many fields in which psychotherapy encounters literature, stories in working with children, as well as illustrations, could greatly facilitate the work of both therapists and children. Sometimes we come up with our own ideas, so we invent them, because in this way, only by recognizing their experiences in the experiences of fictional characters, children more easily notice and recognize the situations that afflict them. Recently, a girl with separative anxiety became aware of some of her own mechanisms only through the story of the heroine Lena, who is afraid of everything, so she falls into some comical situations that made the girl laugh and cheer up. I hope that the Collegium, perhaps in cooperation with the Wings of Hope Foundation, could be a platform where such stories could be written and published.
We joined the hope of our interlocutor, believing that by working together we can work on raising awareness and literacy about the importance of children’s mental health, so that she, parents and school know who to turn to when it hurts. Because sometimes help is hidden around the corner, and enthusiasts, such as our interlocutor, will be happy to provide it.