“For us, parents are experts by experience” - a conversation with Magdalena Kowalska, founder and president of the Mindset Institute supporting children, adolescents and their families in mental crisis.

Children's mental crisis begins earlier than we think  

Wiktoria Ozimek, Editor-in-Chief Jobs Door: According to data from the National Health Fund the number of children and adolescents receiving psychiatric and psychological care increased by more than 34% between 2019 and 2023. In fact, from what I see, there has been a lot of talk about mental health and mental crisis for some time now — not just in the context of children and young people. A lot of reports and analyses have been created. But from your experience, as well as from the experience of the whole Institute, what do you most often face when it comes to the problems of children, young people and young adults? What type of difficulties are these? What diagnoses occur most often?

Magdalena Kowalska, President of the Board and founder of the Mindset Institute: What we observe most often — and we observe this in a group of children and adolescents who are already undergoing psychiatric treatment — are primarily anxiety disorders, depression, attempts, self-harm, problems with emotion regulation, oppositional and rebellious disorders, as well as neurodevelopmental disorders. In older children, there are also the first hospitalizations associated with psychotic episodes. In such situations, hospitalization, observation, and then diagnosis is necessary.

As for the sources of these problems, we do not have access to the medical history of patients. These are not our patients — as an external organization, we support child psychiatry departments. In contrast, in the case of hospitalized children and adolescents and young people supported on an outpatient basis, the sources of mental problems are similar. Most often these are various kinds of dysfunctions in the home environment, lack of adequate support from adults, violence in various forms and also peer violence. We also note that dchildren and adolescents lack basic social skills: competences related to communication, setting boundaries, understanding their own needs, recognizing emotions and regulating them. They lack knowledge about what happens when we ignore the signals that carry emotions. We can say that these are the consequences of insufficient psychoeducation and emotional education. The world around us is changing very quickly, which gives us educational challenges. I have the impression that neither the school nor the parents themselves keep up with them.

There is no single piece of advice for all parents 

Let's start supporting our children by taking care of themselves and their relationship — marital or partner, regardless of its form. Besides, let's take an interest in their world. Being close, we see more. 

Victoria: I also read on the website of your institute that Poland ranks third in the world in terms of parental burnout rate. What does it look like in practice? The activities of the Institute are very comprehensive. On the one hand, you conduct art therapy as part of the Kaleidoscope project in psychiatric wards for children and adolescents, on the other hand you offer free consultations for parents, as well as workshops. So how to help parents? How to support them in responding to the first symptoms? What signals are worth recognizing? I know there are many specialist recommendations, but what would be such a first tip? What do we do when we don't have tools, we're burned out, school can't keep up, and kids are distracted by social media that affects an entire generation after all? What would be the first advice for parents?

Magda: There is no one-size-fits-all advice for all parents. Each family has different resources and different deficits in coping with the upbringing and going through the stages of the child's psychosocial development. However, there is one thing I would recommend to all parents — not just those whose children are struggling. It's about taking care of yourself. An adult who lacks resources, is tired, cannot regulate his own emotions in a healthy way and does not understand the way in which he communicates them, will not be able to create a safe environment for the child to develop. Likewise, parents who do not support each other. As a result, they do not build a stable and safe home in which the child can face the natural tensions that arise especially during adolescence.

Therefore, let's start supporting our children by taking care of themselves and their relationship — marital or partner, regardless of its form. Besides, let's take an interest in their world. When we are close, we can see more. If we notice that the child does not cope with school duties, peer relations or there are behaviors that disturb us - let's talk, let's react. This can be a sudden withdrawal from the relationship, closing in on the room, loss of appetite or, on the contrary, an increase in aggression or excessive excitability. These are not yet reasons for panic, but certainly signals that require more vigilance on the part of parents. Often, such behavior is a form of communication on the part of the child.

Victoria: What is the idea of the Institute that guides the creation of appropriate systems for parents, which they can use during the crisis of their child?

We want to build a community of parents who have similar experiences, can support each other and break the feeling of loneliness that often occurs when a child is sick. We also have such a philosophy of action that we are the ones who learn from our parents. I think in the public space, in the debate around child and youth mental health, that narrative is often reversed. It is run from top to bottom — experts, psychologists, psychiatrists or psychotherapists are at the top who tell parents how they should raise their children, what they are doing wrong and what needs to be changed. This creates pressure and at the same time is detached from the everyday experiences of families. It may be that the child does not need psychotherapy at all to feel better. Perhaps he needs classes that will allow him to build relationships, a sense of agency and belonging. If the only thing he does after school is sitting alone in a room with a smartphone, because his parents are at work, there are no siblings or the opportunity to meet his peers, then it is to create a space to develop interests that can be more supportive for him than private psychotherapy. So I have a lot of objections to psychotherapeutics of everyday families. I would like our foundation to be a place where the voice of parents is truly heard and where we show their reality as it is. 

Victoria: So this is a bottom-up approach.

Magda: Yes. That is why we are present in psychiatric wards. First we listen, learn and observe, and only then design solutions. 

Victoria: From my sociological perspective, this is very important. Therapy is sometimes highly individualized. Of course, it is often extremely helpful, but it does not always allow us to rebuild social relations or change the conditions in which we function. It will not fix all the problems related to our environment and social network.

Magda: I would not like to devalue psychotherapy, because there are situations in which it is very necessary and sometimes even necessary. However, I have the impression that today it has become the answer to almost every problem related to the mental health of children and adolescents. Very often, when the question arises of how to support the mental health of young people, the answer is the financing of private psychotherapy. Meanwhile, psychotherapy does not always solve the root of the problem. Sometimes it is more like sticking a patch on a wound than treating its causes.

Victoria: And what could we do at the level of social policy, family policy or the labor market? How important are solutions to support parents, especially single ones? I have the impression that sometimes focusing solely on individual therapy, we forget that there are also systemic solutions that could improve the situation of families.

Magda: BA very important area is work culture. This is a topic that regularly comes up in conversations with parents. This shows that the professional situation of parents has a huge impact on the condition of the whole family. There is a lot of talk today about work-life balance, employee well-being or friendly workplaces. The question is what is really behind it. Do employers really understand what challenges modern parents face? How difficult is it to reconcile professional development with being a present and attentive parent? This requires tremendous organization, effort and often many compromises. This is an area that needs further conversation and more authenticity. As a foundation, we do not create programs that influence the HR policies of companies, but we can share the experiences of the families with whom we work and show how important the work environment plays in all this. 

Parents are experts by experience 

I would like our foundation to be a place where the voice of parents is truly heard and where we show their reality as it is.  

Victoria: I was also interested in your password that “You're not on the billboards.” This seemed interesting to me because it differentiates you a little from the phenomenon that I observe more and more often - a kind of “mental healthwashing”. It used to be mostly about greenwashing, but today mental health is sometimes used as an element of promotion. However, I have the impression that thanks to your work and the closeness of your parents, you can act as an advocate for their experiences. Give voice to those who really face these issues, rather than basing the debate solely on the perspective of experts.

Magda: Definitely yes. For us, parents are experts by experience. It all starts with the experiences of children, young people and their families. We listen to them first. Based on this, we draw conclusions, learn, and only then invite experts to cooperate. We do not come to parents with ready-made theories and recipes. We try to work together to find solutions that will be adequate to their situation. This is how the Kaleidoscope program was created. This was a response to the real need for psychiatric wards for children and adolescents. My presence in the ward began with observation. We spent time with the children, watching how they function, what they like, what they need, what their rhythm of the day looks like, what form they are in when they come to the workshop in the afternoon, how the medical staff works, etc. It was only on this basis that we began to create a program. Every branch is different. On some of them we do classes on weekends, because then there is not much going on. We work on others during the week. In each place, we adapt scenarios to the specifics of the department and the needs of patients. Coming up with a ready-made solution would probably not respond to the real needs of either the hospital or the children themselves. We have also started training our volunteers in art therapy. We noticed that although they have a solid psychological preparation, they need additional competencies in the field of creative work.

First observation, then action. How does the Kaleidoscope work? 

Our foundation has become a place of development for people planning a career in the profession of psychologist or psychotherapist, which I am very happy about. For many people, this is an opportunity to verify their own career path — to see if such a job is for them. 

Victoria: What exactly is art therapy? What do such classes look like?

Magda: Art therapy is a form of therapeutic work that uses creativity. It is based primarily on strengthening the resources and strengths of children. In the departments we conduct classes using visual arts, bibliotherapy, that is, work with words, stories, fairy tales or poetry. We also use music, rhythm, sound and elements of working with the body, such as relaxation, breathing techniques. Our goal is to create a safe, creative space where children can express themselves through different forms of art and play. Art therapy helps to regulate emotions, which very often patients have a problem with. Studies show that creative activity lowers cortisol levels and promotes relaxation. What we do in the wards does not replace psychotherapy, but it is a beautiful complement to the treatment process. Sometimes we work directly with emotions, but through creativity. Anger can be expressed in color, image or sound. For many children, this is much easier than talking. Very often, what they cannot say appears precisely in the works they create. Working with younger children looks different than with teenagers. There is more spontaneity, fun and unpredictability. It is more difficult to maintain a rigidly planned class structure, so a lot of flexibility is needed. In one ward we can have a group of fifteen or twenty children, each of whom has different needs. Some need more stimulation and activity, others calmer work to develop imagination and creativity. With older children, it is already possible to work more structurally. There, an interesting idea and an engaging form are important. If the classes are not interesting, they simply will not want to attend. It is this diversity that makes this work so demanding, but also extremely developing.

Our foundation has become a place of development for people planning a career in the profession of psychologist or psychotherapist, which I am very happy about. We enable them to gain experience in clinical settings. It is an opportunity to learn about the specifics of working with children and adolescents, as well as to get used to the challenges and difficulties faced by patients. For many people, it is also an opportunity to verify their own career path - to see if such a job is for them. Development in the field of art therapy is also of great value. We place special emphasis on this by organizing trainings in occupational therapy art therapy. These are additional tools that they can later use in their practice, even if they do not ultimately choose an art therapy path. The Foundation funds these trainings, which is why they are free for volunteers. Of course, each volunteer must also undergo mandatory training on safety and procedures in hospitals.

Victoria: I understand that volunteers also regularly share their experiences and provide feedback that helps develop the program?

Magda: Yes. Our scenarios are constantly updated. We participate in international conferences and seminars. We cooperate with many organizations, especially foreign ones, so we can learn from the best specialists and implement interesting solutions in the field of art therapy. This is also a value for our volunteers. Not everyone has the opportunity to go to a foreign conference or participate in an international professional environment. So we try to transfer this knowledge to our daily work and share it with the team. We also organise regular interviews. These are meetings during which we discuss the difficulties that arise at work, exchange experiences and look for solutions together. Each volunteer can tell not only about his professional observations, but also about what personally makes him difficult, what he does not cope with and in what areas he needs support. I am also very happy when people who come to us without any knowledge of art therapy discover that it is in this direction that they want to develop further. We also work under supervision because we care about the quality and safety of our work. We are currently recruiting again. Interestingly, for the first time it takes place without a wide announcement of the call. In the previous edition, more people came to us than we could accept. Some of the candidates stayed in contact with us and it is to these people that we return in the first place.

Victoria: Remember the people who have come forward before.

Magda: Yes, most of all.

Future of the Institute 

Instead of focusing on rapidly scaling operations and presence in subsequent locations, we prefer to better respond to needs where we are already. Our priority is the further professionalization of volunteering, the development of the team and the launch of support groups and psychoeducational programs for parents. This requires stable funding. We are also thinking of even greater support for children in the wards. Especially the little ones. It happens that not all children are visited by loved ones.  

Victoria: The final question: what are the institute's plans for the future?

Magda: Our most important goal today is to develop programs aimed at parents. We consult and continuously support families who come to us, but we do not promote this activity on a large scale. We simply do not have such financial resources yet. At the same time, we continue to develop the Kaleidoscopes program. However, we do not plan to expand the business to other hospitals or departments in the near future. We want to focus on places where we are already present. Our priority is the further professionalization of volunteering, the development of the team and the launch of support groups and psychoeducational programs for parents. This requires stable funding. We would like to make sure that if we launch the program, it will work in the long term, and not just in a single pilot edition.

Victoria: So, if funds can be raised, such programs could become a permanent part of the Institute's activities?

Magda: That's our goal. We are also thinking of even greater support for children in the wards. Especially the little ones. It happens that not all children are visited by loved ones. Some do not have parents, others do not have the opportunity to have regular contact with their family. WITH The observation of such situations gave rise to the idea of additional action, which we are currently thinking intensively about. This is an example of a solution that cannot be invented from behind the desk. You have to be close to these children and see what they are really experiencing. We see that staying in the ward can sometimes involve additional difficult experiences. The child goes there for help, but if at the same time he experiences loneliness and lack of support from loved ones, his suffering may worsen. Therefore, instead of focusing on rapidly scaling presence activities in subsequent locations, we prefer to respond even better to the needs where we are already. We want to be closer to the children who really need us. For today, these are ourmost important directions of development.

Victoria: Then I wish you good luck in further development. Thank you very much for the conversation. She was very interesting and opening for me.

Magda: Thank you very much for the invitation and for the conversation.