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Social, Emotional & Mental Health

What are SEMH special needs?

SEMH (Social, Emotional & Mental Health) special needs is a term introduced in the 2014 Special Educational Need and Disabilities
(SEND) Code of Practice to replace two previously used terms – BESD (Behaviour Emotional Social Development) and EBD (Emotional & Behaviour Difficulties).

A key reason for the change was to drop the word ‘behaviour’ from the description of certain manifestations of special needs. This was down to a greater understanding that a raft of ‘problem’ behaviours can be a child’s way of trying to communicate other struggles a child may be experiencing. This views certain behaviours as a response to unmet social, emotional or mental health needs rather than ‘being difficult’ or anti-social
for its own sake. 

The move to using SEMH as a descriptive term also acknowledges how mental health is a key element to be be considered when trying to help children who show behaviours linked to the diagnosis. These are often driven by factors in a child’s life over which they have no control.

Yet for many years, such children were often punished for ‘bad behaviour’. Sadly, there is still a significant lack of understanding within the education system, with research suggesting up to half of pupils who are permanently excluded from school have SEMH needs. Even for pupils who remain in schooling, there can be a huge impact on academic progress.

Some facts about SEMH needs

An estimated 150,000 children in UK mainstream and special schools are believed to have SEMH challenges.
Behaviours children with SEMH needs may display include:

What are the causes of SEMH needs?

Causes of SEMH vary from child to child, but can usefully be seen to fall into certain broad categories:

Attachment history

This can be caused by lack of acceptance of a child’s self-identity or key needs not being met.

Trauma history

Other contributory factors might be a change in family dynamics (for example, emotional upheaval caused by divorce, or sudden financial hardship due to a parent losing their job), as well as broader social changes that impact on a child, such as an incident in their school or community. 

Ways to work with children who have SEMH needs

Well-trained specialist tutors can help provide many of the kinds of support most beneficial to helping children with SEMH needs. Building a relationship of trust can be a highly beneficial part of support. Ways to achieve this might include:

A specialist tutor can also take real time to talk with a child exhibiting SEMH needs, to help them explore the underlying nature of their feelings. In a school setting, ways to do the same can include: 

“Vojtech has been extremely excellent tutor, regardless of Denzel's challenging behaviour.
In school Denzel has two to one support, sometimes even requires more help due to his extremely aggression. Vojtech has used different skills and knowledge to make Denzel calm down. We have seen a lot of changes in Denzel, his attention span has increased and improved in his eye contact.”

In a school setting, building relationships with their peers can also be highly beneficial to help a child with SEMH needs.

Ways to do this might include:

Resources for SEMH needs

Specialist tutors can draw on a range of resources to help children dealing with SEMH needs. You can see an example of one teacher toolkit to help pupils with SEMH here.

The Boxall Profile

The Boxall Profile provides a framework for the precise assessment of children who have social, emotional and behavioural difficulties (SEBD) and are struggling at school.

This helps teachers plan focused interventions for children exhibiting SEMH ‘behaviours’, allowing those working with a child to better understand what may lie behind the behaviour.

Pyramid of need

Boingboing, a mental health charity specialising in developing resilience, and YoungMinds  youth mental health charity, have collaborated to create a Pyramid of Need tool that offers both an insight into an individual child’s state of well-being, and how it relates to those around them.

Other approaches may involve input from professional practitioners in areas including through psychotherapy, occupational therapy, speech & language therapy and working with families.

“Vojtech has been extremely excellent tutor, regardless of Denzel's challenging behaviour.
In school Denzel has two to one support, sometimes even requires more help due to his extremely aggression. Vojtech has used different skills and knowledge to make Denzel calm down. We have seen a lot of changes in Denzel, his attention span has increased and improved in his eye contact.”

Tutor Spotlight


Debbie shares her professional history of working with children with SEMH:

I have been an English teacher for 30 years with experience as a Head of Year and as a Head of English. My favourite role was as a form tutor and being responsible for the pastoral care of teenagers for all these years, I have seen many forms or SEMH from the very mild to the most severe of cases. I was lucky in that all the schools I worked in had amazing SEN departments and two of them had specialist ASD/Aspergers units too. 

I have always veered towards those who are struggling and need my help as they are the children to whom I can really make a difference and who may not quite get through without that extra support. Having experienced SEMH first hand as a parent with both of my now adult children, which stemmed from very different places, I became committed to the idea that I wanted to give something back to other children and support them in the way that (some) of the professionals supported mine. 

Debbie’s experience working with children with SEMH:

I have worked for many years with children suffering from SEMH as both a professional and a parent and I understand how crippling it can be. I have worked with those who are suffering as a result of trauma or grief through to young people who are not able to leave their house and to those who are tragically as far down the line as being unsafe.

I have worked with eating disorders and disordered eating and SEMH related to other diagnoses such as ASD. Having worked in schools for so long, I thought I had encountered almost everything there was but since I have been working solely with children who are EOTAS for such a multitude of reasons for the last 5 years, I discover that I had only seen the very tip of the iceberg.

Debbie’s approach for working with children with SEMH:

It is very difficult to provide ‘an approach’ as every single child suffering with SEMH has a story as unique as they are themselves. The first step is always to build trust and a healthy relationship and then to take very small steps to help the young person to open up. This usually takes some time, and it starts with doing very normal things together whilst building up a rapport and then using their interests to guide me towards the next steps.

Debbie’s top tips for parents/carers with children with SEMH:

I have been here myself and I understand. My first piece of advice may sound obvious, but it is to never give up hope. There will be some very dark days where it feels like nothing will ever get better, but it will. Believe that everything you try and offer to support your child will help without doubt.

It will take time to find the right person or method to get you both there but trust that there is someone out there who will be able to help if you are able to trust them. And finally, have patience.

It can feel really frustrating sometimes when you are trying to deal with something not quite rational by using a rational method. This comes from a place of desperation, confusion, pain sometimes and it cannot always be met rationally. And remember, there IS light at the end of the tunnel.


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